Slate Star Codex

In a mad world, all blogging is psychiatry blogging

OT23: Thread, White, And Blue

This is the semimonthly open thread. Post about anything you want, ask random questions, whatever. Also:

1. Comment of the week is queenshulamit on Pope Francis being a tricksy Jesuit

2. I’m interested in switching this blog to a two-sidebar design kind of like Popehat so I can have more links. I can’t do the CSS myself. If anyone thinks they can help, let me know.

Please steer the open thread away from the five toxic topics that mindkill SSC readers: race, gender, doge, one-tailed t-tests, and cuddling.

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The Case Of The Famous Physicist

I.

Old news, but I only just heard about it: Long Island woman says psych ward doctors believed she was delusional for insisting Obama follows her on Twitter.

The story: a woman was brought in for psychiatric evaluation. During the evaluation, she said President Obama followed her on Twitter. The psychiatrists decided she was psychotic and forced medication on her. But in fact, President Obama does follow her on Twitter, just as he does six hundred thousand other people. So they committed a perfectly sane person for telling the truth, leading to what the article calls a “frightening eight-day ‘One Flew Over the Cuckoo’s Nest’ ordeal”.

I don’t know anything about this case or this person, and I definitely don’t want this to sound like I have anything to say one way or the other about this person I have never met. But I’ve been involved in enough similar cases to have a different perspective, and wonder whether it was quite as much of an outrage as the article makes it out to be.

Consider: the comment occurred when she was in a hospital for psychiatric evaluation; that is, she was brought in before the Obama comment. According to the article:

The bizarre experience began Sept. 12, when the NYPD seized her prized 2003 BMW 325Ci in Harlem because they suspected she was high on weed, her attorney, Michael Lamonsoff, said. Cops found no marijuana but confiscated her ride anyway, he said. The NYPD declined to comment.

The following day, Brock walked into the NYPD’s Public Service Area 6 stationhouse in Harlem to retrieve her car, her suit charges. Brock — an eccentric 32-year-old born in Jamaica with dreams of making it big in the entertainment business — admitted in an interview she was “emotional,” but insisted she in no way is an “emotionally disturbed person.” Nevertheless, cops cuffed her and put her in an ambulance bound for the hospital, her suit charges.

This sort of elides over everything in between “went into police station to ask for car back” and “cops put her in an ambulance bound for the hospital.”

I’ve had patients sent by ambulance from the police station. It’s almost always because they started screaming and yelling threats at the police. Now, screaming and yelling threats at the police, although not a very good idea, is not always evidence of psychiatric disorder. But it often is. If you’re manic or on drugs, you’re a lot more likely to have the particular type of bad judgment that makes screaming threats at the police a seem like a good idea.

I don’t know what happened with Ms. Brock, and the article doesn’t say. I did take a look at her Twitter account, which is mostly angry tweets about Trayvon Martin, Mike Brown, and police brutality. A typical example is “Police should NOT be allowed to Murder the Citizens of this Country!!! We are not Animals!!! @BarackObama fix it NOW!!! #BanGuns”. Other Tweets seem maybe a little threatening, like the ominous “@NRA you people deserve the wrath that will come on you in the very near future” and “#KillRacists”.

So – cops have just done something very unfair to a person who likes making threats and doesn’t like cops, and who herself admits to being “eccentric” and “emotional”. Again without knowing what went on, my guess was that her “discussion” with the police was sufficiently exciting that they thought calling an ambulance for a psych evaluation was in order.

So imagine you’re the psychiatrist, you’re receiving a patient from the police for evaluation after she got in some kind of screaming match with them. And now she tells you Barack Obama follows her on Twitter. The article says:

“I told (the doctor) Obama follows me on Twitter to show her the type of person I am. I’m a good person, a positive person. Obama follows positive people!”

This is weird. At best, it displays a surprising ignorance of how Twitter and/or the world works. Yes, Obama follows 600,000 people on Twitter, but this does not prove that each of them is “a positive person”. I would assume he has some program that auto-follows anyone who mentions him. When you think this is a good thing to bring up during, of all times, a psychiatric evaluation, then I start to wonder.

(I should also add here that, in my limited experience, social media is God’s gift to grandiose psychiatric patients. None of them are “a guy with a Facebook page”. They’re all “social media celebrities with hundreds of followers”. It’s always “YOU CAN’T DO THIS TO ME! DO YOU KNOW WHO I AM? I HAVE HUNDREDS OF FOLLOWERS ON TWITTER! EVEN [NAME OF TWITTER PERSON I HAVE NEVER HEARD OF] FOLLOWS ME! THIS IS GOING TO GO VIRAL!” One patient even told me, in a threatening manner, that his blog had over a thousand hits. “You mean a day?” I asked. “No, total,” he answered. Then he wondered why I was so utterly failing to look impressed.)

So I’ll be honest – if someone had just been brought in for a shouting match with police, and the first thing they told me was that President Obama follows them on Twitter, well – among the most common symptoms of mania are irritability, grandiosity, poor decision-making, and flamboyant dress/behavior. Getting in a fight with the police sounds like irritability and poor decision making, thinking the Obama follow is relevant sounds like grandiosity, and this woman’s Facebook photo certainly suggests a flair for the dramatic. I’m not saying I would commit her on these factors alone, and a lot would depend on the rest of the history. But she already would have started digging quite a hole for herself.

Remember, psychiatrists have to err on the side of admitting people. Even if this lady didn’t have bipolar disorder, admitting her for further evaluation seems like the sort of thing that could be an honest mistake.

(and remember, all we have here is her side of the story. Goodness only knows what other things she might have said or done that she didn’t leak to the news for their sympathetic article based entirely on her testimony.)

But then there’s the hospital’s subsequent conduct. They said that she was unemployed. She said she was employed and could prove it through her Internet presence. The hospital apparently didn’t check and continued to say she was psychotic for thinking she was employed. How could the hospital possibly be so incompetent as to not check the link to her employment documents that she was personally giving them?

II.

Let me tell you about Professor T.

(this would be a good time to reiterate that every patient story I tell here is a composite of multiple different people with all of the details changed around to protect anonymity. The gist of the story points out a true thing, but the specifics are all twisted around so thoroughly that even the people involved couldn’t recognize themselves.)

Professor T came to me in handcuffs. The police had picked him up in response to a call at the local university, where he was trying to give a lecture to a class that wasn’t expecting him and didn’t want him. The class’s actual professor had asked what the heck he was doing, and he had explained that he was Professor T, world-famous physicist, and that the head of the college had invited him to give a lecture on his theories that day, and it was too bad she hadn’t communicated this with the rank-and-file teachers, but he was a very busy man and they should all be honored by his presence and stop what they were doing and listen to him. A quick call to the administration confirmed none of them had any idea who he was either, and when he refused to go away or stop trying to lecture, the police were called to remove him. He started yelling and screaming at the police and telling them they were fools who were too small-minded to recognize a great scientist when they saw one, and they’d get what was coming to them. The cops decided this was a job for a psychiatrist and brought him to me.

Professor T said he’d just been really angry that the bureaucracy had screwed up badly enough to make him miss his lecture and that no one was willing to accommodate him. He was, after all, a very important leading scientist with a busy schedule. He moved in elite circles! Famous people like Edward Witten knew him well, and I was welcome to call to confirm that! He was used to being shown more respect!

I got a weird vibe from Professor T during our discussion. I know that distinguishing between professors and hobos is a famously difficult problem, but he just struck me as a little too much towards the hobo end for comfort. So I asked him if I could see any proof that he was who he said that he was.

He was happy to comply, and once we got to a computer he showed me some scientific papers with his name on top, suitably peppered with complicated words like “tachyon” and “chromodynamics”. He showed me a picture of him winning some prestigious physics prize, dressed in a lab coat with a medal around his neck. He even showed me what looked like a press release: “Professor T comes up with new Theory Of Everything that may explain Higgs Boson”. It was pretty convincing.

But.

First, a bunch of patients had cancelled on me that day, so I had way too much free time.

Second, I used to be in a really complicated geopolitical simulation. One of my roles was the local investigative reporter. I researched and published stories about all of the weird conspiracies and manipulations going on. I was pretty good at it. One day, a trusted source sent me links to what turned out to be the biggest story I’d ever stumbled upon. A bunch of forwarded emails and a password protected forum (which my source helpfully provided the password to) proved that the people nobody trusted were in fact involved in a large and highly illegal plot against everyone else. Delighted, I published the story, only to be met with total denial from everyone involved. Not the sort of denial I usually got in situations like this. The kind of denial you get when someone actually didn’t do something. Further investigation eventually revealed that my “trusted” source had made it all up. He’d laboriously faked both sides of all the email conversations he sent me, then made the entire secret forum by himself, posting daily under five or ten different aliases for weeks in order to create the illusion of a large community. Some famous magician – I can’t find the quote right now – once said that the secret of magic was to spend more effort preparing than any sane person would think possible. That was how my trusted source got me, and it was a lesson that really, really stuck.

So since I had the time, I started looking into Professor T’s credentials a little more. His papers were hosted on a private site and didn’t show up on Google Scholar and didn’t seem to be affiliated with any journal. The press release was on the same website, and seemed suspiciously badly written. There was nobody else in his photograph, and it was impossible to see what was written on the medal. Was it possible that a crazy hobo had just written some things that looked like papers, written something that looked like a press release, and then bought a lab coat and medal and taken a picture with them? Do real theoretical physicists even wear lab coats?

So I asked him if I could talk to Dr. Witten, whom he said he knew well. Professor T agreed. I Googled his phone number and called him up.

(It wasn’t actually Dr. Witten whom I called, but the case I’m adapting this story from involved someone else about as famous)

His secretary answered the phone, and I said I was a psychiatrist, and I asked if I could speak to Dr. Witten. The secretary was reluctant, but when I said it was about Professor T, she immediately asked me to hold, and I got Dr. Witten himself. I asked him if he knew Professor T.

“Absolutely,” said Dr. Witten. “He’s a crazy guy who keeps calling me up and telling me he’s solved physics. I don’t think he’s actually a professor of anything. I read one of his papers once, just for kicks, and it’s just a bunch of science terms like ‘tachyon’ and ‘chromodynamics’ strung together without rhyme or reason. It might fool a layman, but trust me, it makes no sense. I told him to stop calling me, and he wouldn’t, and finally I had to block him on my phone, and now he’s sending me letters in the mail, and it’s always same ranting about tachyon chromodynamics, which isn’t even a real thing. Did you say you’re a psychiatrist? Perfect, I’m so glad he’s finally getting treatment.”

I told Professor T about this, and he nodded his head. “Yes,” he said “I told you that Dr. Witten knows me well. I didn’t say he liked me. He still doesn’t fully understand my theories. But I am sure he’ll come around.”

I kept Professor T in hospital for about a week, and I can’t count how many times he yelled at me and complained that I was being unfair to him by not doing whatever the heck he wanted me to do that day. Read another one of his papers that would convince me his theories were sound. Call up yet another famous physicist he “knew”. Look at yet another of his fake websites devoted to himself. Every day, he threatened to sue me and my boss and the entire hospital for keeping him there even though he’d “proven” to us he was who he said.

Remember, delusions are fixed false beliefs. People are quite sure they’re true, quite sure they have evidence for them, and nothing (except occasionally really good psychiatric treatment) will convince them otherwise. They’ll keep demanding you take time to investigate more and more bizarre “arguments” and “evidence”, and if you ever stop, even after days and days of everything they say being one hundred percent refuted, they’ll accuse you of acting in bad faith.

(it’s like Internet arguments, only more so)

In everyday life, we get by on an assumption of trust. If I tell my boss I’m sick, he probably believes me. If he doesn’t believe me, and I send him a doctor’s note, he probably believes that the doctor’s note isn’t forged. If he doesn’t believe that, and he asks me for a number to call the doctor at, he probably believes it’s a real doctor and not my brother pretending to be a doctor to help me out. Yes, there are a couple of people who abuse that trust, but few enough that the rest of us are usually able to get by.

In psychiatry, there are a bunch of delusional people, paranoid people, narcissists, compulsive liars, and others who deliberately or unknowingly stretch the truth past the breaking point. Worse, a lot of the cues we use to detect liars, like “Are they shifty-looking?” don’t work, either because the person involved really believes what they’re saying or because they’re too far from the neurotypical norm for our usual intuitions to apply. A lot of the assumptions of trust we usually use crash and burn. If the person sitting next to me on the train says he’s a physics professor, I believe him. If the person brought in by police for a psychiatric evaluation says he’s a physics professor, maybe I don’t, and “how much time do I spent assessing the evidence and how much do I believe?” is a really tough question.

I am not trained as a police officer, detective, or judge. I’m also not paid to do their jobs. I’m also stuck in a system where the primary incentive is that if I ever fail to commit someone, then if they do anything bad after that I can be sued for everything I own. So I am stuck drawing partial conclusions, from incomplete evidence, in time I don’t have, from people I can’t necessarily trust, without even the ability to err on the side of caution.

I don’t think the hospital in the article followed great practices – in particular I’m unclear on how they came to believe the person was unemployed. And sending her the bill for her own involuntary commitment is an obvious injustice (albeit a universally practiced one). But the mistakes in the admission process are all ones I can imagine any psychiatrist making. Including me.

And that means something. You can trust me. After all, four different Dalai Lama accounts follow me on Twitter.

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Reflections From The Halfway Point

I.

A while back one of my patients was having a foot problem, so I consulted the hospital podiatrist. He met me in my workroom, and I explained exactly what I needed from him, but over the course of the explanation he started looking more and more uncomfortable and distracted, so finally I stopped and was just like “Okay, out with it, what’s your problem?”

And he said: “That guy with the wild hair pounding on the window and shouting threats and obscenities at us.”

And I said: “Oh, him? That’s just Bob. Don’t worry about him, he always does that.”

The podiatrist seemed inadequately reassured.

I thought about this because as of today I am halfway done with my four-year psychiatry residency.

One of my teachers told me that you go to medical school to learn things, and then you go to residency to get used to them. It’s not quite that simple – you certainly learn a lot in residency – but there’s a lot of truth to it. I remember that my first week on call, somebody had a seizure and I totally freaked out – AAAAH SEIZURE WHAT DO I DO WHAT DO I DO? – even though I had previously been able to pass tests on that exact situation. But my last time on call, somebody also had a seizure, and I sort of strolled in half-asleep, ordered the necessary tests and consultations and supportive care, then strolled out and went back to bed.

And then there are the little things, like learning to tune out a psychotic guy banging on the window and yelling threats at you.

II.

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.

III.

I’d like to say I’ve taken advantage of this to go mad with power. But it’s actually a really crappy situation for everyone involved.

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.

The most common type of case I see is “person who was really angry, said ‘I’ll kill myself’ in a fit of rage, and then their partner called the cops and they were brought to hospital.” These people stop being angry after a day or two and then no longer make these comments, even assuming they meant it in the first place which most of them don’t.

The second most common type of case I see is “person who was really angry, did try to kill themselves, and it didn’t work.” Again, these people have stopped being angry. Failed suicide attempts also have their own interesting way of clearing the mind for a little while, so they’re in a sort of grace period. Sending these people to a psychiatric hospital makes the public feel good because they’re Doing Something About Suicide, and makes psychiatrists feel good because after a few days they’ve stopped being suicidal so it looks like we’re Making A Difference. There is no way we could leave this equilibrium now even if we wanted to, because if we didn’t keep these people for a week and they ever attempted suicide again, we would get sued to oblivion.

The third most common type of case I see is “severely mentally ill person who’s been living at a care home for twenty years, but then they got in a fight and so their care home sent them to the hospital.” We shuffle their medications around and send them back to the care home where they’d been living happily for twenty years until some random trigger set them off.

We don’t call this “security theater”. We do sometimes call it a “holding environment”. Psych hospitals are kind of boring. There’s no boyfriend to get in a screaming match with, no boss pushing you to work harder, and no drug dealers to get heroin from. On the other hand, there’s lots of structure – art therapy at 10, meeting with your doctor at 11, recreation group at 12, and so on. It’s like a terrible vacation in the world’s least attractive hotel. People get a chance to cool off and forget about whatever set them off. Then they go back to their life. If they’re lucky, our social workers have managed to connect them to a better outpatient psychiatrist, care home, or support group, and maybe that will improve their lives sometime down the line. But I don’t think anyone imagines there was some fundamental Quality Of Dangerousness in them which is now gone.

To the degree that it is all security theater, it’s really hard to give an honest answer to a patient asking why they have to stay in hospital.

When I first started this work, my reaction to these people was “Come on, it’s only a week, it’s not like you’re stuck here forever, just deal with it.” This lasted until I remembered that when some stupid policy forces me to come into hospital on a day I would otherwise have off, I freak out, because I value my free time too much to be okay with having it taken away from me for bad reasons. Heck, my power was out the past couple of days, and I couldn’t use the Internet, and I was calling the power company and being like “COME ON YOU NEED TO FIX THIS ALREADY I AM LOSING DAYS OF MY LIFE THAT I COULD OTHERWISE BE SPENDING IN IMPORTANT STUFF.” So now I try to avoid throwing stones.

(there’s another aspect of this, which is that people constantly protest that horrible things will happen to them based on that week. For example: “My boss said if I miss one more day of work, I’ll lose my job, and then I’ll have no way to support my family.” Or: “My rent payment is due tomorrow, if I miss it I’ll be evicted and all of my stuff will go to the landfill, and there’s no way I can handle this through Internet or telephone or asking a friend to help.” I assume 90% of these stories are false, but the 10% that are true are still bad enough to more than outbalance any good we can do.)

After that, my reaction to these people was “Yes, you may be angry now, but you will thank us later.” This is true of many people, including some of the most histrionically upset. But I’ve since learned that it’s probably not true of the majority. The Shrink Rap blog surveyed former psychiatric inpatients and found that 62% said their experience was not helpful and they were “the same or worse at discharge”. I’d like to dismiss this as people just carrying a grudge for having to be there at all, but the same survey finds that a very similar 56% of voluntarily admitted patients said the same thing (although not all “voluntary” admissions are as voluntary as the name expects). Now, I don’t know for sure what to think about that survey – a lot of people describe their hospitals as doing things which are super illegal and which I wouldn’t expect a hospital to be able to get away with and stay open for more than twenty-four hours, and the population of psych patients who read psychiatric blogs is probably a nonrandom sample – but I no longer feel like I can confidently say that our patients will thank us later.

(none of this is to say that you shouldn’t check yourself into a hospital if you’re feeling suicidal – you’ll get the holding environment that makes sure you don’t kill yourself for the immediate future, you’ll get connected to a system that can give you useful referrals and medications much faster, and 38% will also end up being directly helped.)

So now what I tell people is the Cliffs’ Notes version of the above – “I’m sorry you have to be here, but we are going to keep you for a few more days to evaluate you, your estimated day of discharge is X but that’s not a promise, if there’s anything specifically making you uncomfortable please let me or the nurses know and we’ll see what we can do.”

I can’t figure out a good way to say the spiel without the last sentence, which is too bad because then they do let me and the nurses know things. Most of them are things that I, as a low-ranking doctor who cannot totally rearrange the unit according to my will, have no ability to change. Some of them are things nobody can change.

Like! It turns out when you lock constitutionally anxious people in a new environment full of psychotic people, they become really really anxious. They tend to request antianxiety drugs. I am happy to give them reasonable doses of the non-addictive anti-anxiety drugs, which then totally fail to do anything, because their idiot outpatient psychiatrist was giving them heroin mixed with horse tranquilizers every day or something. They demand whatever they were getting on the outside, but twice as much, and I can’t give it to them even if I want to because of our safety policies. And now I’m the bad guy.

Or! Some people don’t like noise. I sympathize with this as I am just about the most misophonic person in the world. On the other hand, there’s always one screamer in a psychiatric hospital. Sometimes this screamer chooses to do their thing at four in the morning. The law gives us limited ability to lock them in a soundproof room, and definitely not all the time. So if you are startled by loud noise, you are kind of out of luck. Even if we can put you on the other side of the ward, you’re still going to be bothered by staff coming in your room every fifteen minutes to make sure you haven’t killed yourself, which they are legally required to do. You can complain that the lack of sleep is hurting your recovery, and I believe you, but aside from showing you where we keep the earplugs there’s not much I can do. Once again, now I’m the bad guy.

Add to this people with picky tastes that our kitchen can’t satisfy, people who get bored in the absence of some kind of entertainment we can’t provide, smokers who are unsatisfied by nicotine patches, and the occasional very honest drug addict who just wants some drugs, and I spend about 30% of my day patiently explaining to people why their preferences are totally reasonable and I realize they’re in pain but there’s nothing I can do for them at this moment.

And I know it sounds really selfish of me to say so, but this is really exhausting.

Sometimes I wonder if the concentration camp guards in Auschwitz ever had this problem. Like, the ones who weren’t especially sadistic, but who took it because it was a 9-5 job, and word around the water cooler was that it was an easy way to make Scharführer after a few years. And every night they would come home to their wives and be like “Gott in Himmel, Helga, you have no idea what I have to put up with every day, all of these prisoners won’t stop asking me for food and water and stuff, and I try to give them a couple of extra scraps when the regulations allow, but even after I do that they just want more food and they never stop, don’t they realize it makes me feel really guilty and there’s nothing I can do, and every day is more miserable and draining than the last, and I mean, seriously Helga, how entitled can people get?”

I know that’s a horrible metaphor, and our hospital is really good and run by some of the best staff and nurses and doctors I have ever met and tries 100% to help patients whenever it can. It’s just how I feel sometimes.

As you may have guessed, I do not very much like inpatient work. You can adjust to having to treat someone having a seizure. You can adjust to somebody banging on the window and screaming. But it’s really hard to adjust to constant moral self-questioning.

IV.

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. 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.

And the thing I love about psychiatry – other than, I am contractually obligated to say, The People You Meet and The Chance To Make A Difference – is the lore. If all science is either physics or stamp collecting, psychiatry is stamp collecting par excellence with the world’s most interesting postal system, hunting through this incredibly confused and unsystematic mass of work done by thousands of brilliant people and trying to drag some kind of meaning out of it. Sometimes that involves dredging up weird drugs that no one else thinks about or remembers but which are perfectly suited for the precise situation at hand. Sometimes it’s disentagling complicated claims about what does and doesn’t work so you can be sure to give your patients the former. Other times it’s something totally out of left field, like reading this study and massively increasing the amount my consult patients liked me pretty much overnight with zero work.

I think outpatient will be good for this. There’s more freedom, more focus on treatment rather than warehousing, and a little bit more of an academic bent to it.

In the meantime, I am now a third year resident. There are people beneath me, and sometimes they do what I say! I get enough of a raise that I can say, for the first time in my life, that I am making the US median household income! I mostly get weekends off, except when I don’t!

And in two years, I’ll be done in Michigan and maybe I can move somewhere else and hang out with some of you people full-time.

Links 6/15: Monsters, Link

Study shows that banning bottled water on campuses just makes students switch to bottled soda, with obvious detrimental consequences to health and no decrease in bottle waste.

Pakistan’s transgender tax collectors.

A couple of posts ago, I mocked the Muslim activist who claimed Mossad broke into his house and stole one of his shoes to creep him out. Jonathan Zhou corrects me and points out that this sort of thing is actually a known intelligence agency tactic.

A systematic review of all 55 medical conditions whose risks vary with your month of birth.

Popehat does some very impressive investigative reporting into the government trying to make a (literal) federal case out of random libertarian blog commenters criticizing a judge at Reason.com. A pretty good example of the abuses of power possible if laws about Internet threats are made too strict. Followups here, here, and here.

Probiotics watch: maybe eating fermented food decreases social anxiety?

Nevada enacts comprehensive school choice law. The experiment has begun.

Life imitating JRPGs – mysterious “time crystals” may hold the secret to outlasting entropy. No word on whether you have to get all seven, or whether they are hidden in temples themed around the seven elements. Some people on Tumblr try to help me understand the implications.

A while ago, I was getting the impression that the Mexican drug cartels were unstoppable and the Mexican government was too corrupt to be able to do anything about them. Now the cartels are almost all defeated or in retreat. What happened?

Long ago I reviewed a book claiming the future was glia. Now some scientists are proposing that maybe SSRIs work by affecting glial cells.

American Hippopotamus describes the 1910s plan by two larger-than-life Boer War guerilla-assassins to “turn American into a nation of hippo ranchers”. The story alone would be worth your time even if it wasn’t well-written, but it happens to be very possibly the best-written article I have ever read. Long, but also available on Kindle if wanted.

Program that teaches college women how to avoid rape may cut risk of rape in half as per new study.

This article on whether the US could replicate Scandinavia’s low poverty rate is interesting throughout, but what makes it for me is the claim that Swedes in the US have the same poverty rate as Swedes in Sweden [edit: possibly this is false?]. How much should we make of this?

Not only are we living in the future, but it’s exactly the future Philip K Dick told us to expect: “Abortion drone” to make first flight into Poland

The mysterious resemblance between the ancient Numenorean calendar and the French revolutionary calendar (h/t an-animal-imagined-by-poe)

I’d always heard the story “Iceland rejected fiscal austerity and did everything exactly the way the left wanted and did great.” Scott Sumner and Tyler Cowen say that actually Iceland had lots and lots of austerity.

I think it’s probably time to stop bothering Rachel Dolezal. She seems like a good example of a person who’s not hurting anyone, has some really weird problems she needs to sort out, but because she doesn’t fall into a designated “here are people we have agreed it’s not okay to mock” category we are mocking her. The psychoanalyst in me wants to say this is some kind of displacement where people who are upset they can’t get away with making fun of real black people suddenly see an apparent black person (and NAACP leader, no less!) lose their magical protection and become a valid target, and are now channeling years of pent-up rage at her. Anyway, not totally related, but an explanation of why this is not a good analogy for transgender.

Article originally reported as “no gender gap in tech salaries” gives a more nuanced description of their result. Summary: true based on sample of equally qualified people one year after graduation; no evidence whether or not it’s true in other situations. This article is also good example of “if you have data supporting a controversial point, ignorant people on Twitter will throw out some terms that sound statistics-y and bad, like ‘confounding’ or ‘cherry-picking’, then say you have now been debunked.”

Doctors with the highest ratings on those rate-your-doctor sites may deliver worse care than less-well-rated docs. Maybe you get higher ratings by giving patients what they want, which is usually amphetamines, narcotics, antibiotics, and unnecessary tests.

The time Harriet Beecher Stowe wrote an article about Lord Byron’s divorce so controversial it caused a third of The Atlantic’s readership to cancel their subscriptions.

Alyssa Vance writes on Facebook about Ivy League colleges’ sketchy methods of soliciting alumni donations.

In a study of 20,000 people, an uncommon allele of the MAO-A gene may cause a sevenfold increased risk of violent criminal behavior, making it probably the strongest gene-crime link to date.

Previously on SSC links: if robots are taking our jobs, how come productivity numbers aren’t increasing? Now: okay, productivity numbers are increasing, but the robots still don’t seem to be taking our jobs.

A man angry at the German government for falsely imprisoning him is adopting a thousand children in order to make them German citizens and do his part to strain the welfare state. Apparently everything legally checks out and no one can stop him. Open borders advocates take note. [edit: old story, loophole since possibly closed?]

Anti-science-denial group Committee for Skeptical Inquiry wants to make a $25,000 bet with the global warming doubters at the Heartland Institute about future climate trends. While I totally approve of this strategy (“A bet is a tax on bullshit” – Alex Tabarrok and Bryan Caplan), the exact terms seem kind of dumb – AFAIK, Heartland doesn’t believe that the Earth is not getting warmer, just that it’s not necessarily human-caused. Betting on next year’s temperature does nothing to settle that.

In the last links post, I mentioned a study that tried to use transgender people to test the sources of the gender gap. A new study from Brazil tries to do the same with race – Brazilians are frequently very multiracial, and different companies might classify the same employee differently. The study tries to match that with salaries – does a boss who thinks of an employee as white pay them more than their boss next year who thinks of them as black? They conclude that 40% of racial income gaps can be explained in that way, though of course it sounds like Brazil’s racial situation is different enough from America’s that it might not generalize.

Nothing sophisticated or intellectual about this one – just trucks driving off aircraft carriers. Wheeeee!

Some linguists talk of “the Anglic languages”, a language family including English and some of its weirder relatives and descendants that have evolved to the point of mutual intelligibility. You’ve probably heard of Scots, ie “the reason you can’t understand Robert Burns”. But did you know about Forth and Bargy?

Google’s neural nets can now amplify images without human guidance. And by amplify, they mean add shoggoths (warning: shoggoth). Also, this seems way too much like the visual effects of LSD to be a coincidence, and I look forward to neuroscientists explaining the exact connection.

A mildly interesting Wall Street Journal article on how jobs are staying open longer because employers can’t find qualified candidates also contains some surprising information – 5% of job interviews include an IQ test, and almost 20% include a personality test. I’m not sure how that meshes with our recent discussion of Griggs vs. US. I’m starting to think the importance of this case is overblown – the actual ruling specifically banned assessing qualifications based on IQ tests or on degree completion. Everyone does the latter, so why are we so sure this case is restricting people from doing the former?

Obvious once I heard it but something I never thought about it before – the Statue of Liberty is green because all old tarnished copper is green. When it was first built, it was, well, copper-colored. When it tarnished the government was supposed to raise money to fix it, but never got around to it. Now it’s impossible for me not to find the idea of the Statue of Liberty being green kind of hilarious.

California college professors told they can be disciplined or fired for committing “microaggressions” including “describing America as a melting pot” or saying that “I believe the most qualified person should get the job”. Assumed this was some kind of total fake, did some digging, still seems legit, but if anyone can find otherwise I will correct myself with apologies and relief. At least every time I see this sort of thing it’s in universities, suggesting the contagion is somewhat contained. [edit: a claim that this doesn’t matter much]

We already know that many medical studies and many psychological studies fail to replicate. What about economics studies? The necessary work is still being done, but the recent progress report suggests that about 66% of replication attempts completely fail to replicate the original finding, with another 12% partly failing to replicate and only 22% replicating completely. Possibly an argument for privileging theory more in the interminable Econ Theory Versus Empiricism Wars?

Contrary to some reports, nationwide gun violence and nationwide violence against police do not seem to have spiked after the latest round of police brutality stories and race riots.

This wins my prize for real case most like the sort of weird murder mysteries you see in books: A man is found dead in the desert with an obvious fatal gunshot wound. He has no enemies but recently suffered a major financial setback; everyone suspects he committed suicide and only wanted it to look like murder. However, this ruse is very convincing; no gun is found anywhere nearby. How did he shoot himself?

How long can a con man with no soccer talent whatsoever play soccer at the professional level before anybody catches on? How about twenty years?

IQ researcher, Ian Deary collaborator, and SSC victim Dr. Stuart Ritchie has written an introductory book on IQ and intelligence studies that looks pretty good. Not sure if the ambiguity of meaning in the subtitle is a horrible mistake or 100% deliberate.

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OT22: Flow My Tears, The Policeman Thread

This is the semimonthly open thread. Post about anything you want, ask random questions, whatever. Also:

1. Some people frustrated with the commenting system here are trying out r/slatestarcodex, a subreddit where they can comment on recent SSC articles with all of the upvoting and downvoting their heart desires.

2. Comments of the week are Edward Scizorhands on why banning discrimination based on college degrees might be easier than you think, Larry Kestenbaum on the surprisingly sane employment policies of the US post office, Jaime Astorga on a metaphor for college maybe even better than my tulips one (old, but I missed it the first time), haishan on why driverless cars aren’t legal yet, Pax Dickinson on purges, and Brandon Berg on Tom Swifties.

3. If you’re into effective charity, there may currently be an unusually high-impact opportunity to donate to Giving What We Can.

4. I finally cleared my backlog of reported comments. Fwhgdsd is now banned indefinitely and RCF for one month; check the Register of Bans for more information. Everyone else gets a general amnesty, on statute-of-limitation-type considerations.

Please steer the open thread away from the five toxic topics that mindkill SSC readers: race, gender, doge, one-tailed t-tests, and cuddling.

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NYC Meetup 6/21

There will be a New York City rationalist/LW/SSC meetup at Highgarden House (851 Park Place, Brooklyn) on Sunday, June 21 at 6:00 PM.

If you’re reading this and can make it to Brooklyn, you’re invited.

There was some discussion at the last Michigan meetup about how the previous sentence should be emphasized more. If you are reading this and can make it to Brookyln, you’re invited. You do not have to have read very much of this blog or Less Wrong, you do not have to agree with me about anything, you do not have to “be smart enough” for any value of “enough”, and you do not have to be the “sort of person” whom you think goes to these things. In fact, the less you are like everyone else, the more interesting it will be.

No particular activities planned beyond undirected conversation, but there will probably be pizza, and Raemon has raised the possibility of a dramatic reading of A Midsummer Night’s Dream for those interested (in a way that doesn’t interfere with continued undirected conversation for people who don’t want to do that).

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Fifty (More) Swifties

[see: Wikipedia: Tom Swifties, Tom Swifties Written By An Author Willing To Go To Any Lengths To Make A Tom Swifty Thus Resulting In Constructions That Often Require More Work For Readers Than For The Author, and Fifty Swifties. Previously on Twitter here.]

“This sandwich is gross,” Tom said deliberately.

“My Frisbee is stuck on the roof of that circus building,” Tom said discontently.

“I hate Google,” Tom said probingly.

“Godzilla swallowed a United Nations bunker, but then he threw it back up,” Tom said unfortunately.

“I think Objectivism is stupid,” Tom said randomly.

“It’s so exciting to visit Leonardo’s birthplace,” Tom said invincibly.

“Persephone must marry Hades and live with him half the year,” Zeus said despairingly.

“I now control majority shares of CBS, FOX, and the New York Times,” Tom said immediately.

“Enemy fighters just scored a direct hit on my plane! I’m going down!” Tom said knowingly.

“We were badly injured in the struggle with the Orcs, but luckily the Ents’ medicine restored our health,” Tom said tremendously.

“I took Gollum’s precious trinket in a riddle contest,” Tom said wonderingly.

“I’ve lost this Maxis game ten times in a row on the easiest difficulty setting,” Tom said sympathetically.

“I can commit adultery three more times and still be just under the threshold for damnation,” Tom said syntactically.

“O Lord, why are you punishing me like this?” Jonah said inefficiently.

“Look! Nicaraguan guerillas!” Tom contraindicated.

“I forgot to give up meat before Easter, so I’ll do it before Christmas,” Tom said redolently.

“I’ll see you in court!” Tom said supersonically.

“When I speak Japanese, I think of myself as a young, cute person,” Tom said mechanically.

“Iä Cthulhu! Iä Azathoth!” the man called maniacally.

“Stay away from Stalin,” Tom commissioned.

“It’s one of those old phones, from before wireless and touch-tone,” Tom said cordially.

“She’ll have sex with me for $20 any time I phone her up,” Tom said horrifically.

“I read the Cliff Notes to Dante’s Inferno,” Tom said synergistically.

“I’m going to recover the lunar lander from the surface of the moon and make a fortune,” Tom said apologetically.

“I covered myself in a layer of gold,” Tom said amblingly.

“I covered myself in a layer of pyrite,” Tom said shamblingly.

“I covered myself in the Golden Fleece of Colchis,” Tom said ramblingly.

“The poverty rate has increased 10% recently, but I don’t have any kind of visual presentation of its course,” Tom said pornographically.

“We should perform an autopsy,” Tom said wide-eyed.

“That tree is naked under its bark!” Tom said prudently.

“I can afford either an iPhone or a yacht, but not both,” Tom said on self-ownership.

“The guy who was installing the granite tops in my kitchen had a cardiac arrest,” Tom countermanded.

“We can stop progress by attacking a conference on new ideas with a many-headed monster,” Tom said well-hydrated.

“You’re a bell,” Tom told me.

“The wages of sin is death,” Tom said diurnally.

“Abortion is murder,” Tom said prolifically.

“Can do!” Tom said candidly.

“I have a present for you, Madame,” Vincent said endearingly.

“Arrrrrr,” Tom aspirated.

“My lower social status as part of the new rich prevents me from winning my true love,” Gatsby said lackadaisically.

“The Minoans sucked,” Tom said discretely.

“Well, if you think the Minoans did a bad job with their empire, you should try ruling them yourself,” his teacher said, giving him a B−.

“Ha ha, just kidding,” Tom ingested.

“Sheep can’t have sex changes!” Tom said, heedless of the ramifications.

“I wrote a synoptic Gospel,” Tom remarked.

“People used to lay wires across the country for the telegraph system, an early precursor to the telephone,” Tom said according to protocol.

“My laptop came bundled with malware that causes a serious security flaw,” Tom said superficially.

“We need artillery cover!” Tom said canonically.

“Someday my family will rule the world,” Tom said clandestinely.

“The West’s treatment of Palestine is an example of Orientalism,” Tom said.

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Fearful Symmetry

[Content warning: Social justice, anti-social justice, comparisons of social justice to anti-social-justice, comparisons of different groups’ experiences.]

The social justice narrative describes a political-economic elite dominated by white males persecuting anybody who doesn’t fit into their culture, like blacks, women, and gays. The anti-social-justice narrative describes an intellectual-cultural elite dominated by social justice activists persecuting anybody who doesn’t fit into their culture, like men, theists, and conservatives. Both are relatively plausible; Congress and millionaires are 80% – 90% white; journalists and the Ivy League are 80% – 90% leftist.

The narratives share a surprising number of other similarities. Both, for example, identify their enemy with the spirit of a discredited mid-twentieth century genocidal philosophy of government; fascists on the one side, communists on the other. Both believe they’re fighting a war for their very right to exist, despite the lack of any plausible path to reinstituting slavery or transitioning to a Stalinist dictatorship. Both operate through explosions of outrage at salient media examples of their out-group persecuting their in-group.

They have even converged on the same excuse for what their enemies call “politicizing” previously neutral territory – that what their enemies call “politicizing” is actually trying to restore balance to a field the other side has already successfully politicized. For example, on Vox recently a professor accused of replacing education with social justice propaganda in her classroom counterargues that:

All of my students, regardless of the identity categories they embraced, had been taught their entire lives that real literature is written by white people. Naturally, they felt they were being cheated by this strange professor’s “agenda”…It is worth asking, Who can most afford to teach in ways that are least likely to inspire controversy? Those who are not immediately hurt by dominant ideas. And what’s the most dominant idea of them all? That the white, male, heterosexual perspective is neutral, but all other perspectives are biased and must be treated with skepticism […]

Have we actually believed the lie that the only people who engage in “identity politics” are black feminists like me? Could it be that when some white men looked at more powerful white men, they could see them only as reasonable and not politically motivated, so they turned off their critical thinking skills when observing their actions? (Not everyone, of course.) Could it be that we only consider people ideologues when they don’t vow allegiance to capitalism?

Compare to the “Sad Puppies”, a group of conservatives accused of adding a conservative bent to science fiction’s Hugo Awards. They retort that “politicization is what leftists call it when you fight back against leftists politicizing something”. As per the Breitbart article:

The chief complaint from the Sad Puppies campaigners is the atmosphere of political intolerance and cliquishness that prevails in the sci-fi community. According to the libertarian sci-fi author Sarah A. Hoyt, whispering campaigns by insiders have been responsible for the de facto blacklisting of politically nonconformist writers across the sci-fi community. Authors who earn the ire of the dominant clique can expect to have a harder time getting published and be quietly passed over at award ceremonies […]

Brad R. Torgersen, who managed this year’s Sad Puppies campaign, spoke to Breitbart London about its success: “I am glad to be overturning the applecart. Numerous authors, editors, and markets have been routinely snubbed or ignored over the years because they were not popular inside WSFS or because their politics have made them radioactive.”

Torgersen cites a host of authors who have suffered de facto exclusion from the sci-fi community: David Drake, David Weber, L.E Modesitt Jr, Kevn J. Anderson, Eric Flint, and of course Orson Scott Card — the creator of the world-famous Ender’s Game, which was recently adapted into a successful movie. Despite his phenomenal success, Scott Card has been ostracized by sci-fi’s inner circle thanks to his opposition to gay marriage.

I see minimal awareness from the social justice movement and the anti-social-justice movement that their narratives are similar, and certainly no deliberate intent to copy from one another. That makes me think of this as a case of convergent evolution.

The social justice attitude evolved among minority groups living under the domination of a different culture, which at best wanted to ignore them and at worst actively loathed them for who they were and tried to bully them into submission. The closest the average white guy gets to that kind of environment is wandering into a social-justice-dominated space and getting to experience the same casual hatred and denigration for them and everyone like them, followed by the same insistence that they’re imagining things and how dare they make that accusation and actually everything is peachy.

And maybe that very specific situation breeds a very specific kind of malignant hypervigilance, sort of halfway between post-traumatic stress disorder and outright paranoia, which motivates the obvious fear and hatred felt by both groups.

Someone is going to freak out and say I am a disgusting privileged shitlord for daring to compare the experience of people concerned about social justice to the experience of genuinely oppressed people, but they really shouldn’t. That’s the explicit goal of large parts of the social justice movement. For example, on the Hacker News thread about far-rightist Curtis Yarvin being kicked out of a tech conference for his views, one commenter writes:

I’ve been involved in anti-racist/anti-fascist work, either directly or on the periphery, for about ten years at this point. This takes many forms, from street confrontations with fascists, protests at book readings and other events, and also disrupting fascist conferences and similar […]

As far as this issue and other similar issues are concerned, I’m overjoyed that, as you put it, a climate of fear exists for fascists, misogynists, racists, and similar. I hope that this continues and only worsens for these people.

I’m happy for many reasons. The first is that it has, as you’ve said, made privileged people afraid. I think this is only the beginning. Privilege creates safety, and as it is removed, I think the unsafety of the oppressed will in part come to the currently privileged classes. But if I could flip a switch and make every man feel the persistent, gnawing fear that a woman has of men, I would in a heartbeat. I wouldn’t even consider whether the consequences were strategic, I would just do it.

This not the only time I’ve heard this opinion expressed, just the most recent. I feel like if you admit that you’re trying your hardest to make privileged people feel afraid and uncomfortable and under siege in a way much like minorities traditionally do, and privileged people are in fact complaining of feeling afraid and uncomfortable and under siege in a way much like minorities traditionally do, you shouldn’t immediately doubt their experience. Give yourself some more credit than that. You’ve been working hard, and at least in a few isolated cases here and there it’s paid off.

The commenter continues:

I would not say that I set out to defeat a “discourse-stifling” monster. The monsters I set out to defeat were patriarchy, capitalism, and white supremacy. These systems violently oppress, they don’t “stifle discourse.” In fact, they LOVE discourse! When people are discoursing, they aren’t in the streets. I’ve seen so many promising movements hobbled by reformism that I’m glad the possibility no longer exists, though that isn’t at all the fault of SJW-outrage (and is rather a consequence of the fact that the economy is in large part so perilous that nobody can afford the concessions that were previously won by reformists). So if discourse is permanently removed as a tactical and strategic option for future leftists, I’ll consider it a victory.

Needless to say, that is not this blog’s philosophy. But I think there is nevertheless something to be gained from all of the hard work this guy and his colleagues have put in making other people feel unsafe.

The mirror neuron has always been one of liberalism’s strongest weapon. A Christian doesn’t decide to tolerate Islam because she likes Islam, she decides to tolerate Islam because she can put herself in a Muslim’s shoes and realize that banning Islam would make him deeply upset in the same way that banning Christianity would make her deeply upset.

If the fear and hypervigilance that majority groups feel in social-justice-dominated spaces is the same as the fear and hypervigilance that minority groups feel in potentially discriminatory spaces, that gives us a whole lot more mirror neurons to work with and allows us to get a gut-level understanding of the other side of the dynamic. It lets us check my intuitions against their own evil twins on the other side to determine when we are proving too much.

II.

A couple of months ago the owners of a pizzeria mentioned in an interview that they wouldn’t serve pizza at gay weddings because they’re against gay marriage. Instantly the nation united in hatred of them and sent a bunch of death threats and rape threats and eventually they had to close down.

I thought this was ridiculous. I mean, obviously death threats are never acceptable, but there seemed to be something especially frivolous about this case, where there are dozens of other pizzerias gay people can go to and where no one would ever serve pizza at a wedding anyway. A pizzeria hardly holds the World Levers Of Power, so just let them have their weird opinion. All they’re doing is sending potential paying customers to their more tolerant competitors, who are laughing all the way to the bank. It’s a self-punishing offense.

This was very reasonable of me and I should be praised for my reasonableness, except that when a technology conference recently booted a speaker for having far-right views on his own time, I was one of the many people who found this really scary and thought they needed to be publicly condemned for this intolerant act.

In theory, the same considerations ought to apply. There are dozens of other technology conferences in the world. Technology conferences also do not hold the World Levers Of Power. And when they reject qualified rightist speakers, that just means they’re just making life easier for their competitors who will be happy to grab the opportunity and laugh all the way to the bank. It ought to be self-punishing, so what’s the worry.

My brain is totally not on board with this reasoning. When I ask it why, it says something like “No, you don’t understand, these people are relentless, unless they are constantly pushed against they will put pressure on more and more institutions until their enemies are starved out or limited to tiny ghettos. Then they will gradually expand the definition of ‘enemy’ until everybody who doesn’t do whatever they say is blacklisted from everywhere.”

And if you think that’s hyper-paranoid, then, well, you’re probably right, but at least I have a lot of company. Here are some other comments on the same situation from the last links thread:

I spent a semester of college in Massachusetts. That’s where I found out that there are a lot of people who’d kill me and most of my family if they were given the chance. And thought it was totally reasonable and acceptable to say as much. (The things that are associated with Tumblr these days existed long before it. And mostly came from academia.)

About the same time that sort of thing was happening in that online community, the same thing was happening in the real-world meat-space gatherings, also quite literally with shrill screams, mostly by [reacted] [reacted]s, who would overhear someone else’s private conversations, and then start streaming “I BEG YOUR PARDON!” and “HOW CAN YOU SAY THAT!”, and by [reacted] [reacted]’s who were bullying their way onto programming committees, and then making sure that various speakers, panelists, artists, authors, dealers, and GoHs known to be guilty of wrongthink were never invited in the first place. Were it not for the lucky circumstance of the rise of the web, the market takeoff of ebooks, especially a large ebook vendor (named after a river)’s ebook direct program, and the brave anchoring of a well known genre publisher that was specifically not homed in NYC, the purging of the genre and the community would have been complete.

Almost nobody wants to physically murder and maim the enemy, at least at the start. That’s, well, the Final Solution. Plan A is pretty much always for the enemy to admit their wrongness or at least weakness, surrender, and agree to live according to the conqueror’s rules. Maybe the leaders will have to go to prison for a while, but everyone else can just quietly recant and submit, nobody has to be maimed or killed. [The social justice community] almost certainly imagine they can achieve this through organized ostracism, social harassment, and democratic political activism. It’s when they find that this won’t actually make all the racists shut up and go away, that we get to see what their Plan B, and ultimately their final solution, look like.

And if you think my commenters are also hyper-paranoid, then you’re probably still right. But it seems like the same kind of paranoia that makes gay people and their allies scream bloody murder against a single pizzeria, the kind that makes them think of it as a potential existential threat even though they’ve won victory after victory after victory and the only question still in the Overton Window is the terms of their enemies’ surrender.

I mocked the hell out of the people boycotting Indiana businesses because of their right-to-discriminate law:

But if some state were to pass a law specifically saying “It is definitely super legal to discriminate against conservatives for their political beliefs,” this would freak me out, even though I am not conservative and even though this is already totally legal so the law would change nothing. I would not want to rule out any response, up to and including salting their fields to make sure no bad ideas could ever grow there again.

Like many people, I am not very good at consistency.

III.

Author John Green writes books related to social justice. A couple of days ago, some social justice bloggers who disagreed with his perspective decided that a proportional response was to imply he was a creep who might sexually abuse children. Green was somewhat put out by this, and said on his Tumblr that he was “tired of seeing the language of social justice – important language doing important work – misused as a way to dehumanize others and treat them hatefully” and that he thought his harassers “were not treating him like a person”.

Speaking of the language of social justice, “dehumanizing” and “not treating like a person” are some pretty strong terms. They’re terms I’ve criticized before – like when feminists say they feel like women aren’t being treated as people, I’m tempted to say something like “the worst you’ve ever been able to find is a single-digit pay gap which may or may not exist, and you’re going to turn that into people not thinking you’re human?”

Here’s another strong term: “hatred”. The activist who got Mencius Moldbug banned from Strange Loop reassured us that he would never want someone banned merely for having unusual political views, but Moldbug went beyond that into “hatred”, which means his speech is “hate speech”, which is of course intolerable. This is a bit strange to anybody who’s read any of his essays, which seem to have trouble with any emotion beyond smugness. I call him a bloodless and analytical thinker; the idea of his veins suddenly bulging out when he thinks about black people is too silly to even talk about. The same is true of the idea that people should feel “unsafe” around him; his entire shtick is that no one except the state should be able to initiate violence!

Likewise, when people wanted TV star Phil Robertson fired for saying (on his own time) that homosexuality was unnatural and led to bestiality and adultery, they said it wasn’t about policing his religion, it was about how these were “hateful” comments that would make the people working with him feel unsafe. At the time I said that was poppycock and that people who wanted him fired for having a private opinion were the worst kinds of illiberal witch-hunters.

On the other hand, consider Irene Gallo. I know nothing of her except what the Alas blog post says, but apparently in science fiction’s ongoing conflict between the establishment and the anti-SJW “Sad Puppies”/”Rabid Puppies” groups, she referred to the latter as:

Two extreme right-wing to neo-nazi groups that are calling for the end of social justice in science fiction and fantasy. They are unrepentantly racist, sexist and homophobic.

These are some pretty strong allegations, and range from “false” to “bizarre”; Brad Torgenson, leader of the group she called “extreme right wing neo nazi unrepentant racists”, is happily married to a black woman. And the people she’s talking about are her company’s authors and customers, which hardly seems like good business practice. Some authors have said they feel uncomfortable working for a company whose employees think of them that way, and others have suggested boycotting Tor until they make her apologize or fire her.

Barry says that since she said these on her own private Facebook page, it is a private opinion that it would be pretty censorious to fire her over. Part of me agrees.

On the other hand, if I were a sci-fi author in one of the groups that she was talking about, I’m not sure I’d be able to work with her. Like, really? You want me to sit across a table and smile at the woman who thinks I’m a racist sexist homophobic extremist neo-Nazi just because I disagree with her?

Robertson’s comment is just standard having-theological-opinions. Like, “Christian thinks homosexuality is sinful, more at eleven.” Big deal. But Gallo’s comment feels more like white hot burning hatred. She’s clearly too genteel to personally kill me, but one gets the clear impression that if she could just press a button and have me die screaming, she’d do it with a smile on her face.

But this is just interpretation. Maybe Gallo doesn’t consider “neo-Nazi” a term of abuse. Maybe this was just her dispassionate way of describing a political philosophy with the most appropriate analogy she could think of.

It doesn’t seem likely to me. Then again, even though it seems obvious to me that stating “homosexuality is sinful and similar to bestiality” is a theological position totally compatible with being able to love the sinner and hate the sin, gay people have a lot of trouble believing it. And although I cannot condone firing people for their private opinions, back when people were trying to get rid of Gawker honcho Sam Biddle for saying that “nerds should be constantly shamed and degraded into submission”, God help me it certainly crossed my head that there were even the slightest consequences for this kind of behavior, maybe other social justice writers would stop saying and acting upon statements like that all the frickin’ time?

Once again, I’m not scoring very highly in consistency here.

IV.

A little while ago I had a bad couple of days. Some people were suggesting I was a liability to a group I was part of because I’d written some posts critical of feminism, and I got in a big fight about it. Then someone sent my ex-girlfriend a Tumblr message asking if they’d broken up with me “because I was racist”. Then despite my best efforts to prevent this, my Facebook feed decided to show me a bunch of Gawker-style articles about “Are all white people to blame for [latest atrocity]? I was too exhausted to write a real blog post, so I just threw together a links post. Because among two dozen or so links there was one (1) to the Moldbug story previously mentioned above, one commenter wrote that “your links posts are becoming indistinguishable from Chaos Patch” (Chaos Patch is the links post of notable far-right blog Xenosystems).

So I decided to ban that commenter. But since I have a policy in place of waiting an hour before doing anything rash, I took a long walk, thought about it a bit, and settled for just yelling at him instead.

Is banning someone for a kind of meaningless barb excessive? Well, yes. But given everything else that had happened, I didn’t have the energy to deal with it, and since this is my blog and the one corner of the world I have at least a tiny bit of control over I could at least symbolically get rid of a small fraction of my problems.

Plus, to me the barb seemed like an obvious veiled threat. “As long as you post any links about rightist causes, I can accuse you of being far-right. And we all know what happens to far-right people, eh?”

So even though out of context it was about the most minimal hostility possible, barely rising to the level where somebody would say it was even capable of being a problem at all, in context it really bothered me and made me at least somewhat justifiably feel unsafe.

Ever since I learned the word “microaggression” I have been unironically fond of it.

When I’m putting up with too much and I’ve used up my entire mental buffer, then somebody bothering me and hiding under the cover of “oh, this was such a tiny insult that you would seem completely crazy to call me on it” is especially infuriating, even more infuriating than someone insulting me outright and me being able to respond freely. The more you have to deal with people who hate you and want to exclude you, the more likely you are to get into this mode, not to mention people who have developed their own little secret language of insults.

Here’s an example of what I mean by “secret language of insults”: consider the term “dude”, as in “white dude”. There is nothing objectively wrong with “dude” when it is applied to surfers or something. But when a feminist says it, as in the term “white dudes”, you know it is going to be followed by some claim that as a white dude, you are exactly the same as all other white dudes and entirely to blame for something you don’t endorse. The first page of Google results is overratedwhitedudes.tumblr.com, Gawker saying Wimpy White Dudes Ruined American Idol, and Mother Jones saying glowingly that You Won’t Find Many White Dudes At This Tech Startup. Being called a “white dude” is always followed by the implication that you’re ruining something or that your very presence is cringeworthy and disgusting.

I had a feminist friend who used to use the term “dudes” for “men” all the time. I asked them to please stop. They said that was silly, because that was just the word the culture they’d grown up in used, and obviously no harm was meant by it, and if I took it as an insult then I was just being oversensitive. This is word for word the explanation I got when I asked one of my elderly patients to stop calling black people their particular ethnic slur.

The counterpart to subliminal insults is superliminal insults; ones that are hard to detect because they’re so over-the-top obvious.

I was recently reading a social justice blog where someone complained about men telling women “Make me a sandwich!” in what was obvious jest.

On the one hand, no one can possibly take this seriously.

On the other hand, there’s a common social justice meme where people post under the hashtag #killallwhitemen.

Certainly this cannot be taken seriously; most social justice activists don’t have the means to kill all white men, and probably there are several of them who wouldn’t do it even if they could. It should not be taken, literally, as a suggestion that all white men should be killed. On the other hand, for some bizarre reason this tends to make white men uncomfortable.

The obvious answer is that the people posting “Wimmen, make me a sandwich!” don’t literally believe that women exist only for making them sandwiches, but they might believe a much weaker claim along the same lines, and by making the absurd sandwich claim, they can rub it in while also claiming to be joking. At least this is how I feel about the “kill all white men” claim.

As long as you’ve got a secret language of insults that your target knows perfectly well are insulting, but which you can credibly claim are not insulting at all – maybe even believing it yourself – then you have the ability to make them feel vaguely uncomfortable and disliked everywhere you go without even trying. If they bring it up, you can just laugh about how silly it is that people believe in “microaggressions” and make some bon mot about “the Planck hostility”.

V.

I’m taking a pretty heavy Outside View line here, so let me allow my lizard brain a few words in its own defense.

“Yes,” my lizard brain says, “social justice activists and the people silenced by social justice activists use some of the same terms and have some of the same worries. But the latter group has reasonable worries, and the former group has totally unreasonable worries, which breaks the symmetry.”

Interesting. Please continue, lizard brain.

“Black people might be very worried about being discriminated against. But the chance that someone would say ‘Let’s ban all black people from our technology conference, because they are gross’, and everyone would say ‘Yes, that is a splendid idea’, and the government and media would say ‘Oh, wonderful, we are so proud of you for banning all black people from your conference’ is zero point zero zero zero. On the other hand, this is something that conservatives worry about every day. The chance that someone would say ‘You know, there’s no reason raping women should be illegal, let’s not even bother recording it in our official statistics’ is even lower than that, but this is exactly what several countries do with male rape victims. If someone says ‘kill all white men’, then all we do is hold an interminable debate about whether that disqualifies them from the position of Diversity Officer; if someone said ‘kill all gays’, we would be much more final in pronouncing them Not Quite Diversity Officer Material.”

But don’t you –

“The reason why we don’t care about a pizzeria that won’t serve gay people is that recent years have shown an overwhelming trend in favor of more and more rights and acceptance of gay people, and the pizzeria is a tiny deviation from the pattern which is obviously going to get crushed under the weight of history even without our help. The reason we worry about a conference banning conservatives is that conservatives are an actually-at-risk group, and their exclusion could grow and grow until it reaches horrific proportions. The idea of a pizzeria banning gays and a conference banning conservatives may seem superficially similar out of context, but when you add this piece of context they’re two completely different beasts.”

Two responses come to mind.

First, this is obviously true and correct.

Second, this is exactly symmetrical to my least favorite argument, the argument from privilege.

The argument from privilege is something like “Yeah, sure, every so often the system is unfair to white people or men or whatever in some way. But this is not a problem and we should not even be talking about it, because privilege. Shows that mock women for stereotypically female failings are sexist, but shows that mock men for stereotypically male failings are hilarious, and you may not call them sexist because you can’t be sexist against privileged groups.”

My argument has always been “What’s good for the goose is good for the gander”.

But either this argument goes, or my lizard brain’s argument goes, or we have to move to the object level, or somebody has to get more subtle.

VI.

My point is, there are a lot of social justice arguments I really hate, but which I find myself unintentionally reinventing any time things go really bad for me, or I feel like myself or my friends are being persecuted.

I should stop to clarify something. “Persecuted” is a strong word. “Feel like we are being persecuted” is way weaker.

A couple weeks ago there was a Vox article, America’s Never Been Safer, So Why Do Republicans Believe It Is In Mortal Peril?. It brought up a lot of cute statistics, like that the rate of pedestrians being killed by car accidents is much higher than the rate of civilians being killed in terrorist attacks. It joked that “You’re over 100 times more likely to die by literally walking around than you are to be killed in a terrorist attack.”

On the other hand, vox has practically led the news media in 24-7 coverage of police officers shooting unarmed black people, talking about how it’s a huge threat to our values as a civilization and how white people don’t understand that all black people have to constantly live in fear for their lives.

But a quick calculation demonstrates that unarmed black people are about 10 times more likely to die by literally walking around than by getting shot by a white police officer. One gets the feeling Vox doesn’t find this one nearly as funny.

But here I would perform another quick calculation. Here’s a list of people who have been publicly shamed or fired for having politically incorrect opinions. Even if we assume the list is understating the extent of the problem by an entire order of magnitude, you’re still more likely to die by literally walking around than you are to get purged for your politically incorrect opinion.

Like a lot non-feminists, I was freaked out by the recent story about a man who was raped while unconscious being declared the rapist and expelled from college without getting to tell his side of the story. I have no evidence that this has ever happened more than just the one time mentioned in the article, let alone it being a national epidemic that might one day catch me in its clutches, but because I’ve had to deal with overly feminist colleges in other ways, my brain immediately raised it to Threat Level Red and I had to resist the urge to tell my friends in colleges to get out while they still could. If we non-feminists can get worried about this – and we can – we have less than no right to tell feminists they shouldn’t really be worried about college rape because the real statistics are 1 in X and not 1 in Y like they claim.

Hopefully some readers are lucky enough never to have felt much personal concern about terrorism, police shootings, rape, rape accusations, or political correctness. But if you’ve worried about at least one of these low-probability things, then I hope you can extend that concern to understand why other people might be worried about the others. It seems to have something to do with the chilling effect of knowing that something is intended to send a message to you, and in fact receiving that message.

(as an aside, I find it surprising that so many people, including myself, are able to accept the statistics about terrorism so calmly without feeling personally threatened. My guess is that, as per Part VIII here, we don’t primarily identify as Americans, so a threat deliberately framed as wanting to make Americans feel unsafe just bounces off us.)

In an age where the media faithfully relates and signal-boosts all threats aimed at different groups, and commentators then serve their own political needs by shouting at us that WE ARE NOT FEELING THREATENED ENOUGH and WE NEED TO FEEL MORE THREATENED, it is very easy for a group that faces even a small amount of concerted opposition, even when most of society is their nominal allies and trying hard to protect them, to get pushed into a total paranoia that a vast conspiracy is after them and they will never be safe. This is obviously the state that my commenters who I quoted in Part II are stuck in, obviously the state that those people boycotting the Indiana pizzeria are stuck in, and, I admit, a state I’m stuck in a lot of the time as well.

VII.

Getting back to the thesis, my point is there are a lot of social justice arguments I really hate, but which I find myself unintentionally reinventing any time things go really bad for me, or I feel like myself or my friends are being persecuted.

Once events provoke a certain level of hypervigilance in someone – which is very easy and requires only a couple of people being hostile, plus the implication that they there’s much more hostility hidden under the surface – then that person gets in fear for their life and livelihood and starts saying apparently bizarre things: that nobody treats them as a person, that their very right to exist is being challenged. Their increasingly strident rhetoric attracts increasingly strident and personal counter-rhetoric from the other side, making them more and more threatened until they reach the point where Israel is stealing their shoe. And because they feel like every short-term battle is the last step on the slippery slope to their total marginalization, they engage in crisis-mode short-term thinking and are understandably willing to throw longer-term values like free speech, politeness, nonviolence, et cetera, under the bus.

Although it’s very easy enter this state of hypervigilance yourself no matter how safe you are, it’s very hard to understand why anyone else could possibly be pushed into it despite by-the-numbers safety. As a result, we constantly end up with two sides both shouting “You’re making me live in fear, and also you’re making the obviously false claim that you live in fear yourself! Stop it!” and no one getting anywhere. At worst, it degenerates into people saying “These people are falsely accusing me of persecuting them, and falsely claiming to be persecuted themselves, I’ll get back at them by mocking them relentlessly, doxxing them, and trying to make them miserable!” and then you get the kind of atmosphere you find in places like SRS and Gamergate and FreeThoughtBlogs.

But I’m also slightly optimistic for the future. The conservative side seems to have been about ten years behind the progressive side in this, but they’re catching up quickly. Now everybody has to worry about being triggered, everybody has to worry about their comments being taken out of context by Gawker/Breitbart and used to get them fired and discredit their entire identity group, everybody has to worry about getting death threats, et cetera. This is bad, but also sort of good. When one side has nukes, they nuke Hiroshima and win handily. When both sides have nukes, then under the threat of mutually assured destruction they eventually come up with protocols to prevent those nukes from being used.

Now that it’s easier to offend straight white men, hopefully they’ll agree trigger warnings can be a useful concept. And now that some social justice activists are getting fired for voicing their opinions in private, hopefully they’ll agree that you shouldn’t fire people for things they say on their own time. Once everyone agrees with each other, there’s a chance of getting somewhere. Yes, all of this will run up against a wall of “how dare you compare what I’m doing to what you’re doing, I’m defending my right to exist but you’re engaging in hate speech!” but maybe as everyone gets tired of the nukes flying all the time people will become less invested in this point and willing to go to the hypothetical Platonic negotiation table.

My advice for people on the anti-social justice side – I don’t expect giving the SJ people advice would go very well – is that it’s time to stop talking about how social justice activism is necessarily a plot to get more political power, or steal resources, or silence dissenting views. Like everything else in the world it can certainly turn into that, but I think our own experience gives us a lot of reasons to believe they’re exactly as terrified as they say, and that we can’t expect them to accept “you have no provable objective right to be terrified” any more than our lizard brains would accept it of us. I think it’s time to stop believing that they censor and doxx and fire their opponents out of some innate inability to understand liberalism, and admit that they probably censor and doxx and fire their opponents because they’re as scared as we are and feel a need to strike back.

This isn’t a claim that they don’t have it in for us – many of them freely admit they do – and that they don’t need to be stopped. It’s just a claim that we can gain a good understanding of why they have it in for us, and how we might engineer stopping them in a way less confrontational than fighting an endless feud.

Yesterday, a friend on Facebook posted something about a thing men do which makes women feel uncomfortable and which she wanted men to stop. I carefully thought about whether I ever did it, couldn’t think of a time I had, but decided to make sure I didn’t do it in the future.

I realized that if I’d heard the exact same statement from Gawker, I would have interpreted it (correctly) as yet another way to paint men as constant oppressors and women as constant victims in order to discredit men’s opinions on everything, and blocked the person who mentioned it to me so I didn’t have to deal with yet another person shouting that message at me. The difference this time was that it came from an acquaintance who was no friend of feminism, who has some opinions of her own that might get her banned from tech conferences, and who I know would have been equally willing to share something women do that bothers men, if she had thought it important.

If we can get to a point where we don’t feel like requests are part of a giant conspiracy to discredit and silence us, people are sometimes willing to listen. Even me.

(Late) Predictions for 2015

I was supposed to institute a tradition of making predictions at the beginning of each year, then grading them at the end to test my calibration. Everything went according to plan last year – last January I made predictions for 2014 and then this January I scored them. I ended with “2015 predictions coming soon,” then totally forgot to do that.

So now that it’s June and predicting what will happen in 2015 is about 40% easier, I might as well get started. Acceptable confidence levels are 50%, 60%, 70%, 80%, 90%, 95%, and 99%, to make it easy to score. All predictions are about the state of the world on 12/31/2015:

World Events
1. US will not get involved in any new major war with death toll of > 100 US soldiers: 70%
2. North Korea’s government will survive the year without large civil war/revolt: 95%
3. Greece will not announce it’s leaving the Euro: 60%
3. Neither Russia nor Qatar will lose their World Cups: 80%
4. Ebola will kill fewer people in second half of 2015 than the in first half: 95%
5. No terrorist attack in the USA will kill > 100 people: 90%
6. Assad will remain President of Syria: 70%
7. Israel will not get in a large-scale war (ie >100 Israeli deaths) with any Arab state: 90%
8. Syria’s civil war will not end this year: 80%
9. ISIS will control less territory than it does right now: 70%
10. ISIS will continue to exist: 80%
11. Iran will reach a deal with the West on nuclear weapons: 80%
12. No major civil war in Middle Eastern country not currently experiencing a major civil war: 90%
13. Iraq’s situation not to get any worse (eg gov’t collapse, new rebellion): 60%
14. Obamacare will survive the year mostly intact: 60%
15. Hillary Clinton will be the top-polling Democratic Presidential candidate: 95%
16. Jeb Bush will be the top-polling Republican candidate: 50%
17. Trans-Pacific Partnership to pass at least mostly intact: 60%
18. US official unemployment rate will be < 7% in Dec 2015: 95%
19. Bitcoin will end the year higher than $200: 95%
20. Oil will end the year >$60 a barrel: 50%

Personal Life
21. SSC will remain active: 95%
22. SSC will get fewer hits in the second half of 2015 than the first half: 60%
23. At least one SSC post in the second half of 2015 will get > 100,000 hits: 70%
24. Shireroth will remain active: 90%
25. I will remain at my same job through the end of 2015: 95%
26. There will be no further ramifications or lawsuits from either side over the flooding of my house: 80%
27. I will reach my savings target: 90%
28. I will get a score at >95th percentile for my year on PRITE: 50%
29. I will be involved in at least one published/accepted-to-publish research paper by the end of 2015: 60%
30. I will not break up with any of my current girlfriends: 80%
31. I will not get any new girlfriends: 50%
32. I will not finish [project]: 60%
33. I will attend NYC Solstice ritual: 80%
34. I will flake out of my plan to lead some kind of Solstice Ritual myself: 60%
35. I will be living in the house I’m currently trying to arrange to rent: 70%

These are all the things I could think of worth predicting; feel free to suggest others.

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Michigan Meetup 6/13

There will be a Michigan rationalist/LW/SSC meetup at the Ann Arbor District Library (343 South Fifth Avenue, Ann Arbor) on Saturday, June 13 at 1:30 PM. You can find a map here.

If you’re reading this and can make it to Ann Arbor, you’re invited.

I will be in New York/New Jersey the weekend after that, and probably available the evening of Sunday the 21st. If anybody in the area has space for a meetup, let me know and we can work something out.

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