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Comment by cup | Hacker News Reader

This has been posted a number of times in different iterations on HN. I'm curious why the user group here has such a fascination with medical doctors.

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Engineers have a peculiar relationship with doctors. When they have need of one, and the doctor decides on a treatment plan for them, they think about the complexity of the problem space the doctor had to navigate to reach that decision. They wish the doctor would chart the parameter space for them, so they can agree or disagree with the choice in an informed manner, and have more of a clue about the competence of the doctor. This is usually not what happens, not to their satisfaction anyway, and it's deeply unsettling having to trust rather than know when it comes to something that appears so much like engineering on the surface.

An alternative title for this article might be "what doctors really think", and thus strikes to the heart of this issue.

I'm saving that paragraph. That was a fantastic explaination.

Or, as a (former) doctor, I love telling my engineer friends:

Intuition can't be formalized.

Part of the reason simply being the "system level" thinking that has to be developed, practiced and honed by any doctor worth his/her salt. And when you think of it, even with our current understanding of the human organism and the phenomenon called life, we are primarily working using 'heuristics', barely glimpsing the ultra-complex jigsaw that makes everything tick. Someday, when the ken of this knowledge is complete, we may be able to formalize the logic, albeit, the 'computer' it runs on, may well be as complex as our own brains!

Want to bet? I'll bet that in 20 years we will have programs that can diagnose a patient and explain how it came to its conclusions.

I had a doctor back in my home country who was fascinating. He would give me hard facts about everything and he would explain all the reasoning behind his recommendations with numbers, probabilities, etc., putting everything down on paper. I loved being treated by that guy. I wish every doctor were like this.

Here in the US I've only so far had the tipical experience of:

1) Telling my symptoms. 2) Observing that half of what I'm saying is being ignored - this pisses me off because I'm very obsessive about my health, so any interested doctor can hear me give them extremely accurate descriptions of what I'm feeling, and how those things relate to daily activities, eating habits, exercise, other symptoms and a number of other things. 3) Being diagnosed with something I'm very sure I don't have (and I'm right most of the time). It's usually something super generic, like "upper respiratory infection".

It has nothing to do with a fascination with doctors and everything to do with a fascination with death. Death today in first world countries is so far removed from what death ought to be, that it's almost unrecognizable. Dying in a sterile white room, in a building that houses thousands of sick people, with bad food, busy nurses, and often alone, is what I'd imagine a dystopian future from a Hollywood movie like Soylent Green would look like, but instead it's what Death looks like today. There is no need for this, and if most of us were asked in advance, few would choose it as the outcome. Yet very few people have living wills created, nor plans communicated with close family for these circumstances.

You can't avoid Death, it happens to everyone. So it's bizarre why so few people plan for the only truly predictable event in their entire life.

To be fair, in Soylent Green you died by opting for assisted suicide in an environment with good food, beautiful views and classical music. I'll go with that over a lot of other options. I'll swap the environment for home, and be surrounded by family, but yeah. Soylent Green was hardly the worst dystopia, I think.

I can only say why I shared it here:

I thought it would be of interest to hackers. That's what these doctors are doing...hacking the end of life.

Thanks for sharing. Reading and thinking about this makes me feel rather relieved about the 'Do Not Resusciate' status a close person to me had before dying.

I once had a conversation with some ER nurses about the best way to commit suicide. They took indeed a very hacker-like approach to the problem. Some of the suggestions were insulin or potassium overdoses. Maybe not what you'd expect as a layperson.

It seems like the go-to drug for terminally ill patients is often hoarded morphine or morphine derivatives, but death is slow and drawn-out, and someone might get the brilliant idea to resuscitate you, leaving you brain damaged and worse off than the situation you tried to escape from.

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