Matthew Markert MD PhD 🧠/acc

This story only scratches the surface, but shows how our work in #brain #interface testing can lead to real-world #neurostimulation feedback for disease treatment #TheFutureIsHere #BCI. Now we need to expand the @OpenBCI data collection and @OpenAI systems #BigData

@aakashgupta This was at Basel just against a hallway wall without the case and it got me several times

Duane Hanson spent 40 years engineering exactly this reaction. He cast living people in fiberglass and bronze, then painted in every vein, every patch of stubble, every coffee stain. Real thrift-store clothing. Real hair, embedded one strand at a time. The duffel, the watch, the ticket stubs sourced from Florida flea markets. "The Traveler" is dated 1985, bronze polychromed in oil, mixed media with accessories. Hanson's "Cowboy" sold at Christie's for $428,400 in 2022. Life-size pieces clear $200K-$400K at auction. The Whitney, Smithsonian, and SF MoMA hold him in permanent collections. His estate is represented by Gagosian. In 2018 the Met Breuer hung one of his sculptures next to a 2,000-year-old Polykleitos marble. The brief was: make a sculpture that a stranger walks past, registers as another tired person at the gate, and feels something for, before the brain corrects. Hanson said his goal was capturing "fatigue, a bit of frustration, rejection." The realism is the delivery mechanism. The exhaustion is the cargo. You felt the fatigue first. Then you noticed the case. That sequence is the work.

@Mr_Husky1 *not the mother, apparently

@Mr_Husky1 Reading the replies, I hope when the question "will you please trade" is reframed as "if you don't move I will threaten, insult, and attempt to dox you" it becomes more understandable to those taking the side of the mother. A question has an answer, her's was never a request.

✈️ Imagine boarding a flight and settling into the seat you carefully selected and paid extra for, just to enjoy the view from the window. Minutes later, a mother with her crying child approaches and asks you to switch seats with the child. She's about to plead, as if giving in were your obligation. You're about to get up, because you were raised to be kind. But then you remember: you've been enduring the child's constant crying for several minutes. You stop and think: "Why should someone else have to put up with the tantrums of a child who barely knows me? Why give up what I worked hard to get just because?" So you calmly reply: "I'm sorry, I'd rather not move." That's what Jennifer, a passenger on a flight in Brazil, did. She refused to give up her seat and was filmed without her consent by the boy's mother, who accused her of lacking empathy: "I'm filming your face because it's disgusting that in the 21st century you have no empathy for a child." Jennifer didn't insult anyone. She didn't react with anger. But the media exposure cost her dearly: she went viral, was publicly shamed, all for saying "no" to something that wasn't her responsibility. Today, months later, Jennifer has decided to take action. She has sued the mother for defamation and emotional distress, and also the airline for failing to defend her against the harassment or intervene as they should have. According to her, the flight attendants even asked her to give in to the child's tantrum, which she considers inappropriate and unprofessional. Jennifer isn't seeking revenge. She's seeking respect. She's seeking to set boundaries. Because saying no is also a right. And this time, she might just win against the system that abandoned her. What do you think? Did he defend himself justifiably? Or do you think he overreacted?

@Rick_Pescatore @patrickc @mattpelo Then: the Electrome (mine!)

@patrickc @mattpelo Next up: the phenome

I'm lucky enough to have a great doctor and access to excellent Bay Area medical care. I've taken lots of standard screening tests over the years and have tried lots of "health tech" devices and tools. With all this said, by far the most useful preventative medical advice that I've ever received has come from unleashing coding agents on my genome, having them investigate my specific mutations, and having them recommend specific follow-on tests and treatments. Population averages are population averages, but we ourselves are not averages. For example, it turns out that I probably have a 30x(!) higher-than-average predisposition to melanoma. Fortunately, there are both specific supplements that help counteract the particular mutations I have, and of course I can significantly dial up my screening frequency. So, this is very useful to know. I don't know exactly how much the analysis cost, but probably less than $100. Sequencing my genome cost a few hundred dollars. (One often sees papers and articles claiming that models aren't very good at medical reasoning. These analyses are usually based on employing several-year-old models, which is a kind of ludicrous malpractice. It is true that you still have to carefully monitor the agents' reasoning, and they do on occasion jump to conclusions or skip steps, requiring some nudging and re-steering. But, overall, they are almost literally infinitely better for this kind of work than what one can otherwise obtain today.) There are still lots of questions about how this will diffuse and get adopted, but it seems very clear that medical practice is about to improve enormously. Exciting times!

@timecaptales Big ups to the legend himself, Marcus Pacheco holding it down for the Sharp collective

Daytime television in the 1980s was unhinged

@docakx Your body has limits, and optimal performance ranges, just like any other (bio)mechanical system. Most risks will reduce, most diseases will partly constrain, and most medications will be effective at a smaller dose with less side effects, if you lost weight and exercised.

Hit me with a harsh medical fact.

@curiositry I used a drill as a scroll saw today on 1/8" plywood, then filled the backing with gap foam - from the front it looks perfect #thereifixedit

I’ve often tried to think of examples of “function over form” thinking. Today I cut my floss with a lighter.

@AetherFox_ There is a wonderful book you may consider, I think it's speaks directly to this point of view - it's called "An Unquiet Mind" - Is the memoir of Kay Redfield Jamison. She was awarded a MacArthur fellowship genius grant, strong recommend to listen to the audiobook she narrates 🔥

Everyone is all pro ‘mental health’, until you actual live it and discover that a psychiatric diagnosis, however benign, will mean you are stripped of any credibility and will never be treated like a human being again in your healthcare.

@jewstein3000 You have my deepest regrets for what I'm sure I have no idea the extent it has been a challenging journey. I hope whatever scars that have been left are able to heal and if not, that they hurt you less sometimes, at least today. I'm sorry if I didn't know I was picking a scab.

@MatthewMarkert You're doing everything we say is awful about doctors: approaching patients with superiority, treating patients like we are crazy, not actually listening to us, etc. All that in a few tweets.

A lot of Drs mad at this thread and I just want to offer that the many MANY projections being made onto me only confirm what the original thread said, which was: if you mention a medication name, doctors will make tons of assumptions about you challenging their authority!

@jewstein3000 @julia_doubleday I only wish agreeing on what we agree on was easier. I listened. You are saying things declaratively, then want me to ignore your declarations. Seems like friction for friction's sake, but, I doubt categorizing docs as a class of people unable to listen makes it easier. I'll go.

@MatthewMarkert @julia_doubleday Listen, you're a doctor so you're likely to have this problem constitutionally. People in your profession are flawed like this: You are missing the point.

@jewstein3000 @julia_doubleday Great! Big fan of CGRPs and e.g. Botox for the right patient. Getting in the weeds. I hope you see the original statement...that I replied to...was not "I know Rx 3rd line agents so expensive they require authorization might work better." It was "NSAIDs and caffeine don't work."

@MatthewMarkert @julia_doubleday Ubrelvy has less side effects for me than excedrin

@jewstein3000 @julia_doubleday Of course I do, and individual experiences of course must be evaluated properly by an expert. However, at scale, by definition an over the counter medication has not met a side effect profile that was high enough to require prescription according to a safety committee.

@MatthewMarkert @julia_doubleday You had me until “less side effects than prescription drugs first.” That is case by case. A lot of doctors don’t even realize how many of us don’t tolerate Advil liquid gels bc of the formulation. Patients talk about it all the time. Do you?

@jewstein3000 @julia_doubleday I hope you have empathy for patients, the number of people who refuse to take over the counter meds for headaches without a doctor's permission would truly surprise you. It's ok to at least ask if they have tried something with less side effects than prescription drugs first.

@MatthewMarkert @julia_doubleday This is not advice. We all try excedrin.

@jewstein3000 @julia_doubleday Sounds like maybe this isn't the right combination for...I'm guessing...your particular migraines. Rather than an indictment of...as it appeared...the utility of the combination as being effective for *any* migraines, that someone plausibly well intentioned may have suggested.

@MatthewMarkert @julia_doubleday Jesus you dolts

@dr__idz It's not dumb. The statement is true - if patients prefer to take metformin than change diet is separate. Many will not tolerate doctors who say "lose 20lbs by next visit, here's how." It's true that this causes creep against effort from us...so not as zealous as we could be.

This is the dumbest thing I’ve read all day. Do you really think doctors don’t tell patients to “exercise and eat a healthy diet?” 🤦🏽‍♂️ The reality is, it’s far easier to adhere to taking a medication once a day than it is to go to the gym / for a walk and change your diet every day. Not to mention the social determinants of health that create barriers to healthy eating and exercise… but clearly this guy doesn’t have the capacity to understand these nuances.

@unintrstngcritt Step 1 of X: When did hurt start? Intermittent or constant? If intermittent, how long does it hurt? If intermittent, how frequent is the hurt? If constant, same hurt or progressively worse? Do you have [survey complex possible simultaneous cranial nerve compression] symptoms?

Can a big brave doctor explain to silly little me how "my head hurts" can distinguish a migraine from a brain tumour?

@jewstein3000 @julia_doubleday

@julia_doubleday And I just argued with a doctor claiming caffeine is good treatment for migraines plus NSAIDs. A rheum doc

@julia_doubleday Regrets on the challenges. Couple points: 1) Switch CGRP binding sites, ligand vs receptor. Try Vyepti. 2) Botox 60 units to the traps and 10 each to the masseters 3) Consider triptamine alkaloids (carefully) 4) Never forget migraines are symptoms of an overstimulation syndrome

Atp, I am on triptans, CGRPs, Botox, Topomax, beta blockers for my migraines which I stilllll get, along with eliminating alcohol, caffeine/all stimulants, gluten, using blue light glasses and reducing screentime. So on that note, bye bye! 👋

@julia_doubleday Not trying to confront your larger point, but the number of people who will not take Tylenol/NSAIDs without a doctor's permission would clearly surprise you and far eclipses the informed patient who might ask for an Rx by name. (FTR - I can't imagine being butthurt by that)

lol- well that’s exactly my pt. Why would a doctor get offended that I knew the name of the medication I needed and instead be contrarian and punish me by offering a less effective med that’s available over the counter- which I’ve obviously already tried if I’m at the doctor?

@0xQuasark @PWojcikowsky Former NIDA post-doc here, I've studied this space for decades. Absolutely not 3M amanitas users - I would be astonished if it was even 3 thousand. This is certainly a sampling error, most likely including ambrosia tea drinkers and muscarinergic prescription drugs (not similar)

@PWojcikowsky It caught me off guard, too, but I'm not making it up. I think it's all the Santa was a shaman stories and the increase in stories like Alice in Wonderland. Amanita has seen a massive surge in popularity coz of social media and such.

How many people are taking psychedelics in the United States? > 𝟱-𝗠𝗲𝗢-𝗗𝗠𝗧: 769k > 𝗜𝗯𝗼𝗴𝗮𝗶𝗻𝗲: 941k > 𝗦𝗮𝗹𝘃𝗶𝗮: 1.1M > 𝟮𝗖-𝗕: 1.2M > 𝗠𝗲𝘀𝗰𝗮𝗹𝗶𝗻𝗲: 1.4M > 𝗗𝗠𝗧: 2.2M > 𝗟𝗦𝗗: 3M > 𝗞𝗲𝘁𝗮𝗺𝗶𝗻𝗲: 3.3M > 𝗔𝗺𝗮𝗻𝗶𝘁𝗮 𝗠𝘂𝘀𝗰𝗮𝗿𝗶𝗮: 3.5M > 𝗠𝗗𝗠𝗔: 4.7M > 𝗣𝘀𝗶𝗹𝗼𝗰𝘆𝗯𝗶𝗻: 11M More Americans have tried mushrooms than actually live in New York City. 𝗕𝘂𝘁 𝘆𝗼𝘂𝗿 𝗱𝗼𝗰𝘁𝗼𝗿 𝘀𝘁𝗶𝗹𝗹 𝗰𝗮𝗻'𝘁 𝗽𝗿𝗲𝘀𝗰𝗿𝗶𝗯𝗲 𝗶𝘁. [𝘍𝘳𝘰𝘮 2025 𝘙𝘢𝘯𝘥 𝘗𝘴𝘺𝘤𝘩𝘦𝘥𝘦𝘭𝘪𝘤𝘴 𝘚𝘶𝘳𝘷𝘦𝘺]