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tpfour

310 karma · joined December 4, 2017

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tpfour··on Being a programmer will make me a better doctor
I have family who are MDs and I have been working with MDs for over 5 years. I have always felt the same, but usually MDs don't agree that much - feeling special is part of the meme I guess.

I do feel, however, that the converse would not work as well: most MDs I met do not practice the "abstract" thinking that is required to be a successful programmer. But that's just my experience.

tpfour··on Canada to bar entry to non-residents (except US)
Because that's not the federal government's problem. They are mostly interested in: international relations, facilitating business and the economy (trade deals etc), making sure shipping flows freely, defence, etc (you can find a list of all provincial vs federal competencies online). The healthcare systems are run by the provinces, even if the federal government took the liberty to redistribute tax monies to provinces for their own healthcare, subject to federal govt conditions, as well as assure service to some populations (first nations, veterans, etc).

Trudeau has even stated that he thinks each province should be acting on that since they're competent wrt healthcare. Borders are under his control, yet weren't seen as a particularly pressing issue as I highly doubt (as we have, I believe, clearly seen) that this was even on his daily agenda before a few days ago. He went from 0 to 100 in a day. Just yesterday he was serving the same old same old.

There were a bunch of statements made by some of his ministers on Twitter. Overall bad handling of what should have been a no-brainer. Premier Legault had to publically call Trudeau out multiple times on his inaction. That kind of thing shouldn't happen.

tpfour··on What we can learn from the 1918 flu pandemic
If you are part of a high mortality rate demographic, you are better to get it first in your demographic to have a better access to resources (or very late when the resources are back under control). The issue is not really the virus per se, but its effect on the healthcare systems. That is something health systems work with _every year_ with flu season, nothing new under the sun. What's different is _nobody_ has immunity to this virus, and a lot of people initially dismissed the virus, or are still dismissing the risks.
tpfour··on Clojure: A Lisp that wants to spread
Gerbil Scheme allowed me to be productive in Scheme. It really is a treat to work with. No tooling required other than compiling Gambit, Gerbil and having a text editor. Those three things let you ship fast binaries, with static or shared libraries. Couple that with a nice macro system (a la Racket) and you can get going really fast.
tpfour··on Racket-on-Chez Status
Racket is more of a meta language. For another example, see Gerbil Scheme (cons.io). It is a meta language written on top of Gambit Scheme. Gambit was chosen because it can compile to portable, efficient and fast C code. Gerbil on Gambit currently tops the R7RS benchmarks [1].

Actually, Gerbil used to be written on Racket. As you can see, it now benefits from Gambit's strengths without having to re-implement them...

[1]: https://ecraven.github.io/r7rs-benchmarks/

tpfour··on Clojure – Fascinated, Disappointed, Astonished (2016)
You never spent much time with it and the parens are a major impediment? If you cannot overcome the "parens" (non) issue, I suppose the language is not for you. It really is not an issue, _at all_.

I don't say this to be demeaning! I would say there are far more chances you really enjoy the language than not. Give it a try and stop worrying about the parenthesis and start thinking in terms of an AST.

    (let ((x 0)) (+ x 1))
If you want Python that's fine but there is definitely no problem with parens in Lisp/Scheme :)
tpfour··on Clojure – Fascinated, Disappointed, Astonished (2016)
You can modify the reader to do that but then you can also just write Python.
tpfour··on Clojure – Fascinated, Disappointed, Astonished (2016)
Not everyone uses plugins. I don't have autocomplete but my parens flash when they're paired. I like it.

You write the parentheses because they have meaning. I can understand your frustration but I don't think you gave lisp a fair chance if you are asking "why parens".

    > '(this is a list)
    > this is a list
These don't have the same meaning. The computer can't know what meaning you want to give to the code beforehand.
tpfour··on Physician burnout widespread, especially among those midcareer, report says
Not really IMO as that has a certain level of subjectivity that could lead to endless argumentation. What's truly needed from my limited perspective is democratization of medical schooling. I've met MDs who are trying to make it with their startup who only went through medical school because of other people's expectations and an immensely stressful sense of sunk cost that had to be avoided at all cost. If they could have studied 2-3 years and then made the change to programming, for example, that would have made much more sense to them.

I take issue with the closed entrance door policy. I'd rather see selective internships than selective pre-screening.

tpfour··on The few remaining uses of the name “Macintosh”
Of course I am concerned with creativity on an intellectual level, not necessarily related to painting or sculpting or other arts.

Curiously the MDs I work with have been relatively unanimous about this: there is a variability in cases and you do, in a way, have to be "creative", but in a very limited sense of what that means. "Creative" in your analysis. Some thought that was a boring aspect of the job, some thought that was the whole point.

What kind of creativity could you demonstrate in the OR?

tpfour··on Physician burnout widespread, especially among those midcareer, report says
I've been working in the field (software side) for a while and it is a little bit complicated. Some medical procedures absolutely require constant practice to maintain a very high level of quality and safety. Others don't. If you grow the number of residents by 10x, the total number of cases won't follow and you can end up with a more dangerous situation overall as every physician will be less qualified by virtue of practising less. That varies by specialty.

There is also the money. Sure you can train 10-100x physicians, but total compensation won't grow as fast, and so you should see lower overall wages (supply and demand). But it's still more complicated than that, because some people choose not to undergo X or Y procedure for various reasons, insurers don't cover or whatever. So even if you could train enough doctors to fulfil the whole population's needs, that doesn't mean you will have: 1. enough equipment, material, operating rooms, etc to do the procedures 2. enough supporting staff, and on and on.

The most common reason I hear from MDs against training much more doctors is the first one I gave you: less practice means a more dangerous practice.

My own opinion is relatively simple. Medical schools should stop screening applicants as much and let students join freely.

Medical schools are all about getting well-rounded individuals who did extra-curriculars etc. They usually view it as a good thing that you have life experiences outside of medicine, like working or studying an entirely different subject. However it works one-way: you can't (generally) just go to med school, learn the subject matter and then move on to another field, enriching _that_ one with your experience. I have come to believe that if we are to see any improvement, med school will have to open up just like every other discipline. The current system of stressing out students for a few years before even being allowed in the classroom is, IMO, partly responsible for the job dissatisfaction that you see.

Now freeing up med school admissions does not mean allowing everybody to _practice_ medicine. Prospective students would actually get a chance to learn the material for a few years before having to interview for internships. So instead of filtering _before_ med school and forcing a huge sunk cost psychological barrier to students, you can let the students figure out by themselves if they actually enjoy the subject matter. It's not a perfect solution but I am quite certain that society as a whole would benefit. It is entirely unfair that medical knowledge (not practice) is restricted to a lucky few.

tpfour··on The few remaining uses of the name “Macintosh”
That's a very interesting perspective, thank you!
tpfour··on The few remaining uses of the name “Macintosh”
I also have experience with something of an EMR, both from the implementation/standards side and the buying side. It is a complete and utter mess. The amount of cruft is insane, and service is very poor (nobody masters the subject, so you get the poor support). It is very tiresome.
tpfour··on The few remaining uses of the name “Macintosh”
Thanks. I'm specifically not concerned about money (other than tuition if it comes to that). Not that it is unimportant, but I won't bring any to my grave.

As I've gotten to do business, negotiations, and dealing with "money" more, I became kind of disillusioned to the power game. It's not always as fun as commonly portrayed and medicine seems like a very demanding but cool job. Maybe the grass is just greener and it gets as boring (if not more due to the lower potential for creativity).

tpfour··on The few remaining uses of the name “Macintosh”
Hey, this is an unrelated question but I've been looking for MDs turned SWEs and vice versa. I assume since you are here that you understand the life of a SWE. Do you have any thoughts about jumping from SWE to medicine?
tpfour··on Show HN: Terrastruct – A Diagramming Tool for Systems
Hmm. Can you expand further? I also use draw.io and a quick look at your landing page did not enlighten me.
tpfour··on Why introductory chemistry is boring: a long-term historical perspective
The author has a very, very limited experience with Chemistry. I also found the article to be a rambling rant with no actual basis in reality.
tpfour··on Why introductory chemistry is boring: a long-term historical perspective
I'm sorry, but that is a _very_ poor argumentation. In fact, it's just a rant.

Maybe I should let this pass but this essay really rubs me the wrong way. I would like to stress that the author is _not_ a chemist. That was obvious before he wrote it in his text. He does not have formal training in the discipline (art?) and thus his opinion should be taken with serious skepticism.

On the other hand, I am a (published) college trained chemist, specialised in computational/theoretical chemistry in grad school but I did go through a very good program with anywhere between 10-15 hours of lab work every week, every year. Contrary to the author, I remember the names of all the textbooks I used because I spent so much time with them. Really, the author seems frustrated with his own _very_ limited experience of chemistry.

There is a reason why we "follow recipes". Mishandling of chemicals can and do cause injuries. Labs do get blown up. For all of my education, entrance to any laboratory was conditional on passing a test. Every time. One would be evaluated by either graduate students or professors before being allowed in. If you did not know what you were going to do, how you were going to do it, why you were doing it, what you should expect to happen, along with any other necessary information deemed essential by the instructors, you would be refused access to the lab and consequently get 0 in the mandatory laboratory report. And accidents _still_ happened, sometimes innocuous, sometimes dangerous to the point of having to evacuate the lab for a few minutes.

Not all experiments were "cookbook laboratory work" either. From the very first lab session, students had agency in how you plan and execute your experiment. No two students held notes exactly the same, for example. And no two students researched the subject as much beforehand, something which was _very_ obvious during lab work. Sharing a laboratory with students who did not prepare properly is dangerous in a way you can't really grasp until you're three hours into a multi-step anhydrous synthesis, you need to act fast to add a reagent in your air-free setup and the student next to you flushes a syringe of oxalyl chloride[1] in the sink beside you.

We _did_ have to analyse unknown compounds. We _did_ have a lot of liberty in how we conducted experiments, as long as we prepared well and acted safely. Practicing balancing chemical equations is NOT useless as the author suggests. Contrary to what he seems to believe, empirical evidence is _all there is_. Theories have to conform to reality, not the other way around.

All in all, this is a very bad argumentation that _completely_ misses the point. The author is talking about general chemistry as if it defines a complete chemical education. In actuality, general chemistry is only the very most basic knowledge one needs to have to be allowed in a lab. Chemistry doesn't stop there.

I was ready to give the author a chance but he has shown himself to be unqualified to discuss the topic. Being a dilettante is fine but there is a mountain of work separating a dilettante and a professional. Nobody on HN would seriously consider a rant about the current state of Medical education written by someone who had 2 semesters of biology.

[1]: https://en.wikipedia.org/wiki/Oxalyl_chloride

tpfour··on Ask HN: Which project does not have any good open-source alternatives?
There is no good FOSS or even just open source RIS (Radiology Information System).
tpfour··on Reflecting on 8 months of full-time self-study
Your profile does not give a way to reach you.
tpfour··on Barcelona’s Line 9 – Inspiring Montreal’s Pink Line
I rest my case.
tpfour··on Barcelona’s Line 9 – Inspiring Montreal’s Pink Line

    You might as well say that quebecoi don't want to
    learn the language of the rest of the country.
You are conveniently proposing a revisionist view of history.

The word "Canada" has had multiple meanings which have been thoroughly perverted. Technically, Canada is not a country per se, rather it is a federation. Canada referred to the nation of what were later called "French Canadians" long before English settlers came. This [1] map from 1579 uses the word Canada almost 200 years before the English conquest. The process of nation building was underway a _long_ time before any English settlers joined. The English appropriated the name (and the flag, and the national anthem) for themselves and promptly outlawed giving or receiving education in French in _all provinces except Quebec_. Some are still fighting against it _to this day_. These facts would not be disputed by any party at he national assembly because... they are facts.

So did the English not want to learn the language of the rest of the country, even when they were vastly outnumbered? No, they did not (and still don't). Yet for example, they generously split their debt between all of the inhabitants of the federation, at a time when the English were vastly outnumbered yet millions of dollars in debt, and the French were much more numerous yet had budget surpluses!

The Quebecois (Canadiens) have absolutely no lesson whatsoever to receive from anybody. The English minority in the province receives many times more funding than it would pro rata. It is cited by the UN as the world's most well treated minority. You, like a lot of other English Canadians, are merely expressing your disdain for Canadiens. The history of this federation is clear, if only more people would learn about it.

[1]: https://www.loc.gov/item/2017585794/

tpfour··on Great apes appear to have “theory of mind”
You personally have the luxury of reflecting on food ethics. That doesn't make the whole of humanity "cruel" and "lacking empathy".

Raw, brutal hunger simply does not exist in advanced societies anymore. You have the privilege to be allowed to question your and others' eating habits. For most of our history that wasn't really a possibility.

tpfour··on Apple is evaluating new keyboard mechanisms to make thinner MacBooks
I have a T470 and I love it. Some say the keyboards aren't what they used to be, but overall, I absolutely love the machine. While I think it looks good, I consider it a tool, not a fashion statement. I just need it to work, all the time, and have a great keyboard. It has everything I personally need.
tpfour··on Apple is evaluating new keyboard mechanisms to make thinner MacBooks
Just get a Thinkpad and (mostly) stop worrying.

I bought a Macbook Pro in 2009 and used it until 2017 when I switched to a T470. Haven't regretted it one second. Debian works flawlessly, as does OpenBSD.

tpfour··on Python Is Eating the World
No.

All languages are typed in one way or another. Unless you write a generic function, you cannot evaluate (+ 2 "a") in scheme. Here is racket's error message:

    > (+ 2 "a")
    ; +: contract violation
    ;   expected: number?
    ;   given: "a"
    ;   argument position: 2nd
    ; [,bt for context]
    >
The function absolutely expects its arguments to have a certain shape (type). The difference with C is that variables don't have types set in stone, they can... vary. The compiler/interpreter just takes care of them for you.
tpfour··on Show HN: DICOM Medical Image Parser in Go
Read the standard. There truly is no way around it if you need to perform actual "real" work with DICOM. You need to become familiar with the vocabulary. Also get a copy of [0]. Write a small C program that outputs whether a file is in DICOM format or not (don't do extensive validation, but learn enough to know what to look for). Will you be doing networking? If so, read the standard. Use Wireshark. Look up the DUL state machine and read some library's net code (e.g. pynetdicom).

[0]: https://www.springer.com/gp/book/9783642108495

tpfour··on Ultralisp: A fast-moving Common Lisp software distribution
I suggest you take a look at Gerbil Scheme, based on Gambit-C.

https://cons.io

tpfour··on Launch HN: Atomic Alchemy (YC W19) – Manufacturing Nuclear Medicine
Theoretical/computational chemist turned software developer. What kind of skills are you looking for?
tpfour··on Telegram adds the option to delete chats on other people’s devices
They are utterly confused about "privacy". Allowing someone ELSE deleting MY messages on MY device is bordering on insanity.

I have a small theory about why they chose to do that. Telegram is the de facto messenger for cryptocurrencies. There are a LOT of scams being perpetrated on Telegram. This new feature facilitates plausible deniability for scammers, with the intent of making lawsuits against Telegram less likely.

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