Castillo de San Marcos - Built at Sea Level in 1672.

Castillo de San Marcos - Still at Sea Level in 2025.

How is this of any significance to humanity? Seems like a weird way to waste both time and money.

Now all my crappy code will crash much faster. ;)

I made my chat font Comic Sans because I think it's funny that the "Supreme Allied Linux Commander" for our organization (me) uses Comic Sans on Skype For Business. Keeps 'em on their toes.

But Brave Browser has no problem blocking them.

The point of advertising is to generate demand (want). The more you can influence people to want your product, the more of your product you're going to sell.

I bought $1000USD of Doge back when it took 12 of them to make a single penny just to have fun with on IRC. We set up a doge wallet bot and used tipping in Doge as a way to encourage productive/constructive comments and contributions to our little channel, as well as educating people about crypto. I ended up giving away at least half of the Doges to various channel dwellers just for the fun of it. (Using random soaks & tips of 100 doge here & there.)

Fast forward to now it's around .13c per doge and the coin I so liberally threw around like confetti actually has some value. It feels really good to have contributed in a positive way to crypto-currency awareness and to see those contributions actually have value.

I still have quite a bit of Doge left and it has oddly turned out to be one of the most entertaining & enjoyable successful investments I've made.

TO THE MOON!

I always wonder why they don't just move the clock 30 minutes in one direction and then NEVER DO IT AGAIN.

We do. This is where the guidance to stop resuscitation after 15 minutes without a rhythm comes in. Unless you're a child who drowned in cold fresh water, of course, or an adult who apparently died of hypothermia. The problem is that there are so very many different sets of facts, and people are far more resilient than you can imagine. And in the heat of the moment, we tend to opt to fight rather than to let go. Which is actually OK, I think.

Well, yes, ECMO is probably a bad example, because it's by definition an acute therapy that can't be continued more than a few days, at least at the current state of the art. Even there it's a bit questionable in the case of chronic disease exacerbated by acute cardiopulmonary collapse from a (presumably) reversible cause. But other therapies, like the simple $10K/day ICU bed, are much harder to argue against, unless you've given specific instructions. It reminds me a little of the old instructions for tuning a carburetor - turn the screw until the engine dies, then back up half a turn. Most of the really futile ICU cases I've seen didn't START as futile cases, but they sure ended that way.

I'm not actually all that impressed with medicine in "most other Western countries" as a touchstone for our own. Every country has its own social norms and conventions, all of which fold over into health care. We tend to value privacy, autonomy, personal space, personal choice, and hope for recovery more than most, and it costs us a lot of money.

I think the problem is that we don't know in advance when the "last days of life" are for anyone. Or at least we don't know if prospectively, and knowing it after the fact is kind of pointless in terms of limiting costs.

If there are treatments that are virtually never helpful, we need to stop using them. There aren't many interventions that actually fit that description, though, and even the most invasive of them - ECMO, for example (basically continuous heart-lung bypass) - have their place in restoring people to health in the right circumstances. Eventually the circumstances are such that death is inevitable, but recognizing that point is not something we know how to do with certainty. Even when we're pretty sure, communicating our own conviction is very hard. And where there is no certainty, there is the great likelihood of erring on the side of treatment.

Hospice care, which tends to be very inexpensive compared to attempts at cure, is helping because it gives people a viable alternative path. Most physicians with whom I deal (a very large number, as it turns out) are big fans of hospice care. Not because it's cheap, but because it helps make the case for avoiding further torture. It's not a bad way to reduce costs, though, and that's not irrelevant.

I'm a board-certified physician (among other things). There is no way that I would allow my colleagues to inflict the kind of death on me that they are forced to inflict on so many. Part of this is certainly that I know full well that we all exit this mortal coil toes-up, and there's no getting around it. Part of this is the personal reluctance to experience the diminished autonomy, indignity, pain,and hopelessness that comes with fanatically-treated terminal illness.

But a big part of it, I think, is just that I know that there are so, so many things that are worse than simply dying. Dying in agony, for one. Dying after having bankrupted my wife or my children. Dying after being reduced to a stinking thing in a bed long enough that only those who loved me most even want to be near me, and that only because they feel they must. Physicians see these things all the time, and we see the road that leads to them. We're not (that) stupid, and we would rather exit early on that road, not at its terminus.

As long as I have the capacity for joy I will strive to remain alive to experience that joy. When the capacity - or the joy - is gone for good, I have given quite strict instructions not only to my family but to some other clear-headed and insistent people who will do their best to ensure that I too will be gone without further "heroic" intervention.

The only problem that I have with the article is that it pretends that everyone should make the same decisions. Everyone has their own decisions to make, and without my knowledge and experience I might not make the same ones. I think as physicians we owe it to the people for whom we care to educate as well as we can and help them to understand why we might personally decide one way or another. But I will never tell them how they "ought" to decide - it's really their choice. Taking that choice away from a person leads too easily to very real outcomes that are much nastier than simply a life that ends later than it ought.

Good luck Rob. Don't be a stranger. :)

Not that I was all that fond of Sony anyway. Trying to rootkit my machine from a CD a few years ago didn't impress me, and the prices they charge have always been a little silly. With this action, Sony has now officially asked their lawyers to burn down decades of customer relationships. "Sony" and "Don't buy this" are now synonymous.

As far as two years of IP logs, good luck with getting anything useful out of that one. Then again, that wasn't the point. It was just another intimidation tactic to keep people from spreading the private keys. A little late, I think.