He says, “Doc, can you give me a medicine?
The name ought to be on my chart
But it’s safe and it’s strong
And it helped me along
When I had a younger man’s heart”

♪ ♬ La la la, de de da, la la la de da, da dum ♪ ♬

Give us some drugs, you’re the evening doc
Give us some drugs tonight
Well we’re all in the mood for some opiates
And they’ll get us feeling alright

Now John in bed five is a friend of mine
He gets bouts of COPD
And he’s quick with a joke or to light up a smoke
Which I guess is what brings him to me

He says, “Doc, I believe this is killing me”
I agree he is probably right
And he tells me that’s it, and he swears that he’ll quit
And he asks me to pass him a light

♪ ♬ La la la, de de da, la la la de da, da dum ♪ ♬

Now Paul is a boy with leukaemia
Who never had time for a wife
And he’s talking with Meg, who takes food through a PEG
And will probably have to for life

And the man in bed ten yells obscenities
As the lady in six gives a moan
She’s paying eight thousand for hospice care
But it’s better than dying alone

Give us some drugs, you’re the evening doc
Give us some drugs tonight
Well we’re all in the mood for some opiates
And they’ll get us feeling alright

It’s a pretty good crowd for a Wednesday
And the pharmacist gives me a vial
‘Cause he knows that it’s that, they’ve been coming to get
To forget about pain for a while

And the corridor smells like c. difficile
And the bed alarm sounds like a jeer
And I take some caffeine and I stare at my screen
And think God, what am I doing here?

Give us some drugs, you’re the evening doc
Give us some drugs tonight
Well we’re all in the mood for some opiates
And they’ll get us feeling alright

At the time I had no good answer. Now I do. I would give them Charlotte Lennox’s write-up of how MsScribe took over Harry Potter fandom (warning: super-long but super-worth-it).

Ozy informs me that everyone else in the world read this story five years ago. Maybe I am hopelessly behind the times? Maybe all my blog readers are intimately familiar with it?

If not, read it. Read it like an anthropological text. Read it like you would a study of the Yanomamo. No, read it even better than that. Read it like you would a study of the Yanomamo if you knew that, statistically, some of your friends and co-workers covertly become Yanomamo after getting home every evening.

I hesitate to summarize it, because people will read my summary and ignore the much superior original. I would not recommend that. But if you insist on skipping the (admittedly super-long) link above, here is what happens:

In the early 2000s, Harry Potter fanfiction authors and readers get embroiled in an apocalyptic feud between people who think that Harry should be in a relationship with Ginny vs. people who think Harry should be in a relationship with Hermione. This devolves from debate to personal attacks to real world stalking and harassment to legal cases to them splitting the community into different sites that pretty much refuse to talk to each other and ban stories with their nonpreferred relationship.

These sites then sort themselves out into a status hierarchy with a few people called Big Name Fans at the top and everyone else competing to get their attention and affection, whether by praising them slavishly or by striking out in particularly cruel ways at people in the “enemy” relationship community.

A young woman named MsScribe joins the Harry/Hermione community. She proceeds to make herself popular and famous by use of sock-puppet accounts (a sockpuppet is when someone uses multiple internet nicknames to pretend to be multiple different people) that all praise her and talk about how great she is. Then she moves on to racist and sexist sockpuppet accounts who launch lots of slurs at her, so that everyone feels very sorry for her.

At the height of her power, she controls a small army of religious trolls who go around talking about the sinfulness of Harry Potter fanfiction authors and especially MsScribe and how much they hate gay people. All of these trolls drop hints about how they are supported by the Harry/Ginny community, and MsScribe leads the campaign to paint everyone who wants Harry and Ginny to be in a relationship as vile bigots and/or Christians. She classily cements her position by convincing everyone to call them “cockroaches” and post pictures of cockroaches whenever they make comments.

Throughout all this, a bunch of people are coming up with ironclad evidence that she is the one behind all of this (this is the Internet! They can just trace IPs!) Throughout all of it, MsScribe makes increasingly implausible denials. And throughout all of it, everyone supports MsScribe and ridicules her accusers. Because really, do you want to be on the side of a confirmed popular person, or a bunch of confirmed suspected racists whom we know are racist because they deny racism which is exactly what we would expect racists to do?

MsScribe writes negatively about a fan with cancer asking for money, and her comments get interpreted as being needlessly cruel to a cancer patient. Her popularity drops and everyone takes a second look at the evidence and realizes hey, she was obviously manipulating everyone all along. There is slight sheepishness but few apologies, because hey, we honestly thought the people we were bullying were unpopular.

MsScribe later ended up switching from Harry Potter fandom to blogging about social justice issues, which does not surprise me one bit. But let me do some social justice blogging of my own.

A lot of the comments I have seen discussing the issue say “Yeah, teenage girls will be teenage girls”.

Two responses seem relevant. First, quite a few of the people involved seem to have been in their late twenties or early thirties.

But second and more important, I am a guy and this story speaks to me because it is eerily similar to the story of my online life with a bunch of other guys when I was between about ages fifteen and twenty-two.

I’ve mentioned before how I spent long portions of my life in the interactive geofiction/”micronation” community. And because of the innate urge for self-presentation, I emphasized the part where we create amazing grand-scale fictional universes in which we enact epic battles and build civilizations from the ground up. And not the part where we behave like ridiculous little children having a hissy fit.

The first constructed country I was ever in, another guy named John from my school comes in and says that I am a bad leader and abusing my power. Because my online handle at the time was Giant_Squid314, he classily nicknames me “Squitler” and leads a bunch of his supporters to make “Squitler” related comments at everything I do. Then he and his friends secede to start their own country, named after a Red Hot Chili Peppers album. I retaliate by convincing his friends that he is oppressing them and they need to start a communist revolution to kick him out of the country, which works. Later he gets back in and convinces his friends to join my country under fake names, swelling the ranks of voters with people who are there just to vote for the worst policies in order to destroy the country. This becomes so bad that my friend Evan pulls a bloodless coup to abolish democracy and make himself sole leader, but then he cracks down so hard on John’s supporters that everyone gets upset and leaves (“emigrates”). This upsets my friend Bill, who somehow hacks John and tries to delete all his stuff; John counterhacks Bill and destroys his country. Then we all team up with a bunch of guys from Ireland, infiltrate John’s country and destroy it the same way he destroyed us as an act of revenge.

All this happened within about three months real-time, and I was in this hobby for ten years. Ten years.

There was an entire era when people would accuse other people of having said racist things on IRC (where logs were often unavailable, and context was absent). This would then be followed with the demand that every political ally of the affected person shun him forever and kick him out of the country and destroy every institution he had built, or else obviously they were secretly racist themselves. This was met with the only possible response: “actually, no, you’re the one who said racist things on the chat!”. These accusations often resembled the MsScribe story in their sheer not-entirely-social-justice-movement-approved incongruity: “You’re racist, and you’re a fat lardass!” “Oh yeah? Well you’re a f**king homophobic autistic Aspie who will never get laid!” Inevitably the more popular person would win and anyone so foolish as to defend the unpopular person (which I kept doing, because I never learn) was banished to Racist Hell. As for Actual Hell, there was a guy named Archbishop Fenton who kept saying really extreme Christian stuff about how we were all going there, and although we all suspected he was a sockpuppet I was never able to figure out whose.

So MsScribe? I’ll give her this: she was a gifted amateur. That is it. An amateur. We had frickin’ decade-old “intelligence organizations” whose entire job was to collect a network of spies – some real people, some sock puppets – who would join other people’s countries under fake (or real!) identities, get information on their secret plans, and throw important elections in favor of the parties we supported. I’m not even ashamed of my role leading one of the largest of these organizations, Shireroth’s spy bureau S.H.I.N.E. – if we had unilaterally disengaged from these kinds of games, we would have been demolished by people who didn’t.

I remember our scandals. We would build up “dossiers” on various individuals, then publicize them at times calculated to cause maximum damage. One of my favorite was when a prominent female politician was revealed to in fact be male – causing her support to plummet among the key “people who do whatever a girl says in the hopes that she will like them” demographic. In another, which happened a bit after my semi-retirement, the micronational world’s largest communist country, with thirty highly active citizens and a prominent international role, was found to be just one guy posting under thirty different names.

As leader of an espionage organization, I was expected to be able to avoid these damaging revelations, advise my countrymen on how to do the same, and run circles around my enemies. Without tooting my own horn too much, I maintained my most successful character for the better part of a year. This was a guy named Yvain, who infiltrated a Celtic-themed fantasy state called the Duchy of Goldenmoon, took it over, took over its largest neighbor, and was halfway to ultimate power over the entire continent before I got accepted to medical school and decided I should probably reassess how I was using my time.

(to create a paper trail and avoid breaking character, I used the nick “Yvain” for a lot of the websites I joined around this period, which is why half the Internet still knows me by that name. I am suitably embarassed by this)

Now I will say this for us boys – and we were boys, like 95% of us, and even the girls were usually found to be boys after careful investigation. We did it with class, we did it with cool names like “Paramountgate” and “The Three Hours’ War”, we wrote up our petty scandals into epic history books with bibliographies and appendices, and we backstabbed each other so elegantly it would make Machiavelli shed a single tear of pure joy. But in the end? We behaved exactly like teenage girls in a Harry Potter fandom.

It is hard at this point not to be reminded of the Robbers’ Cave experiment. Social psychologists divided boys at a camp into two groups, intending to do some experiments in order to figure out what they needed to do to make the groups hate each other, only to learn that the boys had already started hating each other with the burning fire of a thousand suns while they were busy planning the experiments. They boys had even formed little group identities, like “Our group are the rough and street-smart ones, the other group is a bunch of holier-than-thou goody-goodies” (the groups were chosen at random).

I read a lot of psychology even as a teenager, so it never surprised me that separating people out into different fictional countries would have the same effect.

But it did kind of surprise me that you could get quite those depths of hatred between people who thought that a fictional wizard should hook up with his best friend, versus other people who who thought he should hook up with his other best friend’s little sister. Every time I feel like my opinion of people is sufficiently low, I get new evidence making me bump it lower.

Anyway, once those depths of hatred are established, they will proceed in the same way among twenty-somethings trying to discuss Harry Potter romantic pairings, teenagers trying to run fictional countries, and Senators trying to pass vitally important legislation. And that’s why, if aliens ever requested exactly one item to teach them about the human race, I would give them the MsScribe story.

They’d kill us all, of course. They would sterilize Earth so thoroughly that not even the archaeobacteria would remain. But in the moment before I was vaporized, I would feel like our species had finally been understood.

I.

One of the downsides to working in psychiatry is that it is slowly but inexorably sapping away first my enthusiasm about, and now even my willingness to, have children.

Medicine was bad enough. It wasn’t the kids who get leukaemia at age seven and die who got to me. It was the ones with syndromes. Down Syndrome is the one everyone knows about, but by no means the worst. Lesch-Nyhan Syndrome is a lovely little condition in which children are born without the ability to metabolize uric acid properly. The results include severe mental retardation, stereotyped jerking movements of the limbs, face frozen in a permanent grimace, and something the textbooks charmingly refer to as “involuntary writhing”. For poorly understood reasons, these children also exhibit “uncontrollable self-injury”, usually head-banging and trying to bite any part of their body within reach of their mouth – something caregivers quickly learn not to let parts of their bodies be. Oh, and also vomiting, spitting, and uncontrollable urges to use profanity.

(for a fun intellectual exercise, imagine what arguments might be able to convince William of Ockham that “deficiency in uric acid metabolism” is a more parsimonious explanation for this syndrome than “possessed by demons”)

The disability rights crowd will probably call me ableist, or disableophobic, or misodisablistic, or whatever people say these days, but the idea of having a child with Lesch-Nyhan Syndrome, and having to take care of him until he dies (likely in his teens; it’s not a very survivable disease) or gets old enough to go off to a group home – that terrifies me. I worry I would spend every second of every day hating my kid and begrudging him the countless hours and tens of thousands of dollars I would be spending on him, all while maintaining a smile both to him – because goodness knows he has it bad enough already without having to cope with crushing guilt and parental enmity – and to the rest of the world – so I could get my official status as Brave and Kind Long-Suffering Caretaker, instead of Ableist Jerk Who Kind Of Wishes He Could Just Put His Kid Out Of His Misery And Get On With His Life).

(note: I use the masculine pronoun not unreflectively, but because Lesch-Nyhan is x-linked recessive)

The good news is the incidence of Lesch-Nyhan Syndrome is only 1/400,000 births. The bad news is that if it’s not Lesch-Nyhan Syndrome, it could be Treacher-Collins Syndrome. Or DiGeorge Syndrome. Or Cornelia de Lange Syndrome. Or any of a thousand others. Have you ever seen a Pediatric Genetics text? They’re not small books.

And not all of these are Lesch-Nyhan-level bad – I like playing with Down Syndrome kids. But I would still be unexpectedly finding out that what I thought was just a perfectly normal super-gargantuan committment to sink most of my resources into a mostly-helpless creature for twenty-five years would in fact become, without my planning or consent, a super-ultra-titano-gargantuan commitment to sink even more of my resources into an even-more-helpless creature indefinitely. And all the associated dreams – of seeing my kid get grow up and raise a family, of debating the great questions of life with zir, of secretly training zir to be a child prodigy who does calculus at age five like John Stuart Mill – would all be gone. I am reluctant to say “all the things I look forward to about having a kid”, because someone will lecture me about how I should want to just gaze deep into my child’s eyes, loving them unconditionally as a human being in the image of God. But as the saying goes, we can do what we want but cannot want what we want. Also, eye contact is scary.

But at this point it’s not even the syndromes that worry me the most. The kids with syndromes I’ve met are nice people, I like them, and if it came to that I’d at least have great social support from my amazing friends.

Right now what scares me is psychiatry.

II.

I remember vividly the first time I met my first antisocial personality disorder patient with perfect parents.

The dad was a something something manager at Ford. The mom was a high school teacher. Both from middle class backgrounds, never been in a fight, never been in jail, never even used drugs. Two other children at home, one of them working on college applications to nice schools, the other getting As in junior high and playing in the band.

Their oldest kid was in the psychiatric hospital where I worked because…actually, no, I can’t remember what he was in for, the particular time when I met his parents. It could have been the stabbing people. It could have been the constant drug use. It could have been lying like a rug to the police. And as I was explaining whichever the latest disaster was to his parents, on their faces was just this look of heartbreak mixed with total lack of surprise.

I’d seen dozens of patients worse than this guy already, but they’d all been easy to brush off as something that could never happen to me. Either their parents were just as bad as they are, or they’d been beaten as a kid, or they had a history of sexual abuse, or something else where it was very easy to say “Aha! I will just not attack my children with broken beer bottles when I am a father, and then they won’t turn out this way.” Or since technically I’m supposed to be kind of a genetic determinist, I could just not have terrible person genes, and marry someone else without terrible person genes, and our kid would be okay too.

This guy’s family – and he was the first of several – didn’t give me any of those easy outs. You can do everything right in the world, and your kid can still grow up to be a murderer, or a rapist, or just one of those guys with a tattoo of a skull and a nickname like “Snake”.

I like the metaphor of “the genetic lottery”, but on the worst days it starts to feel more like genetic Russian Roulette. Maybe the first kid is beautiful and grows up to be a scientist, the second one is compassionate and becomes an artist, and then boom, the third one vivisects stray cats and tries to burn the house down. But it’s too late to return her for store credit; you’re morally obligated to spend twenty years taking care of her and sending her to special schools and taking late night calls from the police and paying her bail, all in the desperate hope that maybe one day she’ll shape up. Like I said. Russian roulette.

III.

I get irrationally angry whenever I hear people diss discipline. Like, if you just believe spanking is often bad for children, then that’s fine and as far as I can tell empirically correct. What bothers me is the people who see someone spank their kid and say “What that parent really needs to learn to do is talk things out. If they would just learn to communicate with their kid, the kid would learn that what ze’s doing is wrong, apologize, and none of this violence would be necessary.” This is the sort of statement that makes perfect sense if you’ve never been in a position where you had to control a genuinely bad (or even mediocre) kid.

(as such I am suspicious of its signaling value. That is, I worry that saying children should never be disciplined harshly is a way of saying “Ha ha, my children are so great I never need to discipline them. And there you are with a bad apple. Chump!”)

Don’t get me wrong, there are lots of problems with parents abusing kids under the excuse of “discipline”, and the idea of an unelected and unaccountable individual being able to hurt someone else whenever they want is terrifying. It might be that a Congressional bill to ban all discipline stronger than dirty looks would on net be a good thing. But when people try to push it by saying “If you just demonstrated your love and affection, you wouldn’t need any discipline” – that’s what gets my blood boiling.

I think this dates from my time as a schoolteacher. When I was a student, I hated all my teachers and thought that if they just ditched the constant repetition, the cutesy but vapid games, the police state attitude, then everyone would learn a lot more and school would finally live up to its potential as “not totally incompatible with learning, sometimes”.

And then I started teaching English, tried presenting the actually interesting things about the English language at a reasonable pace as if I were talking to real human beings. And it was a disaster. I would give this really brilliant and lucid presentation of a fascinating concept, and then ask a basic question about it, and even though I had just explained it, no one in the class would even have been listening to it. They’d be too busy chattering to one another in the corner. So finally out of desperation I was like “Who wants to do some kind of idiotic activity in which we all pick English words and color them in and then do a stupid dance about them??!” (I may not have used those exact words) and sure enough everyone wanted to and at the end some of them sort of vaguely remembered the vocabulary.

By the end of the school year I had realized that nothing was getting learned without threatening a test on it later, nothing was getting learned regardless unless it was rote memorization of a few especially boring points, and that I could usually force students to sit still long enough to learn it if and only if I bribed them with vapid games at regular intervals.

Yet pretty much every day I see people saying “Schools are evil fascist institutions that deliberately avoid teaching students for sinister reasons. If you just inspire a love of learning in them, they’ll be thrilled to finally have new vistas to explore and they’ll go above and beyond what you possibly expected.”

To which the only answer is no they frickin’ won’t. Yes, there will be two or three who do. Probably you were one of them, or your kid is one of them, and you think everything should be centered around those people. Fine. That’s what home schooling is for. But there will also be oh so many who ask “Will the grandeur and beauty of the fathomless universe be on the test?”. And when you say that the true test is whether they feel connected to the tradition of inquiry into the mysteries of Nature, they’ll roll their eyes and secretly play Pokemon on their Nintendo DS thinking you can’t see it if it’s held kind of under their desk.

I don’t think I used to be an optimist. I think I used to be a narcissist. I figured that when I was a teacher, everything would work out, my kids would be kind and attentive, my lessons would stick, and there would be no behavioral problems or if there are they would quiet down after I give them a friendly talk about why attention is important. I felt like the Universe owed it to me to have everything work out. I didn’t realize on a gut level that kids could just not cooperate.

The parents who pooh-pooh strict discipline have the same blind spot. It’s an easy blind spot to have if your own kids are wonderful. It’s hard to realize that you can just ask them to behave until you’re blue in the face, set strict limits, send them to bed without dessert, and the kid can just choose to not behave.

And we’ve come a long way from Lesch-Nyhan Syndrome here, but these all tie together into a complicated knot of worry. It’s a fundamental realization that I could have a kid I can’t fix. Not in the “I want her to be a businessperson but she wants to be a poet” sort of way, but in the “I want her to not vivisect cats for fun, and she wants to vivisect cats for fun” sort of way. Someone whom I lavish all the love in the world on, and give exactly the right dose of prenatal iodine, and whatever, and the universe just says “Nope, you’re stuck with this person. You should have thought of that before one of your sperm had a single nucleotide mutation in an out-of-the-way corner of the genome”.

I have a serious girlfriend, and I’m only two years younger than my father was when he had me, and all my friends are having kids, and I really want children, and I have no idea what I’m going to do.

Suppose I were to come out tomorrow as gay.

I have amazing and wonderful friends, and I certainly wouldn’t expect them to hate me forever or tell me to burn in Hell or anything like that.

But even more than that, I think they would understand and accept the decision. There would be a lot of not-so-obvious failure modes they could fall into, but wouldn’t.

For example, I don’t think any of them would say something like “Oh, obviously you just haven’t met the right woman. I know this really cute girl Alanna, a friend of my sister’s. I’ll introduce you next time she’s around.”

Or “You must have just had a bad experience with women growing up. Maybe you always got into fights with your mother as a child. But there’s no reason to let that control you now.”

Or “But…but…women are attractive! How could you not be attracted to people who are attractive? That’s just silly!”

Or “You know, I’ve hung out with you a long time. You’re not into drama, you don’t wear flamboyant clothing, and you don’t speak with a lisp. You really have all the signs of someone who should be heterosexual. Maybe you’re just wrong about this whole ‘gay’ thing?”

Or “Don’t you realize how important heterosexuality is? Heterosexuality is responsible for childbirth, for most of the love poems throughout history, and for the nuclear family. How can you not recognize that being straight is better than being gay?”

No, there are a lot of things my friends are far too sophisticated to ever even think about saying if I were to announce something as prosaic and socially acceptable as being gay.

But announce that I don’t like math, and suddenly the knives come out.

II.

It’s not that I don’t recognize that math is awesome. If there were “Pray the lack-of-interest-in-math away” camps, I would totally go to one. But just as a gay guy may recognize the many ways his life would be easier if he were heterosexual but this recognition does not immediately lead to finding women attractive – so discoursing on the beauty and importance of math does not suddenly make math books any more readable to me.

Certainly I love the sort of math that doesn’t involve doing actual mathematics. I love reading about Moebius strips and Klein bottles, discussing the implications of Cantor’s discoveries about infinity, even playing around with fractals and tessellations and other forms of mathematical art. It’s just that when you put actual equations in front of me, with numbers and symbols and variables, my brain melts.

I mean, I’m not terrible at math. I managed to scrape together an A in Calculus II, the last math class I was required to take and not coincidentally the last math class I ever took. I did it by memorizing the algorithms involved and plugging things into them, all the while desperately praying that there weren’t any deviations, however minor, on the test. This isn’t normal for me. In every other field, concepts slide naturally into my mind and I can manipulate them however they want, like fitting a bunch of Lego blocks together to make limitless possibilities.

But math is like constructing a Lego set on a picnic table outside in the middle of a thunderstorm. I grope blindly in the pouring rain for the first piece, and finally put it in place, but by the time I’ve found the second piece and move to connect it to the first piece, the first piece has blown away and is nowhere to be found, and the instructions are sopping wet, and the picnic table has just been carried away by a tornado.

I don’t know if it’s that I’m bad at math, or that I just don’t enjoy math enough to be intrinsically motivated to pursue it. I do know that I have never become good at something – good good, not “scrape together an A in a mid-level college class on it good” – without having intrinsic motivation to pursue it. And my attempts to hack intrinsic motivation, which would be like a instant win condition for everything if I could achieve it, have been mostly unsuccessful and left me with severe doubt it is even possible. So I have pretty much given up on math.

When I try to explain this to people, the responses are eerily similar to the ones they would never give if I said I was gay.

“Oh, obviously you just haven’t learned the right kind of math. I know this really cute proof of the Pythagorean Theorem in my sister’s textbook. I’ll show it to you the next time we have pencil and paper.”

Or “You must have just had a bad experience with mathematics growing up. Maybe you always got yelled at by your math teacher as a child. But there’s no reason to let that control you now.”

Or “But…but…math is interesting! How could you not be interested in a subject that’s interesting? That’s just silly!”

Or “You know, I’ve hung out with you a long time. You like rationality, you’re good at science, and you like analyzing things. You really have all the signs of someone who should be into math. Maybe you’re just wrong about this whole ‘not a math person’ thing?”

Or “Don’t you realize how important math is? Math is essential for statistics, for engineering, for science, for cognition itself! It’s closely linked to art and music and poetry! How can you not recognize that being into math is better than not being into math?”

And yes! I recognize it! Being bad at math is one of my biggest regrets in life! If I were building myself as an RPG character, things would look a lot different, believe you me.

My contribution to the “Scumbag God” meme

But I’m pretty sure this is a skill point kind of thing. I think it’s totally possible for people, even smart people, not to be into math. And I am constantly surprised that people who claim to be experts in evolutionary psychology seem to think it’s entirely plausible that natural selection would evolve gay people with zero interest in procreative sex, but find it totally outlandish that anyone could end up without a math drive.

And if they don’t have the skill points, telling someone to just try a little harder at math is like telling Tyrion Lannister to just try a little harder at basketball. Not only is he never going to beat LeBron James, but he’s going to get upset and frustrated trying, and it’s not his comparative advantage anyway.

III.

This whole “comparative advantage” thing took me kind of by surprise.

Some people have trouble believing in ‘g’, the idea that all intelligence is correlated. I’ve always had trouble believing in anything else. I would see people around me being able to solve complicated math problems effortlessly, and think “They are smarter than me. I am their strict intellectual inferior. There is nothing I could possibly contribute to their conversations.”

And when these people started going out of their way to include me in their conversations, when they started making friends with me and even admiring me, I was pretty confused. For a while I was suspicious. Maybe I just had a few talents that were impressive for someone who was bad at math, like a chimp that has no verbal thought but can still remember where it hid the banana days later?

The idea that intelligence wasn’t monolithic, that I could be much worse than them in proofs and theorems but still be their equal in other areas, was hugely liberating to me, but it took me a very long time to accept it, to believe that I really was as valuable a human being as they were.

And when I tried to analyzed my certainty that – even despite the whole multiple intelligences thing – I couldn’t possibly be as good as them, it boiled down to something like this: they were talented at hard things, but I was only talented at easy things.

It took me about ten years to figure out the flaw in this argument, by the way.

IV.

I remember gossiping about a friend who was really into the worst types of politics – the kind where you’re obsessed about whether the head of the Republican National Committee will cut funding to a representative who said something mildly contrary to what someone else wanted him to say – and somewhere in the middle of the conversation my tone switched from “Yeah, what a loser to be concerned about that kind of thing” to “Yeah, poor guy, apparently he drew the short straw in the Things To Be Fascinated About Lottery.”

Since then I have returned to the idea of this Things To Be Fascinated About Lottery a lot. There are some good draws you can get – people who are honestly fascinated with business and intrinsically motivated to pursue it only need high IQ and a few other subsidiary skills to get super rich. People who draw math can pursue perfect pure and philosophical truth or excel at pretty much any science they choose and advance human knowledge. People who draw science without math have a harder time – I think I’m one of those – but there are still places for them.

And then there are other people who get other straws. There are some people who are really into politics, and find science really boring. There others who couldn’t care less about politics or science, as long as their sportsball team wins the Sports Bowl. Ozy picked a straw and ended up fascinated with gender, which wouldn’t be so bad except that it means ze occasionally has to talk to the other people who are fascinated with gender.

But the thing is, I couldn’t choose to be interested in sports any more than I could choose to be interested in math or a huge sports fan could choose to be interested in psychology or a gay person could choose to be interested in women. I mean, there’s probably some wiggle room, maybe if I put a lot of effort into finding the most interesting sports and learning everything about them I could appreciate them a little. But would I have comparative advantage over the kid who memorized the stats of every pitcher in both leagues when he was 8? Barring getting hit by some kinda cosmic rays or something, I don’t think that’ll ever> happen.

I’d hate to turn this into a “rank which straws are best” contest, but some certainly earn you more money, some certainly help you contribute to the future of humankind more, and some certainly land you in healthy areas of study with nice people and mostly rational thought while others land you in diseased fields full of angry partisans. I wish I had landed in math.

But I no longer blame myself for not having done so. And when anyone starts telling me about how I’d love math if I only did it their way, I now only have a little twinge of guilt in telling them to go away.

But: they are a company, they have a website at http://www.metamed.com, they do personalized medical research, and they are officially launching today.

(they’ve been doing things for a bunch of people already, so it’s not like they’re completely new, but so far it’s been mostly unofficial)

I am usually a couple of steps away from customers, so I can’t speak much about that end of things. But I have been getting to do some research and occasionally just listen in on meetings, and it has been so much fun to listen to people who have this ethos that difficult medical questions should be solveable, who don’t make stupid mistakes or take shortcuts trying to solve them, and who have enough time and money to give them the attention they deserve.

A couple of weeks ago we had our first journal club. It was an attempt to evaluate the efficacy of antioxidants and multivitamins against cardiovascular disease and cancer. We got a bunch of contradictory studies, threw them all together, and started generating hypotheses about why they might contradict each other so much. It kind of fizzled out before we came to any strong conclusions, but in a world where some hard-to-determine number which is not ninety percent of medical studies are wrong, it’s exactly the sort of thing that should be done (also, in the course of the discussion, “buy antioxidant supplements” went on and off my to do list several times; it’s currently off but I have no idea how long that will last).

Now there’s a discussion going on about the biochemicals in ginseng which I have yet to finish doing enough research on to participate in intelligently. But I’ve skimmed through what’s been said and what’s most fascinating to me is that no one has fallen into the standard error modes of “This is labelled as ‘alternative medicine’, therefore we know it sucks without investigating it” or “This is labelled as ‘alternative medicine’, therefore we know it’s great without thinking about it”, a seemingly basic feat of rationality which people nevertheless manage to miss 99% of the time.

There are already a couple of sites that aggregate medical information and try to pull a few tentative conclusions out of the maze of studies. UpToDate is a good one; so is emedicine and (to a degree that surprises even me) Wikipedia. But they all have their problems. UpToDate is very expensive and mostly aimed at doctors; Wikipedia is on average very good but high-variance and proooobably not the sort of thing you want to make life-and-death decisions based on; emedicine is nice but the more second (and third, and so on) opinions you can get the better. And none of them are guaranteed to have exactly what you want – for example, when I was looking into antioxidants, none of them really analyzed the important and controversial SUVIMAX study, which I really would have appreciated some good commentary on.

If MetaMed can supplement some of those with its own brand of rationalist medical analysis, it will be a good thing. If it can fill a slightly different niche by doing personalized medical research on issues other information sources might lack for people with a little more money to spend, it will be a very good thing. And Zvi, Alyssa, Vassar, Sarah, et al seem to have even more ambitious – some would say wildly ambitious – plans for it which I don’t know much about except that I can think of much worse groups of people to be setting the future direction of the health care industry.

This year I’m trying again. I’ll hear back from hospitals in mid-March. I think I have a good chance.

But a good chance is not a perfect chance. And a non-perfect chance means there is some chance of failure. And this is utterly terrifying to me, to the point where I’m literally having nightmares about it and going a little bit off the wall.

The problem is that these job opportunities only come around once a year, and that if I fail a second time there’s not a lot of reason to think I’d do any better next year. In fact, there are a lot of reasons to think I wouldn’t; hospitals are usually less willing to accept people the longer they’ve been away from medical school, and they’re usually less willing to evaluate people they’ve already evaluated before and rejected. And there aren’t that many hospitals offering residencies.

So if I don’t get a job this time, I’m going to have to seriously consider the possibility that four years and thousands of dollars worth of medical school were a total loss career-wise and that I’m going to have to do something else. And I have degrees in philosophy and psychology and not a whole lot of obvious marketable skills. I will be totally back at square one with no idea of what to do with my life.

The rest of this entry is really emo and privileged and people who are actually having serious life crises will find it enraging, so if that’s you please don’t read it.

I am very lucky and grateful to have amazingly generous and far-sighted parents and grandparents who among many other things gave me saving bonds every birthday as a child which have since spent twenty-five years maturing. As a result, I don’t have the problems with medical school loans that you were probably expecting this post to be about, and I have enough money to live comfortably for some time period greater than a year and less than forever. So there will be no immediate crisis. I even have enough money (and/or loan-take-out-ability) to go back to school if I need to. But there is a definite long term “I should probably get a career path or something”.

And since I expect my mental state to be way too shattered to do any kind of planning or decision-making if I do get rejected, I figure I should figure out a backup plan now while I’m still sane so I can carry it out on autopilot if worst comes to worst.

I love working for MetaMed, but they are a very ambitious startup and it seems unwise to bank my entire ability to survive or ever have a career on them sticking around. Besides, just in case they get tired of me accidentally misrepresenting their positions or projecting general cluelessness at them, I should try not to have all my eggs in one basket. MetaMed has thus far not had more work for me than I can do in free time between other obligations, so “continue working for MetaMed but figure out something else to do full time” seems like an obvious best strategy.

It would be nice to work for MIRI in some way. I have a lot of friends who have positions sifting through academic literature for them, and it seems possible I could get something like this if I begged hard enough. But this seems a lot like MetaMed in being a good part-time addition to my workload and not a stable long-term career plan. Harder to explain but more importantly, I think a lot of my sense of “I am useful to people and not just a parasite on the world” would come from being able to donate some of what I made to charity, and if I’m taking my money from what is possibly the most efficient charity already this becomes kind of a farce. Probably also a “good if it works, but do in between something else” option.

I would really like something where my MD is not completely irrelevant. Glibly dismissing “sunk cost fallacy” ignores the likely fragility of my mental state and the fact that my parents and family are also going to feel much better if all the work they put into helping me through medical school isn’t just tossed aside. I have heard that many MDs go on to do a Masters in Public Health. This seems to be only a one to two year course, which is at least a heck of a lot better than having to spend another four years in school. Problem is, I have no idea what a Master of Public Health does, and whether there are likely to be any jobs in it. Anyone here have any experience in that area?

I feel overprivileged just writing this, but I could always just take the LSAT. I’ve been told that lawyers with MDs can get cushy positions in medical law, and although this sort of offends my sense of ethics and not-being-parasitic, a sufficiently good job could give me enough money to donate to charity to make up for that. I know it’s hard for lawyers to find jobs nowadays, but I’ve heard if you go to a good enough law school it’s still not so bad. I could plausibly hope for exceptional LSAT scores – I got a perfect score on the SAT verbal which I hear is similar – so that plus my MD might be enough to get me in somewhere really good. Then again, it’s another four years of very expensive education once again without a guaranteed job at the end of it.

I’ve heard another route some MDs go if they can’t get into clinical medicine is getting an MBA and going into some form of medical business. The fact that I have no idea what forms of medical business exist seems to put me at a disadvantage compared to people who have been wanting to do this their whole lives, plus I think everyone who knows me agrees I would be the worst businessman ever (“Honestly, as far as I can tell the evidence for our product working isn’t that robust, and I’m not sure it meets your particular needs anyway”). This is also one where I’m concerned about whether I would have a good shot at a job at the end of it. Getting business jobs seems to require networking and self-selling and self-confidence other things I am totally unable to do.

I really like biostatistics. I just happen to be really, really bad at it. I can fake writing about them pretty well, but in terms of actual number crunching they sort of slip out of my mental grasp just like all other math. I’m not sure whether going back to school to become a statistician would force me to learn it, or just end up with me failing out of school and being even worse off than I started. Also, once again I really don’t know anything about the state of the job market here.

That leaves non-medical jobs. Mike Blume pushes his idea of “learn programming on your own and make money as a programmer”, and I have to admit it worked for him and that programming strikes me as an extremely honest job with good working conditions. On the other hand,  I don’t know if companies actually give programming jobs to people with no experience beyond independent study, and I don’t know if I could actually teach myself programming. People say that programming is easy and any smart person can learn to do it, but these same people also tend to say that math is easy and any smart person can learn to do it, which makes me think either they’re just wrong or that I don’t qualify for the current definition of “smart person”.

I’ve always sort of wanted to be a teacher, and it’s a decent-paying, decent-status, not-*too*-unethical job. The fields that I would probably be really good at teaching (history, English, etc) are totally jobless, but I’ve heard there’s a big demand for math teachers. I’m bad at math compared to genuine math geeks, but I bet I could be better than high school students and probably better than the average math teacher right now (seriously, some of them are horrible), so going to school to get a teaching credential seems like a good non-medical option.

There are also some super extra backup options, like just going back to Japan and seeing if my old English teaching job is still available and whether I can just do that for the rest of my life.

I’m kind of curious if there are any obvious low-hanging fruit jobs around right now. People used to say that it was both easy and lucrative to become an actuary and they had relatively good working environment/status, but that loophole in the rat race seems to have closed up now. All the ones I know about now (Australian outback, etc) seem more like summer jobs for college students than lifetime careers. Are there any I’m missing?

Right now, if I don’t get a job I think my plan is to stay in Berkeley until June, possibly studying just enough programming to see whether I have any aptitude for it. Then do some clinical rotations in Internal Medicine at any hospital that will take me over the summer to see if maybe the Internal Medicine people are mysteriously more favorably disposed to me than the Psychiatry people. Once the summer winds down and the hospitals kick me out for their normal set of med students, I could spend the autumn applying to, in order of desirability: Internal Medicine residencies if they seem mysteriously well disposed to me, medical externships (yearlong unpaid medical resume builders), law schools, MPH programs, MBA programs, and whoever trains teachers (note to self: look that up). Then wait until next March and take the best thing I get into. If I get into literally nothing, and I have aptitude for programming, go into that. Otherwise, move back to Japan (or Korea? or Arabia?) and teach English (or stick around and work for MetaMed if they’re successful) to earn enough money to subsist while I continue applying to things.

This is a bad plan. I do not like it. I really really hope I get a residency in this year’s Match.