> That might be why you don't see me as someone angry and working out my demons onstage. It's that I love the thing that I most wish had not happened.
Cooper was reading from a GQ interview:
Colbert was quoting Tolkien.
Not for me. When confronted to death or intense pain, everything else becomes insignificant and futile. And when things go back to normal, I tend to forget. I suppose that to be fully functional human beings, we need to ignore the harsh reality of life! Is it really possible to "internalize mortality"? I know some people try very hard but are they immune to anxiety and daily worries, are they happier? I haven't met such a person yet.
Honestly answer. Do you face death all the way? Does the immense pain dissipate, and similar thoughts had with no pain attached?
There is gold in the ashes. It is up for the individual to identify.
Death is painful and dreadful. Anxiety ridden. Everyone feels it when contemplating death. Like the Mideveal ages everyone should walk around with a golden jeweled skull.
We plan for life, never for death. Find in the saddest moments, the hardest moments, the beauty the light gives you.
For in death, there are no answers that pertain to life just as life has no answers that pertain to death.
You may have control over living this life, but only if you fully see the beauty that death allows in life.
Don’t let the anxiety stop you.
Darkness, surrounding and surmounting, where no self exists, life boundlessly feeding into the ether and the ether boundlessly feeding into life.
A process of forget, death, decay, growth and born. Where the process is outside all of that.
The process that persists yet you go away.
Think about that darkness there, that scary insurmountable darkness of the persisting process. The persisting process that if it had awareness and wanted to undergo death and growth it could not, yet you are bounded by this process. To always grow and die, either eternally forever or one time in the whole of forever. Both time being a perfect circle and a straight line, you being the one point for all of that eternity.
To be reprised or forgotten about forever.
The paralyzing will, if fostered, cared for, can exhume paralyization and can find a dark addicting taste for the affinity of the unknowable.
After every near miss, it takes me a while to trick myself into rejoining the world of the living, where paying rent and doing laundry matters.
Being a geek has been an asset. I can lose myself in solving problems. Focusing on those thoughts to push aside the other thoughts.
This current cycle, I got a puppy. Total pain in the ass. But he still needs to be walked, so I get up and we walk. Rinse, lather, repeat.
He started an idea, developed, and has a team to continue it.
He did his role.
What is next for him? Hopefully he has enough money to live without working. Then he can put his efforts into himself.
This quote stood out, because as a promise to your family, it really sucks. We never know what the moments that matter to other people are going to be. Big events are nice. But when you think back on your life, how many important moments were from small events? Just having a nice talk, doing a chore with your dad, telling your mom about your day? How many idle comments from friends ended up having a large impact on you?
When dealing with family, you need to be there enough that moments happen, because the scope of their impact on the lives of those around you are not predictable.
I'm fine with people sacrificing for their work, but don't try to sell the "I'm doing it all" crap.
The weird thing is, despite being unconscious for over a month, I woke up feeling like I hadn’t missed anything, and even now I look back at this with slight disbelief - surely you’re thinking of someone else, surely it wasn’t that long. I felt like I’d been out longer after a general for surgery a few years ago.
They did run a whole battery of neurological tests on me once I was conscious and eating - they were pretty surprised I had no obvious brain damage - I had maintained a fever over 108 for several days, despite ice baths and the, what, 20g of daily antibiotics? I do wonder if there was some, but rather more subtle than what was being looked for.
Re-integrating was weird. For everyone else I’d been as good as dead - they’d seen me carted off in an ambulance, and then a few weeks later term had ended. I on the other hand basically went straight from the end of one school term to the beginning of the next with zero intervening time, and nobody could figure out why I was pissed off. They kept asking me about what had happened - and I answered honestly that they probably knew more than I did.
It also sucked that I had no soft landing back into classes, and in the time I’d been unconscious they’d started calculus - I came back and had to differentiate and integrate and had no frigging idea what I was actually doing - I remember sitting in an A-level maths exam a year later and finally having the revelation that it was about curves and rates of change.
All this because I had what looked like a zit on my knee. It grew until I couldn’t fit trousers over my leg, school offered me a sticking plaster, and said I wasn’t getting out of sport that easily. Then my leg opened up one night fetching water in the kitchen, and I lost consciousness. I’ll never forget the sight of custard in crude oil swirling over the linoleum - perhaps that’s one side effect of the coma - my last conscious moment is vivid in the extreme.
Anyway, that brush with death didn’t change my outlook one bit, but then again I was an invincible 16 year old. The ones since then have definitely left their mark.
I went from feeling fine to I might need a repeat prescription, to having to get a taxi home.
The next day I ended up doing an end run around A&E and went from the lower risk renal ward to the high risk to the ic ward and spent two weeks in Lister.
I am surprised that the US hospital didn't recognise it though - senior Nephrologist who saw me after said its "bloody easy to diagnose"
And yes I did get a blocking for not calling 999 (911) when it happened
Good lord, your school let the thing grow on you without sending you to the doctor!? That's unbelievable negligence!
Negligence was kinda the name of the game at British boarding schools until the late 90’s, and probably still is - “the parents will never believe it” works 99% of the time.
There's a push to protect the title of "nurse" in England, rather than "registered nurse".
20,000mg, am I reading that right? According to my non-medical background that's a shitload of drugs. Good to be reading this knowing you came out of it ok.
Surely the world would be better off without further optimising targeted spam.
If your job is consuming all of your mental space, which is clearly the mindset he describes in the article, there is none left for your family.
Maybe this is simply because anything I read on LinkedIn gives me that feeling.
In the case of one of my relatives, the result was confirmation they had the flu (and too late for Tamiflu or the like to be effective). In my case, it was intestinal perforation that (six months later) led to part of my large intestine being taken out.
Big congrats to this guy for getting through it.
I'm glad this guy could get the care needed to survive, and I wish him the very best in his recovery.
Certainly all the care he received in Toronto would have been covered, assuming he's Canadian.
It's wild to me that the potential financial impact of this was part of the picture for many of the US people reading it (especially the startup founders who are probably without insurance right now, and this would leave absolutely financially ruined for life).
I am puzzled by why the richest nation in the world prefers to spend 3.1 billions of dollars on arming Israel, or spend $700 billion military budget (even though its territory isn't being threatened in any way), rather than provide universal healtcare and education to its citizens, who live in fear of becoming sick.
I mean, I can understand why if you own a military supplier company, you'd rather have it that way. But I don't get why voters do not want universal healthcare.
It isn't threatened because of its powerful military; also why Europeans can spend all that money on healthcare instead of defense: a benevolent democracy to provide safety. Not to mention it stokes the richest economy and innovation.
Payment comes in many forms. When a dictator on the other side of the world needs a "democracy" shot, or a country needs some additional sanctions for national security, the fact that European countries offer support makes the difference between greed/aggression and a "righteousness".
You're saying all the US leadership chain (the people with the authority so decide strategy) agreed to spend billions extra just as a charitable act for another continent. The only way I can take the best interpretation of this is to assume you're joking.
Seriously? You'd expect an invasion from Canada, or Mexico?
I am not against a powerful military, but it seems the US has gone way beyond that and mostly projects its force around the world, with poor results to show for everyone including the US.
UK, and I wouldn't think about it - it's just not a consideration.
I will caveat that by saying dental care is not free, but the prices are reasonable - maximum charge £270 (for a single course of treatment and anything within two months of it, for treatments such as bridges, crowns, and denatures), and "If you require urgent care, you'll pay a Band 1 charge of £22.70."/ "There's no dental charge [...] if your dentist has to stop blood loss".
 unless you receive certain benefits
Keep in mind I live in the backwoods of a small state in the US and could have a catscan in an hour, an MRI tomorrow, would likely only wait 15-45 minutes at an ER, had access to proton cancer treatment years before a single person in Europe had it, and was covered by MD Anderson, the top rated cancer treatment center in the world.
The extra money the US pays into healthcare isn't all for naught.
ACA was a horrible compromise because the right would not allow proper Universal Healthcare. In my state, as in many, there is a gap where you can be denied a subsidized ACA plan and Medicaid. I fall in that gap and get nothing but the privilege of buying a full priced ACA, poor coverage, plan for something like 7-800usd a month plus something like 6000usd yearly deductible plus the multi thousand coverage floor you mentioned. All of which is impossible for me. I did things right. I had a significant savings when this happened, spent most all of it on this stuff, I have a few hundred a month pension I was lucky to have, it doesn't cover my needs, I have no insurance or benefits. I was denied disability. This is America.
Someone else below also brought out the "I know lots of people from Europe who come to the USA for superior healthcare" line as well. I lived in Europe and never met or heard of a single person who did this. It surely happens. But its not "lots" nor proof of some superiority.
I recently got another diagnosis after having to really fight and spend a lot because the system is so broken. The 3-5min you get and insane costs for everything hinders care. I was already on the edge as my history points to...and have been trying desperately to move back to Europe where its not perfect, but even in the paid, private system I would have access to for the first years I can get far superior care to here for less. But the hits just keep coming and I don't see making it anywhere now. I wish people would care about others and how this system hurts them, rather than their politics. I will lose my life because of politics I never chose to be born into and that have continually reduced my quality of life. I just cannot understand why people continually deny this is the case and fight against that which helps all of us. I have mostly passed anger and am in intense disappointment on the issue. I just want to live. I am not allowed to.
It definitely happens, especially for things like plastic and reconstructive surgery.
Some hospitals in the US are free for everybody (some research hospitals and hospitals for sick kids) and I assume that would extend to Europeans.
Routine GPs appointments can generally be gotten within a week, and emergency appointments (where we wait until the GP is done at the end of the surgery, and are then seen) if the triage nurse determines you need to be seen sooner can be gotten on the day. You also have the option of speaking to your local pharmacist, many of whom can prescribe medication for certain conditions if appropriate, or otherwise point you at suitable over-the-counter primary care.
A number of places also have walk-in centres for minor ailments where you don't need an appointment, and they generally have long opening hours (8am-10pm, 365 days a year for my local one). Urgent dental care is also available 24/7 in many places.
You may have to wait longer for non-emergency / non-priority / time-insensitive treatments - my routine MRIs have a lead time of about 8 weeks, and a specialist referral can be something in the region of 6-12 weeks (sometimes longer) - but I think that's a fair trade off. You do of course also have the option of paying for private care as well if you don't want to wait (often NHS doctors / semi-retired doctors working evenings in my limited experience).
 bit of a misnomer really - urgent but not critical is more accurate
Also when my wife had to get an MRI done going private wasn't that much quicker than NHS - you still had to wait a couple weeks through her private health insurance at work.
My wait for a specialist referral is 2-3 days and any delay is usually on my end.
There are just some things the US healthcare system accidentally does much better than Europe.
Additionally, when I lived in the US, we got a special Dutch health insurance plan for temporary expats. They sent us a letter that if one of us ever had to go to the hospital, they'd fly them over to the Netherlands unless the situation required immediate attention.
I personally find it interesting and worthy of discussion that different developed nations can have such different "risk profiles" for entrepreneurs. If anything, it makes me respect US founders even more... since when they set out (and presumably don't have insurance yet), they are risking far more (i.e. their family's long-term financial destitution) vs. a founder in a country with public healthcare.
Not an expert on this, just my reflections.
I sure hope he had travel insurance. Likely did as most companies offer it for employment travel.
Money is nothing. Poverty won't make you unhappy.
Humans are good at finding new baselines. Poverty will simply become your new normal and the little things of life will still bring you joy. Seeing a loved one will still make you a smile. Life is worth living even without any ressources.
I'm sure the millions of people living in poverty, dying of treatable diseases and starving to death right now are ecstatic about it. Or are we just pretending those people don't exist?
I'm glad you and your family managed to beat the odds, but this is demonstrably false on a statistical level.
It won't however make your positive moments any less important. You will be more likely to suffer from mental health issues but that's statistics and they don't represent daily life of people accurately.
If you are not suffering from something such as depression you will still find satisfaction from social encounters, from your community and your family. Unless living in a dangerous situation, your will still be able to feel content about your life. Love will still matter just as much.
That being said, this is my experience living below the poverty line in Canada where healthcare and social programs exists.
And nowhere at all did I suggest "a person's life is not worth the money."
This is a serious question people ask themselves whenever they get sick. It's one no one should have to ask, but one many Americans have had to sincerely consider.
For instance, suppose you trip and fall, and in catching yourself, shatter your shoulder joint.
The emergency room would be obligated to keep that from killing you -- making sure the bone fragments weren't going to sever an artery or anything, stitching up open wounds and the like.
The emergency room would not be obligated to restore you to (as much as possible) functioning. If you need an expensive 20-hour surgery with a team of specialists to put all the pieces of your shoulder back together, well, that's too bad. Sure, your shoulder will heal into an immobile lump without treatment, but it won't kill you, so not actually an emergency.
That said, fiscally, it's a total gamble in the US these days. You may be saddled with a $20/mo debt that will likely never end ever, or you may be facing a bill for $1M that is due in 30 days. The range is essentially unbounded and unknowable in any real way.
US healthcare is shockingly cruel, financially speaking.
I am wondering if having allowed emergency wide-spectrum antibiotics freely for such cases would help? Time seems to be extremely critical in such cases.
The problem is you also need emergency physicians available equally freely and ubiquitously to identify the need. Unnecessary use of powerful, broad spectrum antibiotics has significant potential adverse personal and public health consequences, and the general public is not qualified to appropriately assess need for use.
I am not sure I would use them at home in case you describe though - I would just run to emergency if possible. Also antibiotics don't work with viruses, fungus or parasites, so its not a panacea.
Very soon people would not only die from rare bacteria related decease but any kind of random bacteria infection.
The only remotely viable solution is improving access to ERs.
If you don't consent to the rules, that is fine, you aren't allowed the drugs at home (same as today).
Like the parent said, lots of people will pop those things like candy. In very short order they won’t work at all.
Telemedicine plus improving 24-hour pharmacy distribution and equipping them for rapid door-to-door delivery of critical meds (possibly by drone) might work, and might soon be more viable than ERs for the particular use case.
ER access addresses a lot more problems and probably wins aggregate cost/benefit analysis for the foreseeable future.
Of course I'd do whatever it took to save myself or my loved ones. Anyone would. That's not a good basis for government policy.
(Also, being honest, the number of situations where powerful antibiotics now vs. at the hospital would make a difference and the people involve realize that and administer them has got to be tiny. We can't make policy based on low-probability hypotheticals.)
It might save hundreds and but also kill thousands in the short-term, too: powerful broad spectrum antibiotics aren't without adverse effects, perhaps especially if taken in a genuine emergency that just isn't the kind of emergency the user thinks it is.
A single guy having strict antibiotics discipline doesn't mean anything when you have 1 billion+ countries like India where strong generic antibiotics are sold to anybody over the counter (at least that was the case in 2010).
Once I didn't have them on Kilimanjaro and I went from being perfectly OK to almost passing out within 1 freakin' hour from extremely strong gastro infection. Luckily peace corps members of the team had some and they almost immediately helped a lot (I still had what one can call a shitty experience of the peak, albeit successful). In situations like these you don't care about long-term good of the mankind, you just want to survive, far from any professional help.
Wishing you the best, Mark.
> This mainly involves infection by the Streptococcus pyogenes bacteria and more commonly affects young, healthy adults. I didn't do anything to get it, it just happened - like being struck by lightning.
The jarring contrast between medicine's ability to perform surgical miracles, like those described in the article, and it's total inability to understand what causes illness, is just comical. I guess there is money in one and not the other.
I cannot imagine a mechanism whereby stress causes a human body to create a bacterium, effectively from out of nowhere. To synthesise it. Do you have any evidence or even a posited mechanism for this amazing claim? Or is your claim that the illness isn't caused by this bacterium?
We are surrounded by bacteria at all times. If stress were to weaken your immune system, then you might be more easily infected by them. This seems completely plausible to me (likely, even). It is not a great leap to describe this link as stress "causing" the infection, even if it might be better to describe it more precisely. Perhaps "stress meant he couldn't fight off the infection as he normally would have"?
I had the same experience in a big, prestigious hospital. After a surgery went wrong they insisted I’m ok and getting better despite my less and less vigorous protests. When they finally accepted to investigate this more thoroughly they realized the severity. The story repeated itself through multiple surgeries. Even just hours before the last one they insisted I should be getting better and again only investigated after several pleas. Which was very surprising considering that when going into this last surgery my chances of survival were under 15%, I was basically in septic shock and already mostly unconscious due to the illness and medication.
I think a doctor’s diagnosis starts with assuming basic issues and escalating later rather than the other way around. It might make sense statistically... unless you’re among the unlucky few.
How does an infection like this happen though? What can you do to prevent it?
> By the time I landed in New York that day in February, I felt a flu coming on. The next 48 hours was a marathon, so I resolved to push through.
And he also experienced some very non-flu like symptoms:
> by Wednesday night I was running a serious fever and my left leg was in a surprising amount of pain.
Despite having a high fever and pain, he didn't go to the hospital until he actually collapsed the next day. Had he sought medical treatment as soon as the leg pain manifested, his outcome might not have been as dire.
Stay away from places where a lot of different people touch a lot of different things - and if you have to touch those things, wipe them down first with antiseptic wipes or similar.
In addition to this - take care not to let (or get, if possible - not always easy, depending on what you do for a living, your hobbies, and just life itself) wounds happen on your skin or mouth. If you do get a wound (cut, scratch, bite, etc) - try to take care of it properly immediately; clean it, apply dressing, etc. In the case of mouth wounds (ie - you bite your tongue or lip hard enough to draw blood), about all you can do is a salt rinse and keep your teeth brushed.
Stay away from hospitals and care homes and the like - seriously, one of the best places to get an infection is in a hospital or doctor's office. It seems counterintuitive, but when you have a place where sick people congregate, not everything is going to be "squeaky clean" even when they are regularly cleaned.
You might take the extreme step of wearing some kind of mask to reduce the inhalation of bacteria and/or viruses. It won't completely stop it, but it will reduce it a little.
Don't hang around sick people? If a coworker shows up to work sick, you might want to go home yourself (explain to your boss why, first - and let them make a decision as to who should go home - likely, they'll send the coworker home first). Unfortunately, so many people have kids, and are "carriers" of stuff that don't affect them much because they do have kids, but if you don't have kids and/or don't hang around kids much - you can pick up things that way easily.
Always wash your hands thoroughly after using the bathroom. Elbow out the door if possible (or use a paper towel to open the door).
Avoid stress (easier said than done for some people) - ultimately, though, stress does weaken the immune system; this is known. Better is to understand when you are stressed, and what forms stress can take, so you can know when you are under it. Some kinds of stress aren't always easily apparent. Note that this might also apply to "good stress"; I'm not sure. If you are tired and "stressed" from an extreme workout, I am not sure if that helps or hinders your immune system during your recovery...
Ultimately, though, you can't control everything, and you have to live your life. There's probably no way to trace back to where this guy picked up his infection. If I had to make a guess, maybe the gym? It could have easily have been during a run or a walk outside as well. Or just some door he pushed open to go into a room or building. The bacteria/viruses that cause these kinds of infections and issues are all around us, and our bodies do a fairly good job of keeping them at bay. But sometimes, bad luck happens.
Would bacteriophage have helped?
He was never in a coma, though, so got to be a bit more chipper about the whole thing.
Amount of traffic to pathfactory.com is negligible:
The timing of his illness is rather unfortunate, as it caught him in New York, rather than Toronto, which probably cost him a lot of money.
edit: And the fees aren't trivial. https://www.qch.on.ca/uploads/Finance/Fees%20for%20Cdns%20wi...
Even with your unfair comparison: if you have health insurance in the US, it's quite easy to pay higher fees than you would uninsured in Canada. For example, compare Fidelis Care Silver ambulance charge ($150 after deductible) with Canadian ambulance charge ($240 CAD -> $180.75 USD). The completely uninsured Canadian pays only $30 more than the insured American, and that's if the American has already paid their $1700 deductible, and has paid their premiums (which are more than the taxes Canadians pay toward their healthcare). And that's literally just grabbing the first US plan I looked at: I'm sure that there are worse insurance plans out there which people are forced to take.
No one works for free, the medicine costs money. The money comes from somewhere.
The Canadian, on the other hand, doesn’t have insurance premiums or deductibles.
(For the record, I hate the CND health care system. It’s just that, knowing both systems, the US’ is worse :)
Why do some people think this is a shock?
Nobody thinks medicine is ever going to be free. That's a strawman position. You might as well argue in favor of universal toll roads by saying that roads are never going to be free, so suck it up and accept that you're going to pay $50 one-way every time you commute, and $200 one-way every time you get groceries: The people who protest that aren't saying roads are ever going to be free, they're just saying that better payment models exist.
Pay for what? CEO's billion-dollar salaries and luxury jets? I'm pretty sure Canadians aren't paying for that.
Only America trains their Dr. until they’re 35, while having them do nothing towards their medical degree in their undergrad.
Only America saddles then with $500k in debt.
Remove both barriers, and presumably you’d have market forces push more ppl to the profession reducing wages.
How do you train a neurosurgeon? That level of specialization comes from maybe a few hundred in the U.S. With that level of scarcity (and demand), their time is going to be priced accordingly.
But s/he needn’t have a B.Arts in management to apply to med school first.
I don’t know what you mean by “Maybe a few hundred”. Do you mean schools or neurosurgeons?
If 1., there are only 150 med school for all Dr. in the US, contributing to a very low number of Dr. Per capita.
If 2. They study medicine. Do residency. And train on the job for the rest of their lives... just like today 
 actually one of the reasons for medical errors, a top three killer in the US, is that most Dr. don’t update their knowledge one thy finish their residency. :S
> For reasons that are unclear, it occasionally occurs in people with an apparently normal general condition.
Wtf. Adrenal crisis  would be fatal. You're talking nonsense.