EnglishmanAbroad ری ٹویٹ کیا
EnglishmanAbroad
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EnglishmanAbroad
@WakingDrake
I believe that spirit created matter. Also that metaphysical questions about first cause and the nature of reality can largely be induced from human behavior.
Japan شامل ہوئے Şubat 2011
576 فالونگ498 فالوورز

@macroschema @a_vogel46532 The fruit of different apple trees grow radically different tasting apples.
With humans, the politically acceptable answer is nurture>nature, but I no longer believe this is the case.
cato.org/sites/cato.org…
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EnglishmanAbroad ری ٹویٹ کیا
EnglishmanAbroad ری ٹویٹ کیا

I didn’t buy it because of the woke stuff.
It makes me non-buynary.
We are living in age with so much entertainment available that it isn’t necessary to choose anything one finds inimical.
For a mere $3 someone could be reading one of Robert Howard’s amazing pulp stories instead.
delphiclassics.com/shop/robert-e-…
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@YorchTorchGames KCD2 is amazing and loads of fun.
If you like a simulation sandbox which is slower.
But you clearly care more about the politics than actually if the gameplay is good.
Super super cringe gamer.
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@RussellShaw_MLS @ElieJarrougeMD Yes, fair enough. Well said.
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I’ve worked alongside physicians for 15 years. I’ve called them at 2 AM with critical values. I’ve watched them make decisions under pressure that most people can’t comprehend while running on four hours of sleep, three patients crashing simultaneously, and a system that penalizes them for spending an extra ten minutes with anyone.
Some of them are exactly what you’re describing. Box checkers. Script writers. Twelve-minute machines who stopped caring somewhere around year eight and never found the switch again. I’ve seen those too. I won’t pretend they don’t exist.
But I’ve also watched a physician fight with insurance for 45 minutes to get a patient’s imaging approved because they knew something was wrong and the algorithm said it wasn’t covered. I’ve seen a doctor stay two hours past their shift because a lab result came back that changed everything and they weren’t going to let the night team deliver that news cold. I’ve seen physicians order the tests that the system doesn’t reimburse because the patient needed them and they’d rather eat the cost than miss the diagnosis.
Those doctors didn’t sell their soul. They’re practicing medicine inside a machine that’s trying to turn them into clerks. And they’re fighting it every day in ways you’ll never see because the fight happens in the chart, on the phone with insurance, and in the 10 PM emails nobody reads.
Painting every physician as a captured agent of the system is the same reductive thinking that paints every supplement as a scam or every patient as noncompliant. The world is more complicated than that. The system is broken. The people inside it are a mix. And the ones still fighting deserve better than being lumped in with the ones who quit.
Your frustration with the system is valid. Directing it at every physician who shows up to work inside it is not.
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The thing is that once they’ve repeatedly sold their soul 12 minutes at a time, day after day, week after week, decade after decade, they have become the system. They have learned to love Big Brother. The doctors I’ve known who worked outside the system in the interest of their patients have been exceedingly rare.
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The frustration is understandable. The conclusion is wrong. And the framing ignores the physicians who are actually practicing medicine while the system around them makes it nearly impossible.
Let me take these one at a time.
“Obesity? Drug. Hypertension? Drug. Diabetes? Drug. LDL? Drug.” That pattern is real. And in many primary care settings, the 12-minute appointment window doesn’t allow for anything else. The physician isn’t choosing the drug over lifestyle intervention because they don’t understand the alternative. They’re choosing the drug because the system gives them 12 minutes per patient, reimburses procedures and prescriptions, and doesn’t reimburse the 45-minute conversation about insulin resistance, dietary pattern, sleep, training, and the comprehensive panel that would identify the upstream drivers.
The vending machine isn’t the doctor. It’s the system the doctor works inside.
“100% management. 0% reversal.” Type 2 diabetes is reversible in a significant percentage of early cases through insulin sensitization, dietary changes, and resistance training. Hypertension is modifiable through sodium reduction, weight loss, training, stress management, and potassium intake. Obesity responds to metabolic interventions that go far beyond appetite suppression. Elevated LDL is reducible through dietary changes, fiber, and in some cases lifestyle alone produces the same particle reduction a statin would. Reversal is possible. It’s just not what the system incentivizes.
“AI could replace outpatient doctors tomorrow.” No. AI could replace a bad algorithm masquerading as clinical judgment. It cannot replace the physician who listens, examines, integrates context, recognizes the atypical presentation, and catches the thing the data alone wouldn’t have flagged. That physician exists. There are more of them than this post suggests. The problem is that the system they operate in rewards throughput over depth.
Here’s the lab perspective.
AI could absolutely improve screening. An AI system that flags a fasting insulin trending upward over three consecutive annual panels, cross-references the trajectory with family history, correlates it with rising triglycerides and declining HDL, and recommends a comprehensive metabolic evaluation before glucose ever rises. That system would catch insulin resistance a decade before the current model does. And it doesn’t need 12 minutes or a prescription pad to do it.
But that AI still needs a physician to interpret the clinical context, communicate the findings with the empathy and clarity the patient needs, and guide the intervention. The screening can be automated. The human relationship cannot.
The system needs fixing. The doctors inside it are not the system. Replacing them with AI solves the wrong problem.
Don’t wait for the diagnosis.
Read the label.
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Well, it would be nice to believe in a platonic ideal of a pharmaceutical industry, one which prioritizes health over profits, over repeat business, and over the encroachment of medicine ever further into daily life, but that’s not the world we live in. I once made up (with the help of an LLM) a list of the issues that have reduced my faith.
Massive industry payments to gatekeepers: Pharma paid $1.06 billion to peer reviewers and editors at top journals (2020–2022 alone), creating clear conflicts of interest.
• Revolving door: Regulators and academics routinely move to high-paying pharma jobs, incentivizing them to protect industry-friendly consensus during their careers.
• Publication bias: Journals overwhelmingly favor “positive” results that support the mainstream view; null or critical findings are buried.
• Sponsorship bias: Industry-funded studies are far more likely to show favorable outcomes and get published, skewing the entire scientific record.
• Ideological gatekeeping: Reviewers routinely reject solid papers that contradict their own beliefs or the prevailing paradigm.
• Prestige bias: Work from unknown researchers or institutions is dismissed, even if rigorous.
• Replication crisis: Pharma giants like Amgen could only replicate 11% of landmark preclinical cancer studies they tested. Bayer hit ~20–25%. Huge chunks of "breakthrough" biomedical research (the stuff feeding drug pipelines and guidelines) don't hold up when re-tested.
• Repeated fraud settlements: Pharma companies have paid over $120 billion in penalties since 2000 (including $60+ billion from 1991–2021) for fraud like off-label promotion, kickbacks, and data manipulation—yet misconduct persists, signaling it’s just a cost of doing business that protects profits over truth.
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@AaronSiriSG Worse, it becomes self-sabotage if you criticize only domestically. It weakens your own country’s technological edge, often initiated by the tax and hard work of your fellow countrymen, and hand that advantage to adversarial countries. (3/3)
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Video of my talk at the Kennedy Center this week in which I got to tell members of FDA, CDC, etc., the desperately needed changes they need to make!
(0:00) Intro by Senator Ron Johnson
(14:23) Aaron Siri Begins Presentation
(17:02) Why Vaccine Companies Can Kill With Impunity
(25:34) Current Epidemic of Chronic Childhood Diseases
(30:59) FDA’s Abject Failure to Assure Safety Pre-Licensure
(47:42) FDA Reforms
(49:22) CDC’s Abject Failure to Assure Safety Post-Licensure
(1:09:15) CDC Reforms
(1:10:33) HRSA Reforms
(1:11:18) NIH Reforms
(1:11:58) CMS Reforms
(1:13:28) HHS Reforms
(1:17:18) Depoliticizing Vaccines
(1:19:33) Mandates Are Illegal and Immoral
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EnglishmanAbroad ری ٹویٹ کیا

This is fundamentally correct.
Peter Jackson edited out the Scouring of the Shire, the most important part of the trilogy, where the Hobbit war veterans came back home and killed all the foreigners in The Shire who were committing crime, vandalizing property, driving down wages, and ruining the quality of life for Heritage Halflings!

CBR@CBR
The Lord of the Rings trilogy is an iconic film series, but it also has many elements that are difficult to watch in modern day. cbr.com/8-reasons-toug…
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EnglishmanAbroad ری ٹویٹ کیا

🏴🇬🇧 Chapter One. The Beginning of the End.
This is the story of how ordinary British people ended slavery.
It starts here. In 1086.
William the Conqueror had just seized England by force. His first act was to count everyone in it. What the 'Domesday Book' revealed was extraordinary.
More than seventy percent of the people on this island belonged to someone else.
Not slaves. But not free. Serfs. Bound to the land from birth. Unable to leave. Unable to own property. Their children inherited their chains automatically.
Then in 1348, the Black Death arrived.
Within two years it had killed nearly half the population of England. Villages emptied overnight. And the survivors realised something the lords had hoped they never would.
They had power.
They demanded wages. They walked off the land. They refused to return on the old terms. Parliament passed a law in 1351 to force them back.
The people ignored it.
In 1381, sixty thousand ordinary people marched on London. They burned the records that proved their bondage. They demanded to be treated as human beings. The king rode out, made promises, then broke every one of them. The leaders were hunted down and executed.
But serfdom never recovered.
Without a single law. Without a king declaring it so. Over the next hundred years it quietly collapsed. The English simply stopped accepting it.
By 1500 it was dead.
Three hundred years before France.
Nearly four hundred before Russia.
This was the character being forged. On this soil. By ordinary people who refused to stay down.
And they were just getting started. 🇬🇧
Their individual stories are on our page. Our book is coming soon.
Help us make this possible. proudofus.co.uk/support
Be Part Of Us.
Be Proud Of Us. 🇬🇧
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@DrInsensitive They can’t have read the Scouring of the Shire or King Aragorn’s later border policy for the hobbits which kept their homeland free of anyone else.
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Mrs. Jerk hangs out on Reddit. She says Redditors are offended that Right-wingers think Lord of the Rings is Right-wing.
They see the fellowship as a diverse crew, and the Orcs are White supremacists.
They don't seem to notice that Hobbits, Elves, Dwarves and Men get along so well because they live in separate countries.

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EnglishmanAbroad ری ٹویٹ کیا

@GamehagEN @Pirat_Nation Steam.db lists out player counts.
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EnglishmanAbroad ری ٹویٹ کیا

@orschgeisch @Grummz It appeals to me. I’m enjoying chasing bandits, subduing them, and bringing them back for the bounty. And at the same time exploring, improving my gear, etc. I love the game. Equal to the enjoyment from the best games I’ve played so far.
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@Grummz But it is still a failed mmo turned into Open world single player slop.
Seems to me to be a bad mix of Assassins Crees and Where winds meet + whatever they could find.
Main quest that are like MMO side quest in a single player game, come on, thats Bullshit and you know it.
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@WakingDrake There's nothing to disagree with from my last comment. I said PERSONALLY
P E R S O N A L L Y
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@iAlek00 @kabrutusdeid I don’t agree at all. I’m finding it top quality.
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@kabrutusdeid You can't compare these 2 tittles with games like RDR2, but if you put Crimson side by side with any great open world game, that piece of trash is not even an 4.
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@DrewDruc56 @RealLifeFakeWiz Yes, me too. I think its great.
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@RealLifeFakeWiz Sorry you had that experience. This is the first time I feel like I’ve gotten my $70 worth in a long time.
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I regret buying Crimson Desert.
I especially regret spending $70 on it.
Don't buy this game until they do Cyberpunk 2077/No Man's Sky levels of patching and updates.
Fake Wizard@RealLifeFakeWiz
Crimson Desert has a lot of problems. (Playing on PS5) ((I think that's part of the problem))
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