My girlfriend had three strokes, in succession, two years ago (when she was 22). The night before these strokes occurred, she had a transient ischemic attack (TIA). She began speaking gibberish to her friends. She texted me later that night explaining what happened. Her friends had laughed about it because they thought she was just acting like a goofball. I had no idea these were signs of a TIA, but I told her that if it happened again she needed to go to the doctor immediately.
The next day, the right side of her body went numb. This time, she was around people who noticed something was wrong, and she was immediately rushed to the emergency room. By the next day, I had flown a thousand miles (from the location of my new job) to be with her. She couldn't remember many words. She couldn't read a clock. She did not know the answer to 3 + 0.
It turned out that, similar to the author of this article, clots had traveled through the hole in her heart and up to her brain. Luckily, she recovered fully and was back to her old self within about a month. She had surgery to fix the PFO a couple months later. The neurologist told her that nine times out of ten, the clot travels a different path, and the victim is left dead or braindead. I am so lucky. Writing about this has me in big tears.
I am going to stop writing and go hug her now.
After my severe traumatic brain injury, I'm trying to do the same thing. Brain injuries are so broad and so complex and dangerously invisible. I would guess this is the one unifying thread between us.
This is a solid A-level piece. Good job on both the writing and content.
Even for someone who understands the symptoms conceptually, it's a completely different matter to actually experience what it's like to be unable to speak the name of a person that you see constantly, or to experience real pain from light, or to be around people and then be utterly exhausted afterwards. It took time for my family and friends to grasp the extent of my injury, especially since it didn't occur in any dramatic or obviously horrible way.
If you are like me, you'll have moments in which you feel completely frustrated and hopeless. Be patient and merciful with yourself. Last year I wondered if I'd ever be able to have a job that required serious mental thought -- but this year I've successfully switched careers to become a full time programmer.
I apologize if this is unsolicited advice, but I guess I'm saying what I wish I would have known when I first got my concussion. And for others who read this: if you get a concussion, see and listen to your doctor -- and if your doctor doesn't take you seriously, find someone who does (especially if you have a clinic nearby that specializes in concussion / brain injury). I can't know for sure, but I think my life over the past two years would have been a lot different had I simply _rested_ in the period afterwards, instead of staying up late studying.
"only". All brain injuries are incredibly frustrating.
Adding on the advice, if you have others close around you, please listen to them and take their advice even if it's painful. This was positive for me and I'm glad I did it... but man it was painful. I felt powerless and helpless and couldn't grasp the full details of the situation. When everyone around you is saying the same thing, they're saying it for a good reason.
The largest lesson I've learned is that there's nothing fundamentally wrong with someone who has a brain injury. They manage their deficits like any sane person would. Yes, their deficits will show through but that doesn't speak to who they are. That's their injury showing itself and they're doing their best to control it.
Generally, a patent foramen ovale doesn't cause complications. But, some studies have found the disorder is more common in individuals with certain conditions, such as unexplained stroke and migraine with aura. In most cases, there are other reasons for these conditions, and it's just a coincidence the person also has a patent foramen ovale...The possible link between patent foramen ovale and stroke or migraine is controversial and research studies are ongoing.
I'm 42 and have had migraines with aura (mostly blindness) since I was 15. My father is 72, my oldest sister is 51 and my youngest sister is 45 and they have all had migraine with aura since a young age with no strokes reported yet.
But make sure you'll NEVER take vasoconstrictors during the aura...
Migraines with aura have two phases :
- first vasoconstriction, which cause the aura. Should not last more than 30-60 minutes. Take NO anti-migraine vasoconstrictor at this point.
- next comes vasodilatation which causes the pain. That's when vasoconstrictors can be used.
Find my comment bellow to learn more.
Interestingly, I have literally never taken prescription migraine medication. I don't have severe ones often enough to warrant needing it. The only thing I take - and I take it at the first sign of aura - is two Excedrin. The active ingredients in Excedrin (aspirin, tylenol, caffeine) are identical to the active ingredients in Excedrin Migraine so I generally take either. It seems to lessen the severity and duration of the headache.
As a neurologist once told me - there is no medication you can take that will reduce or eliminate an aura. So to your advice that it is dangerous to do so, apparently it's not effective either. So there is no upside and apparently plenty of downside to taking vasoconstrictors during aura.
Before that, I was usually taking 1000mg of aspirin too.
My advice if your migraines occur in high stress times (mine did): learn auto-hypnosis or find anything to lower that stress level...
There are still gaps in memory. My friends, since this essay was published, have told me how they visited in the weeks and months following my stroke, and I am floored by how I don't recall their visits, whatsoever. Like, nada. But I know I felt their love, so there is that.
Again--thank you all for the amazing response to my essay. I am overwhelmed in the best way. We writers don't get a lot of kudos, so when the love does come around, it matters very very much. I know it holds me through the darkness and keeps me going. So, thank you for keeping me going!
Are you in the US? If so, how much did the ordeal cost?
I'm unsure how much it would have cost (uninsured) had it been a more straightforward path toward treatment. However, I left many details out of the story. Doctors were unsure if the stroke was simply caused by a PFO; they thought she may have had a more serious heart defect. Thus, she was airlifted to a better hospital for a more thorough diagnosis and later ended up having robotically-assisted heart surgery (i.e., not the simple, cheaper PFO closure procedure described in this article).
Another thing: her father was very persistent with the insurance companies throughout this entire ordeal. Had he not paid attention to the way things were being billed (i.e., between primary and secondary insurance), some costs may have been pushed onto her family.
How does one pay attention to this in a time of crisis? Is there a good guide to navigating it somewhere?
Last summer I woke up with a monster headache and suddenly stopped being able to put words to thoughts. Tried calling a taxi, couldn't say where I wanted to go, so he called 911. On the way to the hospital in the ambulance I was just praying I was making the right decisions. The paramedics couldn't understand me and that frustrated them. They asked me what hospital, being an intern and totally new to the city I wouldn't know what to tell them even if I could. I was worried they'd treat me like I was on some kind of drug.
Turns out I had contracted a meningitis. The ambulance ride was $1000.
Until my family members and I individually ended up switching to insurance with nice low flat rates for services, I used to negotiate everything from office visits to ER bills. Before service if you can (especially for elective/outpatient type things), otherwise they really like cash in full. They tend to prefer working outside of insurance too, since it means more money for them even if they're halving your bill.
I'm sure there are services, and occasionally you'll find more tips on places like reddit (/r/frugal comes to mind). I have no immediate suggestions for how to do this in a time of crisis - it mostly depends on someone that knows you well giving enough of a shit, and when they'll try to bill you for services. :(
Why this is a thing is beyond me, but while it's the case...
IMHO negotiation is one of the problems causing high health care costs. Prices are crazy high by default, but insurance companies are able to negotiate lower prices from providers. This means the uninsured are billed higher by default. It turns out that individuals can negotiate lower prices too - sometimes. I advocate that a given service provider should be forced to charge the same price for the same service to all patients. This might result in competition and lower prices, but in the mean time it should lower costs for the uninsured.
I know of these largely through news coverage, and cannot speak to how effective they are (or what the costs are).
The stories I've heard, though, of the absolute complete and total nightmare that is the US healthcare scam, are heartbreaking.
I'm looking for online references but cannot find any at the moment, maybe others here have more information.
Both my parents have suffered strokes. My father had to go to a step down unit which requires Long Term Care Insurance, something that I'm willing to bet most people aren't familiar with. Even that, due to changing regulations, your LTCI that you purchased decades ago most likely no longer covers today's prices. Unfortunately you just can't prepare for everything.
I understand that my coverage is not all that common, although most providers do an 80/20 split. So for a procedure costing $100k (an ambulance ride and a few nights in the hospital would easily run this high) you'd have to pay $20k out of pocket.
Actually, it's the opposite. For the vast majority of insurance plans, there's an annual limit to your copay.
To be honest, if there weren't that limit there would be no purpose to insurance at all.
This is how many people are financially ruined by long-term chronic illnesses. For some less common diseases, medications can easily cost >$10,000 per month – which might not be covered by your health insurance for various reasons or only partially covered. Read the fine print.
It goes up each year (adjusted for inflation), but as an individual, your maximum out of pocket (includes everything: deductible, co-pays, co-insurance, etc) is ~$6,750.
We called my mother at work and the funny thing is that before she came home to take him to the ER he was able to ask for coffee (and drink it) and also to smoke a cigarette.
Moving 15 years forward he's still with us (62 years old) with no movement at all on the left side of his body. Had a heart attack with major surgery, is on more than 15 different medications, has diabetes and a bunch of other "minor problems".
My mother gave up her life to take care of him and everyday is a struggle because of the existing problems prior to the stroke and the ones that came after he became bitter and really mean to those who love and take care of him.
I'm not sure why I wrote about this but I felt like sharing. It's not easy when people don't recover, but for some reason I believe we have to take care of them and do our part.
The first diagnosis was migraine with aura (blindness in my case). But the aura should have lasted no more than an hour. Two days later, the aura (blindness) was still there (a sign of infarct but my doctor didn't know it).
I spent 2 days alone in the dark. I forgot to eat but I knew I had to call a taxi to take me to the hospital. I wasn't scared, I though it was just a migraine. It really looked and felt like my usual migraines. So my doctor had me take anti-migraine pills, which are vasoconstrictors. That might have caused the actual stroke: extreme vasoconstriction. Never take anti-migraine treatment during the aura. Never.
It took 2 days before I was diagnosed at the hospital, but they just told me "I see a shadow on the CT scan"... so I spent the next 2 days wondering what kind of shadow? stroke or cancer? And no, I didn't think about asking.
It took one week to be hospitalized for 10 days (my mother called the hospital, harassed them until she could talk to a doctor, who said it was an emergency... one week after the stroke).
It took 15 days before I woke up in the morning and thought "Wow! WOW! I'm back now!". Before that, I spent most of my time sleeping, reading half a page between two naps. I was sleeping more than I was awake.
It took 3 months before I could look at everything I wanted. Before that, looking at trees (and other complex objects) was "painful", and watching movies was too exhausting (especially action movies). During these 3 months, I recovered from blindness, but not completely. I still have a blind spot in my field of view today.
It took 6 months before my mood was really restored. Before that, I needed a daily nap, lots of soothing music, and no pressure at all.
I took aspirin daily for 3 years, after which my neurologist told me I could stop.
I had a few migraines after that, and even ended under oxygen at the hospital once, but I always recovered within 15 days.
It was 10 years ago, and it changed my life. I quit my job as a developer, spent 2 years wondering what to do next, then became a wedding photographer. In february this year, almost 10 years after, I got a new job as a developer.
I'm back on rails (node.js to be precise :-)
There's something going on here beyond just loss of raw visual input. If you lose an eyeball, or hold your eye closed, and look in the mirror, your one good eye will still show you that you have two eyes (or, as the case may be, sockets / sets of eyelids). Perceiving yourself as having one has to involve a loss of brain function, not just a loss of eye function.
Part of my brain was not irrigated and did not function properly...
There was nothing in /var/logs: I couldn't perceive that I was half blind. syslogd crashed :-)
If it's the first, then it sounds like damage to one visual pathway. The visual input from each eye is divided into left and right fields, and they're processed independently. Here's a good illustration:
After the optic chiasma, the two pathways diverge. Damage any time after there, such as to the occipital lobe of one hemisphere, could result in blindness to one half of the field of view.
It've talked about the face because I did not perceive that half my field of view was missing, but when looking at myself in the mirror, I saw one eye was missing... But it really was half of my field of view.
This seems to be similar, but different condition. Contralateral neglect is a problem of attention: they can see the things they ignore, they just won't spontaneously pay attention to them. This is a problem of perception, where they tried to pay attention to their eye, but perceived it as not being there.
I don't have an easy explanation for how this effect occurs.
You are the only other person I have ever heard describe looking at complex objects as sometimes painful. This happens to me sometimes, mostly with very complex and disfigured cartoon faces. Very strange. I have never had someone understand what I'm talking about when I try and describe it. Do you have any idea what causes this effect?
I might be wrong, and I would love to be educated further if my understanding is incorrect. I hope I never need to use this information in my life.
- happened just before the week end
- began exactly as a migraine (I had them in the past) making the diagnosis more complex
- doctor had never seen a migrainous infarct (it's very rare)
- hospital didn't have a neurology department
- the medicine resident called a neurologist to get advice
All in all, I was lucky it wasn't more severe...
The audacity of health care industry workers (those who should know what a certain disease entails) who place blame on their patients for acting normally is infuriating.
I had kidney stones once at a young age. I remember barely walking into the emergency room one night after they became too painful.
As soon as I arrived, white as a sheet of paper, they asked me a few questions... doped me up on morphine... and managed to "lose" me on a gurney in a hallway somewhere for a few hours until my girlfriend at the time came and found me.
They took xrays I believe and I was free to go with some more painkillers in hand.
Apparently the hospital told me that I was supposed to call them by X date if I wanted any more painkillers.
I called them back about a week after that date had passed, asked for a refill, and was scolded like I was some drug addict just looking for a fix. I think they even hung up on me. How could I be so stupid as to have forgotten a date they told me when I was high as a kite by their own doing? Right.
I ended up passing them without any painkillers which as many of you have probably heard is unbelievably painful.
I understand that it can get monotonous working in a hospital, but with the amount of money they're paid to work there you would hope that they would be required to operate with a little compassion. Considering the fact that many people in a hospital are leaving this world.
What if the author's last memory was that of a person she didn't know berating her for something she wasn't sure she even did?
It's tough dealing with drugs and potential abuse. You know if you're really in need or not, but they deal with people wanting them for any reason just because, and so the skepticism starts to show. There's the default assumption at hospitals/pharmacies of just locking everything down so the healthcare providers themselves can't abuse them too.
My father was in the ER the other month for severe abdominal pain. He got morphine _after_ it was discovered that his blood pressure was through the roof and he wouldn't tolerate even a light touch in the area. Then multiple people were required for disposal and documentation of whatever was left over - after someone had to go get it from an automated dispensing cabinet and _then_ scan both the drugs and his bracelet QR code to verify the order (+allergies+other things). It was impressively thorough.
In comparison, my neurologist and doctor are really freehanded with nerve pain meds for my legs. Can't really recreationally abuse anticonvulsants or antidepressants or lidocaine patches, I guess. Also on the pain front, having something that can be directly tested goes a far way for the disbelief/skepticism that might otherwise be a problem. :(
That's exactly how I felt when I called in for a refill of my pain medication after just having met with multiple doctors in the ER just a few weeks prior.
Do they really think I intentionally got kidney stones (which they saw themselves on xray) just to get an extra refill of pain meds a few weeks later?
No, the lady on the phone probably got intense amount of pleasure by telling me off verbally and hanging up. At least that's one of the only reasons I can think she didn't even bother to listen to me.
I was upset and confused, but too proud to call back and have myself humiliated again. So I just grinned and bore it and screamed like a baby when the stones actually passed a few days later.
A funny side note to this story... I can laugh at it all now seeing as it's ten years in the past. In my long walk to the hospital (I was a poor student at the time, unable to even afford the bus) me and my girlfriend passed a band of elderly ladies who took one look at me and within seconds said "Oh no, look at him. You must have stones, don't you laddy?".
I wasn't sure what was wrong with me at the time and I just replied something like "haha, I hope that's it!" and continued on to the hospital.
6 hours and an xray later... the doctors confirmed the very same thing.
I have ADHD and I've been on almost all stimulant options available, most often Adderall and lately Vyvanse. Those are Schedule II drugs in the US, where you can't get refills on a prescription and there's a whole huge thing about auditing and verifying that you can't abuse it.
I feel like your doctor's office is a little ridiculously strict if that's the case for you too as none of my psychiatrists have ever required that kind of sign-off on picking up prescriptions, but in my experience, yeah... it sucks. I've been treated like a criminal at the pharmacy, many times. Also ask me how many times I've had insurance/pharmacy deny a prescription because I am picking it up literally a day too early. Requiring ID is ridiculous too. I just recently changed my name, but the name change for my insurance hasn't been going anywhere, so I'm surprised I haven't triggered any kind of problem when signing off on picking up these drugs. I don't know what I'd do if I lost a prescription (doctors can write up to 3 separate ones dated appropriately) or if I lost a bottle. :(
I agree 100%.
I passed kidney stones without any pain medication because the "care workers" thought I was a junkie looking for a fix... Even though I had been into their ER a few weeks earlier and was white as a sheet due to incredible pain.
You can't even fake that type of pain afaik.
You have FOUR HOURS to get a person with a stroke to the emergency.
I have seen it several times. The first time it happened to my grandfather, nobody in the family realised what's wrong only that he seemingly was losing memory and repeating things he just said. Several hours passed until we thought we should perhaps call the medics - stroke was immediatelly recognized by the doctor and the emergency saved my grandfather only with very mild consequences afterwards.
The second time my grandfather got a stroke, he started stuttering and had difficulty speaking. Again, we did not believe it could be stroke, because, you know, he might just be feeling bad. And again, the emergency saved him within a few hours.
During the third and final stroke that we know of family was already aware and he was taken to the hospital early but he was released just a couple hours later with instructions to stay in bed and rest. Overall, about 6 to 8 hours passed until he got the required medical care. After that stroke he spent almost five years doing nothing, just existing - with almost completely blank mind. If only the doctors were professionals and we, the family, would have paid better attention, he would have been saved.
TL;DR: pay attention to the people you know. If something is slightly off and the person himself does not seem aware of it, this is definitely a strong signal that it might be a stroke.
But shouldn't the doctors have though, "Ok, this man has had two strokes. These symptoms could be of something much more mundane but as he has had two strokes we will take very precaution"? I don't want to start the free health care debate but is that a problem? We have free health care and doctors seem to be willing to admit you for a night even if there is a very high likely hood you're fine. Do finances come into it more in the US and actually effect patient care?
As discussed in another comment, the earlier the better. The idea is for as little time as possible to have elapsed between blocking off the blood supply and opening it up again. The reason for this is that when part of the brain becomes ischaemic, a central core dies instantly but around this there is a halo or penumbra that is not dead but at risk. This penumbra of tissue dies off over time, and can be saved if the blood supply is reconstituted. The penumbra can be visualised using quite clever MRI . Having said that, trials that have tried implementing this kind of imaging to guide thrombolysis have not been positive, as compared to just thrombolysing everyone.
One source on that: http://www.uamshealth.com/?id=10724
PS: From you link "If the person who is injured is awake and holding a conversation, you can let him or her fall asleep as long as they are not developing any other symptoms such as dilated pupils or issues with walking. "
Time = Brain
every second a stupendously large number of neurons die.
at 4 hours the damage is complete, there will be total wipe-out of the infarcted area.
you really want to get to emergency within half an hour.
Note, this is for an ischaemic stroke. If you have a haemorragic stroke (usually in the elderly and in those with ruptured aneurysms) there will be little that is possible except supportive care
If you think even remotely it's a stroke then straight to the hospital you go.
https://www.youtube.com/watch?v=yXONEHmupy0 (UK National Health Service Advert about strokes)
Diet and exercise are, apparently, the easiest levers you have to control for stroke risk. Trust me: this is the best of all possible reasons to care about those. You do not want to go through it and you do not want your family to go through it. Specifics elided for privacy but suffice it to say that it combined elements of a heart attack, advanced Alzheimer's, and a profound war injury in a compact package that arrived on a normal sunny Tuesday.
While there are often some kind of neurologic deficit associated with a stroke, the goal standard is, of course, a CT or CTA that should be administered immediately upon arrival in the ED of a suspected stroke (depending on the presentation of symptoms an exam by a neurologist may occur first).
The symptoms described in this story would absolutely make me think this person was having a stroke if she had verbalized them to someone with my training.
It's also worthwhile to point out that the person having a stroke may not realize they are having a stroke. People may have the obvious symptoms - slurred speech and hemiparesis - and refuse to acknowledge that these problems exist, because, in their mind, they don't.
If you think someone is having a stroke, record the time you first noticed symptoms and call 911 immediately.
I had a stroke one night in my 20's. When I woke up, my right side was numb (I thought I just slept on my arm), I spoke gibberish and was unable to write but I felt fine and I thought I spoke perfectly fine.
I finally figured out that something was not right when I tried to write a message to my mom on the back of an envelope to tell her that I was fine and I just drew a straight line instead of letters.
That's when she called an ambulance.
Luckily I was back to normal within a month, but I struggled for some time to to find the right words when talking.
At 28 I had to deliver a project with a very tight schedule and ended up working 70 hours a week. It was fine for about two weeks, then started to have a permanent headache, then chest pain, then collapsed in the gym. After a doctor check up it turned out I had a 24h average blood pressure of 190.
It all went to normal again after taking forced holidays.
I swore to never put anything before my health.
Don't overwork guys, it's just not worth it. Screw the rat race. Your health comes first, it's your most valuable possession.
Stress is always there even if you don't see it, and by the time you do and symptoms arise it's almost always too late.
As part of the recovery, I'm reading to her My Stroke of Hindsight, of Jill Bolte Taylor, and her symptoms and the description of the episode of the acute phase match largely: speech loss, paralysys of her right part of the body and rational disconnect with external stimuli.
This article highlights also how sensible we are to the changes of what we are at the end: physicochemical interactions. I was worried my girlfriend would lose her essence, but thanks to God her recovery has been amazing so far.
Would the "controversial routine full body scan" help? Specially to people who have a parent being an early stroke victim?
These things are scary as hell...
First 3 minutes of the house episode Fetal Position (S3 E17) demonstrate it.
I overheard the intake person talking with someone: "I'm worried about that guy in #68." Why? "He thinks he's got a spider bite, but he's got blood clot written all over him."
I felt pretty good about that; it meant I'd have a place to sleep for a whole night. Then I was suddenly surrounded by 5 or 6 people.
Sometimes slurred speech, tingling in the extremities, can't spell anymore, confused by the way people talk so _fast_, confused by simple things, excessively paranoid, feels like there's an Ace bandage wrapped around my chest.
You're a junkie. No. You're exclusively vegetarian. No. You're diabetic. No, I've been tested for that. Well, we'll take a blood draw.
I got an ultrasound over my legs -- and they discovered a DVT. Next thing I knew, they'd slapped me in hospital for eight days. I was put on no less than eight medications, the scariest of which was Coumadin (same as Warfarin, I think?) -- scary because they made me watch a video describing it, by which I mean "You follow these instructions to the letter or you gonna die, son." At least that's what it felt like. And I had to sign all kinds of waivers, or something. Two of the residents (very young women) told me that they had had DVT's themselves... possibly as a result of being exclusively vegetarian?
The diagnosis was: Pernicious Anemia. My understanding (which is not to be trusted) is that the myelin sheathing around my nerves has been dissolving for years. Apparently the communicating tissue between the axons in my brain had been going away for quite some time.
I liked this diagnosis because: it's easily treatable; it explains my increasingly weird behavior; I'm not dead from it.
The treatment is: Take B12 every day for the rest of my life.
The highly-abbreviated coda to the story is: My Doctor told I'd had this disease for at least ten years(!); hospital got me a case manager, who got me Disability, Homed, and a Laptop. But it took 2 years or so.
TLDR: Being exclusively vegetarian can cause DVT's
Every human being on earth that I know of needs this. It's not just vegetarians.
What foods were you eating while homeless?
I imagine it's fairly tough to come by nutritional yeast and other B-complex rich foods whilst living on the street.
My girlfriend is a strict vegetarian, gets her blood checked regularly, and is apparently fine. We assume because she supplements all of the necessary nutrients that she lacks in her food. Mainly iron and the b complex vitamins I believe.
> Each night, he pinched skin on my belly as I screamed like a toddler and he injected the medicine.
Her husband sounds like an awesome guy - taking care of her in that state sounds incredibly difficult.
> My husband and I decided to get a divorce.
> “I think in hindsight, it was your stroke that changed everything for me,” he said.
> I thought it was the affair he’d had. But maybe he had a point. “Maybe that was the year,” I said.
> People have asked if anyone around me could tell I was having a stroke. “Weren’t you acting weird?” they’d ask, and my husband’s mouth would turn into a thin line, and my friends who joined us for New Year’s would lower their eyes.
How long would that be hanging in the back of his head, eating at him about what he could have done differently?
My father ended up in the hospital with internal bleeding after he decided to start taking low dose aspirin on a whim because "it's good for heart health". I just straight up don't have it in my home because the last time I did, it predictably didn't work well because I was on prednisone and checking every little interaction gets tedious. Taking more than you need to of most things is kind of pointless.
Outside of this particular cause, you can live a healthy lifestyle to help prevent/control hypertension, diabetes, high cholesterol, and other problems that can increase your risk for stroke. There's a lot of ways to get sick or die - no point in stressing too much about one particular problem that is otherwise out of your control.
Blood clots and cerebral hemorrhage are the two sides of the coin. By popping an aspirin you shift the odds from blood clots to hemorrhage.
If I had to choose one of them, I'd take the blood clot.
Well I don't know, I'm not a doctor- that's why I'm asking the question, hoping that someone knowledgeable will answer with a concrete reasoning.
Your comment in its present form is quite pointless.
Among many interesting and inspiring themes, of interest to the HN community may be the disassociation of vision and objects. All of the deep learning models succeeding in classification emulate one side of the brain, while perspectives like this present life outside the constraint of rational thinking.
Jill Bolte Taylor:
My stroke of insight
http://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke... (18:19 min, Feb 2008)
And of course, the second consequence of being only a "reputable" publisher...they would've never even had a known name. I wish I could name all the many other news/story startups that have promised "just the good stuff" but have failed (Byliner comes to mind)...except they all quit so quickly that it's hard to even remember them.
I appreciate BuzzFeed's strategy as a content-provider and a technology company. And when it comes to actually reading their site, I have an easy tip: The more boring the headline, the better the content.
I don't even know how you'd find this article on Buzzfeed - the homepage is so obnoxiously cluttered with vapidness ("21 Hashtags All Curvy Girls Really Need") I only lasted about five seconds. It's like a parody of everything that's awful, only it's real.
Buzzfeed may well be a Trojan to get better content to those typically reading vapid junk? Or, more likely, a way of building a financially-secure publication from trashy beginnings.
If Buzzfeed can achieve financial security by creating an audience who enjoy feeble drivel ("54 Things You Probably Didn't Know About 'Gossip Girl'"), surely if they then start replacing that material with long-form, well-written, thought-provoking content (like this article), they run the risk of losing that audience? It seems to me that the people who want to see 27 pictures of Beyoncé with staccato-sentenced captions - and haven't grown sick of this type of content yet - probably don't ever want to read a long article about something more important than Paris Kardashian.
That rather than just vapid trash, I'd prefer seeing something occasionally informative in there for that market.
That monetising first through listicles in order to fundraise for more serious efforts could well be a valid strategy.
If you're Buzzfeed, and you're offering a bit of both, you can't really lose. You have the daily visitors reading their listicles and occasionally stumbling across something premium, and you have other markets who don't enter via the front page, but follow viral links from aggregators like HN or Reddit. Unless a front page is saturated with "ugh boring!!1" content, I don't know that there'd be a risk with their existing market.
One side of the fence gets slightly more educational content. The other gets more quality content, propped up by tabloid junk.
By the way, if anybody wants a hit of meta, it's astonishing how precisely the last five paragraphs there still apply.
How are we defining "good hacker" ?
> It doesn't include most stories about politics, or crime, or sports, unless they're evidence of some interesting new phenomenon.
Can a "good hacker" be curious and intellectually satisfied by political stories even if they don't include new phenomenon?
Don't get me wrong, I enjoyed the article. However, if we're saying, "this is on topic for HN" or "this is off topic for HN" it seems weird to have a definition that is 100% dependent on one's lived experiences and what they individually find interesting. Maybe someone really really likes cat pictures because of the color or makeup of the fur, or the instincts of felines. Maybe someone finds geopolitical discussions about surveillance states to be intellectually uninteresting because they feel helpless to affect reform. Or they feel most startups are void of substance and rely too much on VC funding and thus are not intellectually interesting.
I guess I'm looking for a bit more of an enumerated "this is acceptable" and "this is not" as opposed to "you'll know it when you see it."
A semi-objective thing about most of the uninteresting, non-HN-appropriate stories is how predictable they are, i.e. how repetitive of previous instances of the type. The more predictable a story is, the less information it adds and the less interesting it is.
There's a reason we say "intellectually interesting" to describe the stories HN wants. There are different kinds of interesting. For example, we all have an interest in the things we're personally invested in or identify with, but that is not intellectual interest.
Similarly, as humans we're highly interested in what other humans are up to, but that—think gossip and celebrity news—is not intellectual interest either. So a story can be interesting without being a good fit for HN, quite apart from not all having intellectual interests in common.
Maybe this explains why upvotes alone don't work for a site like HN. We upvote the things that excite our interest. It's too much work to pause and ask ourselves what kind of interest we're experiencing. And the non-intellectual kinds have the advantage—they require less attention to get excited. (For one thing, they rely on recognition, while intellectual interest relies on curiosity, which is an absence of recognition.) This is compounded on the internet, where attention is fleeting and fragmentary.
The advantage to so something like Reddit is if a topic is talked about too much or not at all, you can just add a channel and grassroots it. On HN, you only have a single timeline and front-page (yes, there's searching, but people are lazy). News sites have channels but editors which controls the stream (and most restrict who can edit). I think a more algorithmic approach to provisioning up and down channels for specific topics could be neat. Not really sure where I'm ultimately going with this, kind of free-forming based off issues I've seen with internet discussions and IRL discussions and recent controversies as of late. I think it's important to look at how HN does it's news/info vs. reddit vs. twitter etc, to me it doesn't feel like we've really 'optimized' it yet for user distributed news ... or maybe I'm not hip with the latest app.
If someone posted an article that went into depth about the make up of color and fur and the development on instincts of felines, I don't think the community would object to such an article.
Just posting a picture however, is just lazy.
What to Submit
On-Topic: Anything that good hackers would find interesting. That includes more than hacking and startups. If you had to reduce it to a sentence, the answer might be: anything that gratifies one's intellectual curiosity.
This popular myth of broad specialization of the hemispheres needs to die. The author lost credibility there.
Humanity never ceases to amaze me, on both ends of the spectrum.
Lost credibility? The author is telling her story, she is not writing a scientific paper.