The Ones We Sent Away
theatlantic.com
theatlantic.com
Many of the clients are very aware they’ve been abandoned. Especially so because there are a select few who do get regular family visits.
It was crushingly depressing to work holidays and have the regular crew of kids that never went home or had visitors. If you work with adults it was significantly worse, many of them had no visitors for literal decades
Also those places pay terribly but I’m sure that shocks no one. When I worked there it was at one of the places known for paying very well in the industry and they payed 13/hr for children and 9/hr for adults (2010). AFAIK the rates are only 2-3 dollars more an hour now 13 years later
The unfortunate reality of working with populations that include severe developmental and intellectual disability, traumatic brain injury, dementia, mood disorder, etc is that impulse control can be severely impaired. This can lead to extreme and sudden violence that can catch you quite off guard if you are not prepared for it (and even if you are) and cause significant injury. The staff turnover rate and workers comp claims were crazy high as a result and part of the cause of the low pay (although there were many other major factors involved). It can be quite dangerous. Although to be clear this is absolutely not to suggest that someone who is mentally ill or disabled is inherently dangerous of course; this is a small subset of individuals whose functioning was impaired in such a way that made the likelihood of violent behavior significantly more likely. Often it was not intentional violence, more like a childish tantrum except with the body of an adolescent or young adult that could do serious damage. Although occasionally it was serious targeted violence too. I personally still have a permanent neck and spinal injury a decade later as well as a ton of scars from bite marks. I saw much worse. It’s not just some mild annoyance shit, it’s life changing ruin your body kind of injuries.
With that serious caveat the other issue is that there’s not really a “standard” name for these programs. They vary by level of care, by provider, by state, and sometimes even by county. But some examples from around me would be residential schools, residential treatment facilities, long term structured residences, etc. more generic terms are things like “group homes” and they’re all considered an extension of psychiatric inpatient treatment facilities.
Also fwiw depending on your state/locale there may be volunteer opportunities that offer training to help alleviate the above issues. At another program I consulted with later in my career they had volunteers who would socialize in this capacity. It was a really nice program; they would essentially go through a condensed version of the staff training. They wouldn’t do anything like restraints or things like that but they would teach them evasive maneuvers, de escalation techniques, and then train them on the clients a bit with staff before letting them do more independent socialization. Was really nice for the clients. The downside was the really difficult clients who had extreme behavioral issues tended to not get the service and they also tended to be the clients who got visited the least. But that’s the difficulty of the issue; when your behavior gets to that point you kind of need specially trained people around you at all times for safety.
And the thing is populations change the frequency of this a bit but not as much as you’d think. I’ve spent most of my career doing pediatric stuff, child and adolescent, with some stints doing adult work. All of those populations can have these issues obviously but it does tend to calm a bit with age in my experience. However, I have peers who focus in gerontology and dementia and have similar issues because of the impulse control issues that can come with that diagnosis.
I hope this doesn’t scare you off. I only hope to prepare you for the realities of the situation. I would hate to just post “oh yeah go volunteer” and have some kid bite you and have it get infected (human bites get infected super easily if they break skin, mouths are nasty!) or have your hair pulled and get your neck all messed up. You can do this and be safe if you are prepared and trained, you don’t need to be hypervigilant (that can actually make things worse), but you do need to be aware of your surroundings and know how to position yourself safely. That all said my suggestion would be to find a residential facility near you and contact them directly to see if they have any volunteer opportunities. If they just invite you they most likely have a population where none of this is a concern and you are good to go. If they offer training and you’re up to it go for it, you’ll learn a lot about safe positioning and de escalation techniques. If they ignore you I’m sorry, a lot of these places are overwhelmed and constantly short staffed unfortunately
My dad visited him as a kid. Uncle Charles had never been taught to read or write but he was an excellent chess player and (like his brother, my grandfather) could do complex arithmetic in his head. What a waste of a life for him!
On my grandmother's side, her youngest sister Jean wasn't allowed to marry because her job was to look after the parents when they got old. And when they passed on she had no skills as she hadn't been able to acquire any. What a waste of a life for her!
Most of 20th century Australia was tough.
If women died from the conditions, they could be buried in unmarked graves:
> In Dublin in 1993, the Sisters of Our Lady of Charity – owners and operators of the laundry in High Park, Drumcondra – had lost money in share dealings on the stock exchange; to cover their losses, they sold part of the land in their convent to a property developer. This led to the discovery of 133 unmarked graves. The Sisters arranged to have the remains cremated and reburied in a mass grave at Glasnevin Cemetery, splitting the cost of the reburial with the developer who had bought the land. It later transpired that there were 22 more corpses than the sisters had applied for permission to exhume, and death certificates existed for only 75 of the original 133, despite it being a criminal offence to fail to register a death that occurs on one's premises.[3] In all, 155 corpses were exhumed, and cremated
There was also unmarked graves for babies: https://www.bbc.co.uk/news/world-europe-60464447
(see also institutions in both Australia, Canada and possibly New Zealand for forcibly removing children from certain ethnic minorties, known as "residential schools")
This guy was (and still is) a serial entrepreneur. Really sharp. I would not be surprised to find out that he has used his visible handicap to lull people into thinking he was easy meat.
She's spent the last 20 years of her life living completely alone. She's the last one alive from her generation. Its a sad story.
White Stolen Generation here, checking in.
Can't stand the place, personally.
K=neuroplasticity is an emerging case of this phenomenon for the more recent history, I think the strength of the evidence is high there.
HN has also entertained in its top ranking some articles from Slime Mold Time Mold hypothesizing a K="what if the obesity epidemic has nothing to do with calories in vs calories out, and actually there is some toxin which the body has to sequester in subcutaneous fat and that's why everyone's getting obese" -- that would be a potential modern example, although I don't think that blog makes a very good case for it. (Lustig makes a better case on this front for K="our modern Western diet removes liver protection and starves our gut microbiomes" and I think you could make an even better case that K="the dangers of chronic low-level whole-body inflammation", with Lustig only gesturing at one part of that broader problem maybe?)
A major theoretical discovery of K="computers can't do XYZ" would be another such thing for all of us who in the modern world chase these fads about computers reinventing finance or art or the modern economy. You'd have people in the year 2100 saying "can you believe only 75 years ago, everyone would just believe that computers were magically going to fix X and then they wouldn't and everyone would suddenly believe they would now fix Y and then they wouldn't and then Z and they wouldn't and and and... straight faced rationalist businesspeople acting like 'Tech-Jesus is coming' on August 1st, oh sorry it's September 1st, sorry -- October 1st? November? Maybe in the coming year? well SURELY this decade."
Everyone loses weight on a caloric deficit. And "doubly labeled water" experiments show that people vastly underestimate how many calories they actually eat each day.
See this often cited paper: https://www.nejm.org/doi/full/10.1056/NEJM199212313272701
In a test of people who believed themselves to be diet resistant, every single subject lied about how much they ate when asked to self report.
> The failure of some obese subjects to lose weight while eating a diet they report as low in calories is due to an energy intake substantially higher than reported and an overestimation of physical activity, not to an abnormality in thermogenesis.
In my opinion the fact ozempic, which has nothing to do with calorie consumption or calorie counting but instead is a hormone working on satiety, tells me somethings wrong with the hormones of fat people. And I wouldn’t begrudge a fat person they’re overeating any more than I would begrudge a hyperthyroidic person their thinness!
A croissant is very calorific
Like I don’t know how much a portion of chicken is. But damn if I ate a chicken leg, and I feel like I ate nothing, I’d be sorely tempted to argue I didn’t have a full portion of protein… because it doesn’t feel like I did, in my body. I think that’s what’s happening to fat people. Otherwise drugs like ozempic wouldn’t be working like they do— the fat person doesn’t become suddenly honest on some dumb journal and suddenly the pounds come off! They just actually feel full when they should like normal people for once so their bodies are getting to normal people sizes.
This isn't something that's wrong with fat people, it's something wrong with the food environment they're in. 75 years ago your idea would have some intrinsic plausibility, as only a very small number of people had obesity. Now, in the United States, we're at a point where ~40% of adults have obesity. The explanation almost certainly lies with changes in the food environment, instead of with a huge portion of people catching an unknown disease that causes them to not know how much they're eating.
That's because in fact we do know about changes to food environment that could cause this. Since roughly the 1970s we've switched to foods that are more calorie-dense and less nutritious because they have become cheaper to produce. The relative cost of soft drinks and other sugary goods has increased much less than the cost of fresh vegetables, and in fact the industry has higher profits on these foods. I bought two liters of sugary soda for $1 the other day, that's a common offer at a grocery store near me.
If you drill down to how this is being accomplished, you'll notice that the rates of corn and soy production per person have vastly increased over the last 50 years. That's not because people are eating more tofu (which would be healthy), it's because (a) they're both used as additives or sweeteners (corn syrup), and (b) they're used as feed for animals who get turned into cheap meat at fast food restaurants. The US heavily subsidizes these crops - in fact they make up close to half of US farm land. As a result, the same (genetic) individual would almost certainly experience a much worse food environment today than in 1960.
People who aren't affected by this are those who are either (a) genetically blessed, and would hardly gain weight in any environment, or (b) are socially blessed, in that they are wealthier, live in places with a strong culture of exercise, and/or have easy access to nutritious fresh vegetables.
or c) are disciplined enough to count their calories and stopping when they hit 2,000 kCal/day or so.
https://en.wikipedia.org/wiki/Secret_Eaters?wprov=sfla1
I do understand that it can be challenging for many people to reduce their energy intake.
"Yeah. Weird. Well, guess I'll go have a donut or whatever and think it over. It's a mystery why they aren't just thin like us, must be a personal failing."
Most people do not count calories and calorie counts aren’t accurate anyway. The people sitting around counting calories because they have to are afflicted with the same thing that obese people are, they’re just putting in. A bunch of effort to manage it (or more likely actually aren’t).
The issue you are missing is that the real question is not “can we create a totally artificial situation where one of the outcomes is managed” but instead “why isn’t the system that manages this in healthy people working?”
In the counting calories example, it’s like saying the answer to diabetes is an insulin pump. People who d think this way are missing the point and basically are engaging in the shallowest of thought.
It is also incorrect, which is to say that there is only a vague relationship between the kilocalories reported on the side of the box and the actual marginal energy absorbed into your body. This is due to multiple factors. The most basic is measurement methodology: “count up the carbs in grams and multiply by 4 because this one ancient paper claimed that was the right fudge factor to average all carbohydrates with”; then there is the reality that the carbs described as “dietary fiber” on the label should never have been counted in the first place; add to this that the fudge factor for protein is also 4 kcal/gr even though it is known that proteins require twice the energy input from your body to be metabolized. If you're a physicist you're hoping for very clean simple measurements, “we put this into a calorimeter and burned it, or maybe we let some bacteria rot the thing in a sealed jar and monitored the oxygen in there” or something. The nutrition facts are nothing of the sort! (Related: the scale llliiieeesss, it lies, liar liar pants on fire how it lies.)
However the bigger problem is that it is insufficient. For instance if you are worried about health outcomes, like diabetes risks, it turns out that calories in minus calories out doesn't predict those well. Both Omega-3 fats and trans fats are given the same fudge factor of 9 kcal/gr, but one is significantly less healthy than the other.
It's not even terribly helpful to understand the full context of weight gain. Did you know that before our species grew up in Africa, our ape ancestors actually grew up in Europe? During this process they lost the ability to make an enzyme called uricase, which helps most other mammals eliminate a waste product called uric acid from the body. The loss of this enzyme is usually chalked up to, “those apes needed to put on a lot of weight really fast at harvest time before the winter came up”—google «uricase evolution» to learn more. So we actually have a hardwired tendency which most mammals do not have, to consume fructose and not consciously register those kilocalories as satiety signal, and instead we pack on those kilocalories as fat because of our artificially high uric acid levels. Wild stuff.
The physics curriculum does touch on this but in a strange place: it's the courses where we teach kids to analyze circuits made with nonlinear components like op-amps and transistors. So there's the thermodynamic fact of calories in, calories out... but it also comes with a sales pitch which is trying to provide a simple answer that would work for a linear system, “just perturb this input a little bit and you will get the corresponding output.” But nonlinear systems don't work that way!
CICO doesn't have any opinion on the relative satiation offered by sugars vs proteins, or bread vs potatoes, but it turns one's diet into a marketplace for satiation, which does teach which foods are the best "value" per kcal (even if a kcal is itself very inaccurate).
Maybe we'll see it as a dated but situationally valid tool, like leeches or "Red sky at night, shepard's delight".
But remember this was a thread about a game where you think about these “K factors” that make us laugh at history, and imagining ourselves being laughed at and what sort of K-factor could that be. When I play this game, it's not really truthfinding, it's fun because it's kind of a constructive way to direct a conspiracy-theory impulse that wants to deny a mainstream view by latching on to all of these little details. By declaring myself as the sheeple up-front, the end place is always Socrates’ “well, at least I know that I don't know!”
In that vein, it is fun to think about SMTM’s thesis or, say, K=“obese people literally have a hormonal imbalance H which makes them feel like shit, and them feeling like shit is why they eat and don't exercise, and these people in the past just thought they would cure the problem by making obese people feel EVEN MORE like shit and the less it worked the more goofy shit they tried!”
It's not that this is something I know to be correct, it's not. But if this became the mainstream scientific view 100 years down the line, they would laugh at me trying to do a smoothie cleanse and drinking kale-ginger-cinnamon grossness, “they didn't know that they just needed more lycopene hahaha that green glass is the wrong color!!” and it's fun to imagine yourself as ridiculous. “Well shit, my conspiratorial instincts have generated an alternative explanation to my preferred one and I don't know what is true, haha, see me walking around like some smarty pants knowing nothing.”
Finally off of everything and it was fucking brutal. My life is a pale shadow of what it used to be. Relationships and finances burned to the ground.
Engaging with the mental healthcare system was one of the worst decisions of my life.
This might be a higher-level thing that you mean given that I'm not sure it's something "provable" or "disprovable", but I'm constantly amazed how incredulous people are that I don't expect any car to be fully self-driving (like in the sense that there wouldn't even need to be a steering wheel and someone without a license could ride in it alone) any time in the next few decades. To be clear, I'm not claiming that it's something that _definitely_ won't happen, but I don't think it's super likely, whereas the vast majority of people I share this opinion with (even people with similarly high levels of technical expertise) seem to think that it's almost a foregone conclusion that this will be solved within maybe 30 years.
Personally i see the current limits to rollout as ones of hardware cost, but this is steadily declining.
At this point, driverless taxis are more science fiction than reality for a supermajority of Americans, let alone the rest of the world.
Meanwhile up in Canada, I'm still struggling with the fact that google has completely mislabeled two of the streets that touch my corner lot, and invented a through street that has never existed on my neighbors property. All of this is information that I have submitted a correction to, as well as being available through our excellent public GIS system.
The existence of these sorts of ambiguities in the map, and in the real world means that driverless taxis will be doing exactly what the poor pizza guy does periodically and wandering down my dead end road thinking they are on a completely different street. Luckily the pizza guy has the ability to knock on my door and get directions, while a driverless car will just... turn on its flashers and block the road as far as I can tell.
When driverless cars can operate in Salt Lake City, a city that is incredibly tech friendly, low regulation, car centric, but with genuinely bad weather I will be impressed. In the meantime I would settle for more frequent bus service.
those cars could be in every city and they’d run great (except snow. snow is tough, rain not so much)
but why aren’t driverless cars there?
It’s been decided you want a perfect track record, as close to flawless - to appease regulation bodies.
regulation is what kills and regulation is the biggest fear. The cars and tech are always getting better, the ‘slowness’ is deliberate, the bet is on the future.
The inability to operate in conditions where people are most likely to not be able to use active transportation seems like a pretty major flaw.
This is why I feel China will be the first to have unlimited self-driving. They would be able to treat self-driving cars the way that we treat trains: liability on the person hit by the train, so long as the train was functioning properly.
https://slate.com/news-and-politics/2015/09/why-drivers-in-c...
This isn't an accurate description of SF, but more importantly, the sun doesn't come out at night.
My point wasn't that sunshine specifically helps, but that the complete lack of snow, ice and other roadway altering weather conditions is a serious asterisk that needs to be solved before this technology can be moved out of Beta for most of the US.
Self_driving cars seemingly can't handle snowy conditions. 70% of the roads in the US receive at least five inches of snow per year. (https://ops.fhwa.dot.gov/weather/weather_events/snow_ice.htm)
Don't trust anybody that believe they can predict the future.
I often remind myself that the Australian aboriginal people, the previous members of what was once a fantastic civilisation, had a sense of anti-bacterial properties of plants and things, and often treated their frail and ill in interesting ways which we, 'modern' Europeans, misinterpreted as "primitive hysteria", because everyone know: 'miasma theory was real, whereas the primitives are just cooking themselves'.
So much life lost to those who always, always know best and never question themselves, really...
skip his diet ideas. He’d tell you your baseball team lost because the humidity was too high when in actuality half the team is out sick with the flu. He ignores basic obvious reasons. Always a zebra when he thinks it’s never a horse…
I like to think in 40 years or so that people will look back on radiation and chemo like bloodletting.
Chemo and radiation - at least 10-ish years ago - were pretty close to straight up killing yourself...
As somebody currently used to mediterranean/french cuisine, and seeing what typical american eats and drinks, and how much, its definitely this. Plus idiotic car-first culture, compare it to how say Amsterdam looks like. And compare how local people on streets look like.
HFCS, hectoliters of sugary drinks, pizzas and other fast food in quantities beyond ridiculous. Obviously bad diet messes up your gut biome, which adds to bad stuff happening but is not the primary source. More stressful lives don't help but same applies.
in a similar vein sending your own children away to abominable, putrid institutions at the advice of pastors for being LGBT+ is something still a thing in some.circles.
it's beyond me how such doctors and pastors did and do get away with that inhuman cruel "advice"
The social pressure to commit your child to such institutions was very strong in addition doctors told them that it would be for the benefit of the child and they were acting selfish.
We need to be careful when passing judgement on those who did listen to why society told them.
https://en.wikipedia.org/wiki/Rosemary_Kennedy
https://en.wikipedia.org/wiki/Nerissa_and_Katherine_Bowes-Ly...
>that neurotypical siblings would suffer—from shame, from attention starvation—
>if their disabled siblings were kept at home.
There is alternative perspective of "Young Carers" or "きょうだい児" in Japanese.
https://en.wikipedia.org/wiki/Young_carer
I don't think it was a easy choice then, or easy choice now.
Seems to be a relevant subreddit. https://www.reddit.com/r/siblingsupport
If you have a good childhood you grow up into an well integrated adult with no issues. However, if you are having a bad childhood, not only you have the process disrupted for you but it also cascades into your family, in this case siblings. That's because the childhood is so social, and it is often the bad kind.
Many of non-neurotypical (or even physically disabled) children could grow up into integrated adults, it would just take somewhat more time. However, they often don't have access to that time as they are isolated and sidelined by the social structure.
Adult don't care about each other or meddle in each other's affairs, but children would. That's often deleterious.
Not only has my family had some of this, I know of many, many others.