Once CS became the hot thing to get a degree in, the impact was almost immediate. And based on my experience, it happened a decade earlier than you think.
In the early 90s, universities threw students straight into data structures and algorithms in LISP and expected fully half of them to drop out first year. By the early 2000s, the market was already full of useless grads. I was always on the east coast, but near as I could tell from the refugees I interviewed after the dot bomb, SV had been hiring anyone who could type as a senior developer, and the market just kept going downhill from then on. The schools must already have been complicit in it, because I had employees with degrees who didn’t even recognize the names of basic algorithms and data structures when the need for them arose. Now I see intro curriculum from serious schools that’s just a few loops in python or even visual programming in a browser. Less serious CS schools seem to be little more than job training programs. And of course, like this post shows, tens of thousands of coders who really have just completed a job training program are flooding the market.
When I started working, every programmer I worked with was at least competent. If they weren’t, they just didn’t have a job. There wasn’t such a desperate need for people and it wasn’t hard to find someone competent. Now I assume that someone’s code can’t be trusted until I see evidence to the contrary. I used to bring people straight in for in-person interviews or do a really quick phone screen. Then I started doing much deeper questions on phone screens. Now I have to start with a coding test, because 95+% of candidates cannot write simple programs in their language of choice, even though they’ve got a fancy degree and they sound like an expert on the phone, because they’ve been trained for that... but apparently they have not been trained to actually create software from scratch. One company I worked for had a well researched candidate screening program and was talking about spinning it off as a service by the mid-2000s. Now extensive screening is universal and there are multiple companies that you can outsource it to.
There’s no shortage of developers on the market, but there’s a real shortage of good ones. If you’re right and that shortage ends at some point, there’s going to be a sea of unemployed, unqualified coders who need job retraining or something. But I don’t see the shortage ending unless the pipeline starts spitting out more well qualified people.
Exactly. Street ketamine powder is often heavily cut. If I had to buy illegally for some reason, I would only consider buying sealed vials, and I'd probably still have them tested. My ketamine doctor has worked with patients who used to buy on the street, and they brought in "ketamine" that was the wrong color, had flecks of different colors in it, etc.
The negative side effects of ECT can be dramatic and life-changing. I've known people who lost significant chunks of their memory (and that's with modern ECT), and they said it was worth it for them... but I have zero interest in risking that. If the alternative is killing yourself, it might be worth it, but for TRD without attempted or planned suicide, I have never even considered ECT seriously.
That can be a side-effect, especially with bilateral lead placement. With unilateral placement, it's pretty occasional. I wonder if knowing two people with the same problem indicates a local psychiatrist using bilateral approaches more than usual?
In a situation like that where you're in pain and anxious to start with, and are not prepared for what's going to happen, I can imagine it would be pretty horrible. I was in a comfortable situation and well-prepared when I got my first IV, and there were still a couple of brief, scary moments in the experience. And as someone else said, you probably got a much bigger dose, putting you deep into k-hole territory, if not actually knocking you out. When used for therapy, that kind of dose is usually reserved for those with chronic pain or other conditions, not depression or suicidal ideation.
You don't need to start your own IV to do it at home. I've been getting IV ketamine occasionally for around 8 years. I've also been using a prescription ketamine nasal spray for most of that time. For me, the effects of the two are nearly the same. Intranasal only has about 20% of the bioavailability of IV, supposedly, although in my experience it's closer to 10%. It takes quite a few sprays to achieve the same level of the drug as the IV treatment provides, but it works.
$130 gets me 3000mg in a spray every month. That's enough for about 4 IV-equivalent treatments even with the low bioavailability. The biggest difference is that the intranasal (of course) absorbs more slowly than an IV, so some of the effects last for 2-3 hours after I stop administering the spray, whereas once the IV runs out, I'm ready to leave the clinic in about 15 minutes. (Taking an uber or the subway rather than driving, obviously.)
The therapeutic index for ketamine is ridiculous and I know I don't have adverse reactions to it, so I'm not at all concerned about harming myself with it accidentally. I wouldn't recommend it for anyone who hasn't had some IV treatments, partly because a small number of people do have strong negative reactions to it, and partly because it would be really difficult to know what kind of effect you need to achieve. It's pretty easy for me to tell how high the levels in my blood are because I'm so familiar with how it feels as the IV dose escalates.
While I wouldn't recommend it for an initial treatment, I would recommend it to anyone who has been successfully treated with ketamine. Unfortunately, I think that it's harder to get now. I know my doctor has stopped prescribing it to patients because too many people were selling or abusing it.
I agree. I think people would be far more likely to try it out if you could kick off a dev server from the CLI without having to fire up any extra processes.
Unfortunately, that's not true. Corporate networks got rid of plain old proxies that just passed anything SSL on 443 many years ago. In order to meet regulatory requirements to record employee communications, pretty much every US company of any decent size uses a proxy (blue coat, zscaler, palo alto, etc.) that executes MiTM attacks on all SSL traffic. If it's something other than HTTP over SSL, or if it's to a blocked hostname, it won't go through.
The sad part is that a lot of people don't even seem to care.
When my relatively small company announced that they were installing a Palo Alto firewall and that everyone needed to install client side certificates in order for web browsers to continue working, it set off major alarm bells in my head that led to one conclusion -- "No more non-work related web browsing at the office. No exceptions."
Most of my coworkers (albeit mostly those in support and not developers, but still people at least somewhat familiar with the way computers work) only cared that they'd still be allowed to visit Facebook during the day.
I was assured that "nobody was actively looking at employee web traffic" but that doesn't matter. They didn't even think it was a big deal to put this new monitoring in writing until I made a big stink out of it, and they added this to the employee handbook:
>Each of these communication avenues are subject to monitoring by the IT Security Manager, a supervisor, or the President. When using any of these communications, be aware that a business record is made, which is retained by the company and becomes the company's property. This business record may potentially contain sensitive personal information related to the sites you are viewing and into which you are logging on, including user/password information. If you do not wish to share such information, it is suggested you do not access those items using [employer]'s network.
I generally leave my clinic about half an hour after my infusion ends, but I'm taking the subway. If I were going to drive I'd probably hang out for 60-90 minutes. The dissociative and psychotomimetic effects wear off pretty quickly. But this depends on dose... my doc used to use higher doses before there was as much research around what works, and back then it would sometimes take a few hours before I felt back to normal in terms of cognitive and motor skills.
I'm in the opposite boat, the dose I receive is fairly high and I'm unable to even stand for around 20 minutes after it ends. There's no way I can drive the day of. As for the events, the feeling of dissociation takes around a day to fade for me. I also have a high deal of cognitive impairment from it, or detachment in my thoughts?
$400 is a fairly typical price. The ketamine itself is cheap, but operating a clinic doing off-label infusions that take an hour or two each is expensive. And nope... no insurance in the US that I know of covers it.
In the early 90s, universities threw students straight into data structures and algorithms in LISP and expected fully half of them to drop out first year. By the early 2000s, the market was already full of useless grads. I was always on the east coast, but near as I could tell from the refugees I interviewed after the dot bomb, SV had been hiring anyone who could type as a senior developer, and the market just kept going downhill from then on. The schools must already have been complicit in it, because I had employees with degrees who didn’t even recognize the names of basic algorithms and data structures when the need for them arose. Now I see intro curriculum from serious schools that’s just a few loops in python or even visual programming in a browser. Less serious CS schools seem to be little more than job training programs. And of course, like this post shows, tens of thousands of coders who really have just completed a job training program are flooding the market.
When I started working, every programmer I worked with was at least competent. If they weren’t, they just didn’t have a job. There wasn’t such a desperate need for people and it wasn’t hard to find someone competent. Now I assume that someone’s code can’t be trusted until I see evidence to the contrary. I used to bring people straight in for in-person interviews or do a really quick phone screen. Then I started doing much deeper questions on phone screens. Now I have to start with a coding test, because 95+% of candidates cannot write simple programs in their language of choice, even though they’ve got a fancy degree and they sound like an expert on the phone, because they’ve been trained for that... but apparently they have not been trained to actually create software from scratch. One company I worked for had a well researched candidate screening program and was talking about spinning it off as a service by the mid-2000s. Now extensive screening is universal and there are multiple companies that you can outsource it to.
There’s no shortage of developers on the market, but there’s a real shortage of good ones. If you’re right and that shortage ends at some point, there’s going to be a sea of unemployed, unqualified coders who need job retraining or something. But I don’t see the shortage ending unless the pipeline starts spitting out more well qualified people.