Ask HN: Are three servers better than one? - <AUTHOR> After running into some issues trying to setup a server on DigitalOcean with everything I needed to run my web apps I decided to set one up as a web file server, another as an email server, and a third one as a CouchDB server.
On the down side I now have 3 servers to manage, and I suppose 3 times the probability that one might go down. And users have to configure their web browser to "Allow 3rd Party Cookies" to run my apps.
But, it seems to me this approach may have some advantages too. It minimizes the chances for creating conflicts with dependencies when updating/upgrading. It delegates and spreads the loads for those chores. If one server goes down it doesn't take everything else down with it. And, each of these servers can be scaled to the size needed to handle the load it carries.
So far I've not convinced myself it's worth the effort to build a single box that does all of that. I suspect it can be done, but I'm  also not sure it's a good idea to go that route. So far what I've got seems to be working pretty good and that old adage, "If it ain't broke don't fix it", comes to mind.
But there's a lot I don't know so if I'm missing some things (and I expect I am) I'd be grateful to have them pointed out to me. <comment><USER2> Yes.

No.

Maybe.

Really need more context to your question: certainly separation of duties can be a good protocol to follow ... but having everything in one place can be adequate, too.

Tiering your web and database into different servers, clusters, groups, etc can be smart - especially since you can focus on the resources which best optimize the given tier, and not have to worry about contention (and on services like DO, utilizing private networking so only your web server(s) talk to your db server(s) cuts down on your attack vectors.

Having services on different systems also allows for one (or more) to be down without impacting others (unless it's the db tier, and both mail & web rely on it ... then db being down affects everything).

<comment><AUTHOR> "on services like DO, utilizing private networking so only your web server(s) talk to your db server(s) cuts down on your attack vectors."

Thank you for mentioning this. I was not aware DO provides tools for this so I'll be looking into that. Right now I'm using CouchDB CORS configuration to restrict access to the DB to only the app file server.

<comment><USER2> Spend some time on their docs and API references: there's a _lot_ in there that could benefit you :)

<comment><AUTHOR> There's still surprising little on installing and configuring CouchDB 2.0. there, but there is a lot of great info there and I've poured through a lot of it.

I'll probably post my install instructions in the comments of their CouchDB 1.6 guide so others can help improve them soon.

I've not yet had a chance to play with the DO API yet but I do want to, and will sometime soon.

</comment></comment></comment></comment><comment><USER3> Why would users need to enable third party cookies in this scenario?

<comment><AUTHOR> Right now the DB and App file servers use different IPs and domain names and both are set up with SSL and when I turn that off 3rd party cookies in my browser the authentication used on the DB server breaks.

<comment><USER3> Your users are hitting your DB server directly?

<comment><AUTHOR> Yes. I use PouchDB.js on the client to store data and sync it with the CouchDB server. The CouchDB server also provides the authentication routines for the app.

<comment><USER3> Ok. I'm not very familiar with CouchDB, but with most databases I'vee used, that would be a major antipattern and security risk.

<comment><AUTHOR> The CouchDB has CORS configured to only accept requests from the app server and it authenticates user requests so it's pretty solid.

</comment></comment></comment></comment></comment></comment><comment><USER4> Advanced Marketing +1

<comment><AUTHOR> I didn't mention the app name or the domain names, only the service provider I use, and I pay them, so what do you think I'm marketing here?</comment></comment>


Typeform, a platform for 'conversational' data collection, raises $35M - <AUTHOR> https://techcrunch.com/2017/09/11/typeform-a-platform-for-conversational-data-collection-raises-35m <comment><USER2> Might be more interesting to hear the news from the founders themselves: [https://www.typeform.com/blog/news/series-b/](https://www.typeform.com/blog/news/series-b/)</comment>


The Project Management Triangle: How to manage constraints and ship on time - <AUTHOR> http://clearbridgemobile.com/the-project-management-triangle-how-to-manage-constraints-and-ship-on-time/

<comment><USER2> Love it, is it inspired by DSDM/Atern?</comment>


A React tiling window manager - <AUTHOR> https://palantir.github.io/react-mosaic/ <comment><USER2> This is badass! I've been using blueprint on one of my side projects and this is going to fit in perfectly. Palantir has really been releasing some cool stuff recently.</comment>


Effective Developer Experience (DX) - <AUTHOR> http://uxmag.com/technology/effective-developer-experience Interesting article by Jeremiah Cohick about how platform product developers can facilitate better user experience (UX) outcomes on their platforms by crafting better developer experiences (DX) for engineers building apps on their platforms. <comment><USER2> Perhaps I just live under a rock, but the whole concept (fad?) of someone specializing in the "user experience" barely hit my retinas within the year. Out of nowhere, a bunch of people who knew nothing about design were claiming to be experts in UX and asking ridiculous salaries and hourly fees. It was remnant of all of the people out there claiming to be SEO experts. Now it appears as though they're trying to breach the castle walls and claim a new buzzword for the "developer experience." God help me if I find some guy who doesn't know how to program claiming to be a DX expert in the next year.

I know that some of have legitimately studied how to improve the UX, but there seem to be an exceedingly high number of them out there that know nothing.

</comment><comment><USER3> google](http://www.google.com>google);

</comment><comment><USER3> <http://www.google.com></comment>


Show HN: BetaList Bundle – Get Access to the Best Startup Tools - <AUTHOR> http://bundle.betalist.com/

<comment><AUTHOR> Founder here!

What may seem like a simple product (just get a bunch of services together, right?) might have been one of the most difficult products I've launched. I'm not a salesman, nor a particular fan of sending emails 24/7\. That's what this all boiled down too however. Cold-emailing. Asking for introductions. Scheduling meetups. Sending follow up emails. Etc. While you really just want to work on building a cool product.

That said, I'm really happy with results. Proud to have so many great companies involved and hoping the additional revenue will enable me to grow BetaList further.

Looking forward hearing what you think!

Fun fact: Although BetaList is pretty well known in the startup scene it's smaller than you might think. Bootstrapped and based in Europe. I'm the only full-timer on it at the moment.

<comment><USER2> Can you provide a proper invoice? What is linked in the response email is something like a receipt, but it's not an invoice. It does not have an invoice number nor does it have information about the seller (company name & address).

<comment><AUTHOR> Sorry about that. I sent you an updated invoice with all the information you should need. We'll make sure to add that info by default for other people.

</comment></comment></comment><comment><USER3> The AWS credit is worth the $47 for most people, unless you are already part of AWS Activate, like all YC startups.

</comment><comment><USER4> Amazon AWS 500$ credit just for 47$. Are you sure? Or some other kind of condition is there?

<comment><AUTHOR> Amazon runs a program called 'AWS Activate' which gives you access to a lot of startup resources including promotional AWS credit. The program is generally only available to startups affiliated with certain accelerators, incubators, or seed funds. We came to an agreement enabling us to include that same deal in the BetaList Bundle.

Only if you're already part of that program you're not eligible for the offer (as stated on our site and Amazon's) and there are a few other 'standard' criteria like not using your AWS account on behalf of any other governmental entity, etc. I don't expect these to apply to anyone buying the bundle however.</comment></comment>


On Depression & Getting Help - <AUTHOR> http://robdelaney.tumblr.com/post/414007899/on-depression-getting-help <comment><USER3> This is a very, very good lecture on depression: <http://www.youtube.com/watch?v=NOAgplgTxfc>

Honestly, I think the disorder should be renamed. People associate being "depressed" with the same feeling that they get if they drop their iPod into a lake. They're sad.

General sadness is _one of many_ of the ways that depression as a cognitive disorder can manifest itself. I can't tell you how many times I've talked to friends with real, serious, dangerous depression and heard that there are people who tell them that they just need to get over it and cheer up.

You can't cure cancer with ice cream, same goes for depression.

<comment><USER4> "[I] heard that there are people who tell them that they just need to get over it and cheer up."

I do this. A great many of my friends and family do this too. I'm not sure why you find it so difficult to believe that there are people who do this.

It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it". This is often compounded by the fact that depression( along with asperger's )is the modern hypochondriac's condition of choice.

Combine inability to empathize with widespread attention whoring by people claiming to have depression when they don't, and it's quite easy to see why many people would react cynically or casually.

It's rather unfortunate for those who are genuinely stricken with mental illness, though.

<comment><USER3> >I'm not sure why you find it so difficult to believe that there are people who do this.

I didn't say that it was, I said that it was very common (which should indicate that it isn't difficult for me to believe).

>It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it".

This. Right here, exactly what you just said is _the problem_ with people understanding this disease. "Cheering up" has absolutely nothing to do with getting over depression. This would be like feeding somebody with mono lots of redbull so that they would have more energy and wouldn't be sick anymore.

>It's rather unfortunate for those who are genuinely stricken with mental illness, though.

Yes, it is, and just about everything you wrote only serves to perpetuate the general lack of understanding that most people have when it comes to cognitive disorders.

</comment></comment></comment><comment><USER5> I can't emphasize enough how important it is to seek treatment if you feel this way. For years, I just lived with it. I look back on those now as lost years when I could have accomplished a lot, but instead sat around accomplishing very little.

Some people resist medication because they're afraid it will make them not feel anything at all. While this can certainly be the case for some medications, there are enough of them that you can usually find one that doesn't dampen your emotions completely.

In my experience, antidepressants tend to put a 'floor' under your happiness; you don't fall down into the dark depths that are hard to escape from. You also don't become unhappy quite as easily; I found a big improvement in my ability to cope with external causes of stress and negativity.

</comment><comment><USER6> Hypomania can affect mood.

Hypothyroidism can also affect mood.

Exercise can affect mood.

You need to speak with your doctor about all three (or more since we are all different), and you need to find out if you need medication to get you out of the rut.

<comment><USER7> I don't understand the purpose of this comment, but it seems vaguely as though it is to suggest that "depression" is not a sufficient name for his condition and that its treatment through anti-depressants not a sufficient answer.

I appreciate and support efforts to get people to continue to investigate their condition and to explore treatment options, but I bristle when it seems to stem from a kind of prejudice against psychology and psychiatry as it appears to here.

(As an aside: Hypomania is on the opposite end of the emotional disorder spectrum from depression. Mentioning it here is akin to telling someone complaining of constipation that they may want to speak with their doctor about diarrhea.)

<comment><USER8> "I bristle when it seems to stem from a kind of prejudice against [] psychiatry as it appears to here."

Why? The majority, of the research used to approve the most popular psychiatric drugs is outright fraudulent. And it's not like this is some undocumented fringe claim, there are literally dozens of books about this; the maker of the lexapro, drug the author is advocating, has racked up over 300 million dollars in fines this year alone for ethics violations related to the science of the drug in question. If you don't have a prejudice against psychiatry then you need to read more books.

<comment><USER7> Psychiatry is a branch of medicine based on the science of clinical psychology.

The actions of a given pharmaceutical company hardly invalidate the discipline as a whole.

Furthermore, a prejudice is never a good thing to have.

<comment><USER8> "The actions of a given pharmaceutical company hardly invalidate the discipline as a whole."

It's not just one pharmaceutical company, it's the entire industry. The pharmaceutical industry now tops not only the defense industry, but all other industries in the total amount of fraud payments for actions against the federal government under the False Claims Act.[1] And the psychiatric drugs are, drug for drug, by far the worst offenders. And even for the drugs that haven't racked up massive fines, their scientific support is somewhere between terrible and non-existent.

[1] <http://www.citizen.org/hrg1924>

<comment><USER7> So you're telling me that psychotropic drugs have essentially zero scientific support as treatment for psychopathology?

<comment><USER8> Yes, of course. Read Anatomy of an Epidemic, The Emperor's New Drugs, etc.

Robert Whitaker's blog is also really great, although you wouldn't necessarily have all the information you'd need to read it unless you've already read the book.

<comment><USER7> It's important not to throw the baby out with the bathwater. The enterprise of psychology and its application is a worthwhile and fruitful one despite errant ideas and applications in the past or in some of its member practitioners.

To even dispute the efficacy of some aspect of psychology requires the practice of psychology.

I grant that there are dangerous abuses and manipulations of the approvals process and public opinion, but it is also important to note that many psychotropics have a place in the treatment of dysfunction.

I applaud that you are trying to spread the word about those abuses, but I encourage you to measure what you say so as not to group the nostrums and charlatans with the valid medications and practitioners of which many do exist.

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER9> We're heading into the time of year that I've always struggled the most with my chronic depression. I really have to force myself to get outside and get sunlight, exercise, and eat better than usual. Those three things go a long way. The short days and cold weather really make it hard.

<comment><USER10> Do you have a light box? Seasonal Affective Disorder has high co-morbidity with depression and getting the right amount of the right wavelengths of light at the right time has a surprisingly helpful effect. If you're into hacking in physical space (aka making stuff) set up your bedroom so that you get very bright light in the morning at a set time. Sunrise alarm clocks are crap so ignore them and build the system yourself.

</comment></comment><comment><USER11> Thank you, Rob, for writing this. I figure I'll tell a short version of my story (ok, I tried to make this short, but it didn't really work out well) as well.

From an early age, my parents (both in the mental health field) recognized small symptoms of bipolar disorder in me -- periods of extreme energy and no sleep followed by lulls where I wouldn't want to do anything. However, they decided that the best course wasn't to do anything about it (or even tell me they had these concerns), as they figured it was just me being a kid. For what it's worth, I think they made the right choice.

I was 15 or so when I started seeing these symptoms for myself, and saw them becoming more extreme. I would spend weeks programming furiously on The Next Big Thing (TM), then fall into an equally low period, which usually lasted about twice as long as the high. Originally in these low periods I just had trouble focusing on anything, slept a lot, etc, but gradually I saw them change into something very different. I became suicidal, and the smallest thing would set me off. If I got into an argument with my parents, I would just think "is all this worth it?" and start spiraling downward. My girlfriend at the time is the only reason I made it through; she helped me realize that this wasn't normal, and that I really should do something about it.

At 16, I told my mom that I wanted to see Dr. D (a friend of the family, and probably the best psychiatrist in our small town). It came as no surprise to me to be diagnosed with bipolar I with rapid cycling; it wasn't uncommon to have extreme mood swings in between the longer periods, even happening several times a day at their worst.

He then started me on various drugs. I don't recall the order or combinations, but I was on -- at one point or another -- lithium, Lamictal, Abilify, carbamazepine, Depakote, and others I can't remember now. None of the standard mood stabilizers worked; I either felt completely numb or was sick as a dog. Lithium in particular made me feel worse than I ever have in my life, emotionally and physically. We tried a couple combinations to balance things out, but in the end the mood stabilizers just weren't helping; in retrospect, though, I wonder if they were and I just couldn't recognize it in myself. Regardless, the next step was anti-psychotics; I wanted to be put on anti- depressants, as the lows were what bothered me, but it was simply too risky -- if they were successful, they could well put me into mania that I couldn't control.

The anti-psychotics made me feel nothing. I don't know how I can explain this to someone who hasn't been there, but it's like your emotions just cease to exist. In theory, they worked, but a complete lack of emotions and creativity simply wasn't worth it. I was 17 by then, and I decided to stop taking all meds. I moved to San Diego for my first job shortly thereafter.

I rode on an extreme high for the first few months I was there, working 18+ hour days. I was a 17 year old making more money than he should've been, and I took advantage of it. Sex, drugs, and rock and roll really describes it well. I went to shows, I met a girl (whom I took a cab to every weekend, an hour and a half each way, then got engaged to a month after we started dating), drank a lot, etc. In short, I did everything that someone in the throws of mania would do. It took a while for this to catch up to me, but as always with bipolar, it did. I crashed hard, and if it weren't for my fiancee at the time, there's no way I could've made it through. I frequently thought about checking into a hospital, but I thought I needed to push through. I'm not sure if I made the right decision or not, still.

It took me a long time to really get myself in balance. The first step was to recognize what state I was in -- this is _remarkably_ difficult. The next step was to learn how to bring myself back to normal when I started getting low, and I became quite good at it. Ignoring a few small fleeting thoughts, I haven't been suicidal in about 4 years. Then I learned how to embrace the manic side of it, and put it into my work without letting it go too far; I don't know that I ever really got very good at this, as my first two months in NYC have shown me lately.

A combination of a good support network (key for everyone, IMO, not just those suffering from mental illnesses), knowing myself, and knowing when to say "no" has been crucial in me largely stabilizing myself over the past few years. It's not perfect by any means, but it's working better for me than anything else has.

To close, I want to impress upon everyone the importance of getting help with mental illness. This doesn't necessarily mean medication (it certainly didn't in my case, even thought it was tried), but just knowing yourself is insanely important. Too many people refuse to get help, and end up in far worse place. I'm happy with my life as it stands, but it could easily have not gone this way.

<comment><USER12> Sounds kind of familiar. I always read such write-ups with great respect and some sort of fear as I know how easily and quickly it can become 'wrong', so as to speak. Could you please be more specific with this though:

        The next step was to learn how to bring myself back to
        normal when I started getting low, and I became quite
        good at it.

I've been tying to do that myself with no success so far. Also, I seem to have become different through years as the maniac phases are very short now and the low phases are very long — but I've learnt not to take any decision during those phases so I suppose I'm already on the safe side.

Thanks for sharing.

<comment><USER13> What daeken said. Improving my mood translates almost exactly into simply acting like I would if I wasn't depressed. I don't try to pretend to be happy or fake it (though I do use cognitive therapy techniques.) Instead, I just try to do the same activities I would do if I wasn't depressed. I call someone on the phone and ask them how they're doing instead of sitting and thinking about myself. I make a healthy dinner instead of ordering pizza. I get some exercise instead of lying on the couch. If I work, I release myself from self-criticism (I'm so slow, I'm hopelessly stupid, I'm accomplishing nothing) and concentrate on the work instead. If I watch a movie, I allow myself to enjoy it instead of thinking the whole time about how much I suck and how I should be doing something productive instead.

It's hard to do those things, of course. The essence of depression is hopelessness. For me, it's hopelessness about myself, a deep conviction of my own worthlessness and the impossibility of ever _not_ being ashamed of myself. When you think that way, it's hard to see the point of making dinner or going for a run. Long term, the biggest factor for me was to slowly learn to disregard the reality of depression. By now I have a long enough perspective on my life and my depression that I am better at seeing it as a temporary illusion. I knew a girl who had persistent auditory hallucinations; she heard voices constantly, angels and demons mostly. She knew they weren't real. At least she said she knew, and she usually did, but when she didn't, it was a problem. Coping with depression is a bit like that -- a constant effort to disregard what your brain thinks it knows. So when I go out the door for a run, or start cooking dinner, a big and very persuasive part of my brain is convinced it's stupid and pointless, even while it's making me feel better. By the time I'm done running or cooking, I'm completely aware -- with my whole brain -- that it was worthwhile, and the fact that I've accomplished something worthwhile in itself discredits the illusion. That doesn't completely dispel the depression, not for long. Soon enough, the next activity I want to make myself do still feels stupid and pointless. But it makes it easier to cope, and it reduces the severity of the symptoms.

The older I get, the more consistently I manage to make myself do the things that make me feel better. When I was younger, depression was overwhelming and terrifying. Now it's mostly just miserable instead of scary. Especially now that I know I can hold down a job through a bout of depression, and my friends won't desert me, it's a lot less frightening.

<comment><USER14> This describes my experience well, but I think it is worth pointing out that what I (and I can only describe myself here because I don't want to assume you are the same) have could be described as mild depression. What the OP describes would be, I assume, described clinically as severe depression.

I have been able to "self medicate" like you with exercise, diet, rigorous organizing and planning tools, and other ways of "ignoring" what my brain tells me to do. When I was younger, I was briefly on medication and did not like the side effects, and I have been lucky enough to be able to cope with the tools I have at my disposal. I do not believe this is possible for people with severe depression, and highly encourage them to seek professional help.

</comment></comment></comment></comment><comment><USER15> Really appreciate this article, as someone who has struggled with depression extensively and (more or less) come out the better for it. People who are experiencing the worst depression can mete out feel empty, desperate and alone in a way that is almost indescribable to anyone who has not felt that way. It's important for them to know that people care, are happy to speak with them, and that those who have had similar experiences have, eventually, found a happier and better existence.

</comment><comment><USER16> Beutiful article. For what its worth, i think society is coming around to mental illness. At least so in law enforcement. There are a whole brand new range of policies and proceedures for recognizing and addressing the signs,where as historacly they were much more abrasove and counter productive. However, i believe most of mankinds 21 st century mental illness issues area result of the industrial age where people are spending increasinly longer amounts of there waking hours in the abscence of sunlight. A study conducted by vanderbuilt university revealed that vitamin d3 was able to enhance the uv saturation produced synthetically by uv box lights on a populous of patients suffering from seasonal effectiveness disorder which is depression from lack of exposer to sunlight. I have stated taking vit d3 and have noticed a significant change in the dark montjs alone. You might want to ask your psyc about it to see if he would let you take it alongside rhe lexapro

</comment><comment><USER17> I'm a psychiatrist, an it is my great pleasure to treat people and see them get better. I'm glad this was posted to increase awareness of the seriousness of a Major Depression. It's a very misunderstood condition. Hope you continue to feel better.

</comment><comment><USER18> This being Hacker News, my first thought was "Holy crap on a cracker - <USER2> Koenig is dead!?!". Then I discovered there is another Andrew Koenig of whom I'd never heard, and it wasn't the author of Traps and Pitfalls who'd died.

Just thought I'd mention it.

</comment><comment><USER19> Man, this is serious! My wife is on a challenging treatment, and one of its side effects is depression. That opened my eye on a whole new meaning for the word. Thank you!

</comment><comment><USER20> I've had some unfortunate things happen to me, in turn which gave me extreme depression and PTSD. What I did was pretty simple... I did everything I could do to have a good nights sleep. If that meant exercise, better food etc, I did it.

Now it's manageable without any various medications, doctors etc and that makes me feel pretty awesome.

P.S. The Beatles would always make me cry when I was on a low. Heh.

</comment><comment><USER21> I've been battling depression for years(binge and fasting cycles, not leaving the house for days on end, sleeping 14-16hrs a day) and I'd like help but I'm afraid the medication will affect my creativity. Do any creative people have experience with what medicines to try and which if any to avoid? Thanks.

<comment><USER22> Speaking from personal experience, worrying about creativity is the least of your problems when talking about depression. In my own case, I'd spend 4-6 months without doing anything at all besides sleeping. No side-projects, no programming, no guitar, nada; sleep, watch TV and sleep some more. Once I started taking medications I started programming again, going out, exercising a bit. Once you get to the point where depression is stopping you from doing anything, creativity is worthless (since you're not creating anything).

I haven't found any serious consequence of taking the meds (Zoloft, Elavil and Remeron) w/r/t my creativity. I can still do the same things I used to do before, while mantaining the same level of quality. I've also found that it helps me push myself harder, which is pretty good.

</comment></comment><comment><USER23> <http://www.curetogether.com/depression/treatments/pmi/>

[http://www.curetogether.com/depression/ig/treatment- effectiv...](http://www.curetogether.com/depression/ig/treatment- effectiveness-vs-popularity)

<comment><USER23> "What works for depression (and what doesn't)."

<http://bluepages.anu.edu.au/treatments/what_works/>

<comment><USER7> St. John's Wort is as effective as anti-depressants?

I'm skeptical of this page and encourage others to be as well.

<comment><USER24> [http://www.informationisbeautiful.net/play/snake-oil- supplem...](http://www.informationisbeautiful.net/play/snake-oil-supplements/)

This data visualization suggests that saying that St. John's Wort isn't really snake oil.

</comment></comment></comment></comment><comment><USER7> I am so pleased to find that this is a simple personal testimony about the value of professional treatment and support.

I was expecting to find a folksy anecdote or some "hack," and I was pleasantly surprised.

</comment><comment><USER8> "[Lexapro] addressed some chemical issues in my brain"

Citation needed. Sorry, just because you have depression that doesn't give you a free pass to make stuff up.

</comment><comment><USER25> Why do people keep treating depression as a medical condition? You are depressed because your life sucks. Fix it or accept it. <eom>

<comment><USER26> This guy is being unfairly downvoted. A not insignificant number of cases of depression are rooted in not cultivating proper emotional awareness, and then ignoring the body's emotional signals. But people are unwilling and, frankly, unable to take responsibility for their emotional life so this attitude is an unpopular one. Also worth pointing out is that it's unrealistic to expect that everyone can be happy, some unhappiness is essential to social stability.

<comment><USER7> I downvoted you for the same reason I downvoted the other guy.

You are speaking in vague generalities, with authority, on matters about which you are apparently ignorant. Moreover, your propagating this misinformation is detrimental to attitudes about depression, both for those who might be afflicted and the public as a whole.

Depression is a serious problem which should be addressed through science, credible education, and consultation with professionals.

The comment you are defending is utterly asinine. Persistent depression is far more likely to be the result of cognitive-behavioral factors and/or physiological factors rooted in genetics than it is to be the result of bad life circumstances aside from some negative extremes.

Furthermore, you grant that people are "unable to take responsibility for their emotional life" and yet somehow also support the patent contradiction to that idea in suggesting that "fix it or accept it" is acceptable advice.

Your final line (in addition to conflating freedom from depression with "being happy") belies a kind of moralistic thinking about mental health. Would you say that broken legs are essential to social stability? Or ulcers?

<comment><USER26> You make an excellent point. I should have distinguished between severe depression and dysthymia. I do not know much about severe depression but I have plenty of knowledge about dysthymia. Many people casually conflate the two and I made that fundamental error in my post. My apologies.

<comment><USER7> I appreciate that. I honestly don't care about winning arguments or looking smart on this point. I just wanted to get out my critique of your post for people to read after yours so they can see another angle.

Warm regards.</comment></comment></comment></comment></comment>


Mayor Bloomberg Will Learn How To Write Code In 2012 - <AUTHOR> http://idealab.talkingpointsmemo.com/2012/01/mayor-bloomberg-will-learn-how-to-write-code-in-2012.php <comment><USER2> Note the interesting bit about the London mayor: "The move even prompted London Mayor Boris Johnson to state he was in "awe" of Bloomberg and would consider joining him on the quest to become adept at, or at least acquainted with, programming, as the BBC reported."

This is a great thing for Bloomberg to do. In an age where so many politicians are trying as hard as they can to stifle the new economy in favor of the old economy, the major of a city with a GDP bigger than that of 47 other states paying such public attention to the tech industry is a great step in moving our politics forward.

<comment><USER3> He's not new to the tech field. He graduated with a degree in Electrical Engineering from Johns Hopkins.

Bloomberg's most famous product is probably the Bloomberg Terminal. A dual screen computer and OS for hedge fund manager types, that costs $1900-2500 a month per subscription.

<comment><USER4> It stopped being its own OS long ago. Now the dual-screen computer is a standard Windows PC with a pretty case and fancy keyboard, and the terminal software is just a win32 .exe.

<comment><USER5> Why do they even bother with special hardware? The keyboard I guess I can see.

Seems like the whole thing could just be web app now.

<comment><USER6> This is definitely true, the tech Bloomberg uses was novel in the 80s, but the functionality of a modern browser now outstrips that of the terminal program. There's actually some functions in the Bloomberg Terminal these days which just fire up an embedded browser to render the content!

<comment><USER7> There are many things a browser can do just fine, but there are also many things that the terminal needs to do that would be difficult to do memory or CPU wise without resorting to plugins. Certain things in the terminal use an embedded browser (e.g., displaying company web pages), but almost no terminal apps are written as web pages. (Products such as BLAW, BGOV, etc. are native web apps)

</comment></comment></comment></comment></comment></comment><comment><USER8> Bloomberg was already highly technical once before. Listen to his Techcrunch interview where he talks about having to solder integrated circuits onto boards to build the first Bloomberg terminals. He's not just another clueless MBA CEO.

[http://techcrunch.com/2011/11/28/founder-stories-how- michael...](http://techcrunch.com/2011/11/28/founder-stories-how-michael- bloomberg-got-his-start-i-brought-you-a-cup-of-coffee/)

<comment><USER9> His book "Bloomberg by Bloomberg" is also a good read. I also find it amusing this even made the news. His billion-dollar fortune comes from a tech company founded with money he got as severance after being fired from a previous tech management position, albeit in the finance sector.

</comment></comment><comment><USER10> Well, is writing code the new literacy? Most people in the west can read and write at some level, even if they never write a novel. The future might be like that with code - there are signs of it, where knowing how to write a little script or a SQL query can make a huge difference in plenty of different fields

<comment><USER11> This is an interesting point and one I haven't thought of like this. The past year, I kept telling people to start learning to program, because there will be an unprecedented increase in demand for programmers and knowing how to program (even just a little bit) will be greatly beneficial no matter in what line of life you are in.

But can it come to the point where if you can't code, you get left behind? It might not be so farfetched.

<comment><USER12> Or, the more people who can code, the less valuable the skill? Meh, or not.

<comment><USER13> Maybe it's not supply & demand, but a network effect:

For reading, I would argue the ability to read become _more_ valuable as the literacy rate increases, as society starts to run on the written word.

Perhaps computer literacy is the same.

<comment><USER12> That's interesting. When would you use a supply & demand model versus network effects to explain a trend?

</comment></comment></comment></comment></comment><comment><USER14> Good for him, and good for Codecademy. While a largely symbolic gesture, it can certainly never hurt to have political leaders be at least somewhat familiar with technology, especially when they're trying to create a new SV. I hope this is an actual intention and not just an empty PR move. He could, however, score a massive PR win both for himself and for NYC as a tech center by taking Codecademy up on their offer and showing up for lessons in person.

<comment><USER15> It is a symbolic move, but the interesting thing about it is that this kind of symbolism wouldn't work in most other places on this planet.

<comment><USER16> Agree, and it wouldn't have worked for even New York a couple of years ago. Right now, one of the biggest advantages for New York startups is the terrific (& free) PR push from Bloomberg himself. Go Codecademy!

<comment><USER17> Thanks!

</comment></comment></comment></comment><comment><USER18> Considering his whole business is basically being the tech company for the finance industry it's surprising he never learned about it.

<comment><USER19> Well, NYC finance is still about dealmaking, even in the days of digital trading. Business is still done face-to-face, and the sheer density of New York will probably make sure that deal makers are more valuable than technologists for the foreseeable future. That's not to discount technologists in NY at all, though (they're deal makers too). It's just the reality that handshakes and coffee are irreplaceable.

<comment><USER20> Speaking of coffee, a lot of his early deals were based on him going around to Merrill Lynch and buying people there coffee, then coming back later saying "I'm Michael Bloomberg. I bought you a coffee. Can we talk?"

</comment></comment></comment><comment><USER21> First person to learn how to code AFTER becoming a billionaire?

</comment><comment><USER22> I will consider hiring him in 2015

<comment><USER23> So will I, but only if I can check out his code on github and ask him a whole bunch of puzzle questions first. ;)

</comment></comment><comment><USER24> In 1917 Lenin said that every cook should be able to run a state.

In 2012 a mayor would write code. That's what the mankind achieved.

</comment><comment><USER25> How long before the TV series 'Coding with the Stars'?

</comment><comment><USER26> why?

</comment><comment> wes-exp I suppose I should be happy that authority figures are getting in touch with technology.

That said, I'm pretty sure Bloomberg learning to code marks the peak of the second tech bubble. That, or Ashton Kutcher becoming a VC.</comment>


Ask HN: How to stop a hacker from deleting your off-site backups? - <AUTHOR>

I'm trying to come up with a half-decent backup strategy for a web server.
The strategy so far is to store backups locally on the server and have a cron job copy the latest backups over to an Amazon S3 bucket daily.
To do this, Amazon S3 user credentials would be stored on the web server.
If the web server gets hacked, the hacker would have access to the web server and the Amazon S3 credentials. With this they could delete all local and off-site backups.
Anyone got a good way of keeping backups on S3 and protecting themselves from this scenario? <comment><USER2> Maybe look here: <http://www.tarsnap.com/security.html> it looks like you can create keys to only write and maybe keep decrypting keys offsite for just this situation.

<comment><USER3> _keep decrypting keys offsite_

Yes, you can do that with Tarsnap. More importantly, Tarsnap also allows you to keep _deletion_ keys offsite.

<comment><USER2> I like your service I just didn't really explain my comment well :/

</comment></comment></comment><comment><USER4> Setup pull backups. Rsync.net does this for me. How it works is they ssh into your box using an SSH key and pull down the backups. That way the password is never stored on the box that is being backed up.

<comment><USER3> People who care about security generally don't want to give strangers either (a) SSH access to their servers, or (b) unencrypted access to all of their data.

</comment></comment><comment><USER5> Perhaps you can go from a push-system to a pull-system for the backups?

<comment><AUTHOR> I might go this route, although I'm trying to avoid introducing another system to be maintained.

Would be good if Amazon S3 could do the pulls.</comment></comment>


Show HN: TwitMusic - <AUTHOR> http://twitmusic.com

<comment><AUTHOR> It lets musicians effectively share & promote their music on Twitter. 4,200+ musicians have registered & reach 23,000,000+ Twitter followers. Artists include: Jason Mraz, Bow Wow, Mike Posner, MC Hammer, Bryan Adams, Jon Secada,, Goo Goo Dolls.

</comment><comment><USER2> Well I liked it. Might be worth a re-submission when the USA wakes up.</comment>


Amos Yee: YouTube Star, Teen-Ager, Dissident - <AUTHOR> http://www.newyorker.com/culture/cultural-comment/the-arrest-of-a-teen-aged-youtube-star

<comment><USER2> the kid's living in his own nutshell, thinking how everyone else are sheeple. the author is coming from the US of A, thinking his own country's political setup is the 1 true way. meanwhile, singaporeans may or may not be interested in talking about politics, and perhaps not on youtube; perhaps they're not interested in discussing it with non-singaporeans. they do, however, vote.</comment>


Upgraded Falcon 9 set to launch from Vandenberg this week - <AUTHOR> http://www.floridatoday.com/article/20130915/SPACE/309150063/Upgraded-SpaceX-Falcon-9-set-risky-flight

<comment><AUTHOR> Man I am so thinking "road trip" here. Although what I _really_ want to do is charter a boat to watch the first stage land itself on the water. If SpaceX can pull this off it is going to be seriously cool.</comment>


Time to End the Vi/Emacs Debate - <AUTHOR> https://cacm.acm.org/blogs/blog-cacm/226034-time-to-end-the-vi-emacs-debate/fulltext <comment><USER2> Why limit yourself to only one editor? Learn some emacs basics, learn some vim basics, use both or either as you see fit. Gedit, atom, notepad++, sublime, whatever you are comfortable in will work best for you. Whatever your development cycle best supports is best.

Spacemacs is a nice middle ground and more intuitively usable than either so that is my main editor. Hard to escape emacs when you're working on lisp due to slime. Hard to escape vi when you're setting up new machines.

</comment><comment><USER3> > To further gauge popularity, I counted 22,582 questions tagged with vim and > 15,667 questions tagged with Emacs on Stack Overflow.

well, Emacs has its own Stackexchange site ([https://emacs.stackexchange.com/](https://emacs.stackexchange.com/)) for a while now, currently with 13,271 questions, that makes 28938 questions together, Emacs wins! ;)

</comment><comment><USER4> I think the majority of users of each do not debate the relative merits but simply use them for what they are good for. I use Emacs a lot because I use org-mode a lot. if there was a stand alone og-mode application I might be willing to give it a try, if there was a vi based version ditto but I don't spend any effort to debate the merits of them, I just use what works for me for now.

</comment><comment><USER5> Vi is like C, it just ain't going away because it dominates a niche that it is perfectly suited for. I think emacs will decline as other graphical/simple text editors and IDEs keep making inroads.

<comment><USER3> to me as long time emacs user, I see the opposite: emacs is not declining but gaining users and developers</comment></comment>


Show HN: Generate a fake app to replace any addictive app - <AUTHOR> https://www.detoxify.app/ <comment><USER2> How does this help with addiction as opposed to uninstalling said apps?

<comment><USER3> I was addicted to TV when I was in high school. After school I alwys lied down in front of a tv for few hours. Switching channels, getting a little bit entertained but more and more tired.

When I wanted to break that routine I asked my mom to put a parental lock on the TV.

Even though TV showed jo channel for me I still lied down in front of it, twiddled with remote. Sometimes for many minutes. My dumb brain gradually learned that TV is not fun anymore (not that it was much fun in the first place).

I think similar mechanism might help you shake off your app addiction.

Not sure if this tool does this but maybe you could even have you fake facebook app show you static screenshot of facebook and let you scroll up and down a bit. You might have additional twists like scrolling locking up after few minutes forcing you to abandon or restart. Or maybe screenshot might be blurred a bit.

<comment><USER4> This is the exact feeling that I have had recently when trying to cut the phone addiction. I deleted all games and social networks from my phone, then turned it to black and white. It's still tough since I can just go to reddit or hacker news on the browser, not much I can do about that since even flip phones have internet. The interesting thing was that my phone pick ups remained the same for a week or so, but the time on my phone when dramatically down.

The disturbing part is that even weeks later, if I am really bored I will reach for my phone and pick it up. There just isn't much to do on there anymore, so I put it down. I think I'm going to start leaving it places altogether so I lose the habit of having it on my at all times.

<comment><USER5> Just chuck it off a cliffside... Wait till you see what happens next!

<comment><USER6> Pollution?

</comment></comment></comment></comment></comment><comment><USER7> How does it work? There is no clear message about how it works or how it's supposed to help.

<comment><USER8> @faeyanpiraat described it very well: "It can put an icon on your homescreen looking like an app that you want to stop using. Then when you try to instinctively open for example twitter, a simple page comes up that counts how many times you tried opening it. To make it work open the page, click a popular app click the install button then follow the instructions."

We're far from having a good UX, so please feel free to provide your suggestions, or contribute directly to the repo (it's open source).

<comment><USER7> That should be written in the website (even on about page or similar, just an opinion/idea)

</comment></comment></comment><comment><USER9> I asked a related question 2 days ago. This is a great idea. But how does one make money selling such ideas/apps? Do we make partnerships? Do we list the app on appstore for a small amount? Any other ideas?

</comment><comment><USER10> Is it inspired by this [0] xkcd by any chance?

[0] [https://xkcd.com/2183](https://xkcd.com/2183)

<comment><USER11> Has this study been replicated?

<comment><USER12> This isn't a study; it's a web comic.

</comment></comment></comment><comment><USER13> What's the privacy policy around this?

Will the count be used later?

<comment><USER8> We don't store anything, everything is in the localstorage. We only use Google Analytics without any custom code, we don't use it to track specific metrics.

The app is open-source, you can have a look at the code.

<comment><USER14> Missed opportunity IMO, I would pay good money to get access to that kind of data, especially as it acquired more users.

<comment><USER15> So it's a missed opportunity to make money without regard to the ethics of user privacy?

Thanks for being part of the problem I guess?

<comment><USER14> It's anonymous data. I don't see how getting data on which applications are getting hits and around what times they occur is violating anyone's privacy.

</comment></comment></comment></comment></comment><comment><USER16> Doesn't work for me, the counter remains at 1 on iOS 12.4

</comment><comment><USER8> We would like to hear you feedback so keep them coming:)

<comment><USER17> I don't understand what this does.

<comment><USER18> It can put an icon on your homescreen looking like an app that you want to stop using. Then when you try to instinctively open for example twitter, a simple page comes up that counts how many times you tried opening it. To make it work open the page, click a popular app click the install button then follow the instructions.

<comment><USER19> That's a technical description of what it does. But what is the benefit, compared to just uninstalling the real app?

Edit: I can kind of see how it might work for some people: just uninstalling a 'toxic' app like Twitter doesn't always work for long, as you can usually still go on the website, or even reinstall it absent-mindedly (e.g. when drunk or low on willpower). Having a fake app on your homescreen might help as a sort of reinforcement tool in those situations. For example, when you want to go on Twitter, you open the fake app, and because it's missing the usual toxic notification dopamine hit, you can gradually unlearn the association. Maybe.

Edit 2: I made the above edit before seeing the replies :)

<comment><USER8> I used to remove apps but I'd end up re-installing them after a while. Unlearning a habit (aka forming a new habits to replace the old one) is about having a proper cue (referring to the habit loop from the "The Power of Habit" book). The fake app acts as a cue/signal to remind you about your goal and boost learning the new habit of not visiting the app randomly based on the habit.

By installing the fake app, you'll be surprised how many times you unconsciously you open them, although you are aware that they are fake apps. It feels like our brain is on auto-pilot, once we're hooked/addicted to instinctively open addictive apps.

</comment></comment></comment></comment></comment><comment><USER20> Somebody reads xkcd

</comment><comment><USER21> I made something similar as a weekend hack: [https://quit.social](https://quit.social)

It helped me quit my Instagram habit, so it's already more than paid for itself. Next is Twitter. :(

Detoxify looks a lot better though, and definitely has clearer instructions!

<comment><USER22> It has clearer instructions for sure, but you got the icons right (at least for Instagram, the borders are rounded). It's enough to make me use it! Because the ones from detoxyfy are pure square on my home screen, and just because of that I know there's something wrong and I don't tap. Plus on yours I still get stats after 2 openings ;-)

</comment></comment><comment><USER23> If you reload the page 3 times, it blurs out the counter and message. While I see that this is to make people donate, it would be pretty nice to state, that in order to see it again - you must donate. I was thinking it was a bug at first.

<comment><AUTHOR> Thanks I updated the message with "For us, in order to be able to cover our server costs, we ask our users to contribute a tiny amount if they find the app useful. Donate to see the detox counter again." I basically added "Donate to see the detox counter again." what do you think ?

<comment><USER10> What server costs are you talking about? How much does hosting this run you? $5/mo?

<comment><USER24> Dont be a jerk. There must be some other costs involved. It's a nice way for asking the donation.

<comment><USER10> They should say that then, I'm not sure how a simple app like this could cost more than a few dollars per month on hosting.

PWAs are offline first and there's one database with the number of opens.

I'm not saying that they don't deserve money, but should they ask disingenuously?

<comment><USER25> > one database

You mean one field in local storage [1]

Using github pages or similar, this could be completely free to run.

[1] [https://imgur.com/JKSo6lP.png](https://imgur.com/JKSo6lP.png)

<comment><USER26> Domains aren't free and neither is time, so a simple ask for a donation is never a big issue. You can always make it yourself if you don't want to pay

<comment><USER10> Donations are never an issue, I had a donation link on my blog for years.

I didn't ever say that it was to "cover server costs" because even years ago I barely paid pennies a day for hosting.</comment></comment></comment></comment></comment></comment></comment></comment>


Target CIO resigns amid breach investigations - at-fates-hands http://www.startribune.com/business/248578631.html

<comment><AUTHOR> I have worked at the Walmart home office, and if Target's corporate culture is remotely like Walmart's I can tell you their former CIO likely knew half as much about Target's security practices as any of us do.

Walmart has zero career paths for technical expertise. There are low-level technical positions (rarely entry-level) and they peak at "Technical Expert", and to get past that you have to switch to pure people management.

The IT division, internally called ISD, is so completely inept that the majority of the company still runs on Windows XP despite the fact that support will expire in about a month. They had a Windows 7 team at one point, but that team was dissolved and the rollout "suspended indefinitely".

ISD is so universally recognized as terrible that they were actually the only reason I had a job there. Individual departments and divisions have been forming their own "IT Teams" for years, because it's a hell of a lot cheaper to pay somebody $70,000/year to create a half a dozen new applications yearly than it is to pay ISD $2.8 million to do _one_ of those applications _poorly_ over the course of _two_ years. And then completely dissolve the development team responsible and offer little to no ongoing support for the application.

Despite those exorbitant costs ISD is hemorrhaging money just trying desperately to keep the lights on, mostly because they're still running decades-old legacy applications and hardware. They only recently started drawing up plans to start sunsetting some of the hundreds of legacy systems over the course of the next decade or so.

This is really just scratching the surface of how terrible retail IT can be, and how little they value real technical expertise. Given what I've seen I wasn't so much surprised that the Target et al breach happened, only that it didn't also include Walmart or happen much sooner.

<comment><USER2> Huh, I thought Walmart would be better as the Walmart Labs team seems fairly confident. IS Walmart labs different from Walmart IT?

<comment><AUTHOR> Walmart Labs and Walmart.com are completely separate from corporate IT, mostly because it's the only way they can operate.

I have a good deal of confidence in Walmart Labs' technical abilities, but they do not have responsibility for the majority of the IT areas that pain the company as a whole.

</comment></comment></comment><comment><USER3> _' Target CEO Gregg Steinhafel described the search for an interim CIO as a "first step."'_

Well actually the first step was scapegoating the CIO rather than those responsible for putting someone without an IT background in the position. This was the failure of institutional culture, not an individual who accepted an offered promotion to a level but not a position for which they were qualified.

Target's hiring of a consultant specializing in risk management and regulatory compliance says it all. The culture hasn't changed and Target's board still doesn't see technological expertise as a core skill.

<comment><USER4> "Jacob, who holds an M.B.A. from the University of Minnesota, first joined the company in 1984 as a department store assistant buyer when it was known as Dayton's, then left and returned in 2002 to Target as director of guest contact centers. She was promoted to CIO and executive vice president of Target Technology Services in 2008, and reported to Steinhafel."

Yes, whoever promoted Jacob to CIO should also resign.

<comment><USER3> To me, it looks like a corporate culture where CIO was just another position and happened to be the one that was open when it was her turn to be promoted. It's the sort of decision of which the board and senior management would all be aware.

<comment> at-fates-hands I've been told Target is a total shark tank. If you come in and show potential (whatever your background is) they go to great lengths to push you up the hierarchy and get you promoted. Those managers who don't have "The drive" as they call it, are effectively culled from the herd and never promoted and languish in middle management until they either move on or let go.

Judging by her youthful looks, I'd say she was clearly on one of these "fast tracks" and landed in the CIO position exactly as you pointed out.

<comment><USER5> I worked at Target while in college. The people that were brought in as managers (execs) were not people I had ever met. They'd show up one day from some internship program, and bam 6 months later, they'd be in charge of everything. That said, the people typically were top notch... so I couldn't complain about their management abilities. We'd always say, "they showed up already promoted". It was college life for me though, so I had no illusions of ever wanting to be more than a minimum wage salesfloor guy for a couple of years. 15 years later, and I still have dreams that I still somehow am employed there, and I just happen to check the schedule... and CRAP, I have a shift this week!

</comment></comment></comment></comment></comment><comment><USER6> It says in the linked article "The primary responsibility for information protection ultimately falls on the Target Information Protection team, a group separate from Target Technology Services that reports up through Bjerke to Target Financial Services, an arm of the company that handles credit and noncorporate financial operations, the person said." So the woman who is the scapegoat wasn't even responsible for data security?

</comment><comment><USER7> I actually think the Target CISO (or CIO maybe) job would be awesome. Target as a company overall is great; they might not be up to standard on IT/IT Security, but now that the board sees how IT and IT security can affect their bottom line (or indeed existence), whoever takes the role should be able to do amazing things. Plus, it's high visibility when you succeed.

<comment><USER8> > Plus, it's high visibility when you succeed.

Actually, no. That is one of the biggest problems with properly functioning IT systems, they become invisible - nobody notices until something screws up...

<comment><USER9> I think that's true at smaller organizations where the head of IT isn't on the exec team. But at large companies, the head of IT is a pretty serious role (Jacob was CIO/EVP), with a very large budget, mission-critical systems, and a big team. Someone who successfully runs IT at a company like Target can pretty much get hired into a similar role at any other Fortune 500 company.

</comment></comment></comment><comment><USER10> Does Target still run on mainframes?

<comment><USER11> I don't know about Target because they were one of the few major retailers we never sold to, but most of the rest run at least parts of their business on IBM mainframes. It was very common for us to work on integration projects between Windows or AIX boxes at stores and data centers and the mainframe(s). I would never claim that mainframes are fuckup-proof, but they generally are much better protected than the Windows / AIX boxes. It wasn't uncommon for us to be able to get any of a half-dozen IT guys with sudo / root to quickly make any change we needed on an AIX box, but then to make a change on a mainframe we'd have to set up a meeting with multiple people and discuss the changes. We fought one losing battle over extending a record format: "We haven't even recompiled that code in 7 years."</comment></comment>


Show HN: Juxta: detailed Amazon product overview, to deliver you from tab hell - <AUTHOR> http://juxta.io <comment><USER2> Very interesting.

</comment><comment><USER3> No support for Amazon.uk?

<comment><AUTHOR> I've now enabled amazon.co.uk. Have at it!

<comment><USER3> Sweet, thanks man!

</comment></comment></comment><comment><USER4> how are you scraping data from all Amazon stores? scrapy ?</comment>


Show HN: Submit links to HN quickly with this chrome extension - <AUTHOR> https://chrome.google.com/webstore/detail/post-to-hacker-news/glbemilmegmalchjknamlkamedaknkoi?hl=en-GB&gl=GB <comment><USER2> How does this compare with a simple bookmarlet? [https://news.ycombinator.com/bookmarklet.html](https://news.ycombinator.com/bookmarklet.html)

<comment><AUTHOR> It's pretty much identical - the only difference is you can specify your title before the populated submission page.

It would come down to user preference: some people may not display any bookmarks without navigating the relevant menus so an extension is helpful, and some people may not want to install an extension for such a simple function :)

</comment></comment><comment><USER3> Nice job! How many links does an average user submit?

<comment><AUTHOR> Thanks - I couldn't say yet, not enough users!</comment></comment>


Parents Break Teen Out of Mayo Clinic - <AUTHOR> https://minnesota.cbslocal.com/2018/08/13/teenager-escape-mayo-clinic/ <comment><USER2> There is a huge conflict of interest here. The hospital makes diagnosis, requests that the person lose their autonomy, gets control over that person, financially benefits from that control, and can use that control to hide any misdeeds or contrary evidence.

There is also a profound disrespect for human autonomy. Hospitals disrespect autonomy for many people in many ways, with the most common being when birthing mothers get locked in.

In this case, besides the parents, credit goes to a couple judges who denied the Mayo clinic's requests. You'd think one should be enough of course, and that seeking another judge should be prohibited. To give a doctor analogy: it's like hopping from doctor to doctor in search of pills.

Hospitals that do this sort of thing ought to take a fatal hit to their reputation. Nobody should accept being a customer. I suppose the news doesn't get out much, memories are short, advertising works, and most hospitals have a regional monopoly.

<comment><USER3> On the flip side, we have thousands of obviously mentally ill people on the street homeless because we can't commit them because of that human autonomy that you mention.

It all points to public healthcare where there is governance at a political level and not profit level.

<comment><USER4> It's unconscionable to suggest that hospitals be allowed to legally kidnap people because of something as hand wavy as 'some homeless are mentally ill'.

<comment><USER5> This is a complicated issue. I've seen this happen in practice. As long as the process remains conservative and respectful of the patient, it results in better outcomes for the patient and a more peaceful society.

The cases where I have seen this happen: schizophrenia, drug-induced psychosis, acute mania, dementia.

Patients come out far better in an institutionalized setting, as opposed to being on the streets and walking aimlessly in dangerous traffic.

<comment><USER4> There's a huge, gigantic, gaping chasm between a hospital patient with no history of mental illness with two parents, neither of which have a history of mental illness, and a schizophrenic homeless person. Saying one has anything to do with the other to justify a hospital kidnapping its own patients is seriously messed up.

<comment><USER5> I was referring to your reply to outside1234's comment. His answer was in the scope of the "obviously mentally ill" population. And I addressed your reply to that.

It is incorrect to take my response outside of its intended context and attempt to attack it there.

</comment></comment></comment></comment></comment></comment><comment><USER6> It's easy to attribute this whole situation to greed and/or malice but I think that fails Hanlon's razor. I can easily see this whole situation occurring because of poor communication and the culture of paternalism in medicine. It is not hard to imagine a team of healthcare providers that know or think they know what is good for their patient and do a poor job explaining why they are making the decisions that they are making whether that is because of poor communication skills or because they are simply too busy. I think the article proposes a good solution in calling up the hospital's ethics council. This should be standard operating procedure when a patient disagrees with medical staff and the presence of this resource should be communicated to the patient early on and by a employee who isn't directly involved with the patient's care.

<comment><USER7> Is there a need to attribute to malice when all the incentives are stacked against the correct behavior ?

Poor communication partly occurs because at no point does the Clinic have to go against its interest, there is that much less friction in the decisions taken.

Ethics is an issue but it seems that wouldn't be sufficient as a focus for a solution.

<comment><USER6> I agree that the monetary incentives are definitely incorrectly aligned in the current healthcare system as is. That said, I don't think that monetary incentives are the only incentives present here. Most physicians don't go into medicine only to make money. There are easier ways to make more money. From my experience, most healthcare providers genuinely care about the patients' well being. That is why I bristle whenever people rush to attribute a physician's actions to greed. I totally agree with you that a better incentive structure would improve the system.

</comment></comment></comment><comment><USER8> My mother in-law was kept at a facility when we wanted to transfer her to a better one, but we were given lots of run-around and people insisted everything was fine. She died. She might have died anyways, but we'll never get to know. We had serious concerns with her care and nobody was her advocate to getting better care, except my wife (her daughter) and she was dealing with a morass of bureaucracy that nobody should have to deal with when someone is in critical condition. I follow the age old advice of most of the older members of my family: stay out of hospitals as long as you can, once you go in, you don't have much control over when you come out again, if at all.

<comment><USER9> When I was a child, I was hospitalized for some issues. I spent a week there, and I only got worse. The Drs would dance around the questions when my parents asked to have me moved to a different hospital.

At the end of the 6th day, my dad told them he was going to take me to a better hospital whether or not they agreed. (There was more words, but that's besides the point).

Within an hour there was an ambulance taking me to the next hospital. If my dad didn't force their hand, I would have died later that night. All because they either didn't care, wanted the money, or were actually that shit of Drs.

This story makes me angry.

</comment></comment><comment><USER10> Wow. That's really horrifying. Imagine losing your rights to decide your own medical treatment because overzealous doctors made up a 'mental health problem'.

I lost a huge amount of respect for Mayo clinic today.

<comment><USER11> It's especially scary if you have no trusted friends or relatives. There's an _awful_ lot of people with asocial tendencies on the internet.

<comment><USER12> I have no friends or family here and am too socially crippled to make friends I would ever trust. I need a harmless procedure completed and doctors refuse to do it unless I have someone else with me who is willing to drive me home afterwards. Uber/Lyft/Taxi is not allowed either.

<comment><USER11> I've been in the same boat for most of my life. I've been lucky enough to make a few friends in the past few years but that's not to say that I trust them with my life.

</comment></comment></comment></comment><comment><USER13> The last paragraph is pretty damning. Apparantly the mother had an argument with a senior physician, then they labelled her as having mental issues, and tried to take her daughter...

But luckily everyone (the biological father, the court, the police) refused to play along.

</comment><comment><USER14> The medical profession really scares me. They have no respect or concern for patients and are largely going through the motions of providing care with no concern for successful outcomes. I find this to be consistently true in every encounter.

I fired my last PCP because they lied about treating me for depression complete with fictional prescriptions. I found out when I couldn't get disability insurance (at a sane price) because there was history of depression in my records I didn't know about.

I asked the PCP to correct it and they said they couldn't they might get sued for insurance fraud. What a joke!

So I avoided doctors for three years. Eventually I got to a new PCP and guess what I find when I check their notes? A herniated disk I don't have (I know, I have the MRI to prove it) and they claimed I was being treated for ADD even though I haven't been treated for that since I left my last PCP and we didn't talk about it beyond my mentioning I used to "have" it.

Believe it or not ADD is a thing insurance companies think can cease to be an ongoing issue. You just have to stop taking the medication. And then poof you go from being mentally ill to having a history of mental illness (yes ADD is a mental illness). It's critically important you not let medical professionals claim you are being treated for fictional things and how long it has been since you were treated matters a lot. If you let them claim they are treating you for a long ago resolved condition they revive it and suddenly you are a bigger liability.

If you go to purchase insurance on the open market or long term disability you will be dinged for the rest of your life for anything they claim as part of their insurance fraud. If it's an ongoing or recent issue you are dinged even worse.

PCPs in particular are financially incentivized to invent issues they are treating you for in their records because they can bill more for office visits if they can increase the number, complexity, and seriousness of the conditions they treat you for. And the insurance companies just take them at their word!

And the craziest part is that as part of HIPAA you can ask the doctor to correct the record, but they are under no obligation to do so. They make the final determination of medical fact, or fiction as it were. You can add a letter to your file pointing out how insane and contradictory their records are, but I can tell you from experience insurance companies aren't buying it and have no appetite for risk.

<comment><USER6> It seems pretty unfair to malign the entire field of medicine due to a single bad actor. I went to medical school prior to becoming an engineer and my impression was that most if not all of my classmates were genuine in their desire to help improve the lives of others. I'm sorry that you had a bad experience with your previous PCP but they don't represent the profession as a whole.

Also, if ADD is not a mental illness then what is it? I think this point is a conflation between medical definitions and social stigma.

<comment><USER4> > It seems pretty unfair to malign the entire field of medicine due to a > single bad actor.

Do a little research. Prescription fraud of this sort is widespread in the US.

<comment><USER6> I have definitely seen anecdotal stories of this occurring. Do you have any evidence to back up your claim that this type of behavior is widespread?

</comment></comment></comment></comment><comment><USER15> Unless the parents were crazy abusive or actually unfit, Mayo basically stalled to steal their child and charge them more money. Also bad is a recent scam of random average people being involuntarily assigned conservatorship and having their assets stripped.

</comment><comment><USER16> Seeing the Americans in this thread discuss their fear and mistrust of the medical system and the completely befuddling incentives that have been created in the US due to a for-profit medical system is straight up DISTURBING.

Healthcare is a human right in our modern prosperous civilization. What America has done to it is preposterous. You should be rioting, not starting lawsuits.

<comment><USER17> The Mayo Clinic is a Non-profit.

[https://en.m.wikipedia.org/wiki/Mayo_Clinic](https://en.m.wikipedia.org/wiki/Mayo_Clinic)

I agree that this particular case is egregious. But calling for riots based on unfounded speculation isn't going to help fix healthcare.

</comment></comment><comment><USER18> To me this sounds very much like the superiority complex many doctors and hospitals take when it comes to patient care. They are the doctors. They are the hospital. How dare you disagree. As stated, hospitals are not prisons and unless someone is an absolutely, clear and present danger to themselves or others, that person should be allowed to walk out. Even still, the law should err on the side of the patient's wishes.

<comment><USER19> >> To me this sounds very much like the superiority complex many doctors and hospitals take when it comes to patient care. They are the doctors. They are the hospital. How dare you disagree.

This is academia in a nutshell. They're told they are superior due to the time/resources spent in advanced schooling and only respect the opinions of people who have letters after their name. It is endemic amongst MDs and PhDs alike.

</comment></comment><comment><USER20> So, this looks awful. I would expect for the Mayo clinic to come out with a response sometime soon. In the meantime, I'm just trying to remind myself that news stories that stoke outrage often turn out to be telling the story in the way best tuned to get forwarded and clicked on, not always the most accurate way. But, really, this looks awful.

<comment><USER21> The fact that this happened a couple of years ago seems to make the "outrage of the week" angle a bit less likely? Since the patient has recovered, attended high school for another year to great success, and enrolled in college, it's pretty clear that she is competent to make health care decisions. She wanted a second opinion. Decision-makers (perhaps no longer?) at Mayo didn't want her to get that. (A bit rich, considering Mayo's reputation for second-guessing diagnoses across the Midwest...) When she got a second opinion, it was for a different and more successful course of treatment. If this report were false, threats from Mayo's lawyers would have prevented its publication.

There's little in this report to indicate that there is any sort of "culture" of false imprisonment at Mayo, and it seems likely that they're supervising the social workers a bit more closely now, so it's probably a fine hospital at which to receive health care...

<comment><USER20> Yeah, probably not Mayo clinic policy to imprison 18-year olds and take over guardianship, and the results afterwards make it clear their diagnosis was wrong. But, although the events were a couple years ago, the news article itself is pretty new, so I would be happy to see some comment from the Mayo clinic as to what they think went on here, and whether it was (or is) against their policy.

<comment><USER21> If actual events were largely as depicted in TFA, Mayo's interests would be best served by not addressing them at all. The publicity of the former board member's letter to a VP (but not his first name!) is a bit of a PR disaster...

</comment></comment></comment></comment><comment><USER22> As a HIPAA issue, the Mayo cannot defend itself here - it has no right to disclose any information on this patient's stay or condition.

Key quote,

>"You're only hearing one side," cautioned Dr. Chris Feudtner, a professor of pediatrics, medical ethics and health policy at the University of Pennsylvania Perelman School of Medicine.

They "broke her out" while she still had a feeding tube in place, and had only just "The video shows Duane pushing Alyssa in her wheelchair down the hospital hallway. She has a bandage on her neck where her breathing tube had been removed a few days before."

If you're getting a feeding tube and a trache, you're likely sick as shit. Even if one thinks the Mayo docs were wrong, that course of treatment suggests they earnestly thought she was extremely ill. Which makes their actions less evil than the article implies.

<comment><USER23> > has no right to disclose any information on this patient's stay or condition

Except that according to the article the Mayo said they would if the patient signed a release form. So the patient did so (called their bluff basically), and they still refused to discuss it.

> they earnestly thought she was extremely ill. Which makes their actions less > evil than the article implies.

Make no difference whatsoever. People have the right to stop medical treatment whenever they like. They have zero right to force anything on anyone.

On top of that a different set of Dr's said she was just fine to go home. So on top of everything else they were also wrong medically.

<comment><USER24> I'm sure their lawyer put the kibosh on that. How could they square their claim that she was not capable of making decisions with honoring a release also signed by her?

<comment><USER23> Since when do hospitals have the ability to unilaterally decide someone is not capable of making their own decisions?

If they believe that is the case they get a judge to give that person a guardian, they don't just make decisions for them.

<comment><USER25> That's literally what they were trying to do; read the article.

</comment></comment></comment></comment></comment><comment><USER23> Can we change the URL to [https://www.cnn.com/2018/08/13/health/mayo-clinic- escape-1-e...](https://www.cnn.com/2018/08/13/health/mayo-clinic- escape-1-eprise/index.html) which is the original source?

<comment><USER26> Especially since your link points to part 1 of the article, not part 2 like this post. The article makes a lot more sense starting with part 1.

</comment></comment><comment><USER27> According to the article, the hospital had attempted to gain medical guardianship and that was rejected by a court. So unless I'm missing something here, how on earth does a hospital justify keeping someone prisoner when a judge has ordered you to allow them to transfer hospitals if they want? They went through the rigamarole and lost. That sounds criminal. Did they lie to the cops, too, and say they were allowed to keep her there? How did they get an entire hospital to go along with this?

<comment><USER28> Not just one judge, but two different ones. They didn't like it when the first judge disagreed so they went to a different one who rejected them as well.

</comment></comment><comment><USER29> Nothing can make you feel powerless quite like a kafkaesque bureaucracy where the decisions are faceless and unaccountable.

</comment><comment><USER30> This is one way to make a profit off the patient. I wonder if it would have happened if she had no insurance. Highly unlikely as the hospital wouldn't be able to milk the patient for money.

A second issue is these social workers whose main goal seems to want to remove children from parents and break up families in general for what I can only say is their own sick amusement. This is a fucked up job that gives way too much power to people who really don't care about others and often are unsuited to work with others. No one or even two individuals should have this kind of power. Removing someone's legal ability to make choices for themselves or their children should only be done by a consensus of multiple, independent parties that are not allowed to communicate with each other.

Finally, why did the DA not file charges of wrongful detainment / kidnapping against the hospital? This is not a mere disagreement. The article brushing this off as some petty doctor ignores the kidnapping and sending the police after the patient based on false statements to the police. At the very least the social worker, doctor, and nurse who contributed to this should all be fired and lose their licenses. These people should not be working on their respective fields and likely should be in jail. I hope the patient does sue but that won't prevent greedy or petty healthcare workers with too much power from doing this in the future.

<comment><USER31> _This is one way to make a profit off the patient. I wonder if it would have happened if she had no insurance. Highly unlikely as the hospital wouldn 't be able to milk the patient for money._

I have no idea how to find it, but your comment reminds me of some horrifying article about the addiction treatment industry leeching all the money they could from patients with good insurance without really getting them better, not sincerely trying to do so.

<comment><USER30> They made a documentary about it as well: [http://www.thebusinessofrecovery.com/phone/index.html](http://www.thebusinessofrecovery.com/phone/index.html)

Hardly surprising. Every other medical specialty does the same and addiction treatment is essentially unregulated. Lots of suffering and misery to exploit here to make a ton of money for people with no morals (of which there are many).

</comment></comment></comment><comment><USER32> This is the second similar news story this month.

The thing in common is that both sets of parents were either divorced or not biological, and the hospital tried to use leverage to push them off balance with bogus law citations and police involvement.

The trump card that hospitals play in a dispute is to call police and have you arrested for trespassing.

</comment><comment><USER33> Really would like to know how it got to that point. I'm not far from Mayo and its of course a well ('world renown') known hospital. I haven't heard many good stories. I know of close friends who have gone there to get help and heard multiple stories about how the Drs ego got in the way of patient care and listening to what the patient was telling them. It's sad that this is reflected in this story to what I think is the extreme and then to boot what looks to be attempts to cover it up by adding stuff onto her records after she had already left.

Would like to hear Mayo's story on this, but I have a feeling it will be more excuse/finger pointing than explanation.

I do hope that they take this as a lesson on patient care especially the Doctors.

</comment><comment><USER34> What is shocking that Mayo legal department was contacted and there was no reaction, nobody cared to prevent this blowout. Mayo vice president was contacted by the board member, and nothing was done. Social worker who should've defended patient rights actually acted against patient's will. Mayo Patient Experience office was contacted and nothing was done.

Basically every person and institution whose jobs are to protect patient rights, failed. I wonder if all departments so unaccountable and dysfunctional in Mayo?

If its a case of one bad doctor, why so many of the hospital departments failed to do their job?

</comment><comment><USER35> Imagine what happens to people like this who have no family.

<comment><USER36> They stay in a reputable medical institution and get better after a debilitating aneurism?

<comment><USER23> That demonstrates an ignorance of what the medical profession is like in practice.

People without family to watch them get terrible care.

There are exceptions (ICU for example is usually pretty good), but any care that doesn't have someone watching/caring for them 24/7 is going to be bad.

You NEED someone in the hospital watching out for you, unless you are in a unit where there is a permanent nurse on duty with you (not doing rounds). Typically family or friends fulfill this role because hospitals can not afford to do it.

<comment><USER36> We weren't talking county general here. This was the Mayo clinic.

I'm appalled at the anti-science luddite response to this yellow journalism that's called a news article, especially from HN folk.

<comment><USER35> LOL... my mother was in a hospital more famous than Mayo and it's a lot different than you might think. My mother got 1000% better care than her roommates that didn't have 24/7 family coverage.

</comment></comment></comment></comment></comment><comment><USER37> This is way beyond Hanlon's Razor assuming this article is both complete and accurate. Mayo Clinic clearly acted in a way that would protect their income and not their patient, going as far as to try to use legal leverage to ensure neither the patient nor the parents could decide to get even a second opinion. Would you step foot into a Mayo Clinic the same ever again if this happened to you?

</comment><comment><USER38> I am having a hard time understanding how Mayo was able to basically hold one of their patient hostage. Isn't that akin to kidnapping?

But also:

What prevented Alyssa from getting up her bed and walk out? When did her parents start "figuring out _how to escape_ " and how long for? If they were at that point were they believed they needed to "escape" from the hospital, why didn't they call the police?

<comment><USER39> > What prevented Alyssa from getting up her bed and walk out?

She needed to be pushed out in a wheelchair. She was presumably only provided access to one due to the pretext of "Grandma Betty" who (it was claimed) could not access Alyssa's room. Additionally, hospital staff attempted to physically restrain her from leaving, which may have been more successful without the ruse.

> If they were at that point were they believed they needed to "escape" from > the hospital, why didn't they call the police?

This is a good question that's not fully addressed by the article, however, given that the police initially did side with the hospital when it came to a "our word vs theirs" situation, it may have been the correct choice.

</comment></comment><comment><USER40> This reminds me of the film Unsane [https://www.imdb.com/title/tt7153766/](https://www.imdb.com/title/tt7153766/)

</comment><comment><USER41> They should definitely be taking Mayo to court. Absurd. But a good lesson and next time I check anyone into the hospital I will have legal counsel at hand.

</comment><comment><USER42> know how I know this story has falsehoods?

"After the calls from police, Alyssa's parents figured out that their phones were being pinged and took the batteries out."

90% chance they all had iPhones. can't take iPhone batteries out. if they didn't, what phones have removable batteries?

riddle me that.

<comment><USER43> >90% chance they all had iPhones

Not necessarily. Outside of tech and the wealthy android has pretty good market share. It wasn't mentioned what her parents did for work but among blue collar professionals cheaper Android phones are the norm because their work environment tends to be hazardous to phones with large, thin glass screens.

</comment></comment><comment><USER44> I would consider this click bait and irrelevant on HN. The article is very long and contains very little factual information, making it impossible to understand the story or any of the arguments that could be made.</comment>


Show HN: Customised Jitsi Meet as a Service - <AUTHOR> https://meet.sabhagar.com <comment><AUTHOR> We have hosted Jitsi Meet and plan to customise it to have real-time speech to speech audio translation and multilingual speech to text transcription.</comment>


Science is not your enemy - <AUTHOR> http://www.newrepublic.com/article/114127/science-not-enemy-humanities

<comment><USER2> Quote: "They were cognitive neuroscientists, who tried to explain thought and emotion in terms of physical mechanisms of the nervous system. They were evolutionary psychologists, who speculated on life in a state of nature and on animal instincts that are "infused into our bosoms." And they were social psychologists, who wrote of the moral sentiments that draw us together, the selfish passions that inflame us, and the foibles of shortsightedness that frustrate our best-laid plans."

Yes, except the fact that the article is about science and these aren't sciences. Science requires evidence and falsifiability. Because of that uncontroversial definition of science, psychology isn't science, it's philosophy. Oh, by the way, "Cognitive Neuroscientist" is the new code word for psychologist, now that "psychologist" has become a dirty word, and now that psychologists are desperate to appear to be scientists.

With respect to psychiatry and psychology, society is moving away from any reliance on their imitation of science. Thomas Insel, director of the NIMH, has recently decided to abandon the DSM, psychiatry and psychology's "Bible" and central authority, on the ground that it's not scientific enough to guide research efforts. Announcing this decision, Insel said, "While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" – each edition has ensured that clinicians use the same terms in the same ways. _The weakness is its lack of validity._ "

Source: [http://www.nimh.nih.gov/about/director/2013/transforming- dia...](http://www.nimh.nih.gov/about/director/2013/transforming- diagnosis.shtml)

As to social psychology, the field is a joke. ScienceInsider reports: "In their exhaustive final report about the fraud affair that rocked social psychology last year, three investigative panels today collectively find fault with the field itself. They paint an image of a "sloppy" research culture in which some scientists don't understand the essentials of statistics, journal- selected article reviewers encourage researchers to leave unwelcome data out of their papers, and even the most prestigious journals print results that are obviously too good to be true."

Source: [http://news.sciencemag.org/people-events/2012/11/final- repor...](http://news.sciencemag.org/people-events/2012/11/final-report- stapel-affair-points-bigger-problems-social-psychology)

Science is certainly not anyone's enemy, but there are many who want the status of science without the substance. One way is to simply use the word "science" without actually meeting science's requirements. Examples include Christian Science, Scientology, and now Cognitive Neuroscientist.</comment>


"Make Simple Tasks Simple!" – Bjarne Stroustrup's CppCon2014 Keynote - <AUTHOR> http://www.youtube.com/watch?v=nesCaocNjtQ

<comment><AUTHOR> Slides are available at github [1].

Other CppCon talks are available at CppCon youtube channel [2].

[1] [https://github.com/CppCon/CppCon2014/tree/master/Presentatio...](https://github.com/CppCon/CppCon2014/tree/master/Presentations/Make%20Simple%20Tasks%20Simple)

[2] [http://www.youtube.com/channel/UCMlGfpWw- RUdWX_JbLCukXg](http://www.youtube.com/channel/UCMlGfpWw-RUdWX_JbLCukXg)</comment>