Brian Appavu, MD

link.springer.com/article/10.100… I wanted to share our latest study (last study fully completed at Phoenix Children's, before I left), now published in Neurocritical Care, where we demonstrated a method using EEG to detect signs of covert conscious processing in comatose-appearing critically ill children. Access to the full article can be seen here: rdcu.be/e3xW3 This study was difficult and challenging - probably the most challenging study I've done at this point in my career. Everything that could've gone wrong did go wrong. There were many points where I thought the study would halt, but it was seen to the end, and now it's complete and published. Thanks to everyone who supported this work, especially my co-authors. @PNCRGtweets @CuringComa @NeurocritCareJ @neurocritical

Endless money printing is the source of most of your economic woes. It's not 'billionaires', 'capitalism', or any particular race of people. Your pounds, dollars, euros, naira, and yen are devalued daily. And as long as the problem is misdiagnosed, it will continue forever.

This is true on so many levels...

@AdamBLiv I credit Naval Ravikant (@naval) for saying something that really resonates with me: "Groups search for consensus, individuals search for truth".

Too many investors on X outsource conviction by seeking consensus instead of cultivating understanding. Consensus is an illusion, because every trade requires disagreement. The illusion deepens when people seek comfort from those with different time horizons, risk tolerances, or goals. True conviction arises only from differentiated insight - understanding what others don’t. Therein lies the opportunity.

The best decisions I’ve made in my life so far were the ones that made sense to me—but looked bad or 'weird' to others around me. The worst decisions were the ones that aligned with everyone around me—when a quiet part of me knew something didn’t feel right. Both kinds of decisions have shaped my life—in investing, relationships, and professional ambitions. I think true progress in this beautiful, mortal life comes from asymmetric conviction—the courage to act when your intuition sees something the crowd doesn't. Consensus exists for a reason—it’s not always wrong. But growth requires knowing when to listen, and when to break away. See the flaws others overlook. Build where the world is brittle. Follow your gut and your passion, but make sure that you've searched deep within for the clarity you need to act with conviction.

@FischerKing64 Is this an advertisement for Singapore?

I just want a society where I can live in a city, walk down the street, be confident no one will attack me, see no homeless ‘camps,’ I can shop at businesses - and it all kind of works out. Not hard. We’ve had it before.

@PatrykDenari Dude, you are making great content here and on your Youtube channel. Keep up the great work!

You were never supposed to win with fiat. They gave you school instead of skills. Debt instead of ownership. Wages that shrink and bills that grow. And called it “the economy.” But you started asking questions. You started reading. You started stacking. And now… they call you crazy. Stay crazy. Because that’s what they always say to people who escape first.

This is an interesting area of discussion. I have lots of patients with epilepsy that have an aversion to doctors and starting antiseizure medications. I always am up front that antiseizure medications fundamentally act on the brain, and as such, they are bound to have risks of side effects, and we need to figure out how to balance benefits and side effects. Among clinical peers and trainees, there's often a common conversation of what drug I 'go to' for certain types of epilepsy conditions. I find the conversations a bit puzzling in the sense that while there may be studies showing comparative advantage for certain medications in reducing seizure burden, nothing is a one size fits all. I don't have 'go to' medications. I'd rather listen to the patients family, hear what represents good quality of life, educate patients and families regarding their epilepsy and various antiseizure medications, and then work to respect and empower their informed decision. They almost never make a terrible decision when they are respected, educated and fully informed Sometimes, I feel like there are others who think I'm bizarre for taking that approach.

I just had a patient experience an hour ago reflecting this exact situation. She has uncontrolled diabetes, cholesterol, and hypertension and came in with a stroke. She told me she hasn’t been on meds because of her lack of trust in the system/doctors and what she has heard about medication side effects I acknowledged and sympathized with her concerns and explained the rationale for wanting to start meds and explained possible side effects. Simply taking the time and not dismissing her fears was enough for her to take a new position. It was a wonderful moment to see her relief and feeling heard.

It's hard to truly understand how radical some of @DavidDeutschOxf theories are compared to much of modern scientific consensus. One of Davids most controversial but valuable contributions to society is the rejection of probability (with the exception ex. card games) as an expression of truthiness or justified beliefs when applied to predictions or conclusions. There is no probability of how likely we are to be hit by a meteor tomorrow. There is no probability of how likely the stock market is going to be doing as well tomorrow as it is today. There is no P(Doom), no percentage you can put on whether AI is likely to wipe out humanity or not. Things either happen or they don't and we can either explain why they will and how or we can't. All attempts at putting percentage on a prediction is really just guesswork dressed up as reasoning. If a meteor is going to hit us tomorrow it's already on the way and the probability is 100%. If the stock market is going to crash tomorrow the reasons for it's crash have already been put in motion maybe decades before. If the AI is going to kill us all depends on what we decide to do with it not what some calculation says. Davids primary critique is for the field of science but it goes beyond that. Far too many of decisions done in modern society is based around the false certainty of using Bayesian probability. It's like a placebo for a society that demands certainty in an uncertain world. It's not just false it's regressive as it slows down knowledge creation. The only thing that can change the outcome of the future is the creation of new knowledge. Knowledge based on good explanations that are hard to vary. We can create knowledge that allow us to divert the meteor before it hits earth. We can create knowledge that will allow us to hinder a crash of the stock market (both directly or indirectly) We can create knowledge that let us evolve side by side with very powerful AI instead of enslaving it or be enslaved by it. Like everything else in life there are no guarantees but there are definitely better or worse ways to deal with uncertainty, probability just isn't one of them.

The Art of Medicine: My Recent Experience youtube.com/watch?v=L3rWMW… #Medicine #Healthcare

There are few things as professionally motivating for a young man as having children. I have seen it time and again over the last few years. A friend has their first child and they seem to go into beast mode at their job or company. Part of it is probably a drive to provide financially for their family, but there is also a sense of pride to work hard as an example to their child. Whatever the reason, give talented young men a child and they seem to amp everything up. Pretty cool to see.

Reification: The Invisible Spectra Our Words Ignore youtu.be/ll5rM3k5o4w #Philosophy #Neurology #Neuroscience

Many situations in life are similar to going on a hike: the view changes once you start walking. You don't need all the answers right now. New paths will reveal themselves if you have the courage to get started.

@Mark_MNLocal Awesome article, Mark! @Mark_MNLocal

@AppavuBrian So true I meant to tag you on this post. I thought you’d appreciate it

If you have to make a hard life decision, play with your kids the night before you do. You'll know what you need to do.

Great comprehensive article from Dr. Mark Stephany (@Mark_MNLocal) looking at bitcoin from the thought process of a clinician.

I felt compelled to write an article in response to the recent New York Times article from @sjauhar regarding redefining brain death. As a neurologist with my own experiencing working in this domain, I have thoughts I wanted to share.

“The truth or falsehood of a belief depends upon whether the belief corresponds to a fact, not upon any other circumstances, however useful the belief may be.” - Bertrand Russel (The Problems of Philosophy, 1912) nytimes.com/2025/07/30/opi…