Ask HN: What should I learn to position myself to work on a self driving car? - <AUTHOR> Hey HN, I'm a CS sophomore at the University of Toronto, positively obsessed with self driving tech. What can I learn before I graduate, or add to my portfolio, to position myself to work on a self driving car at a startup or of course Google/Tesla? I only have experience with CRUD apps and full stack web dev (only just beginning to learn "low level" stuff). I am taking an introductory embedded systems course right now, and loving it, the whole deal with robot localization, sensors, and control systems.<p>I would appreciate any advice on courses to take, online communities to get involved in, or fun projects to build. <comment><USER2> while True:

        1. Goto website of company that builds self-driving-car

        2. Look into jobs section

        3. Check requirements

        4. Learn them + build stuff with them

        try:

            apply_job()

            break

        except NoJob:

            pass</comment>


The 12 cyber-scams of Christmas - <AUTHOR> http://www.bbc.co.uk/news/technology-25200338

<comment><AUTHOR> Not much to do with Christmas, but ashamed to admit I didn't really consider number nine (your phone attempting to connect to past networks, but handing out the SSID while doing so)!</comment>


'Stealth bailout' shovels millions of dollars to oil companies - <AUTHOR> https://www.bloomberg.com/news/articles/2020-05-15/-stealth-bailout-shovels-millions-of-dollars-to-oil-companies <comment><USER2> My personal feeling is that we should have just cut everyone a 10k check and be done with it. Some direct funding to hospitals maybe; but 95% of the stimulus should have just been direct cash. Seems like the best way to ensure that people who need it got it, and also give people a cushion to figure out what to do next in the new economy; and not feel compelled to prop up the old one.

I'm sure there's some very good reason we didn't do it. Love to hear it.

<comment><USER3> There is not really a mechanism to do that. The US does not have the mailing address of every citizen, or no sure knowledge which SSNs belong to dead people, and what the current address is that corresponds to an SSN, etc. The closest is tax returns. There are about 100m more people in the US than tax returns, and some people file more than one return (companies, trusts). I am sure the US has the correct information for half the population. But if you start thinking about millions of $10k checks being sent to the wrong address the potential for fraud is pretty mind boggling.

I don't think that is the only reason, but it is something to consider.

<comment><USER4> That seems rather silly. How can a country function well if you don't have basic information to connect with the people?

<comment><USER3> There are people in the US that don't like the idea of a national id card. The US has a very special love / hate relationship with government.

</comment></comment></comment></comment><comment><USER5> Meanwhile millions of people approved for unemployment benefits still aren't getting paid.

Not cool.

</comment><comment><USER6> 83% of US energy portfolio is connected to Oil, Gas and Coal.

Either you prop energy industry now, or fight KSA's wars and ideological misadventures in ME.

For what its worth, saving ONG jobs in US at least gives us better policy options than being energy hostage.

Green tech is not there yet to pick heavy load. In the interim you need ONG.

<comment><USER7> Why not let the free market decide.

<comment><USER8> It isn't a free market. OPEC+ is literally a cartel trying to gain monopolistic control over oil prices. With NA ONG bankrupt, they can proceed to gouge oil prices for the next half decade, until NA ONG can be recapitalized and operating at full capacity again. In the meantime, KSA will then be given large amounts arms and wealth to prop up their shenanigans in the ME.

<comment><USER9> Easy enough to fix. Tell the Saudis that they don't get anymore hardware or support unless they sell us oil cheap, and otherwise we'll send all that support to Israel instead.

<comment><USER10> This comment shows you don't understand ME politics. KSA couldn't care less if we give arms to Israel.

<comment><USER9> So maybe Israel is irrelevant. They're a US puppet state, though, and the US could pull those strings.

</comment></comment></comment></comment></comment></comment><comment><USER11> My understanding is that the change was to allow the stimulus loans to be used to pay off and refinance loans they currently have as well as claim back past losses on taxes.

While questionable in many ways, why is that specific to the oil and gas industry other than them having many past profits?

<comment><USER12> Because they were already over leveraged businesses that shouldn't have been given access to stimulus capital. This is exactly the problem causing "zombie companies" [1], companies that are only able to survive with cheap capital (similar to the VC model funding business models that are never going to be profitable at any scale).

And of all companies to provide stimulus for, oil and gas is not what we should be wasting even more fiat on. This is a handout, plain and simple, no different than the governor of North Dakota trying to prop up a coal plant that hasn't been profitable in years _that the owners themselves want to shut down_ [2] [3].

[1] [https://en.wikipedia.org/wiki/Zombie_company](https://en.wikipedia.org/wiki/Zombie_company)

[2] [https://www.cnbc.com/2020/05/11/north-dakotas-largest- power-...](https://www.cnbc.com/2020/05/11/north-dakotas-largest-power-plant- set-to-close-as-owner-bets-on-wind.html)

[3] [https://www.utilitydive.com/news/north-dakota-governor- oppos...](https://www.utilitydive.com/news/north-dakota-governor-opposes- Great-River-energy-coal-exit/577660/)

</comment></comment><comment><USER13> eh this just temporarily reinstates the prior tax code before the 2017 Tax act changes.

The 2017 law removed the ability to carry back net operating losses, only leaving carry forwards. We had carry backs for at least 3 decades.

The CARES Act temporarily reinstated carry backs. I think it is disingenuous to say thats a problem, when its more normal than anything else that has happened.

Regarding how it was sold for the "little guy", who cares? Like imagine being that naive not to notice that everything gets consensus in this country by catering to the constituents that can gain consensus. Consensus needs numbers, you don't sell a bill by saying "in this esoteric accounting standard that you will never encounter, we need to make a rule change regarding carrying losses to encourage growth ACT", you cater to things most people will encounter, and that the representatives of those people will relate to, and get phone calls and emails from their people about.

I take social cues from other people, so I can tell I feel differently, as in feel nothing, from this. But I think you should too.

</comment><comment><USER14> Should not be surprising, particularly now when there is a 3-way turf war on between Russia, Saudis and US.

</comment><comment><USER15> You must live in the Truman Show to believe Uncle Sam would let anything happen to Oil and Gas companies.</comment>


Spotify is cracking down on family plan sharing again by asking for userlocation - <AUTHOR> https://www.theverge.com/2019/9/12/20863066/spotify-family-plan-sharing-location-terms-conditions <comment><USER2> Or they are just monitizing user data in a super common way. That seems the default these days, does occams razor back me up?</comment>


Ask HN: Remote-only job boards - <AUTHOR> I'm looking for job boards that specialize in remote positions. <comment><AUTHOR> [https://weworkremotely.com](https://weworkremotely.com)

Any others?

<comment><USER2> [https://whoishiring.io](https://whoishiring.io)

</comment></comment><comment><USER3> [https://remoteok.io](https://remoteok.io) By Pieter levels is also worth looking at

</comment><comment><USER4> [https://remotebase.io/](https://remotebase.io/)

[https://nomadlist.com/](https://nomadlist.com/)

</comment><comment><USER5> [https://remote-first.com/](https://remote-first.com/), full disclosure I built and run this site. You can read more about the process here: [https://hungryadmin.com/starting-and-finishing-a- project.htm...](https://hungryadmin.com/starting-and-finishing-a-project.html)

<comment><USER6> No offense, but this site seems either empty or broken. There's no immediate list of jobs. There's no buttons other than "Submit a Job". I presume that I need to enter a search and hit enter, but a button would help. I get "No ads match your search" but there's no indication of what I searched on so I don't know if I mistyped something or what. Searching for "developer" brings up nothing, which points me back at empty or broken.

</comment></comment><comment><USER7> [http://www.workingnomads.co/jobs](http://www.workingnomads.co/jobs)

</comment><comment><USER8> [http://nodesk.co/remote-work/](http://nodesk.co/remote-work/) has a collection of remote job boards

</comment><comment><USER9> [https://github.com/kaizensoze/remote-freelance- jobs](https://github.com/kaizensoze/remote-freelance-jobs)

</comment><comment><USER10> [http://stackoverflow.com/jobs/remote](http://stackoverflow.com/jobs/remote)

</comment><comment><USER11> [https://hnjobs.emilburzo.com/](https://hnjobs.emilburzo.com/)

</comment><comment><USER12> [http://jobs.remotive.io/](http://jobs.remotive.io/)

</comment><comment><USER13> [https://www.wfh.io/](https://www.wfh.io/)

</comment><comment><USER14> Thanks for asking this, I was looking for resources for this myself.</comment>


Desktop support comes to Signal for iPhone - <AUTHOR> https://signal.org/blog/signal-desktop-ios/ <comment><USER2> As happy as I am that more people will use Signal thanks to the desktop integration, I am pretty sure I won't use it myself.

I consider Signal the only "secure" public way to communicate with me, and it's because it's restricted to a native app running on an unjailbroken updated iOS device, which puts the cost of exploitation in the 1M$ band.

Pairing it with a laptop, in a browser context, kind of defeats that use case. And WhatsApp is a valid alternative for convenience.

<comment><USER3> >it's restricted to a native app running on an unjailbroken updated iOS device

But it's been on android longer than it's been on iOS?

<comment><USER4> He was discussing endpoint security so I believe he intended to say his own personal use is restricted to an iOS device.

</comment></comment></comment><comment><USER5> mtgx mentioned this on the earlier thread, and I'm curious to know too ([https://news.ycombinator.com/item?id=12585597](https://news.ycombinator.com/item?id=12585597)):

Have they said what are their long-term plans for the desktop app, now that Google has started deprecating Chrome apps?

[https://blog.chromium.org/2016/08/from-chrome-apps-to- web.ht...](https://blog.chromium.org/2016/08/from-chrome-apps-to-web.html)

<comment><USER6> Fingers crossed they go with a saner native option like QT rather than a slow, crappy, wrapped web app.

<comment><USER7> Or platform specific versions using native tooling, sharing only what can be shared under the hood, and ending up with great apps?

Yeah, what am I thinking? I know that will probably will never happen, but it would be awesome if it did...

</comment></comment></comment><comment><USER8> Crypto community question - why is everybody so adamant about using Signal? Outside of work, I don't own a smart phone and refuse to, so signal is not an option. It's to the point where it's actually gotten in the way with getting in contact with at least three people I know.

<comment> crooked-v > why is everybody so adamant about using Signal?

Because it's convenient, secure, open-source, and well-designed.

> Outside of work, I don't own a smart phone and refuse to

That makes you, in the eyes of most people, a weird outlier.

<comment><USER8> I dunno, it just feels that the crypto community is shooting itself in the foot by largely catering to those with smart phones. A huge chunk of population, (poor, elderly, etc) are in a similar boat as I am and it doesn't make much sense. Many of the civics/activist/crypto folk seem to only want to make flashy toys to prove their worth rather than tackling problems in solid ways :\\.

<comment><USER6> I'm not aware of any "solid way" of reliably transmitting encrypted messages of any useful length within the 160 characters allowed in a single SMS message, let alone installing a usable method of encrypting the messages.

<comment><USER8> That's not really what I'm asking about, though. It just feels like those who truly need to use something like Signal are shooting themselves in the foot by requiring others to have a smart phone. This has affected my ability to communicate with two separate journalists, so I'm not just spouting just to spout..

<comment><USER9> You can use Signal on android.

</comment></comment></comment></comment></comment></comment><comment><USER10> >Desktop support

Chrome Web Browser support.

</comment><comment><USER11> That doesn't seem as good as Wire. Why should I bother with Signal?

[https://wire.com/](https://wire.com/)

<comment><USER6> I think the better question is why should I bother with Wire? It's all of 3 months old, (and iOS is already on 2.0? Really?) Signal has been around for a few years now and uses a well-respected ratcheting encryption library similar to OTR. It's been well-audited and widely-adopted. It's already the de facto standard for FOSS E2E mobile messaging.

<comment><USER10> Wire has launched in 2014 with emphasis on encrypted calls, it was only recently open sourced.

It also ticks many boxes, only it's not decentralised and the server ain't open source (yet).

<comment><USER12> Signal/TextSecure was released in 2014.

Can you be specific about the "many boxes" you're referring to? The most relevant to the grandparent being: has it ever been audited?

</comment></comment></comment></comment><comment><USER13> Seems like its failing to import contacts and groups from my phone? Anyone else having this problem? I can provide debug logs if that would be helpful.

<comment><USER14> I know a number of people how have had success with syncing but you may want to post your logs in Github or thumbs up if you are dup of [https://github.com/WhisperSystems/Signal- Desktop/issues/909](https://github.com/WhisperSystems/Signal- Desktop/issues/909)

<comment><USER13> I've updated that issue with my debug logs, thanks!

</comment></comment></comment><comment><USER15> What is the endgame for Signal? Now that its protocol has been implemented by several popular apps, will Signal continue to be developed?

</comment><comment><USER14> "Use Signal. Use Tor."

<comment><USER16> Makes me wonder why they don't embed Tor into signal as an alternative (or fallback) way of connecting to the network.

It could be very useful in countries that routinely censor the web (including apps like signal).

<comment><USER14> I can't think of anywhere that blocks Signal but doesn't block Tor.

I think the OWS developers would probably be more interested in a system that can conceal metadata from the Signal server rather than pure network surveillance.</comment></comment></comment>


Death match EBS versus SSD price, performance, and QoS - <AUTHOR> http://www.mysqlperformanceblog.com/2011/02/21/death-match-ebs-versus-ssd-price-performance-and-qos/

<comment><USER2> One thing I got from this article is that I really have to try Baron's diskstats tool. I wonder if his customer was using the cluster 4x instance, as it has a 10 gigabit network adapter.</comment>


This is a pipe. (Something dear to me.) - <AUTHOR> http://blog.200nipples.com/2009/09/new-shirt-notice-this-is-a-pipe/

<comment><USER2> I love it, but I'm not a "T-Shirt" kinda guy. I wish they would do something other than just T's.

<comment><AUTHOR> I can send you a High Quality PDF of the 11x17 poster mentioned in the post if you'd like to print it out.

Just shoot me an email at wade |at| 200nipples |dot| com.

</comment></comment><comment><USER3> in a similar vein, i have a print of <http://www.threadless.com/product/543/This_is_not_a_Pipe> hanging on my wall, over my wii & xbox. feels very appropriate

</comment><comment><USER4> mmh... something is wrong tough. I always thought of a unix pipe as a conduct. The word "pipe" in french is correct for the smoking item (and also to describe a sexual act) but it does not refer to a conduct.

The conduct you call a pipe in english is a "tuyau" in french.

<comment><USER5> _conduct_

Conductor or conduit?

<comment><USER4> I meant conduit, thanks for pointing out

</comment></comment></comment><comment><USER6> I'm a programmer, so I have a tendency to sit on my ass and snack. Why would I want a shirt that draws attention to my waistline?

</comment><comment><USER7> Does anyone ever buy the $100 shirt?

<comment><USER8> Looks like someone did.

Have to say this is 1) a brilliant tshirt, 2) a brilliant business model. Just placed an order. :-)

<comment><USER9> Now it appears that they didn't purchase it, as it's available.

</comment></comment></comment><comment><USER10> If I could get it cheaper, I'd buy one.

</comment><comment><USER11> What's that snarky quote, _modern art is 90% justification_?

Not sure why that popped into my head whilst reading seven paragraphs about his t-shirt with a vertical bar...

</comment><comment><USER12> I hate to look really amateurish, and please correct me if this is irrelevant to the thread, but would the following python code equal to the amount of money received if each shirt was sold for one design?

(It's python, and I'm very new to programming. Criticism is welcome.)

        a,b = 1,1
        while a <= 100:
            a = a + 1
            b = b + a
        print(b)

<comment><USER13> Nope, that ends up with $100 too much. The proper way is documented here: <[http://wiki.answers.com/Q/What_is_the_sum_of_the_first_100_p...](http://wiki.answers.com/Q/What_is_the_sum_of_the_first_100_positive_integers>).

One way of computing it in Python, using a loop approach like you did, is like so:

        sum = 0
        for p in xrange(101):
          sum += p
        print (sum)

This uses better variable names, and a simpler looping construct. The reason for the 101 is because it starts at 0.

<comment><USER14> Shouldn't that be

       print ((n-1)*n)/2

<comment><USER15> That's not entirely right. It should be: print ((n+1)*n)/2

(fold the sequence in half, which gives you 100 + 1 on one end and 50 + 51 on the other.)

<comment><USER14> Ah right, sure.

I took the 'n' to be the 100, not the 101. A little too quick on the submit there, I should have run it :)

But anyway, that seems to be a damn sight faster than to run a loop to add a bunch of numbers in a fixed interval.

Especially for large 'n'.

<comment><USER15> Probably much faster, but also doing half the work yourself. It'll depend on the situation which is the better solution.

</comment></comment></comment></comment></comment></comment><comment><USER16> Its good to know there are more typography geeks out there reading HN.

<comment><USER17> I'd say it has to do more with the use of the pipe character on the command line than the typography angle of it, but I could be wrong.

<comment><USER18> ^ mildweed is behind Tiny Sauce

<comment><USER16> Indeed. And proud of it.

</comment></comment></comment></comment><comment><USER19> Fabulous post, wmeredith - thanks.</comment>


Being right won't pay your bills - <AUTHOR> http://austinlchurch.com/being-right-wont-pay-your-bills/ <comment><USER3> > People remember the last 2% most vividly.

Agreed. I'm going to remember this guy as the one who shoved a pop-up in my face asking for my email shortly after I reached the end of the article. Not to mention the first 2%, where he asked for my email so he could send me his business tips before I even got to read the article.

<comment><USER4> Didn't get to the end of the article, it instantly popped up on me, was surprised it managed to gain any traction here. (Rotated monitor is probably why)

<comment><USER5> This actually shows the principle opposite to this article being at work - <USER2> demonstrates that you can be annoying to people, and they will somehow deal with you anyway :).

<comment><USER4> Depends, I skipped the contents completely when that happened, only went to the comments to see if I was the only one.

</comment></comment></comment></comment><comment><USER6> A seasonal company calls me in to do customer support during their busy season when the mail has lost customers packages and they havent been delivered and everybody is crabby. In helping 1000+ customers on a live chat alone none have ever given me a negative review. (which I never let the company forget:) and a major reason they call me in.

One tip when dealing with a upset customer, they will often call in angry and instantly start on a tirade of why they are upset. If they do I instantly interrupt them and ask them for account information and assure them we will take care of any issue they have because we are here to help.

It does 2 things, you dont want them to rant and build up negative energy so you nip that in the bud and they dont have to relive negative feelings. The assurance that we will take care of them instantly sets tone that no matter what their problem will be solved so you take all the stress away from the start. Telling them you are there to help in a friendly tone makes it very hard for them to express anger since you dont get angry at those helping you.

Take away the anger and leave them with happy thoughts. Once the anger is gone the rest is easy.

Edit- Also when you interrupt and ask for account information it shows that before you even have to hear the problem you are already working to solve it in a fast and effective manner for them.

<comment><USER7> Of course if you don't have the juice to actually fix the problem then this can backfire.

The most angry I've ever gotten is with Comcast's offshore chat/call center. The reason is because they are trained to tell you that they _will_ solve your problem, and that afterwards that it _has_ been solved in such an emphatic fashion that only a sociopath would dare to question. Yet they do this without any _actual_ indication that what they are doing is having any effect at all. And the worse thing is, even when you call back they act like they are listening to what you did previously, but in fact they are just waiting to interject the script where they make you jump through the same 20 hoops over and over again. In my case it turned out to be a faulty modem, so none of what they were doing had any effect at all, but in no way did they ever let on any actual information or engage in any reasoning.

I suspect the only reason hasn't replaced that call center with a voicemail tree is presumably because they need a Turing-test capable human to get the customer to calm down long enough for them to re-read step 25 from the level 1 tech support handbook.

I apologize for hijacking your thread, but I had to get this off my chest.

<comment><USER6> I think you bring up a great point and I couldn't agree with you more! If you are not in that situation or can't honestly say that, I strongly suggest not doing it. It would make you look like a liar and leave a bad overall taste in customers mouth.

The company I work for thankfully takes customer service very serious. I don't mind helping them because they want their customers to be happy not be blown off or jump through hoops and that personally makes me want to help the company because its something I respect.

I usually cant stand support from a company because of many of the concepts you touched on, specially the "hoops" and support not knowing what they are talking about so I empathize with the customers.

Appreciate the post! I do love HN because the high level of discussion.

</comment></comment></comment><comment><USER8> This is a good article that many would call "Customer Service 101." The author seemed to have been weak in that area. Good the author realized how important it is to overall earnings.

On blogs or whatever, I can be pretty blunt and harsh. With my customers, I walk a tight rope between being aggressive and being gentle almost always moderate. I'm quick to concede something to customer if the overall value proposition is still good for long-term or it's a little thing that can't hurt my image. Past that, I might try to shift blame from them or I to the circumstances of the situation while portraying us as a team handling it. Pissing them off is the last thing you want to do, though, given long-term is more important.

Author either skimmed over or didn't mention two things, though. One is that customers often talk to other potential customers. Even those you "fire" you should separate from on good terms or not too harshly if possible. They can spread word fast through other clients who are then more likely to turn down contracts.

The other issue is the clients asking too much: many do it on purpose. There's so many hustlers out there who play proper capitalist by always getting as much as possible while giving as little as possible. So, you need to determine ahead of time what's your willing to commit to, possible extras, possible compromises, and absolute upper-bounds for any given job/client. Then, stick to it and politely if people are pushing it too much. Give those types an inch, they'll take a mile: you go from profitable, independent consultant to many to practically under-paid employee of one.

Things to remember.

</comment><comment><USER9> > But in retrospect I can see that my touchiness in that moment probably cost > me tens of thousands of dollars.

I don't know if it's a side effect of living in a western society, but I see people make this kind of mistake all the time in the corporate world -- i.e. assuming that behind it all there's some neutral arbiter who will square any conflicts that arise in the workplace. In reality, if you make your self look like an ass in front of the wrong person, at the wrong point in the fiscal year, it affects your bonus / promotion / etc., and you never get that back, plus it's used to factor into every reward you get until you leave that company. Definitely better to be diplomatic.

<comment><USER5> In a corporate world, it probably doesn't matter most of the time. Corporations are big entities - individual failings get lost in the noise. If you're a top executive then sure, your every word will push the stock price around. But an average employee can absolutely be an ass, as long as they don't anger the management, and it won't likely affect the bottom-line that much.

It also applies to smaller companies; in fact, I'm beginning to believe that people are being too obsessive about pleasing the customers. For instance, the best way to get a company to respond to your complaint today is through social media. They will ignore your e-mails. They will bullshit you on the phone. But they will not ignore a complaint on a Facebook page. But why is that? An average consumer has exactly _zero_ capability to inflict any damage to the company. They won't even lose a single sale over it, unless the company is very new or caters to a niche market.

Some companies, those in extremely competitive environments, know it all too well. In convenience stores, besides meeting tons of cool people, you can also meet tons of assholes. They don't care. They know you have to buy food anyway.

<comment><USER10> >But an average employee can absolutely be an ass, as long as they don't anger the management, and it won't likely affect the bottom-line that much.

Parent was referring to being an ass in general. If you act like a dick in the workplace, it will affect your promotions, etc. People will just not think of you first when looking to shower praise.

</comment></comment></comment><comment><USER11> Totally agree with the premise of being diplomatic and calm, even when a customer is wrong.

However, it almost reads like he's saying he should have just issued the (undeserved) credit the customer asked for. Personally, I think that could be just as costly over the long term...it sets a precedent that the customer will likely leverage over and over again.

<comment><USER12> Yeah I think the best lesson to take from the parable is to keep the ego and corresponding negative emotions out of it.

There's nothing really wrong with what he told the guy (at least, what he says he told the guy), it's just that by his own words, the way he said it came across like him being a ____.

When instead if he'd been able to get past his anger/offense at being questioned, he could have done the same thing but positively, like "dude check out all this awesome shit i am literally already doing for you, for free! Doesn't that actually look like you are getting a pretty sweet deal?" And so then instead of this client being like "oh well fuck me for asking I guess" he could have been like "whoa shit this guy is giving me the sick hookup, I better hire him all the time from now on forever!"

</comment></comment><comment><USER13> That's pretty much customer service 101 / consulting ABCs. Sometimes you have to learn it through experience if it doesn't come natural to you, but I think it can be learned, taught, and coached.

The more nuanced, hard part is to be able to effectively read ( _over a phone_ even) whether your customer is the type that has been burned by charlatans in the past and wants technical excellence first... or whether they would prefer "bedside manner" moreso (this is an area that a lot of doctors also fail routinely). Some people are extremely hard to read, and it gets more difficult the higher up a corporate hierarchy you go and for more lucrative verticals in my experience - they're all used to very strong poker faces. But few high level business decisions are made purely upon raw information, so understanding emotion becomes very important if your business focuses upon fewer customers with greater $ / customer.

All too often people fail to read the emotions behind what someone wants and tries to execute to the details of the request instead of looking for context first before touching a keyboard. I worked with a good engineer that diligently worked on problems reliably, and my customer had an issue that they really just didn't care about that much but only wanted to just send out the door for the sake of finishing it and marking it done (it's turning into shelfware, but there's... obligations / due dilligence). I had a hard time communicating that over the phone with the customer present and the customer was getting frustrated (visible but not audible) but another senior engineer figured out between the lines what I was implying between my words, drastically reduced effort on the problem being worked, and the customer was happier for it.

</comment><comment><USER14> >You may have heard the old saw about marriage: "You can be right, or you can be happy." \--

Happy to see that saying in there. In its sometimes hard to remember that not everyone is as logic oriented as myself.

<comment><USER15> I think you could safely add that last sentence to the list of things NOT to say to a spouse.

<comment><USER16> Is that necessarily true? It seems like it would depend on the dynamic. I know I've had many and extensive (and quite good) conversations with my fiancee as to how she was brought up in a family that valued emotional reasoning over logical reasoning. Knowing the inputs and broad transactions to someone's mental processes (especially if they're very close to you) can help facilitate communication/understanding, regardless of the value judgement one applies to them.

To tie this back to the article, sometimes being right can work, but it's a risky line to push without the above, a clear understanding of the person opposite you's mental process. That being said, also as the above, I find that in situations where a business relationship can build that trust and understanding even in the face of contrary views on certain things (logic vs emotion, to draw that parallel) a far better working relationship can be established, although I have a feeling to an entrepreneurial community this is stating the obvious :)

I think the author touches on this but not specifically, "be easy to work with" is a nice umbrella that I'd add an addendum to, a hope that both parties try to give each other the benefit of the doubt and some tolerance through disagreement in the hope that the opposite party is doing the same, and eventually, you may not have to worry as much about the friction of being right. (within reason)

<comment><USER17> >I know I've had many and extensive (and quite good) conversations with my fiancee as to how she was brought up in a family that valued emotional reasoning over logical reasoning.

I understand that most people value emotional reasoning more than I do. I don't get people valuing it more than logical reasoning.

There is just so much potential danger with implicit and explicit bias. Sexism and racism tends to be more the result of emotional reasoning than logical reasoning. (Think of a jury/judge sentencing a black guy to a harsher sentence than a white guy who did the same crime. Imagine if the difference between if the justification was the black guy felt more dangerous vs a justification such as in this instant the black guy having similar prior offenses. Which justification is racism?)

<comment><USER16> To clarify my point, my intent wasn't to assign value to thinking emotionally, but to suggest that being candid and open about differences such that they exist is an important step to working productively despite, or even because of them.

That being said though, you bring up an addendum I would counter that although you're right to say there is potential danger to emotional thinking, there's potential danger to purely logical thinking as well; to bring this back to my original statement in which avoiding confronting these differences in an "easy to work with" fashion reduces the chances of moving even a little towards a middle ground to 0.

<comment><USER17> I would definitely agree there is great danger in purely logical reasoning, especially if it were someone who had limited empathy.

I wonder, if both extremes are dangerous, is the middle ground safe?

</comment></comment></comment></comment></comment></comment><comment><USER18> Great article and the last mantra stood out: >Value, not prices. >Experiences, not products. >Outcomes, not processes.

Would love to see the title changed to "Being right(eous) won't pay your bills" \- being right is important, letting everybody know it is a totally different thing :)

<comment><AUTHOR> Love this nuance you teased out.

</comment></comment><comment><USER19> If I feel that strongly about something, I just stop. I don't like confrontations at work TBQH. I'll leave if I think I can't be of any further service or someone doesn't need my expertise. No use getting worked up or arguing about it.

</comment><comment><USER20> This is absolutely true, and applies to people other than "creatives".

There's a slightly patronising tone to this, whether it's right or wrong: " we must Siberia educate our clients". While true, it's not the key issue. They can educate us too, and perhaps that's the take-away here. I hope to put myself in my clients' shoes every time I talk to them. That way, everything they say makes perfect sense, and we can agree a way through any issues together, as a partnership.

I don't always manage to do this effectively, of course, but reflecting on this helps me slowly, slowly improve.

<comment><USER21> Compassion is almost always worth the effort. Very difficult thought.

</comment></comment><comment><USER22> The author's observation that the last 2% of a transaction has a bigger impact on the customer's perception is consistent with the peak-end rule, which is a pyschological heuristic predicting a person's overall impression of an experience based on its most intense and last moments. Daniel Kahneman (the guy who wrote Thinking, Fast and Slow) and some others have done good research on it.

[https://en.wikipedia.org/wiki/Peak%E2%80%93end_rule](https://en.wikipedia.org/wiki/Peak%E2%80%93end_rule)

</comment><comment><USER23> Whenever I feel like I have to respond immediately, like right now damnit: I should wait.

</comment><comment><USER24> This basically has to do with how our brains work. We weigh negatives things in our mind much more than positive. Thats why even a good friendship built over many years with many positives can be ruined by a small mistake. Its core to survival to look out for negatives over positives, because it can avoid major trouble. Sympathy and compassion are things we need to work on to overcome our brains natural push.

</comment><comment><USER25> > Feeling very righteous and indignant...

Recognizing those feelings and knowing that it is time for a walk and NOT time to respond to emails is a useful skill.

<comment><USER26> Absolutely. I took a mindfulness class and the biggest takeaway for me was to take time between the event and the response whenever you feel an immediate emotional reaction.

<comment><USER11> There's an "undo send" feature in gmail (settings->general) that has saved me a few times. I wish it would allow for a send delay higher than 30 seconds though.

</comment></comment></comment><comment><USER27> If you're an agency that can scale up arbitrarily, by all means work for bad clients, especially as you've got people relying on you making payroll. If you're just a freelancer, why bother? There are only so many billable hours in the year, and there's more work than you could ever turn down, most of it for agencies that are unable to say no.

</comment><comment><USER28> The need to be right is frequently dangerous. From my days motorcycling:

 _Being right won 't keep you out of a hospital bed_

</comment><comment><USER29> Nice blog post, though I disagree with the title -- being right certainly pays my bills. ;)

The theme is more like, "Learn to pick your battles with clients."

<comment><USER30> It's more than that.

Even if you choose to fight, fight the right way. Being overly emotional and ego driven ("I'm right, how dare they?!") can be very damaging to a relationship, even if you end up "winning".

The key, as I'm trying to teach myself every day, seems to be to get yourself and your ego out of the picture. The advice I really loved was to picture yourself as some absurd, godlike dictator, demanding the world bend to your whim... With that in mind in mind you realize how silly you're being.

It's something I struggle with every day, but learning this kind of self control is very important to long term success.

<comment><USER31> I'm sure it's different when contracting, but it's really hard when working in a large organisations. There are a few different kinds of reactions to the inefficiencies and inequalities in $BIGCORP:

* Try to fix everything - this will lead to burnout

* Ignore it, and just work on your stuff - this will work, but you probably won't get promoted

* Play politics and try to fix a few things through the "right channels" \- this probably works, but it's really really difficult and can be soul-destroying.

* Do what you can, and update your resume - cynical, but probably the best option if you like eating food.

I mean, you're not always in a position where you can educate your clients. Sometimes doing that would be a career limiting move.

</comment></comment></comment><comment><USER32> Learned this the hard way, minus 10K!

</comment><comment><USER33> Related to the last 2%, I'm always shocked whenever a waiter balks at splitting up a check when multiple people are paying. I always think "Really, you are going to annoy me right before I decide how much tip I will give you?"

<comment><USER34> As a former waiter who spent over a decade in the industry, working everything from casual to high dining, this comment irks me at a personal level. These examples are not directed at you but an explanation of how a waiter sees the situation.

1\. Some Point of Sale systems have a limit on how to split a check. I physically cannot split a check more then 6 ways and the customer is asking or 7 ways, then what am I suppose to do? Be "nice" and promise the impossible? So now I pissed off a customer who's about to tip me because I cannot reprogram the POS.

2\. The more likely scenario is when a table of 7, who just had pre-fix brunch is asking me to split a $70 check 7 ways which takes my time away from my couple who just dropped $70 by themselves.

What customers in restaurants don't understand is that tipping might be optional but my time is money. As a customer is tipping on service, I'm also providing service comparable to the tip I receive.

Waiters are really good at "guessing" how much a customer will tip and will act on that belief.

Disclaimer: I worked with a ton of awful waiters who were straight up rude to good guests. No guest should ever be treated poorly.

Ive also served some awful customers:

Some of them tipped very, very well because they wanted to be awful. I loved those assholes and always welcomed them with open arms - money's green regardless.

Some were just awful and I tried to steer clear of them.

Now as an olive branch; all guests should be treated with outmost respect and all people in the service industry should be as well

<comment><USER35> Now, I know this is something that waiters might not have the power to change, but how about not putting whole tables on the same tab to begin with? How is this practice even OK? It should be obvious that each person pays for him or herself. When you go shopping with some friends it's not like you have to split a tab just because you are hanging out together. I pay for what I consume, putting us all on the same tab is just being lazy.

<comment><USER34> I'm not sure where you're coming from with this comment. Most tables are couples and families...So should you separate a check for husband and wife/brother and sister? How do I know if two guys are together or "together"? Should I ask?

I can "guess" if you'll tip 18% or not and if I'm wrong...I'm wrong. If I assume your relationship to another person you're dining with - I might get fired...

<comment><USER36> You mentioned that your POS allows to split the check 6 ways. So, if you see more than 6 people at the table, then you may ask them how they are going to pay: separately or by one check.

<comment><USER34> Makes sense - what would happen if they have 6 and then a 7th joins them afterwards? Should we refuse service?

Hypotheticals are everywhere. Usually its easier when tables ask to split a check in the beginning, then the logistics can be figured out and you don't have a situation that OP mentioned.

Bit off topic: I had a table, I don't remember how many people but it was large (7-10). One guest joins late and quickly orders her food. Since the rest of the table is already on appetizers, I rush to place the order and get her salad as soon as possible.

Once the salad arrives, I check back and, after the guest is satisfied, go to take care of a different table.

Maybe two minutes later, the table franticly calls me over and asks if there are mushrooms in the salad, to which I reply "Yes". Calmly, the gentleman to the right of the lady with the salad reaches into his bag, grabs an EpiPen and stabs her.

My manager and I look at each other and are mortified - how did this happen? I quickly start to apologize but I had no idea that she was allergic to Mushrooms. While we're freaking out, the table is as cool as the other side of the pillow - everyone just continues eating and the lady is all smiles.

Turns out that the entire table are doctors and the lady routinely forgets to mention her allergies. The gentleman, her husband, explains the situation while the lady apologizes for creating a fuss (at this point my manager is as white as a sheet).

Even though everything turned out "ok" it was certainly a scary moment. It also relates to your comment - shouldn't I ask each person that comes in about their allergies or is it their responsibility to inform me of their dietary restrictions?

</comment></comment></comment></comment></comment></comment><comment><USER37> Be easy to work with, but at the same time there is absolutely no reason to give the client in the beginning a credit. Doing so will probably hurt you more, as the client will lose all respect for you and your rates.</comment>


How to Design Classes (in Ruby, Python, Java or any OOP) - Open-Juicer http://www.ccs.neu.edu/home/matthias/htdc.html

<comment><AUTHOR> This looks like a great book, but I'm not sure it really represents a good way to learn how to design classes in Ruby or Python. It seems heavily biased towards designing classes in a statically-typed, non-type-inferring, java- style language. Programming in Python is a lot more about knowing when defining a new class (rather than using built-in types and classes) even a good idea to begin with.

<comment><USER2> I shamelessly clicked away as soon as I realized it was Java. Well, not completely shamelessly. I kind of feel like a "rassa-frackin' whippersnapper" disgustedly changing the radio station when stumbling on classical orchestral music.

Then again I also feel a little dirty for comparing the likes of Tchaikovsky and Beethoven to Java...

<comment><USER3> No, this is quite right. Classical music is as bloated, heavy-handed, and decadent as Java. Good music is found in the 16th century and earlier, and in the 20th century and later. We can see this maps to software: good ideas are to be found in the 70s and earlier, and in some hoped-for new era yet to come . . .

<comment><AUTHOR> Check out Haydn's "Lord Nelson" mass, specifically the recording by Banchetto Musicale (it's very light and clear). For the antithesis of heavy-handedness, pay attention to movements 2, 4, 5, 7, and 12. But the whole thing is only about 40 minutes and really easy enjoy start to finish, especially since those movements I mentioned are meant to contrast with the slower ones.

Movement 5, while not my favorite, is especially notable for being a canon at the 5th. It's quick, fun, the imitative counterpoint is very easy to hear, and at a minute-forty, hardly overstays its welcome.

Overall though, Western music between Bach's death in 1750 and Beethoven was anything BUT bloated and heavy-handed. Balance, taste, and clarity were highly valued.

</comment></comment></comment></comment><comment><USER4> This book is rather naive. It starts with a quote by, the inventor of Smalltalk, Alan Kay. The book focuses on Java.

Smalltalk is a message-passing language. Java is a method-calling language.

A book about object-oriented programming that doesn't distinguish between message-passing and method-calling fails to express how languages like Ruby and Objective-C work.

<comment><AUTHOR> Excellent point. I think that more generally, as it relates to what a student might be interested in, it fails to address the fundamental question "why am I learning this?"

I think if I were going to design a book or course in object-oriented programming I would either approach top-down using a dynamic language or bottom-up with C. In the top-down version I would focus on the advantages of OOP as a discipline and why seemingly arbitrary restrictions really are useful (not just some hand-waving about static type checking) Going the other way, I'd have them write method dispatchers and basically implement classes without the features of modern object-oriented languages and then discuss OO languages in terms of the features they provide to simplify that style.

</comment></comment><comment><USER5> This book is too long for the subject it purports to impart.

Good coding is not a craft of many secrets; rather it is an art of a few core principles. Mastering them is a matter of direct experience. I believe a good book can point a programmer in the right general direction, but it is up to her to go the distance.

</comment><comment> buff-a Compared to bicycles and shapes, this book is a step in the right^H^H^H a different direction in that it is data-oriented rather than object-oriented. Rather than make the claim (as they do in the introduction) that other textbooks are doing it wrong, I would have prefered to see acknowledgment that different tasks call for different approaches, and highlight that the data- oriented design presented here is usually left out of other texts. Giving examples, as they do, of tasks where the goal is simply to store and present data, it is only natural that a data-oriented design is what shows up. That does not mean that there are not programs whose job is to act on and manipulate data.

But. Fundamentally, designing classes upfront is simply the wrong way to go about it. The argument may be made that the end result (I now know what good classes look like) justifies the method, but I disagree. It is the journey that is important, not the result. The students will not remember what a good jogging journal class hierarchy is. They will remember how to design classes on paper. In my experience, classes hierarchies written on paper or on fancy UML software, are bound to be "wrong". This is a Bad Thing.

UPDATE: In fact, any tutorial about how to design classes that does not describe an iterative process, and make use of _all_ the refactorings built into Eclipse or IntelliJ, is guaranteed to fail to teach kids what I do every day I program java (or C#).

</comment><comment><USER6> This is the textbook for one of my classes at Northeastern. The prerequisite class used HtDP (<http://www.ccs.neu.edu/home/matthias/HtDP2e/>) and Racket (<http://racket-lang.org/>), and the focus was on design principles and writing good code more than it was on the actual language we were using. I'm expecting the same from this class, but I'm not against becoming more experienced with Java either.

</comment><comment><USER7> I found this to be a great (ruby based) design book. Ruby best practices by Gregory Brown (free download <http://rubybestpractices.com/>)

<comment> Open-Juicer Eloquent Ruby is the design book to read.

Why not import some of HtDC best ideas to the Ruby world, for those of you think HtDC is Java biased? Actually, many good ruby books are adapted from the Java land.

A side note: To many rubyists' surprise, Matz is not a language-biased guy who would like to start a language war.

</comment></comment><comment><USER8> 666 pages.

</comment><comment><USER9> Nice to see NEU on here, they are big Scheme fans there I know so I don't know how much Ruby it will relate to. Python is used in some classes as well I believe (I was an ME major with friends in CS).</comment>


As a Founder, Do Less - <AUTHOR> https://medium.com/@feliks/do-less-2c81556edce5 <comment><USER2> These vapid postulations around some ideal set of behaviors in order to be "better" in some way at the difficult task of building an effective company are as numerous today as they are infuriating to read. I wish people would just stop writing these pseudo thought pieces. They're just humblebrag garbage.

</comment><comment><USER3> Some data would be make this argument better. The current narrative is I did "a lot" was successful but now looking back I should have done "less."

</comment><comment><USER4> Interesting, I think some of these are quite valid. It's just important to know when to turn the switch at times.

</comment><comment><USER5> Pretty much a sum up of the Essentialism book. I recommend it to anyone who is interested in this philosophy.

</comment><comment><USER6> TL;DR: as a founder, if you focus on the essential and do less stuff than most other people do, you'll be more successful.

Yet another trivial and superficial piece of advice from a nomadic/minimalist entrepreneur. Not really anything eye-opening there.</comment>


The case for being a medical conservative - <AUTHOR> https://www.amjmed.com/article/S0002-9343(19)30167-6/fulltext <comment><USER3> I only know anything about one of the authors of this (Prasad). The history leading up to this article is relevant. His modus operandi is to severely criticise clinical trials to an audience that is only peripherally or not at all involved in the field. You can see why this works - being extremely shrill about something to people that don't have any idea tends to garner agreement, since they can't evaluate your claims and you seem so adamant about it. It creates the illusion of someone that is 'telling it like it is' and not just following the norms of the profession.

The problem is that this doesn't generate anything of actual value, except for Prasad. It is easy to criticise medicine. It is easy to criticise any complex and difficult human endeavour. He takes the practice of critical thinking about studies and results and what they mean, something which all doctors do and are taught to do, and turns it into a blood sport which plays to the masses. There are plenty of academics who do what he does, and publish in well respected journals. At any conference where a major result is presented, people in the audience get up and ask questions about the value of the intervention, the conduct of the study etc, just the kind of things Prasad rants about. The difference is that Prasad has monetised this practice by pretending that he is the only one doing it. He writes books, publishes endless articles which are mainly reviews and rehashings of other's work and the person that hired him to a faculty position openly admits they chose him because of his propensity for scathing criticism.

This article therefore, I find largely self-indulgent and in some parts sheer nonsense. The authors style themselves as custodians of some higher art, a priesthood of common sense and clear thinking. They pull the trick of trying to cement their importance by defending themselves against a bogeyman, the force of 'commercialisation'. Of course, there is no single person or group who is causing this commercialisation, so there is nobody to question them. They also bizarrely say that they are better placed at evaluating medical evidence than the people who know most about it ('content experts'), because the experts are too enthusiastic.

<comment><USER4> Thank you for your comment.

 _At any conference where a major result is presented, people in the audience get up and ask questions about the value of the intervention, the conduct of the study etc, just the kind of things Prasad rants about._

For people with incurable conditions, "dread diseases" and very deadly conditions, the current system is already too conservative. They denied approval for a non-drug treatment for cystic fibrosis because some participants had lung bleeds. Lung bleeds are common with CF. CF is extremely miserable and has a very short average life expectancy.

There are many stories like this out there. People with horrible conditions hear the news that some new drug they were hoping would get approved has been denied by people who seem to be comparing it to some internalized standard for someone relatively healthy and not actually comparing it to "Is it better for _this_ group of people than what they currently have?"

There are very, very expensive drugs and surgeries that get approved at times and that's a whole other issue for such communities. But it's a very real problem that some people are dying and drug approvals don't seem to actually take that into account. I've seen people say things like "Just let me live the additional five years that it takes to get these horrible side effects instead of dying before then. I will worry about the horrible side effects then."

Most people want to live, even when that involves terrible suffering. Most people want that chance. And our drug approval process is often maddeningly conservative already in the eyes of people with various terrible conditions who would be happy to be a guinea pig to have some kind of shot at survival.

It's a logic that makes sense to the people enduring these diseases, but one the medical establishment recoils from.

<comment><USER5> My grandmother was killed by an FDA approved drug, so my experience is that sometimes the current system is not conservative enough.

What's worse, the company reportedly knew about the danger of the drug, and didn't tell anyone.

Eventually the drug was removed from the market, but not before hurting thousands of people.

This particular story is about Baycol (1), but perhaps, while reading this, you may have been thinking about another similar story. It's happened many times.

If "medical conservatives" can help prevent this from happening even one time, they are creating something of value. I think it's ridiculous to claim, as GP did, that protecting people from harm does not "generate anything of actual value".

1: [https://www.nytimes.com/2003/02/22/business/papers- indicate-...](https://www.nytimes.com/2003/02/22/business/papers-indicate- that-bayer-knew-of-dangers-of-its-cholesterol-drug.html)

<comment><USER6> The medical system is always going to be an ongoing series of tragedies. People are going to die stupidly in the medical system because it is run by humans who make mistakes. The human body is not a controlled and repeatable environment like an aircraft; it is a mess, a lot of the parts look accidental and it is a miracle it works on a good day.

"A mistake was made so we must adjust the system to stop that happening" isn't a workable philosophy in this specific instance. There is no scenario where mistakes don't happen. A strategy that attempts to achieve the impossible is not a good idea. Tradeoffs will be made that are bad.

I can acknowledge that your story is horrible and unfair; but if that thinking takes hold in medicine (which realistically it probably already has) then people will suffer for no reason in a predictable way. It is better that at least people suffering is a surprise or at least somewhat unexpected. Decisions must be made using statistics and risk assessments rather than grasping hopelessly at certainty and happiness. We must tolerate a few bad drugs slipping through.

<comment><USER5> According to the FDA itself (1), adverse drug reactions (ADRs) "are one of the leading causes of morbidity and mortality in health care" and may be the _fourth_ leading cause of death.

We need people willing to speak up and be skeptical. And whatever small reward they may obtain by doing so is trivial in comparison to the billions that pharma and their sponsored scientists stand to gain by unjustified cheerleading.

It's laughable to question the motives and incentives of skeptics like Prasad while ignoring the immeasurably greater perverse incentives in favor of approving drugs too quickly.

I can understand the desire, the hope, that a new drug might be the miracle we've been waiting for. But precisely because we so desperately want new drugs to be helpful, it's crucial to remain rational and evaluate new drugs based on what they actually do, not based on our hopes or on the claims made by pharma companies.

1: [https://www.fda.gov/drugs/drug-interactions- labeling/prevent...](https://www.fda.gov/drugs/drug-interactions- labeling/preventable-adverse-drug-reactions-focus-drug-interactions)

<comment><USER6> But the statistic you cite might just as likely be evidence that the system is working very well. If the drugs being approved are 99.999% perfectly efficacious and 0.001% deadly then nearly all the deaths would be attributable to when the drugs fail. We aren't going to do better than that.

The better the system works and the more effective the medicines, the more deaths will be attributed mainly to adverse drug reactions. That is why we must tolerate them. We can't work towards a system where nobody dies in hospitals; but we can work to one where the leading cause of death is failure of medical care as opposed to natural causes.

The better our healthcare gets, the more likely the leading cause of death will be "nurse didn't follow the checklist", "the machine broke" or "the drugs made their body go haywire" and similar. Something has to be the leading cause of death. As we become gods unto our own bodies that cause will be human factors and mistakes.

<comment><USER5> In that hypothetical world, life expectancy would be rising. In fact, it is falling.

<comment><USER6> I promise I'll stop being argumentative after this, but in the meantime - <USER2> necessarily. Simpson's Paradox might get triggered where better healthcare encourages more marginal people to have children/migrate to the better healthcare/whatever. There is no single statistic or even a small batch that is safe to make uninformed decisions on.

This is optimising a complex system. It needs to be done slowly, holistically and with statistics and science. Just because one part is failing doesn't mean that the system is out of control. It might be out of control, but the evidence needs to be quite deep to conclude that because the system is very complicated. A response powered by emotions, anecdotes or silver bullet stats probably feels right but is likely to do more damage than good. This is a field where high-functioning sociopaths should be given a lot of room to make decisions; they are the ones who can make hard decisions and get to a greatest-good-greatest-number style outcomes despite that fact that gut- wrenchingly unfair and tragic thing happen every day in the world of healthcare.

What it comes down to is people die and often suffer. The fact that people are observed to die in the hospital system is _not_ evidence. Even aggregate stats getting worse is not necessarily a problem. Arguments have to talk thoroughly about what the costs and benefits of any change is likely to be and we have to accept that death is a cost that the healthcare system is going to pay whether we like it or not; because that really is an elephant in the room with these sort of decisions.

<comment><USER5> What I don't understand is why you'd want to shut down the discussion. Why object, not merely to a specific statement a "medical conservative" made, but to their very existence?

Why should we trust the system to high-functioning sociopaths, as you said, and not listen to both sides and have a vigorous and ongoing debate?

You're right that people die, and will continue to die, in medical care. And it's a difficult and emotional subject. And people don't always make the best decisions. But I'd still rather have public discussion about every little detail rather than trust insiders (with their own, sometimes perverse, motivations) implicitly.

<comment><USER4> I don't want to debate it with you because you led with stating that your grandmother died. You made it emotional and personal from the very first sentence and in a manner such that arguing with you looks like emotional cruelty.

Nothing can bring your grandmother back. The closure you desire is unlikely to be found in trying to protect others from her fate.

I have a form of cystic fibrosis, as does my oldest son. It's just as personal for me as it is for you. No good ever comes from trying to argue whose hurt feelings or personal suffering trumps the other's.

I've been talking about medical stuff a long time. I sometimes make comments that do decently well. I also still make comments that bomb, such as this one from this same discussion that was quickly downvoted to the negatives and still remains there:

[https://news.ycombinator.com/item?id=22042276](https://news.ycombinator.com/item?id=22042276)

I'm only responding now to this comment of yours because it makes me completely crazy when I can't get engagement, I get downvotes and the silent treatment and people act like I'm too emotionally fragile to have a reasoned discussion with.

I'm responding in hopes that something I say will help you more effectively find your way forward in future discussions. I still have zero plans to debate you in this one.

<comment><USER5> I apologize for making it emotional. I didn't mean to; I only offered my grandmother's story as a cautionary anecdote. The truth is, it happened a long time ago and I've already found closure.

I hope you find medications that help you.

</comment></comment></comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER7> > A conservative is someone who stands athwart history, yelling Stop, at a > time when no one is inclined to do so, or to have much patience with those > who so urge it.

Identifying yourself as simply a conservative or an anti-conservative in any context _as a rule_ , without regard for circumstance, is just absurd to me. It's like identifying as someone who walks northward or southward. Or someone who prefers large numbers or small. There is no useful across-the-board argument that can be made for either changing things or not changing things.

<comment><USER8> I agree with you. That said, my reading of the article is that they do identify themselves as conservatives within a context - that of medical care in the US in 2020. They make their argument on the basis of a utility function, which one can debate the merits of, but the whole arguemnt seems very contextualized.

<comment><USER7> By "context" I meant, in this case, a specific medical decision/direction of research/etc. An entire field isn't sufficient context to make a judgement call.

</comment></comment></comment><comment><USER9> To be honest, I think they are trying to make a "thing" where in day to day practice, and both in academic centers and in the private practice realm, I haven't really seen much distinction. Most physicians I know are aware of the major studies, and debate with colleagues and amongst themselves regarding efficacies and appropriateness of treatments. In so much that yes, there are variations between different practitioners and schools of thought, but I haven't seen a binary line in the sand saying "this is conservative medicine" vs. "this is liberal medicine".

There is "conservative vs. aggressive" medicine, which is more based on individual wishes of patients and familes, and also, well, "current" practices versus "out of date" ones that have fallen out of favor due to new research and data, for sure, but to color/frame it on political conservatism vs. liberalism is a bit of a stretch.

<comment><USER10> Further than that, medicine in general tends to the conservative by nature. I'm not sure this is a distinction with much value.

</comment></comment><comment><USER11> I agree with this in that I believe that many industries (esp. health care) are being harmed by hyper-financialization, which is reducing transparency for consumers and creating massive waste.

What worries me is the part about judging the worthiness of an intervention based on a hypothetical homo economicus' decision to pay for it. These kinds of cost-benefit analyses end up feeling really strange when applied to things with strong "intangible" value.

Even if set up in a well intentioned manner, I could see these kinds of analyses themselves becoming victims of regulatory capture and being used to restrict access to care rather than improve it, similar to how the Office of Information and Regulatory Affairs[0] has used economic arguments to gut regulations on coal ash, vaping, and prison rape.

[0]: [https://mattstoller.substack.com/p/did-economists-stop- congr...](https://mattstoller.substack.com/p/did-economists-stop-congress- from)

<comment><USER12> I don't understand how the analysts could put a price tag of $300K+ on a prison rape, multiply by the number of rapes, and still conclude that it's not worth investing in prevention. Or, you know, if their argument is that the cost of preventing a rape is less than the cost of compensating victims, why the law isn't compensating victims. As it is, it's levying massive tax on victims of crimes. Same for the car backup camera law. OIRA is economically incoherent, by optimizing for supposed total utilitarian benefit without any regard for _who_ gets the benefit. They block laws because they claim the cost to society is greater than the benefit to victims, and therefore rule that victims of catastrophes should get nothing. Under their own economic model, it's blatant theft from the poor to give to the rich.

Here's the NYT trying to be "fair and balanced", but at least linking to a critical report, and a much later Reuters article with more critical detail.

Naturally, since this malfeasance occured in the Democratic Obama administration, almost no one cared, and Twitter wasn't ablaze with complaints that Obama was killing children.

[https://www.nytimes.com/2012/08/04/science/earth/cass- sunste...](https://www.nytimes.com/2012/08/04/science/earth/cass-sunstein-to- leave-top-regulatory-post.html)

[https://www.reuters.com/investigates/special-report/usa- regu...](https://www.reuters.com/investigates/special-report/usa-regulations- oira/)

</comment></comment><comment><USER13> > the actual benefit derived by an individual can be far less than what is > advertised or publicized

which is why the UK has NICE to evaluate everything. THe individual GP/family doctor/specialist simply does not have the time to evaluate every single treatment.

Basically the author has described what NICE does, but without knowing what NICE does. (for reference, NICE evaluates the evidence of new drugs and techniques and works out if they are safe, effective and worth the money. Where they cost lots of money and show marginal efficacy, they do not get approved.)

However despite protestations to the opposite, the author appears to be calling for a political judgement ("The expert is just very enthusiastic, but this isnt real progress") instead of an evidence based authority with clearly defined thresholds.

Dangerous twaddle basically.

</comment><comment><USER14> See also (with no overlap in authors): The case for medical nihilism and "gentle medicine" (Richard Smith's review of book by Jacob Stegenga): [https://blogs.bmj.com/bmj/2018/06/04/richard-smith-the- case-...](https://blogs.bmj.com/bmj/2018/06/04/richard-smith-the-case-for- medical-nihilism-and-gentle-medicine/)

> Most practising doctors are, I believe, instinctive medical nihilists even > if they would never use that term: they know the limitations of magic > bullets, are highly sceptical of claims for new drugs, and recognise the > importance of the human as opposed to the technical. Some patients and > politicians are also medical nihilists, but most are not. They are the group > who would benefit the most from this important book but also, sadly, are > perhaps the least likely to read it.

</comment><comment><USER15> > We believe this is the ideal approach to patient care.

There's the rub: Ideal for the patients? Or for the doctors/nurses? The incentives are not at all aligned.

Reading everything we can about birth as my wife is pregnant and it's astonishing the amount of interventionism that the field gets into. It seems like things are implemented first and then dialed back only if they backfire in an obvious way. You end up with hundreds of dubious interventions: [https://elifesciences.org/articles/45183](https://elifesciences.org/articles/45183)

But the incentive is almost never towards respecting the precautionary principles, and almost always towards billable services.

</comment><comment><USER16> A great listen..

EconTalk: Keith Smith on Free Market Health Care [https://www.econtalk.org/keith-smith-on-free-market- health-c...](https://www.econtalk.org/keith-smith-on-free-market-health-care/)

<comment><USER17> And:

[https://www.econtalk.org/adam-cifu-on-ending-medical- reversa...](https://www.econtalk.org/adam-cifu-on-ending-medical-reversal/)

[https://www.econtalk.org/adam-cifu-on-the-case-for-being- a-m...](https://www.econtalk.org/adam-cifu-on-the-case-for-being-a-medical- conservative/)

Both with one of the authors of the linked paper, Adam Cifu.

<comment><USER18> I recall enjoying both very much. The health/medical realm is so hard to navigate as a layperson

</comment></comment></comment><comment><USER19> It would be interesting to quantify the psychological effect of concrete actions compared with the feeling of impotency, separated from the placebo effect.

I understand the absolutist monetary argument: If a treatment is not consistently effective, yet costs a lot, services such as the NHS - and the pockets of those on lower incomes in other countries - suffer avoidable losses.

But for an individual with a disease with no good prognosis, the feeling of doing something positive about this thing they have no control of will certainly have beneficial effects on their mental state, and provided it is not harmful, their body.

A good example recently is in remitting / relapsing MS - patients have for a long time been prescribed large doses of Vitamin D. It turns out that Vitamin D is useful for MS sufferers, much as it is for the rest of the population (maybe a little more as a common side effect, photosensitivity, means they are likely less exposed to sunlight) but that actually they don't need anywhere near as much as they are being prescribed.

(It is still being researched, so that study may yet be wrong.)

My point is, if I told you "There's some evidence to say that this massive dose of Vit D will reduce the frequency of your relapses," you will feel like there is a positive step you can take to beneficially impact your situation.

If, instead, I say "Take some vitamin D because it's good for you" that only leaves the crushing sensation of seemingly inevitable defeat.

So I guess my point is, there is value in hope. Where there are major side effects, or the costs are wildly prohibitive, that's a very different equation and I'd probably follow the OP's conservatism on that. But I'd like to see some mention of the mental effects of this policy, as well as the positive impact on research that real-world use of new drugs has.

</comment><comment><USER20> questionable choice quoting a notorious segregationist and homophobe like Buckley.

</comment><comment><USER21> omg. If you did everything a doctor suggests you do without a critical ear, you'll probably die younger.

You just care an lot more about the results and have more time to focus on researching just one person's condition.

But you're also a lot more likely to be kidding yourself than a medical professional is. But I think sometimes they just keep that to themselves sometimes because it's too hard to challenge an idea a patient has locked on to.

No easy answers.

<comment><USER22> I get the impression that Doctors prescribe things/give advice under the assumption that most patients don't care about the details, and aren't likely to stick to any long term plans. I wish there was an easy way to communicate to a doctor that I'm willing to research things, and to stick with better diets/excercise in the long term if that's the best fix for me.

<comment><USER23> I don't know how medicine is practiced in other countries, but finding a doctor that shares your philosophy about treatment and sticking to them seems like a problem best solved at a local level.

In my country, you are assigned a GP, but can switch with a specific administrative form. There are several well-known(via word of mouth) GPs in my town that have people deliberately switching to them due to the way they practice medicine - less short-term treatment, conservative prescription of medicine(especially antibiotics and painkillers), focus on lifestyle/diet changes and regular check-ups to catch serious ailments early. The GPs will also recommend particular specialists who have a similar philosophy.

Mind you, this kind of treatment is far from controversial. I've talked to some of these doctors and a common problem they have is justifying their costs - e.g. a patient comes over, they listen to the symptoms and examine them and prescribe...toughing it out and maybe changing your diet a bit. People feel like they're not getting their money's worth("I already know that!"). There's also plenty of people who are looking for a quick fix - e.g. I'm under so much stress at work now, I just need a pill, I'll fix my life later.

There's also plenty of people who think they can follow a strict regime and make lifestyle changes, but just can't, and it ends up being a resentful relationship with the doctor(the doctor feels like the extra time they put in is wasted, the patient may rationalize the failures as the treatment just being ineffective, etc).

All of this points to me that this is something best decided on an individual basis, when the doctor and patient have a good relationship.

</comment></comment></comment><comment><USER4> _We see true medical progress as slow and hard, in large part because nature has provided the human body with inherent healing properties.

The wisest of conservative physicians understand and embrace how little effect the clinician has on outcomes._

Blah blah blah.

Now if only more doctors/medical researchers were intensely curious about how to better support the body's "inherent healing properties" effectively. Then we might see a real sea change that is both dramatic and actually, in fact, honors the pledge: _First, do no harm._

Edit: Would people be happier if I said "This is nonsense." instead of "Blah blah blah"? (Serious question here. It says the same thing to me and someone else has made much the same point and been upvoted for it.)

<comment><USER19> In answer to your edit, probably downvoted because your post seems to have no point, other than to say "this is nonsense". Also, at a glance it sounds like the prelude to a homeopathy advert - doctors aren't listening to our bodies, they should be more in tune with their [insert pseudoscience rubbish here]. And given the narrow focus of the original post (talking about bias in economic trade-offs) fairly off-topic.

Also:

 _honors the pledge: First, do no harm._

Alas, in many places that pledge (and various variants) while studied, and not imposed upon students as an oath - other than through medical malpractice legislation

 _how to better support the body 's "inherent healing properties"_

That's almost exactly what most drugs are designed to do. Vaccines don't kill maladies, just hint at your body to prep for a siege. Painkillers don't kill pain, just hint at your body to ignore it. Antibiotics are an exception to this I believe (though happy to be corrected). So I'm pretty sure the majority of drug research is exactly what you've said that more doctors should do.

<comment><USER24> Painkillers do kill pain, but pain itself is rarely a problem. And as there are different kinds and causes of pain, as many types of painkillers exist. Pain is only a symptom, but better quality of life is often worth the side effects.

Likewise antiinflammatories, though sometimes inflammation itself is one - mostly autoimmune or to reduce damage when other treatment is curative.

Most drugs are in fact designed to work on their own, but are insufficient due to their laser focus, this the rest of body's mechanisms are required. Or they are directly messing with the chemistry doing either exactly as they should or otherwise known side effects due to relatively simple causation.

The about only place where it does not apply is carcinogenic or teratogenic effects.

Probably the only place where those remarks about "working with the body" apply is where we know next to nothing, such as psychiatry and very deep metabolic changes such as obesity.

Careful with analogies and broad generalizations.

<comment><USER19> _Painkillers do kill pain, but pain itself is rarely a problem. And as there are different kinds and causes of pain, as many types of painkillers exist. Pain is only a symptom, but better quality of life is often worth the side effects._

As much as I appreciate a technical debate (and before I fall off Mount Stupid [1]) I feel like maybe we're approaching a non-question at different ends. Questions like "What is Pain?" "What does it mean to 'kill' pain?" "What constitutes working with the body?" and "If a head is cleaved in the forest, does it make a noise?" are all questions I'd love to spend hours debating, but the answers to these probably have little bearing on my original point.

The only reason I piped up is that I know how crappy it is to be downvoted with no explanation, because what you said sounded perfectly reasonable in your own head.

Apologies if I accidentally promulgated a misinformation bugbear!

I will be more careful with my analgesics and my broad general anaesthetics ;)

[1] [https://www.urbandictionary.com/define.php?term=mount%20stup...](https://www.urbandictionary.com/define.php?term=mount%20stupid)

</comment></comment></comment></comment><comment><USER25> I thought these going to be about doubting those new results that say X time honored surgery or other big procedure has no evidence of efficacy.

</comment><comment><USER26> I think calling themselves "medical conservatives" is a massive homegoal. If the goal is to populise this term they have immediately made a lot of people more skeptical of it than they need to. Why not search for a more neutral word than "conservative"? The anti-science "skeptics" certainly were thinking in the right way by co-opting that word for themselves.

<comment><USER18> Little 'c' conservatism is a very reasonable guiding principle within the realm of healthcare, so on the contrary I think it's a well chosen word here. I am generally tired of the marketing/PR mindset that leads to perfectly good words from being marked as off limits due to various optics

</comment></comment><comment><USER27> I wish the authors would just make their point instead of bandying about florid prose (which is extra out-of-place in a medical journal!) and inappropriately invoking political conservatism. It takes them until the 5th or 6th paragraph to even start to describe what they mean by "medical conservative"

<comment><USER28> The reference to political conservatism (little 'C') seems quite apt. The quote describes the idea well--I'd summarize it as: not everything that's new is good, and we would do well to think hard before making major changes that might cause serious harm.

Those old-timers that did those old-time things? Sometimes they did them for very good reasons, even if they've since been forgotten.

<comment><USER29> Conservatism is essentially the philosophy of Chesterton's Fence, as opposed to Move Fast and Break Things.

<comment><USER28> Link: [https://en.wikipedia.org/wiki/Wikipedia:Chesterton%27s_fence](https://en.wikipedia.org/wiki/Wikipedia:Chesterton%27s_fence)</comment></comment></comment></comment>


Show HN: Unlock China – Crowdsourced tech hubs and resources in China - <AUTHOR> https://coda.io/d/Unlock-China_dSjGaEDiHwH/_suwjO <comment><AUTHOR> A few months ago, I became very interested in China. Though a major problem I faced, which I'm sure you've faced too if you've been interested in breaking into the China market, is how difficult it is to find resources independently.

Here in North America, and in many other parts of the world, I can find Meetups or Facebook groups and immediately integrate into the community. For someone coming from this part of the world, there are multiple challenges:

1\. Not knowing the online platforms or where the communities are

2\. The language barriers of accessing them

3\. Not being able to easily search or access tech hubs in China

4\. Not having much information in general

5\. WeChat groups not being publicly accessible, and limited in size (invite only)

I would love to break down some of these barriers, and for the community interested in working with China to make it easier for people to learn about, integrate and understand what's going on in China.

</comment><comment></comment><comment></comment><comment></comment><comment></comment><comment>

I've started a large document on Coda called Unlock China. So far the categories I've got are:

1\. Tech Hubs (accelerators, coworking spaces, maker spaces, with maps, locations and contact info etc)

2\. Apps (Chinese versions of all the apps we use)

3\. Daily Essentials (Filtered view of the Apps list, to indicate the most important daily-use apps)

4\. News/Information (English news outlets about China, podcasts etc)

5\. Reports (A collection of large reports by Deloitte, EY, and other major sources about technology)

6\. Noteworthy Articles (important articles about tech and news in China)

I would love peoples' thoughts and feedback on categories you'd like to see, other information you'd like to see and contributions. Please note this is very preliminary right now, I've spent a few days collecting some of this data, and would love some help. I don't want this to be a resource that one person hogs and profits from, but rather a resource that people build together collectively for the benefit of everyone.

Thanks for your help!</comment>