Relocating to Copenhagen considered harmful - <AUTHOR> http://www.easyexpat.com/forums/copenhagen-housing-hell-t27714.html <comment><USER2> The problem is that you sent e-mail instead of calling.

I had the same experience in a nearby city, sending 30-40 emails for every 1 response. I finally decided to get a prepaid SIM and start calling people, and suddenly things became much easier.

The person who I eventually rented an apartment from explained that she placed the ad in the morning, went to work, and received my call (and a few others) before she returned home to read her e-mail, which contained over 100 replies. The people who called already had appointments to see the apartment, so she wasn't even going to look at the mails unless those people were uninterested. She also remarked that she could tell from our brief initial conversation that I seemed like a nice person, which helped my chances; she doesn't get that benefit from an email conversation.

Looking at it from a potential landlord's point of view, it makes sense that calling an ad that has just been placed is going to have the highest success rate; not everyone checks their mail as often as tech-minded people.

<comment><AUTHOR> Sage advice, I'll probably try it. Still, this may fix _my_ immediate problem but it doesn't do anything for the elephant in the room that, judging from the comments here, was hardly addressed:

 _she returned home to read her e-mail, which contained over 100 replies._

 _THIS_ is the real problem. At the end of the day (or the week) it doesn't matter _how_ one out of the 100 candidates is selected; what matters is that 99 fools will have to keep looking. Finding housing shouldn't be like applying to Google.

<comment><USER2> What are you claiming is the "real problem?" I'd argue that the housing market in CPH is no more scarce than any major city, and the only reason it seems so to you is because you were seriously handicapping yourself by not optimizing your approach.

The fact that my landlord's ad received over 100 replies just indicates that there's a pool of "bottom performers" who are repeatedly trying to find housing by responding to ads despite the fact that they're doing some things wrong. Every new ad is going to receive a large number of responses from this same group of hopeless people. If they want to find a place, they're going to have to find out what's wrong with their approach and make some changes, just as I had to do.

</comment></comment></comment><comment><USER3> Wow. Just wow. You've basically managed to reinforce just about any stereotype of an ignorant, unprepared American who shouldn't even be trying to live abroad.

This quote says it all:

> The building looked like a century old, fourth floor with no elevator (seems > to be the norm almost everywhere)

BTW, one of the first things you should figure out when relocating is how the local housing market works, otherwise you will get screwed. Guess what: it works the same way the other way around (what do you think a European will experience if they try to move to NYC unprepared?).

<comment><USER4> My least favorite bit is the part that says "I'm now seriously considering to cut my losses, call it quits and fly back to civilization.".

As if civilization is determined by the housing situation and/or your own efforts required in order to get affordable housing, and any place that doesn't instantly give you a place to live within your means is not civilized.

<comment><USER5> Nevermind that Copenhagen is arguably one of the nicest cities in the world, in one of the most "civilised" nations in the world. Ugh.

</comment></comment></comment><comment><USER6> Copenhagen is one of the most expensive and over-crowded cities in the world. I'm not surprised that you couldn't find something in a rush. People sign their kids up for housing when they're born in this city.

That said, it sounds like your scope is something like the inner city of Copenhagen. That's a terrible starting point. It's much easier to find an apartment in the greater Copenhagen area: Frederiksberg, Albertslund, Ballerup, Brøndby, Gentofte, Gladsaxe, Glostrup, Greve Strand, Herlev, Hvidovre, Ishøj, Lyngby-Taarbæk, Rødovre, Søllerød, Tårnby, Vallensbæk, Værløse.

I am surprised, however, that your employer hasn't given you any references, tips, or even subsidized housing. Considering how hard it is to find housing in Copenhagen as a Dane, it seems strange they would expect a foreigner to just "figure it out".

At least get a Dane to interpret all of the Danish apartment postings you're missing.

<comment><USER7> > Copenhagen is one of the most expensive and over-crowded cities in the > world.

Overcrowded? Copenhagen has 6,100 people per km2. New York City has 10,600, Paris has 20,900.

Expensive? Sure, but not when it comes to housing. Renting an apartment in the city center is much cheaper in Copenhagen than in many other larger cities.

> Considering how hard it is to find housing in Copenhagen as a Dane

It used to be hard. Nowadays it isn't that bad. But you do need to ask around. What cphhell should have done is talked to his employer - and, like you said, he should broaden his scope. If I go to live in NYC I don't expect to get an apartment on Times Square.

<comment><USER8> Population density is hardly a good measure. Munich has 4300 people/km2 and, let met tell you, it's hard to find an affordable flat there. NYC or Paris are hardly a good comparison, either. In this sense, Munich is very crowded. In October, in particular, the housing situation is even more difficult, given thousands of new students. I'm sure Copenhagen is somewhat similar.

<comment><USER7> > Population density is hardly a good measure.

thirsteh claimed that Copenhagen was overcrowded. I didn't bring density into the discussion.

> Munich has 4300 people/km2 and, let met tell you, it's hard to find an > affordable flat there. NYC or Paris are hardly a good comparison, either. In > this sense, Munich is very crowded

"Crowded" in the sense that thirsteh used refers to population density, not whether or not it's hard to find an apartment. Also, you can't automatically assume that it's hard to find an apartment in Copenhagen just because it is in other cities. It's gotten a lot easier in the past few years, and if you're willing to look beyond the city center, you'll find something pretty fast.

<comment><USER6> So, basically, exactly what I said? Are you just arguing for arguing's sake? :)

</comment></comment></comment></comment></comment><comment><USER4> If a small bump on the road like this is going to make you run then emigration is probably not for you.

In time you'll have to deal with lots more friction and red tape than the simple act of scoring a place to live in an area where such places are scarce.

If you do decide to stay, ask your colleagues if any of them would mind a roommate to cut their rent. In environments where housing is scarce doubling up is quite common. You might actually make someone happy to lower their effective rent a bit.

The domain linked is funny, being an expat is never 'easy', there are always hang-ups and issues. The grass always seems to be a lot greener on the other side, once you arrive you realize quite quickly that each place has its advantages _and_ its drawbacks. Easy is staying at home. Being an expat stands for broadening your world view and your skills at the expense of some inconvenience.

Oh, and we actually like those old buildings, the one I'm writing this from was built in 1903.

<comment><AUTHOR> > then emigration is probably not for you.

I'd probably think the same if I hadn't done this exact same thing on three different countries already without breaking a sweat (relatively speaking).

<comment><USER4> What countries were those?

Have you mastered the language?

<comment><AUTHOR> Suffice to say that one of them was Spain, a country with one of the lowest percentages of English speakers in Europe, and me not speaking a word in Spanish at the time.

Language is not the (main) issue.

</comment></comment></comment></comment><comment><USER5> I moved to Copenhagen from the UK in February and had no problem. You just approached it terribly -- Copenhagen is not in America, and different places have different ways of doing things. You can't just expect foreign cultures to play by your rules. You have to do your research and find out how the locals do it. I got to see several nice apartments and they were decently priced, and am spending approx. 10% of my monthly wage on rent.

"Donating half of my paycheck to the taxman in order to live in a city overpriced by any measure is one thing."

Copenhagen has some of the highest wages in Europe. It also has fantastic levels of social welfare, income equality, universal education and healthcare, etc. Whining about high taxes also just comes across as so bloody stereotypical.

<comment><AUTHOR> Is the 10% before or after taxes? Would love to get a sense of your rent (or equiv. wage) range if there are no privacy concerns.

The high taxes line was just a flippant remark, I can't really complain as I knew about it beforehand. Having said that, the perks that come from high taxes are of little value to an expat moving there for a 1-2 year gig.

<comment><USER5> Before tax. Rent is 3400 DKK, in a nice house share with two developers. Our lease is up in January (original owner wants it back), but it has been nice otherwise. 10 months here.

You can extrapolate the wage from this, but it's not high in the field at all.

</comment></comment></comment><comment><USER9> Culture shock. I was a military wife and lived in Germany for a bit less than four years. I had to deal with some culture shock when I first got there, but not nearly as bad as many Americans who go there: My mother is German, I already spoke some German, I knew from family stories that the furniture and stuff is different.

One of the big issues Americans have with German homes: "The refrigerator is the size of a dorm refrigerator!!!!" This weirds out many Americans like it's the end of the world or something. Oh, and let's not get into the fact that many apartments are "unfurnished"* -- by that, they mean there is no refrigerator or stove or kitchen cabinets or light fixtures (just wires sticking out the ceiling) or kitchen sink (just a tap sticking out the wall). Germans move into rentals and buy appliances, kitchen cabinets, etc. The American housing office would cut deals with landlords and go in and supply the sink, stove, frig (an American style frig), etc. If you aren't military and don't have a housing office bridging some of these issues for you, hey, you get to cope on your own with the difference between what is normal in the US and what is normal in other places.

If you aren't up for that, yeah, run back to the US and continue to measure "civilization" solely in terms of (your concept of) material wealth, without regard to food quality, actual culture, local history and so on. Please do so quickly, before doing yet more damage to the public image other nations have of us "ugly Americans".

* This was more than 2 decades ago. I have no idea if things have changed since then. Feel free to give an update if you have more current info.

<comment><USER10> 99% is still unfurnished, most Germans I know would never rent a furnished place unless they are students.

Update: A kitchen is often the exception.

<comment><USER9> Most American rentals are unfurnished, but it comes with a fully outfitted kitchen and bathroom(s). The bedrooms and dining room typically have light fixtures in the middle of the ceiling. The only room without lights is typically the living room. We also have closets which are a great deal less common in Europe.

Another big difference is that most American apartments have "wall to wall carpeting", something apparently so unusual in other countries that I often have to explain what on earth that means to foreign friends (the carpet is installed as part of the floor and nailed down). In your typical American apartment, you have vinyl flooring in front of the front door, in the bathrooms and in the kitchen. All other areas have wall to wall carpeting. From what I gather, wood, tile or similar flooring is far more common in other countries. I have respiratory problems and allergies. I wish I could find an apartment here with wood floors. Wall to wall carpeting is something I loathe. In the US, if you want wood and tile floors throughout the home to accommodate allergies and respiratory problems, you pretty much have buy your own house (or possibly live in New York, which I have no plans to do). In fact, wall to wall carpeting is so common here that even if you buy a house, you probably either have to rip out carpeting and install your own flooring or have the house custom built.

I am betting that the lack of carpeting is something the author of this article would view as proof of being "a dive"/slum. Lack of carpeting does occur in some older American homes, often ones which were never upgraded. So it tends to get interpreted by Americans as a mark of poverty. Given my health issues, I tend to side more with some of my foreign friends who are sometimes appalled at the idea of wall to wall carpeting and find the idea disgusting and unclean.

Last, I will note that I have lived in five different US states and every rental market has its quirks. I lived from age 3 to age 20 in the same town. When I first left home, moving to another part of the US was something of a shock as well. In short, anyone who feels strongly that the rental/housing market should behave X way should just stay where they are. (It won't stay the same where they are either, but the changes are likely to be more gradual and thus less shocking than moving elsewhere.)

Peace.

<comment><USER11> >In the US, if you want wood and tile floors throughout the home to accommodate allergies and respiratory problems, you pretty much have buy your own house (or possibly live in New York, which I have no plans to do).

Wood floors are plentiful in San Francisco, too, because there's a lot of pre- WWII housing.

<comment><USER9> Thanks. San Francisco is the only large city I have ever visited that I wished I could live in. (Granted, I haven't visited many large cities outside the US.) But even in most large US cities, wood floors in rentals seems to generally not be the norm. (Anyone with hard data, please correct me if I'm wrong.)

</comment></comment></comment></comment></comment><comment><USER12> _> The building looked like a century old_

That's because it almost certainly is. 100 years is not an advanced age for a building outside the US.

I have been to copenhagen and it is basically a paradise. You are lucky to be living there.

<comment><USER7> Exactly - the century-old buildings is where people want to live, because on the inside they're modernized and on the outside it's great architecture. Here's a couple of street views from Islands Brygge, the neighborhood cphhell mentioned:

[http://maps.google.com/maps?q=islands+brygge&ie=UTF8&...](http://maps.google.com/maps?q=islands+brygge&ie=UTF8&ll=55.667831,12.578058&spn=0.011061,0.036778&sll=55.663644,12.562222&sspn=0.010481,0.036778&t=m&vpsrc=0&radius=0.86&layer=c&cbll=55.668127,12.578483&panoid=nQ23Q-W3-HGrX1-QaQI81A&cbp=12,21.95,,0,-9.98&hnear=Islands+Brygge,+2300+K%C3%B8benhavn,+Danmark&z=15)

[http://maps.google.com/maps?q=islands+brygge&ll=55.66727...](http://maps.google.com/maps?q=islands+brygge&ll=55.667275,12.577372&spn=0.011061,0.036778&sll=55.663644,12.562222&sspn=0.010481,0.036778&t=m&vpsrc=6&radius=0.86&hq=islands+brygge&z=15&layer=c&cbll=55.666902,12.578234&panoid=q1yVOY4WXAA1lxtRF4JMHg&cbp=12,254.56,,0,-6.72)

</comment></comment><comment><USER13> I guess you need to talk to people to calibrate your expectations before looking. $750/month is simply not much in Copenhagen, I'm sorry to say.

I've looked a bit lately, and it is easy to find nice, 100sqm, modern flats with elevator etc. for 2000 Euros/month. It is possible but more difficult to find them for 1500. And to pay less one has to look for smaller, less modern etc.

However, the buildings in Copenhagen are generally about 100 years old (the one I live in now is from around 1920). And elevators are very rare in these old buildings. And there is a large body of old, small appartments with tiny bathrooms like the one you describe (around Copenhagen they are even called "Copenhagen bathrooms") - so if one looks at flats in the cheaper end of the spectrum that is what one will find. With eg. postdoc salaries after tax around 3000 Euros it is possible to find a place to live for most expats.

<comment><AUTHOR> Already replied on a sibling comment but once again, the $750/month was for a single room, no more than 15-20sqm, in a two-bedroom flat. If that's "on the cheaper end of the spectrum", I might have to negotiate a raise.

The "Copenhagen bathroom" was the single worst turn off in the whole deal. Glad to know it's not like this everywhere in the city.

<comment><USER13> OK - $750/month for a room in a shared flat is actually reasonable. But if I were you, I would look at the rooms at around $1000/month. The selection should be much nicer and with fewer competitors. Then you can take your time to get advice from colleagues and probably find something equally nice for $750/month within 6 months.

</comment></comment></comment><comment><USER14> You say it's a job offer, what had the employer suggested for accommodation? If they're willing to hire foreigners, I'd think they'd be able to accommodate you.

</comment><comment><USER15> If Copenhagen is anything like other Scandinavian countries (I'm Norwegian), then it goes like this:

\- If the ad doesn't list dates and times when the apartment will be shown, you phone up the landlord and make an appointment.

\- You go and see the apartment. Obviously you will be in competition with other applicants.

\- Talk to the landlord and make a good impression -- do whatever is needed to make the owner pick _you_.

\- If you are interested in renting, you write down your contact details in the applicant book.

\- The landlord will go home and consider the applicants and phone up the lucky winner.

\- The landlord may require a credit assessment to determine your financial situation. Some landlords require references from earlier tenancies.

\- You meet the landlord to sign a formal lease (Scandinavian countries are pretty strict about landlord/tenant rights) and get the keys.

When I was renting in NYC, things were different. None of the places I rented (which I found on Craigslist) would have open house dates; instead, you would make a personal appointment with the landlord. Also, landlords seemed to prefer email.

<comment><USER16> Is the rental housing market so competitive in all/most of the bigger Scandanavian cities?

<comment><USER15> The housing market is quite competitive in Norway's bigger cities. Oslo in particular is crazy and expensive; as a student you basically can't afford your own flat, and almost everyone ends up sharing with several other people. I don't know what the situation is like in Sweden and Denmark at the moment.

<comment><AUTHOR> Not welcoming at all: [http://universitypost.dk/article/new-internationals- angered-...](http://universitypost.dk/article/new-internationals-angered- housing-chaos)

As I am not a student, my main problem is not so much the cost as (1) the scarcity and the inane "competition" it promotes and (2) the sad state of the apartments condition, at least compared to modern housing in other first-world countries.

<comment><USER15> Strange that you find the state of Danish apartments to be sur-par. My experience has been the opposite. I am interested to hear what your criteria are.

Fire regulations, plumbing regulations and so on are very strict, so internally you shouldn't really find any qualitative difference between Scandinavia and "other first-world countries".

In Scandinavia we have a strong affection for historic buildings, an affection that extends to interiors. We like fireplaces, creaky hardwood floors, crown mouldings, exposed brick walls, that sort of thing.

So buildings might feel distinctly unmodern, even though they aren't really. Some facilities may be lacking. Elevators are only common in somewhat newer (post-1980) buildings, for example. Common laundry rooms are usually pretty awful. And I have never come across a Scandinavian apartment building that has a porter.

But these are not important things. So again, based on what criteria are you judging Copenhagen?

<comment><AUTHOR> For starters, having a real bathroom with a bath tub, not these tiny solitary confinement cells.

This a typical mid/low end first-world bathroom: <http://www.apollo- plus.co.uk/Design/Leigh.jpg>

This isn't: [http://images.travelpod.com/users/skylarking/1.1230340500.ds...](http://images.travelpod.com/users/skylarking/1.1230340500.dscn0810.jpg)

Edit: According to <http://www.airbnb.com/rooms/111335>, this "cute" style has its own name and history:

 _the type of bathroom typically referred to as a "Copenhagen bathroom". It basically means, that in the "old days", none of the working-class-apartments had showers. Eventually, this changed, but many of the apartments were so small, that it was almost impossible to fit in a big, modern bathroom. However, you get used to it very quickly and it is quite charming in its own way :)_

Um, no, I'd rather not have to get used to it.

<comment><USER15> So of all the things that might classify a first-world country, you picked a _bathtub_? Not sanitation, not drinkable water, not reliable electricity... but a bathtub!

Look, some apartments have small bathrooms. For historical reasons, some old apartment buildings even have external bathrooms (or toilets) that are in the hallway/stairway. This is not true about _all_ Copenhagen buildings. But it's true about some, just as it's true that a lot of buildings in London are afflicted with damp, bad plumbing, shoddy wiring and ugly wallpapers.

But I don't think it's fair to dismiss an entire city as being somehow not "civilization" based on the layouts of a minority of its bath facilities.

In fact, it sounds to me like you might just be a bit spoiled. Have you visited any non-first-world countries? Try Ukraine. You will feel like a billionaire.

<comment><AUTHOR> If I was moving to Ukraine, Cambodia or Somalia, for one thing I would have done my homework (and vaccines) beforehand, and for second and I wouldn't have first-world expectations. But here we're talking about friggin' Denmark, the happiest (allegedly) country in the world and among the top in quality of life, so forgive me for taking sanitation, drinkable water and, yes, bathtubs for granted. New Jersey, Athens or Madrid are not exactly famous for their prosperity and yet finding half-decent accommodation there within a week and without a "network" (yet another ugly danish surprise that was brought to my attention) was a breeze in comparison.

I'm glad that not _all_ Copenhagen buildings are moldy smelling dumps. I will be even more glad if I was unlucky to see one of the few exceptions and the majority are actually decent but I'm not holding my breath (no pun intended).

<comment><USER15> I think that you are pissed because you have unreasonable and weird expectations about trivial things.

Bathtubs? Danes are (allegedly) the happiest country in the world because they have free health care, excellent education, wealth, political freedom, stability, etc. etc. Not because of the size of their baths.

I know how the effect of culture shock can be; everything seems weird and even small trivial things are horribly, almost infuriatingly alienating. But culture shock is a psychological, irrational phenomenon. This is about you, not about the country.

</comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER17> The author is out of touch. 750/mo is what you might expect for a single person, low amenity place in a nice part of town in a _mid-tier american_ city.

What kind of housing market is this guy used to, rural Kansas?

<comment><AUTHOR> Single guy, usually house sharing. Never paid more than 650/mo in the states for better living conditions.

The 750/mo price was for a single room in a two bedroom apartment.

<comment><USER17> In a nice part of town that is not unreasonable.

</comment></comment></comment><comment><AUTHOR> Posting this from a throwaway account for obvious reasons, feel free to include same/different experiences or offer suggestions.

<comment><USER18> The situation you describe seems very recognizable througout a lot of european caitals or bigger agglomerations. During my last searches I encountered all the points you mention in Utrecht/NL, I hear comparable things about Amsterdam , Cologne, Frankfurt, Hamburg or Paris.

So, welcome to a european capital! 1 hour travel to work, 5th floor without lift is the way to go: older houses far outside of the big cities. The suburbs are already filled with locals who do not want/cannot afford to live in the centers. I'm completely unaware of the situation in Denmark, but just looking on google maps tells me that maybe Roskilde or Farum could be places to look for.

Also: you move to another country: other habits. If it's the situation on the housing market I cannot tell, but the million ways of being (un)friendly or (not) answering mails/letters, dealing with business transactions etc are the things which makes relocating difficult at heart, they are not just annoyances. I live in "another" country for some 20 years and will move to another one this month: I expect (and already experienced) a lot of impedance mismatches which could trigger a "considered harmful" post, but in the end I will have to adapt to enjoy the good things of it.

Good luck anyway!

<comment><USER5> Most of my friends live in Amager, Østerbro, etc. Anyone expecting to find affordable, modern accommodation easily in historic city centres is deluding themselves to a degree. Copenhagen has one of the more modern transportation systems in the world, so commuting is hardly an effort.

<comment><USER19> It strikes me a big part of the problem may be where he mentions "30 minute drive" - there's a big difference between 30mins behind the wheel of a car and 60mins on the copenhagen transport system (which, yes, is stunning)

<comment><AUTHOR> I've always picked my location so that I don't have to commute more than half an hour each way but if that's what it takes to find a modern half-decent place in this city, I may consider living further.</comment></comment></comment></comment></comment>


Man saves wife's sight by 3D printing her brain tumor - <AUTHOR> http://makezine.com/magazine/hands-on-health-care/ <comment><USER3> > _Balzer used Photoshop to layer the new DICOM files on top of the old > images, and realized that the tumor hadn't grown at all — the radiologist > had just measured from a different point on the image._

Think about the some of the implications of that statement for a while.

It really is no wonder that the softer sciences have a reproducibility problem.

<comment><USER4> > It really is no wonder that the softer sciences have a reproducibility > problem.

Even Further, I think it's also indicative of medicine being full of people that have a fatalistic, passive attitude towards their patients and medical care. Medicine and health is really hard, and so many health professionals essentially believe that the only thing they can do is wait until something horrible happens before doing anything. And as the case with this woman, when something bad does happen, they bin it in their per-organized mental filing cabinet and you're fucked if they're wrong. Much like police officers, I think many get so jaded by the job that they can't be bothered to give a shit when they really should. And I really hope technology will save us from this.

<comment><USER5> It seems that health care professionals don't have a nuanced problem solving attitude. They make a diagnosis, see how this diagnosis fits into a preconceived treatment bin, then just solve from that position without understanding what's different, what's unique to each case. And, in their defense, they probably just don't have the time for that extra work. That's where I see technology as most useful....how to automate and make more efficient the redundant parts so professionals can concentrate on the important, unique parts to each patient's diagnosis.

<comment><USER6> I come from a long line of docs, though I'm a software dev. Let me tell you that the vast majority of patients can easily be sorted into these pre-formed category bins. Rare conditions are rare by definition. Most of medicine is dreary repetition.

<comment><USER7> This ought to be highlighted, before people start an echo chamber of "doctor's don't know what they're doing!" that ultimately undermines everyone (guess what argument the anti-vaxxers use).

A string of anecdotes of "I double-checked and it turned out the doctor was wrong" remains less than a trickle compared to the flood of patients doctors have to deal with, and a tiny fraction of the hypochondriacs they must deal with. Our medical system is broken enough without adding doubts on the competence of its medical professionals.

By all means, people should double-check what the doctors say, but realize the much worse consequences of sowing doubt.

<comment><USER8> There are some useful questions patients can ask.

"What happens if we do nothing? If we do watchful waiting?"

"What happens if I don't take these meds?"

"How likely is that bad event? Tell me in terms of numbers per 10,000 people rather than percentages".

<comment><USER9> Another useful one is to ask him to explain his reasoning.

If he can't justify his decisions, then he's probably using instinct which is unreliable in the case of rare diseases, or he doesn't know how to diagnose known diseases which means he's incompetent.

Some people are offended when you challenge them for reasons for their advice, but I think that's because they aren't confident in it themselves or feel superior. Doctors shouldn't be in either of those positions and should be willing to tell you how they came to their conclusions.

<comment><USER10> Whilst on the whole I agree with you, the amount of doctors I know that would react (quite strongly) negatively to that is quite high, so anyone who takes your advice should be prepared. The most common response I've seen to your question was the doctor reminding the patient "there is always something called a second opinion", a couple of times though I noticed them taking the time to explain it.

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER11> I coauthored a paper a few years ago on the intra-observer variability of measurements of brain tumors when using the bidimensional product. An increase of 25% in the BP is taken as an indicator of brain tumor progression. We found that the intra-observer variability is so high, you can get that 25% increase purely by chance. The first recommendation of the medical team, to wait and see, is understandable.

<comment><USER12> Having been to three ultrasounds for my children, I'm amazed how casually they use a 2D length to estimate the baby's age, and therefore delivery date, and therefore when it is overdue and calls for a cesarean, etc. Your results seem like they confirm my suspicions that this can't possibly be very accurate.

<comment><USER13> Or maybe you're seeing just a slice of a procedure with a more complex theory behind it that you're not aware of.

Remember, being good at computers does not imply being good at medicine. This should be self-evident, but just a quick perusal of some comments here shows the contrary.

<comment><USER12> Yes, I completely agree. It's not like I'd take action on my doubts. I'm sorry if my original comment sounded critical---that wasn't my point. But it _is_ crude, isn't it? I believe even doctors concede that these estimates are not very accurate (especially when taken mid/late in the pregnancy), and it is sort of alarming to watch a nurse snap lines across the skull cross-section freehand and use those.

I find that in general with medicine my intuition battles against what my intellect knows must be the case. It's not like anything in the body is far away. Cancer isn't even very small. Isn't it weird that it's so hard to treat? Obviously it must be, but it feels like it should be easy. The patient is a foot away. We are inscrutably powerless.

When every day you command computers and they obey, when you can summon distant people and their image appears before you, when you can instantly consult more lore than in the greatest library, when you see people casually toting radiant tablets of spellbinding powers, progress in medicine feels so slow, so analog---so carnal. I know it's wrong, and we live in a world of medical miracles, with vaccines and antibiotics and DNA and everything else, but sometimes I can't help but feel that nothing has happened since Galen. It's not an argument, it's a feeling, but one with pathos that I'm sure many share.

</comment></comment></comment></comment><comment><USER14> Wow... I really hope I didn't get to this thread too late that this just gets buried.

This is a classic example of hyperbolic reporting to try and show physicians as some kind of incompetent lot whereas this 'guy working in his basement with passion and talent' figured out how to hack the entire field of Medicine.

The fact is, nearly all Meningiomas are treated this way because they are overwhelmingly benign and the surgery to remove them is not. If the woman had lost her sight getting this surgery, then our Monday morning quarterbacking would've been entirely different... or not even reported. Also, surgeons in general SHOULD NOT improvise new techniques unless it's specifically warranted because their skill is in their muscle memory and if you upset what would otherwise be a routine craniotomy and turn it into something experimental, you are risking the chance of running into an unexpected complication.

Granted, Radiology can be imprecise at measuring progression of tumors but this is mostly because of inter-observer reliability, sampling errors, etc. that could easily be mitigated by a software-side solution. In fact, there's a lot of research into measuring lung tumors this way. However, issues related to the FDA needing to approve all the diagnostic technology involved are why these are not implemented more quickly--some nifty program to measure the volume of a tumor would probably be against the law to use in a diagnostic setting (IANAL though, I am a physician).

Edit: Another case in point, there is a great technique of placing a new Aortic (heart) valve in place using a catheter from a small puncture in an artery in the leg. This technique (seemingly paradoxically) has a GREATER risk of morbidity to the patient than the open heart surgery approach. There are many hypothesized reasons for this, but it is also a fact that the surgeons are simply better trained in the older open technique and its complications.

<comment><USER15> I absolutely agree with Shinkei. I had a few more thoughts, but summarizing, I worry that this is a case of an 1) incidentally found, 2) benign, 3) asymptomatic, 4) slow or non-growing mass was removed despite the recommendations of multiple neurologists and after fishing for a neurosurgeon who was willing to cut it out.

The story starts with an accidental, incidental finding. The wife recently underwent thyroid surgery, and the husband pressures the wife to get an MRI of a different anatomical location when the patient feels well and did not have any symptoms. This mass is an incidentaloma — something found on a fishing expedition and not by looking for a particular cause to a problem. The problems with such an approach are well described in this old New York Times article, however the synopsis is such: When we look for problems with very precise tests, we can always find something to intervene upon and see something wrong. This is a problem well known in the statistics of screening tests in that even very good laboratory tests have significant harms when applied indiscriminately to everyone and everything. For people not in medicine, this can be analogous to not adjusting in frequentist statistics when one does multiple hypothesis testing and simply using one p-value of 0.05 to make decisions.

The article describes the management of a meningioma, of which the vast majority of cases are entirely non-malignant, either non-growing or slow growing, and asymptomatic (often only found on autopsy or incidental imaging). The wikipedia article on meningiomas says this:

In a retrospective study on 43 patients, 63% of patients were found to have no growth on follow-up, and the 37% found to have growth at an average of 4 mm / year.[23] … In another study, clinical outcomes were compared for 213 patients undergoing surgery vs. 351 patients under watchful observation.[24] Only 6% of the conservatively treated patients developed symptoms later, while among the surgically treated patients, 5.6% developed persistent morbid condition, and 9.4% developed surgery-related morbid condition.

The very fact that the article mentions the surgeon thought that a partial resection of the mass was a success suggests that there was little to no concern for malignancy. One does not try to take out only part of a malignant neoplasm (with the potential to grow significantly) without offering chemotherapy or radiation as adjunct therapy. In fact, I would rather argue that the husband's big triumph was realizing that the two MRIs had shown the meningioma had little to no interval growth — and such a conclusion would recommend against rapid, aggressive surgery.

From all appearances, the article suggests the wife did not have any symptoms. She could have had the meningioma since birth — a harmless birthmark that was hidden until she underwent a superflous but expensive and highly sensitive imaging test. While it is true the meningioma is close to her eye, I would be surprised if a surgeon could intraoperatively tell the progression of the mass more than multiple MRI imaging studies. While it is true that there is always a small risk that a meningioma will grow, the slow progression on MRI suggests to me that symptoms would only slowly occur and there is a low likelihood that she would ever need emergent surgery. Finally, surgical resection causes inflammatory changes in the area which could exacerbate mass effects at the site and there is a high chance that it would come back (particularly with a partial resection).

[https://medium.com/@davidouyang/providing-optimal- care-576ab...](https://medium.com/@davidouyang/providing-optimal- care-576ab231e121)

<comment><USER16> We do not have all the details from that article. It might have been causing headaches or double vision for example. Partial resection was likely very good here. It's generally very slow growing. If it had grown to cause trouble later nuclear surgery could have been a more appropriate option at that point. The craniotomy approaches are what have those percentages you outlined, loss of vision, smell, or taste, as well as difficulty with speech can be complications depending on the approach used. Basically the brain has to be moved away and that causes trauma to nerves as well as which facial muscles need to be cut depending on the approach.

This new approach is intriguing. Expected anatomy would have a wrinkle of the dura near there which should lead to relatively small risk of CSF leak following micro surgery. This could prove to be a very good and more common approach in fifty years.

</comment></comment></comment><comment><USER17> This is an amazing story - and pretty much my worst nightmare. Not necessarily cancer itself, but the feeling and anxiety that you're not being treated and taken care of properly and that someone might be missing something. That doctors are (rightfully) unable to pay proper attention to everyone and everything just due to the sheer number of patients they must see. I know I'm prone to hypochondria, and it doesn't help to read things like this.

I can't wait for a world where we can constantly monitor the body easily, and abnormalities can be detected quickly and unequivocally, and even have software that can aid doctors in diagnosing.

I've read articles where doctors approach such ideas with skepticism, saying that more data isn't necessarily better, which surprises me very much. How can you look at two data points on a curve and guess what the curve looks like?

Anyone else feel similarly?

\----

edit: I see false positives and the cost of dealing with them brought up often in the replies - I think this is an issue exactly /because/ we suck so much at diagnosis.

The argument that what you see may be wrong, therefore you must close your eyes just blows my mind. So you'd rather base timely detection of true positives on random chance?

Maybe if we saw these false positives much more often then we could observe the false positives properly and know how to identify them and improve diagnostics. Or maybe we'd be able to know better when intervening would be more harmful than not intervening. That an intervention would be harmful should not affect the choice to monitor.

And then there is also the issue of the diagnosis itself being potentially harmful (full-body CTs etc) which is equally terrifying and even more conflicting. We can also improve there too.

In any case, this was supposed to be more about the nondiagnosis anxiety, but I'm not unhappy with where this discussion went.

<comment><USER18> >That doctors are (rightfully) unable to pay proper attention to everyone and everything just due to the sheer number of patients they must see.

Why are we excusing this? This is an allocation and resource problem.

Frankly, I never understood why I need to schedule an appointment with a doctor and also visit a pharmacy to get drugs like anti-acids, allergy medicine, short doses of painkillers, antibiotics, short doses of anti-anxiety drugs, anti-depressants, etc. My doctor spends, what I imagine, most of his time on trivial issues and I sympathize with those who have non-trivial issues. It doesn't seem fair to them that they get the same 30 minutes I get for my minor issues.

I think society needs to ask itself if we need a full-fledged doctor for many of these tasks. The politics of healthcare are really ugly. Sorry, but a lot of this level 1 stuff could be done by a non-expert. I should be able to just buy these things. Or, at worst, pharmacists should be able to prescribe this stuff. The system as-is is designed to maximize labor, thus billable hours, for doctors. Its a mess when it comes to actually providing care.

I understand there's potential for abuse here but I kinda don't care. In my society you have the freedom to stuff your face with Big Macs 3x a day, smoke, become an alcoholic, and soon smoke pot all day. Those all have major risks and are completely legal and mainstream. Yet when I want to heal myself, suddenly the regulators, rent-seekers, and moralists come out of the woodwork.

<comment><USER19> Devil's advocate: one man's cure is another's demise. The vast majority of people know how to regulate their consumption of those not-so-bad things, but regulating their consumption of healing technology without understanding the potential downsides is what the powers at be are concerned about.

But I generally agree with you, it is an allocation problem, and the best way to allocate resources is removing arbitrary barriers to trade and promoting specialization. We're overly concerned about what might kill us and hardly concerned about improving the overall quality of our lives. The latter makes the former easier to deal with, but the need to feel safe and taken care of trumps freedom, I guess.

<comment><USER18> I've had stomach trouble my whole life. It was a Big Deal for my uninsured parents to get me Zantac. It involved a script from a specialist and paying out the inflated cost at the pharmacy. This was done for my safety, afterall, the industry and doctors were worried about risk, right? I'm just a dumb patient. What could I know compared to the experts, right?

Zantac can now be gotten OTC for next to nothing. Its completely safe. There was no patient risk for this drug. Same when I had to ask a doctor for Claritin. It also is safe as an OTC drug now. Meanwhile, we have research that shows that even a slight overdose of acetaminophen can seriously damage your liver.

The whole system is about maximizing profits for healthcare. It has very little to do with outcomes or patient safety. This is why so many people aren't getting the care they need. The industry is too busy creating "make work" for profits.

</comment></comment></comment></comment><comment><USER20> Interesting article, glad the operation was successful.

The most interesting part of the article is not the advance in technology (nothing new, we've been using 3d prints as models for complicated fractures / bone tumours or even custom prostheses for years (academic centre)) but the low use rate of this technology by most hospitals.

The trick with overlaying follow-up scans is called image fusion and is easy and can be done by one-click applications (for example [http://www.blackfordanalysis.com/](http://www.blackfordanalysis.com/)) but outside of lung noduli i know of little clinical use. I've seen these types of mistake made before and trying to introduce it locally. Image fusion is also an awesome surgical procedure analysis tool (both for research and clinical applications), complimentary to the standard PA examination.

The patient education part is enormously helpful in practice. Cost per patient is however still high quite high for large models. For example a cardiac tumor model was printed with transparent plastic for around 500e. Our bone models luckily are a lot cheaper (non-clear plastic). When the price comes down i hope acceptance will improve.

<comment><USER21> >The trick with overlaying follow-up scans is called image fusion and is easy and can be done by one-click applications

Just wanted to point out that image fusion is far from easy. The brain is easier than most areas of the body because the skull provides a good basis for performing a registration, but even then the brain has some small room to shift and you can't get a perfect alignment with only rigid transformations, especially when you're dealing with tumors.

For most other parts of the body you have complications like organs shifting around, gas passing through the digestive system, patients being in slightly different orientations, etc. In these cases you most definitely need to use some kind of deformable registration, which is far from a solved problem, especially when you have things like tumors changing shape/size or even appearing from nowhere from one scan to the next.

<comment><USER20> Yes it was a bit of a generalization, but i mean the practical use of the tool. The technology behind it is wonderful! For my specialty its relatively easy (bone being a rigid body). But this type of software already works quite well for lung, liver etc. With careful manual alignment it can work for soft tissue sarcoma (muscle) and other types of more movable tissue, providing a quick overview. Volume measurement is also an option. But as you say its always complimentary to standard workflow.

<comment><USER21> Yeah, I wasn't trying to be disagreeable, just pointing out that this is a very active area of research still, and there is always room for improvement. I work mostly with segmentation and shape analysis instead of registration, but I am involved with a project on multi-modal image fusion, which is even harder (and more interesting).

<comment><USER22> I've done a lot of work on multi-modal registration and would be interested in talking to you about this. It's an amazingly hard problem and I see a lot of wheels being reinvented whenever I look at what other people are doing.

My own work has been mostly commercial and so under NDA or otherwise unpublishable, but is primarily based on applications of the pseudo- correlation algorithm (Radcliffe, Rajapakshe, Shalev, Medical Physics, vol. 21, No. 6, pp. 761 769, June 1994.) I can be reached at tradcliffe at predictivepatterns.com if you're interested.

</comment></comment></comment></comment></comment><comment><USER23> Great story--I think one thing to highlight is 3D Slicer (the publicly-funded open source medical imaging tool used for all this):

[http://www.slicer.org](http://www.slicer.org)

More doctors should be using tools like this. Hopefully stories like this will help to overcome the inertia in adoption.

</comment><comment><USER24> Seems like I should probably use this thread to plug my startup. We are building a web interface for simple 3D modeling from CT and MRI data ([https://www.prevuemedical.com/](https://www.prevuemedical.com/)).

Medical modeling software (e.g. Mimics by Materialise, Slicer) is mainly built for biomedical engineers, rather than radiologists. Our goal is to be Tinkercad to their Autocad. 3D Systems also offers Bespoke Modelling ([http://www.3dsystems.com/ja/solutions/services/bespoke- model...](http://www.3dsystems.com/ja/solutions/services/bespoke-modeling)) but their emphasis is on visually appealing color models rather than accurate tissue segmentation and anatomical reproduction.

We're really at a turning point for physical reproductions of anatomy. One-off cases are turning up all over the world for various surgical planning/training cases but it's not quite clear whether or not they improve outcomes. Some labs and hospitals are doing good work but we need large patient trials to see if physical models actually help reduce operating room time or recovery time. With positive findings hopefully we will see dedicated insurance reimbursements for surgical planning models. Maxillofacial applications are way ahead in this sense.

One thing that's interesting is that the FDA considers 3D printed anatomical models similar to hard copies of X-rays, and so they are not specifically regulated yet. I expect the regulations to become more onerous, though.

</comment><comment><USER25> This makes me doubt the reliability of cancer diagnosis:

>They were understandably terrified, but neurologists who read the radiology report seemed unconcerned, explaining that such masses were common among women, and suggested Scott have it checked again in a year.

Yet at the end of the article they say

>if she had waited six months, she would have had severe, and possibly permanent, degradation of her sight.

<comment><USER26> > explaining that such masses were common among women, and suggested Scott > have it checked again in a year.

I know this sounds insane, but menigiomas (which I'd guess is what the neurologist suspected it was) are almost always benign and shockingly common - many post-mortems find these guys just kind of hanging out in/around the brain. The corollary is that any kind of cranial surgery has enormous risks. Point being, if a doctor sees what appears to be a (surprisingly) common event on a chart, they're not going to necessarily recommend further action other than observation UNLESS there's a change to the patient (which, as kitbrennan pointed out, almost certainly accompanied the "get it checked again in a year").

</comment></comment><comment><USER27> I can't be sure from just a photo, but the I suggest that the procedure wasn't completely without side effects. Her left eye is not symmetrical with the right, and the left eyebrow is elevated. This could represent some degree of peri-orbital muscle dysfunction due to the procedure damaging the nerves that supply those muscles. This could improve with time, not sure how long after the surgery this photo was taken. Even if it doesn't, you could say it is a minor side effect compared to losing your vision, but as Shinkei and others have pointed out, it isn't clear whether the vision was really in danger. Takes some of the shine off I suppose...

</comment><comment><USER28> This is a cool application, but 3D reconstruction of DICOM images isn't that new. For example, there is the Mimics commercial package that is on version 17, and similar things are actually quite commonly used by radiologists. (see [http://en.wikipedia.org/wiki/Mimics](http://en.wikipedia.org/wiki/Mimics))

Patient-specific surgery, and computer analysis in diagnosis and treatment is going to be very big (I'm betting four years of my life in doing a PhD in the field). Its always interesting when there is patient or family led efforts in the field, but this kind of thing was cutting edge in research probably 10-15 years ago (I 3D printed aortic aneurysms as an undergrad in ~2009 for a surgery planning project, and it wasn't a new thing then - <USER2> [http://link.springer.com/article/10.1007/s100160010054](http://link.springer.com/article/10.1007/s100160010054)).

Its curious then why 3D printing for surgery planning hasn't become the standard-of-care yet. My instinct is that we'll see more improvements to 3D rendering, planning, and simulation on the computer, but a physical model is not that additionally helpful to surgeons for most cases. Especially considering increased cost and time compared to a computer model.

</comment><comment><USER29> _> Scott's recent thyroid surgery had taught them that getting the best care requires being proactive and extremely well informed._

So, if you go to a manufacturer or a printer, and you can just leave your order and be assured you'll get excellent service, this has tremendous value. This is first rate service. It saves your mental energy and it might even save you money in the long term. Now, if you go to a manufacturer or a printer, and you know that you have to be informed and stay on top of them, you should know that you are getting crappy service. At the very least, you should be getting a discount of some kind for the hassle.

Healthcare in the US often means paying a lot for crappy service. It's even worse than dealing with mediocre manufacturers or printers, because of market distortions and lack of transparency in the system.

If anyone wants to help this doctor out with spreading the above message, this might be a way to show off your chops as a web designer or a marketer. He's local to the bay area and his website is here: [http://www.truecostofhealthcare.org/](http://www.truecostofhealthcare.org/)

(Disclosure: He's my former PCP)

EDIT: On the other hand, it is a credit to the doctors involved, that they welcomed the husband's input and expertise.

</comment><comment><USER30> In a similar vein, the chap in this article 3d printed his kidney stone to help surgeons:

[http://www.bbc.co.uk/news/uk-england- hampshire-30801273](http://www.bbc.co.uk/news/uk-england-hampshire-30801273)

Ironically, he passed out due to the pain from his kidney stone when presenting to surgeons on the benefits of 3d printing.

</comment><comment><USER31> My recommendation: If you ever have a CT scan, ask the imaging facility for a copy of the data. Make an archival backup for posterity and then download some free tools and spend some time exploring and learning about your own body.

The DICOM format is widespread and you can find plenty of tools with a quick search.

<comment><USER32> Wish this was not only widespread practice for imaging but _any_ medical test data.

</comment></comment><comment><USER33> I'm wondering. Does anyone know if the tumor was cancerous or benign? They say that a lot of women have this, so I'm thinking it's benign like an adenoma, but in which further growth can cause later complications.

</comment><comment><USER34> Wow. Amazing story. Moral of the story : If you can, ask for a second opinion!

<comment><USER35> Beware, my mother, dissatisfied with the first answer[1] asked for a second one, the next doctor told her exactly what she wanted to hear[2] but underestimated the risks. Massive internal bleeding during the operation => emergency decision => remove the whole organ. Like precogs, we may need a 3rd opinion as arbiter.

[1] situation is very complex, probably need to remove part of an organ [2] the he could fix the issue without ablation

le: simplification

<comment><USER34> Thanks for the reply. You're making a very valid point!

First : Sorry to ear what happened to your mother.

Doctors telling what we want to ear is also a problem! Mostly, I believe, because when something like a brain tumor is threatening your life, you might not want (and know) what is best for yourself. Doctors can be influenced by their patients.

As you stated, the second opinion can be wrong and it is very hard for the patient to know who to believe. I wish everybody could have a little help from a friend with some photoshop & 3d printing skills!

<comment><USER35> Luckily, if I may say so, it wasn't that crippling, the damages were more emotional. Waking up to this kind of news unprepared (and they completely dismissed their lack of judgement, ha the sacred doctor) is a pretty big blow.

</comment></comment></comment></comment><comment><USER36> I've been skeptical about 3d printing's real uses and how it might be toy but this sold me.

Great solution and ending. Hope it helps others too.

</comment><comment><USER37> It's reassuring of the human condition that these two stick with it through thick and thin. Charting a course to success even when the medical expert(s) said otherwise.

</comment><comment><USER38> Redundant/distributed/crowd-sourced diagnoses? Instead of a single radiologist, fan it out to many.

</comment><comment><USER39> This is truly amazing. Someone needs to fund this guy :)

</comment><comment><USER40> What's alarming is that a guy in his spare time can come up with a better diagnose than a 'certified professional'...

<comment><USER41> He had spare time, the doctor didn't.

<comment><USER42> The doctor had _work_ time, and ostensibly an entire eduction specifically for this job. The doctor was still at an (extreme) advantage.

</comment></comment></comment><comment><USER43> Alternate title: Man encourages his wife to go through unnecessary surgery for a benign and symptomless meningioma after she had an unnecessarily complicated thyroid removal in order to avoid a 4cm scar on her neck. Oh, he also made a shitty 3D model of her skull in the process.

<comment><USER44> Did we read the same article?

 _The neurosurgeon discovered that the tumor was starting to entangle her optic nerves, and told her that if she had waited six months, she would have had severe, and possibly permanent, degradation of her sight._

Because I'd really like to think you're being this insensitive out of ignorance, rather than malice.

<comment><USER27> I have to say that MRI is usually very good at detecting optic nerve impingement, so this 'crucial' point which is reported third hand deserves some skepticism.

<comment><USER44> Skepticism, or casting aspersions? The first is smart, the second is just jerk behavior.</comment></comment></comment></comment>


The Perfect Bacon Cooking Method - <AUTHOR> http://baconmethod.com/

<comment><USER2> Thats pefect for cripy bacon, though different types of bacon tend to lend themselfs to different ways of cooking. For streaky bacon then cripy bacon style is great, for back bacon I prefer it non crispy.

I do however, especialy back bacon tend to cut the fat off and pop that into the pan whilst heating it up and then add the bacon, using the fat as libricant for the cooking process. Also bacon fat is tastes so nice, I know its bad but I agree with this kid: <http://www.youtube.com/watch?v=2T_obaO46Bo>

</comment><comment><USER3> I've recently taken to draping the strips over the rungs of the oven rack, and letting them drip into a foil-lined sheet pan.

I can't think of a better way. _I strongly prefer to let the fat drip off._</comment>


Coding Intentionally in Bash Grains - <AUTHOR> https://exercism.io/blog/coding-intentionally-in-bash-grains <comment><USER2> I think exercism.io is hugely valuable for solving three problems:

\- Where can I find a set of practice problems which will force me to really engage with learning a new language?

\- Given a specific problem, what does the solution look like in various langauges?

\- Given a specific language, what do the solutions to a variety of problems look like?

Unfortunately, exercism's web interface is really only set up to cater to the first of those.

So I made an couple of indexes to solve for the other two:

[https://gist.github.com/cellularmitosis/ae76bb09973f55418d97...](https://gist.github.com/cellularmitosis/ae76bb09973f55418d97cab3cd0cb86e)

[https://gist.github.com/cellularmitosis/2aec8d88a76771452f35...](https://gist.github.com/cellularmitosis/2aec8d88a76771452f3562f3d8b2e253)

<comment><AUTHOR> Nice work! I'd be interested in how we could improve the UI to cater better to your third point. If I'm interested in how a language looks I tend to find one good solution, then look at the poster's profile and browse other of their solutions in that language. I'd welcome your thoughts :) Would like to open an issue on [https://github.com/exercism/exercism](https://github.com/exercism/exercism) and we can discuss this more widely with the Exercism community?

<comment><USER2> Great! Actually I had opened an issue a while ago but with a much larger scope in mind -- to also do some AST analysis and try to clump the solutions by similarity, so that the UI could present "There are three basic ways to solve this..."

[https://github.com/exercism/exercism/issues/4333](https://github.com/exercism/exercism/issues/4333)

(that's my work account)

<comment><AUTHOR> Ah awesome. Sorry I dropped the ball on that. I'll reply now. Have you seen about [https://exercism.io/blog/automated-mentoring-support- project](https://exercism.io/blog/automated-mentoring-support-project) ?

</comment></comment></comment></comment><comment><USER3> The code presented in the article doesn't communicate the problem. It communicates a clever optimization that will break if the spec changes at all.

This code should be readable enough to give you an idea what is happening and how to change it.

      my $board-depth = 8;
      my $board-width = 8;

      my $squares = $board-depth * $board-width;
      my @grains-per-square = ( 1 .. $squares ).map({ 2 ** ($_-1) })

      say [+] @grains-per-square;

Which if you read Perl6 says number of squares, and in each one put 2^n-1 grains, then add them all up.

Hint: `[]` is the reduction metaoperator, it lets you specify an operator to use when reducing a list. [+] means "add it up".

It finishes basically instantly, and while Perl6 has gotten a lot faster, it is not a fast language (yet?). So no need to optimize this.

I mean you write the code and then marketing will have a poorly specified variation like "double only the odd ones".

If you implemented this as `2^64-1` then you are starting from scratch.

For the above the map only needs a tweak:

      map({ $_ %% 2 ?? $_ :: 2**(n-1) })

Or whatever it turns out that marketing meant.

In the article, I didn't see informational intentionality, I saw premature optimization and obfuscation.

<comment><USER4> Orthogonal to your content, but perl6 allows "-" in variable names? ugh. I get that the "$" delineates a variable, but on first read it looks like "board minus depth".

<comment><USER5> Why would anyone name their variable "_-1" ? Oh wait—

<comment><USER6> `_-1` is an invalid variable name.

The `-` must be followed by an alphabetic character (or `_`) for it to be seen as part of an identifier.

So `_-1` is the same as `_ - 1`

        {
          my \_ = 4;

          say _-1; # 3
        }

        {
          sub _ () { 8 }

          say _-1; # 7
        }

It may be a bad idea to name a variable or subroutine `_` but that is for you to decide, not for Perl6 to decide. (It's not your overprotective mother.)

\---

I suppose if you really want to do something completely daft like that, there is not really anything stopping you:

        {
          my \_ = 3;
          say _-1; # 2

          my \term:<_-1> = my $ = 4;

          say _-1; # 4
          _-1 = 53;
          say _-1; # 53

          say _ -1; # 2
        }

Note that it doesn't just create a variable named `_-1`.

What it does is much more powerful than that. It modifies the parser lexically to add `_-1` as a term. (Since it is lexical it stops being valid after the closing `}`)

The `my $` is just so that it has a rewritable container so that it can be reassigned to `53` later.

This can be useful for constants that wouldn't otherwise be a valid identifier, and for writing subroutines that are parsed as a bare identifier like a constant would be.

        constant term:<> = …

        sub term:<foo> () {…}

        foo;

        foo(); # ERROR: Undeclared routine: foo used at line …

        foo 1; # ERROR: Two terms in a row

</comment></comment></comment></comment><comment><USER7> On the one hand, the article's title that "solutions should be written in such a way that the intent is clear" makes sense for code which needs to be read and maintained. e.g. Martin Fowler suggests even 1 line of code methods can be useful if they describe a distinct intent. [https://martinfowler.com/bliki/FunctionLength.html](https://martinfowler.com/bliki/FunctionLength.html)

But I don't think the point is well made with a contrived whiteboard-interview style problem.

</comment><comment><USER8> I'm basically stuck on the Elixir track waiting for a mentor...

I'd be glad to pay per puzzle or a subscription to get faster feedback.

Please, exercism. Take my money.

<comment><USER9> Perhaps connect up with someone on codementor.io to review what you've done?

</comment></comment><comment><USER10> I just want to point out that it's really annoying that the "Available language tracks" on the front page are completely random and change on reloads. It's already hard enough to figure out where the language I'm curious about is, even worse when it changes after I click a new page.

Also, clicking "explore languages" at the bottom of the blog does nothing.

<comment><USER11> FWIW, the logged in view of this is an alpha-sorted list, basically this view [https://exercism.io/tracks](https://exercism.io/tracks)

I would guess the design choice on the front page change on reloads to try to surface something potentially interesting to everyone, but I am not affiliated with them/have no additional insight. I can see how it would be frustrating.

They must have removed the link you are referencing, because I don't see it now. Clicking it from the front page works (probably because it is an anchor link).

</comment></comment><comment><USER12> Expressing the intent of the code significantly improves maintainability. I think it's important to realize that the problem of missing intent is often only noticed upon review of the code.

So in my opinion, the moral of the story isn't simply "design with intent", it's "get your code reviewed".

<comment><USER13> Often it makes it through review just fine. It's usually not discovered until someone unfamiliar with the problem or complete set of initial circumstances is exposed to the code, at which time their main focus is on fixing/enhancing the code and not changing its readability or documenting intent. The new dev vomits out some code to meet their deadline and now the code is even more convoluted than it was to begin with.

In a perfect world, readability would be one criteria during reviews, unfortunately it is often overlooked.

</comment></comment><comment><USER14> Since this is using Bash, it might be nice to mention that you can't use Bash's built-in math evaluation to solve the problem because Bash uses fixed- width integers and therefore

      let 2**64==0

</comment><comment><USER15> You can do this in any area. In "Without Limits" [1], Bill Bowerman calls a team meeting at 7:27, specifically so everyone is sure to show up on time.

[1]: [https://www.youtube.com/watch?v=yuAtOMGyUx8](https://www.youtube.com/watch?v=yuAtOMGyUx8)</comment>


Fallacies - <AUTHOR> http://www.nizkor.org/features/fallacies/ <comment><USER2> (I'm a philosophy professor.)

Some training in logic -- reflecting on what make good reasons and justified conclusions -- does have value. It has the same sort of value that learning grammar does. It enables you to make certain things explicit, to put them under conscious scrutiny and control, when needed.

But I think this sort of enumeration of logical fallacies is of very limited value. In the abstract there are only a few ways that arguments fail, and informal fallacies are all iterations on an extremely similar theme.

Moreover, the kind of argument for which it is easiest to characterize fallacies is deductive, and many instances of reasoning that appear deductive are in fact statistical, inductive, inferences to the best explanation, or some combination thereof. Even for deductive arguments, what if any fallacies are being committed will depend upon how one interprets suppressed premises.

The best thing is to learn about different sorts of reasoning and how they work in good cases, and pick up a feel for some fallacies along the way. At the end of the day, reasoning is an art.

<comment><USER3> > But I think this sort of enumeration of logical fallacies is of very limited > value. In the abstract there are only a few ways that arguments fail, and > informal fallacies are all iterations on an extremely similar theme.

I think the value of enumerations -- in addition to creating a vocabulary which is often useful in discussing problems with an argument, even if, as you correctly note, exactly which fallacy is most applicable is a subject of interpretation -- is that it helps recognize instances of potentially problematic arguments. Even if, on a certain level of abstraction, a lot of the named fallacies are just different views of a smaller number of real problems, understanding the different manifestations of those common problems helps to recognize them in practice.

<comment><USER4> The limit case of this is lesswrong.com, which is a kind of cultish/Vulcan purge of all fallacies. (Ask around about Roko's basilisk)

<comment><USER5> I read both HN and LW, and enjoy both. I've noticed people on HN describing LW as "cultish" a couple of times now, and am constantly suprised by this. Can you shed any light on why you feel this way?

<comment><USER6> I think there are two main things about LW that strike some people as cultish. (There are others, less important.) Both are less true than they were, say, a year ago.

1\. Its distinctive brand of rationalism grew out of this huge long series of blog posts by Eliezer Yudkowsky, conventionally referred to on LW as "The Sequences". So: we have a group of people united by their adherence to a set of writings by a single person -- a mixture of generally uncontroversial principles and more unusual ideas. It's not a big surprise if this reminds some people of religious scriptures and the prophets who write them.

2\. The LW culture takes seriously some ideas that (a) aren't commonly taken very seriously in the world at large, and (b) share some features with some cults' doctrines. Most notably, following Yudkowsky, a lot of LW people think it very likely that in the not too distant future the following will happen: someone will make an AI that's a little bit smarter than us and able to improve itself (or make new AIs); being smarter than us, it can make the next generation better still; this iteration may continue faster and faster as the AIs get smarter; and, perhaps on a timescale of days or less, this process will produce something as much smarter than us as we are smarter than bacteria, which will rapidly take over the world. If we are not careful and lucky, there are many ways in which this might wipe out humanity or replace us with something we would prefer not to be replaced by. -- So we have a near- omnipotent, incomprehensible-to-us Intelligence, not so far from the gods of various religions, and we have The End Of The World (at least as we know it), not so far from the doomsdays of various religions.

Oh, and LW is somewhat associated with Yudkowsky's outfit, MIRI (formerly the Singularity Institute), and Yudkowsky is on record as saying that the Right Thing to do is to give every cent one can afford to them in order to reduce the probability of a disastrous AI explosion. Again, kinda reminiscent of (e.g.) a televangelist telling you to send him all your money because God is going to wrap things up soon. On the other hand, I do not believe that's his current position.

For the avoidance of doubt, I do not myself think LW is very cult-like.

</comment></comment></comment></comment></comment><comment><USER7> Logical fallacy #1: that actual argumentation in real life can be reduced to some axiomatic system where you can just discard arguments as logical fallacies.

It's easy as a nerd to fell into that trap, but real life has much more nuances than those fallacy lists capture.

Case in point: "the no true scotchman fallacy". In real life groups CAN be argued to have certain characteristics to recongnise members from non-members, hypocritical members, non-practicing members, posers and "fakes". So the "no true scotchman" fallacy breaks down when you're dealing with such nuances.

Or take "appeal to tradition": 1) X is old or traditional 2) Therefore X is correct or better.

Well, it depends on how you define correct or better. If you value tradition and see conformance to it as the most important metric, then X is indeed better for you.

Who is to say what metric you should use for "correct", in issues like ethical ones, that are not clear cut and measurable as things are in the hard sciences and mathematics?

<comment><USER8> You're completely misrepresenting what the No True Scotsman fallacy is. The key characteristic of a No True Scotsman fallacy is that the arguers original claim is revised to handle a counterexample. In the titular example, the arguer originally says "no Scotsman does x," and the obvious implied definition of "Scotsman" is simply a man from Scotland. But when faced with a counterexample (a man from Scotland who _does_ do x), the arguer revises the original claim by adding the word "true." Under this revelation, the arguer's original claim is not an actual claim about what men from Scotland do, but rather a _proposed definition_ for the term "true Scotsman."

<comment><USER7> > _You 're completely misrepresenting what the No True Scotsman fallacy is. > The key characteristic of a No True Scotsman fallacy is that the arguers > original claim is revised to handle a counterexample._

Yes. I don't think I'm misrepresenting it. Revising an original claim to handle a counterexample is something that is essential in actual conversations. It can just mean you forgot an important distinction in your original claim.

> _Under this revelation, the arguer 's original claim is not an actual claim > about what men from Scotland do, but rather a proposed definition for the > term "true Scotsman."_

That's beside the point. In real life conversations, we often use the term X to mean the essense of X (the true X) and not just the bare notion of X. That is, there's nothing fallacious about the following exchange:

\- A metal fan would never listen to Bieber.

\- Well, I'm a metal fan and I listen to Bieber.

\- Well, you're not a true metal fan then.

<comment><USER8> The example you give about metal fans and Bieber is a _perfect_ example of No True Scotsman. The term "metal fan" will be widely understood to mean "someone who likes metal music," not "someone who never listens to anything other than metal music." The initial claim is clearly false, so the person revises the claim to contain the word "true," which reduces the argument to nothing more than "well I refuse to consider you a metal fan if you listen to Bieber."

</comment></comment></comment></comment><comment><USER9> Fallacies are invoked too often in internet arguments. Take ad hominem, for example. People invoke ad hominem as a counter to people who attack the credentials/funding sources of scientists who have an interest in promulgating a particular point of view. However, it is totally valid to argue that the minority of scientific studies that find, say, chemical X not to be harmful were funded by chemical companies. It's not a valid counter for a purely logical argument, but debates on the internet are rarely based on pure logic. Rather, they are usually based on evaluating the credibility of experts, evaluating the relevance of evidence, and distinguishing what kind of conclusions can and cannot be determined by particular evidence.

To me, a better source for internet debate is the Federal Rules of Evidence: [http://www.law.cornell.edu/rules/fre](http://www.law.cornell.edu/rules/fre). Particularly the modern statistical approach to evaluating the relevancy of evidence based on Bayes' rule: [http://en.wikipedia.org/wiki/Evidence_under_Bayes_theorem](http://en.wikipedia.org/wiki/Evidence_under_Bayes_theorem).

<comment><USER3> Attacks against credentials are valid against an argument to authority (in which case they are, in fact, pointing out a fallacy), but you only have an argument to authority when a conclusion is offered on the sole basis that the conclusion was offered by an authority. When the actual argument by the alleged authority is presented (including by reference), an attack against credentials is not a valid rebuttal, because the credentials are not the support offered for the conclusion. It is appropriate and correct to label such an attack, offered as a rebuttal, as invalid by way of the ad hominem fallacy.

<comment><USER9> Your point is correct, but irrelevant. Almost any internet debate that you an imagine is ultimately rooted in arguments to authority. It's simply not useful to look at internet arguments as logical ones. It's the wrong level of abstraction. They involve some basic logical reasoning, but generally, they are all about weighing conflicting evidence and expert opinions. Should we regulate fracking? It all depends on what the evidence is, and which evidence we believe and which evidence we don't believe. Each of those expert opinions might be characterized as logical arguments themselves (generalizing from particular empirical observations to conclusions), and could possible be tackled at that level (well you can't reach this particular inference from that particular data point), but that would make internet arguments completely intractable and not very illuminating.

<comment><USER3> Weighing conflicting evidence and expert opinions is a domain in which correct understanding of fallacies -- particularly those of argument to authority and ad hominem -- is critical. In fact, it is a domain I which it is critically important, because it is intimately tied to the vital distinction between _expert opinion_ , on the one hand, and _reference to evidence which happens to have been previously presented by an expert_ , on the other.

So, no, the distinction between the valid use of attack against credential to rebut expert opinion, and the fallacious, ad hominem, nature of such an attack when used to "rebut" evidence that happens to have been previously presented by an alleged expert is not, at all, irrelevant to internet debate.

</comment></comment></comment></comment><comment><USER10> I'm trying to find the name of a suspected logical fallacy that I think some founders make... wonder if anyone can spot it?

It goes something like: 1\. Established product A has traits X,Y and Z and is a billion dollar business 2\. Our new Product B also has traits X,Y and Z and so it will be a billion dollar business

Example I saw the other week from "Why Bitcoin Matters"

> A mysterious new technology emerges, seemingly out of nowhere, but actually > the result of two decades of intense research and development by nearly > anonymous researchers. Political idealists project visions of liberation and > revolution onto it; establishment elites heap contempt and scorn on it. On > the other hand, technologists – nerds – are transfixed by it. They see > within it enormous potential and spend their nights and weekends tinkering > with it. What technology am I talking about? Personal computers in 1975, the > Internet in 1993, and – I believe – Bitcoin in 2014.

Please note, I'm _not_ knocking bitcoin here. I'm just wondering if this is indeed a fallacy and has a name.

<comment><USER11> "Fallacy of the undistributed middle"

all A are X

this B is X

therefore this B is A

then: for A: successful business. for X: has certain traits. for B: our new product.

<comment><USER12> Not really. The case is not being made that "all successful businesses have this specific trait".

I think the most relevant fallacy here is "post hoc ergo propter hoc", which says that if A came before B, then A must have caused B.

I.e., this business had traits A, and then they went on to become successful, so it must have been these traits, since they were there first.

<comment><USER11> True, there isn't even a claim of "all" (which makes it even weaker of course).

But there is likely a plausible explanation why some property of the product improves its sales. And indeed, that property may really be necessary for a product's success. But it may be an insufficient cause.

e.g. facebook started among college kids so my product focused college kids will success.

So I'm thinking it's a flavor of over generalization or selection bias and I opine that you can most easily show how ridiculous that kind of reasoning is with the "A is X, B is X therefore B is A" fallacy.

</comment></comment></comment></comment><comment><USER13> It's always nice to see the fallacies of debate promoted so we can hopefully all improve in our exchanging of ideas.

Ones to really watch out for IMO are Appeal to Emotion and Ad Hominem. These two are the most used fallacies in internet debates IMO. The more you familiarize yourself with these, the better you may become in recognizing a poor argument.

<comment><USER14> Personally I would guess that biases such as confirmation bias interferes with or reasoning much more than any fallacies. Also, they are harder to get rid of.

<comment><USER13> Agreed. The fallacies are simply a toolset for confirmation bias IMO.

Personally, I think cognitive dissonance is a major problem. People in general have opinion set A at any given moment, and when a direct contradiction to one opinion in set A occurs, they either fight it, or flee.

There's a lot of science behind the idea that most people use their reptilian brain in arguments, emotionally defend their already engrained views, and then try to logically defend it after the fact.

The real challenge is while defending your own views, to try and attempt at discerning whether or not you are simply emotionally responding to a cognitive dissonance, or whether you are rationally defending a built up worldview with foundations in knowledge and insight.

I'd like to say I do the latter, but I'm sure everybody would like to agree with that...

</comment></comment></comment><comment><USER15> That's good as well: [https://yourlogicalfallacyis.com/](https://yourlogicalfallacyis.com/)

<comment><USER16> Agreed. I also use [http://www.fallacyfiles.org/taxonomy.html](http://www.fallacyfiles.org/taxonomy.html)

</comment></comment><comment><USER17> Sadly missing is the "Fallacy Fallacy", which seems to crop up in internet discussions rather frequently.

<comment><USER12> Good point. Though the fallacy fallacy is just a special case of Denying the Antecedent:

      1. If [argument is sound], then [conclusion is true].
      2. [argument] is not sound.
      3. Therefore, [conclusion] is not true.

Similar to:

      1. If it has rained, then the street is wet.
      2. It hasn't rained.
      3. Therefore, the street isn't wet.

</comment></comment><comment><USER18> Interesting. Just keep in mind that pointing fallacies out in friendly conversation is very annoying.

Relevant previous discussion on "YOUR BALONEY DETECTION KIT SUCKS": [https://news.ycombinator.com/item?id=5832320](https://news.ycombinator.com/item?id=5832320)

</comment><comment><USER19> "For example, a moderate amount of exercise is better than too much exercise or too little exercise."

Of course, "too much" and "too little" already implies a negative. "Too much" of anything is bad, that's why it's called "too much".

</comment><comment><USER20> I'd love to see all the fallacies reframed as "persuasion tactics".

<comment><USER21> Yeah, I'm not crazy about the overly simplistic way some of these "fallacies" are constructed. I've always thought people who go on about fallacies in argument are incredibly smug, and the fallacies themselves are just names given to things we already recognized and understood.

In the "Appeal to Pity" fallacy the example given is:

Jill: "He'd be a terrible coach for the team." Bill: "He had his heart set on the job, and it would break if he didn't get it." Jill: "I guess he'll do an adequate job."

The argument that Bill cares immensely about the job IS evidence that he would likely do it well. A coach who cares is more likely to work hard, be more invested in the outcomes of games, etc.

But the real problem, as you mention, is that people don't argue to logically prove something. People argue to convince someone else (often not even the person they're arguing with). If you can convince people you won the argument, you won the argument. It doesn't matter whether you appealed to base human emotion or made a logically/factually empty argument.

</comment></comment><comment><USER22> "Science fallacy": Anything coming from a scientist or a science/research group/organization becomes "scientifically proven" and therefore "the truth".

<comment><USER23> Sounds like "appeal to authority" to me, but the way you stated it, it looks more like a straw man.

The reason to trust scientists is their method, which gives a good approximation to truth. If you are capable of evaluating their results yourself, then you don't need to trust them, but if you aren't, you have a good reason to trust them, even if technically committing the fallacy, because what else are you gonna do?

</comment></comment><comment><USER24> Actually I think "Ad Hominem" is a rather good filter. Although it's not a proof of statement being true or false, it's still good to ask your self a question "why is this person saying this?"

For example: A stranger rolls up in a truck up to a kid on their walk from school and says "get in my truck, your parents were in an accident, and I need to drive you to hospital". Now all the person said could be true - but I would strongly advise from getting into the truck.

<comment><USER25> _Ad hominem_ is when you dismiss what someone says because of who they are, not what they say.

There's no fallacy with simply not bothering to listen to them in the first place, if they have a history of spouting bullshit.

</comment></comment><comment><USER26> What's wrong with example one, the fact that it doesn't explicitly say 'probably'? Just because something is a conclusion doesn't mean it's an absolute. When talking about real-life situations, there are no absolutes. Your premises can change behind your back.

Sometimes you have to go with the most likely option to not get stuck in a quagmire. Being imprecise for the purposes of focus is not an _error_.

</comment><comment><USER25> The Adventures of Fallacy Man (Comic):

[http://existentialcomics.com/comic/9](http://existentialcomics.com/comic/9)

</comment><comment><USER27> interesting, but i want to nitpick on the appeal to authority:

> This fallacy is committed when the person in question is not a legitimate > authority on the subject. More formally, if person A is not qualified to > make reliable claims in subject S, then the argument will be fallacious.

Such arguments are fallacious even when person A is a well informed individual who is sufficiently well qualified to understand the subject. Not recognising this misses the spirit of the fallacy - that all claims must be substantiated and that prior performance is /completely/ irrelevant as to whether any individual claim is valid - even when that experience makes it the case that person A is the foremost expert in the field.

<comment><USER28> Yes, and it's amazing and ironic how many otherwise authoritative sources (i.e. sources worth reading and listening to) get this totally wrong -- they _still_ think that the source of an idea can have a bearing on whether it is true. I think they are variously conflating three issues: (1) whether an idea is true, (2) whether one can (rationally) rely upon it in some way, (3) whether one understands it.

</comment></comment><comment><USER29> It's always interesting to see these (in)formal fallacies on the internet. They're really only fallacies if they're wrong.

Usually I just want to say "fallacy of not knowing mathematical logic."

</comment><comment><USER30> Fallacies are favorites of Internet forums because you don't need a bit of domain knowledge to attack any argument. They're sort of like grammar or spelling corrections.

</comment><comment><USER31> the biggest logical fallacy is not realizing that homo sapiens is evolved to NOT use logic in certain areas: tribal allegiances, bonding and politics. You can see this play out in the GOP/conservative vs Dem/liberal farces in various forums and on TV every day. Same thing goes for what passes for the term 'political correctness.'

Also, religion--logic does not come into play there.

Also, death and the afterlife--logic is precluded there as well.

Homo sapiens is evolved to use logic in certain limited areas only.</comment>