Google is Not a Doctor

Yes, I recognize the irony that you probably found your way to this post by way of Google. Nevertheless, I'm not dispensing medical advice; merely logic.

I see more and more signs in doctors' offices that remind us that Google is not a doctor. Variations include "Do not confuse your Google search with my medical degree." While Google can be useful as a search tool, the doctors have a serious point, because most searchers not only do not limit themselves to reputable sources of information; they have no skill in determining what actually comprises a "reputable source".

Let's look at some examples to see how Google can fail you:

One case is the efficacy of vaccines. Although scientific studies have found no causal link between vaccines and autism, thousands of people avoid vaccines through fear-mongering induced by celebrity endorsements bolstered by flawed and debunked studies that have gained a sort of zombie life through constant repetition. And because of this, some diseases that had been eradicated in the United States have made a comeback due to the vaccine avoidance combined with the re-introduction of these diseases via immigration from less developed nations where the disease still exists. Had more people been properly vaccinated, the disease would not resurge. It doesn't help that humans aren't very good at assessing risk. Despite all evidence, fearmongering has lead many people to conclude that they'd rather face the risk of death than that of autism. And this is despite the "left hand not knowing what the right hand is doing" situation of others declaring that "autism is a difference, not a disability" Comparing risks, anti-vaxxers would prefer a known cause of death to an unproven cause of "difference". This is simply not rational.

Rather than listening to others within their limited "bubble", the anti-vaxxers should defer to medical opinion. But in Google searches, the anti-vaxxer will find plenty of confirmation for their bias. Disinformation is in the top responses because, generally speaking, on social platforms the people who seek out such topics are searching using terms that skew the results and return an inordinate amount of social media rather than professional opinions. On those social media platforms, through confirmation bias, they upvote the responses that makes them feel better about their own opinions.

Google will almost always tell us what we want to hear, because SOMEWHERE in the noise and babble of seven billion voices, you will find others who will tell you exactly what you want to hear. Whether it's about climate change, the reality of the Moon landing, or the roundness of the Earth, you will find loud and aggressively worded defenses of all sides of any topic. Some of them are objectively correct, some aren't; and much of the time you are not qualified to determine which is which.

--==//oOo\\==--

Here's a hypothetical example:

Suppose you're looking at a case study: a 32 year old Caucasian cis-gendered male, with no physical diseases or abnormalities. Nonetheless, this person declares that he is "a paraplegic trapped in a healthy body". He refuses to walk on his healthy legs, though they cause him no physical pain. He uses a wheelchair, and insists on living the lifestyle of a paraplegic. He has gone so far as to modify his automobile with hand controls. In every respect, he seems quite sincere. He then visits a surgeon to have his healthy limbs removed so that his outward appearance will validate his self-image. This is a strong hypothetical, as it's not hard to confirm that such persons do, in fact, exist.

It would be difficult to find a surgeon who would not conclude that the patient has a form of somatic dissociation or somatic delusion and refer him for psychological treatment.

Now, suppose you did a Google search on such a condition, which resulted in many results from reputable medical sources that confirm (in rather dense technical jargon) that this is likely a psychological condition. But due to the nature of search engine rankings and the actual phrasing of the search, the top responses come from social platforms (such as Quora.com) where all of the opinions are from the patients themselves, rather than from medical professionals. A typical top response might include the following:

"Doctors know there’s no such thing as genetic anatomy or any number of other made up terms like 'normal limb development'. A person’s Hox genes code for the development of the fetus, and account for variations of limb development.
"During fetal development these genes determine the production of retinoic acid and FGF hormones and those determine what happens next.
"The phenotype, the actual expression of the genetic code into a real body happens in the influence of those chemicals. The result depends on not only which chemicals are being produced but whether the receptors are properly formed. At the end you end up with a baby with fully formed or truncated limbs. The rest of the body of an infant doesn’t much care.
"Further when we artificially remove the limbs of a person we really are changing the way their entire body is interacting as if they had been born without limbs.
"Doctors know that when the two things, the phenotype and identity, don’t agree that they have a surgical candidate. What did you think the answer would be? That’s the answer for nearly every doctor, and the professional organizations like the AMA, APA and AAFP. It is what is taught in medical school. It is well supported by research and it is well documented by the presence of real life people like me."

However, "Saying it don't make it so."

Again, the disinformation is a top response because, generally speaking, on social platforms the people who seek out such topics are those that have the disorder, and through confirmation bias, upvote the response that makes them feel better about themselves. The response may look legit, because the responder has included enough jargon to sound scientific without being obscure. Of course, there are logical fallacies in the response, but these are easily missed by those who aren't looking for them. Other people may therefore take it at face value, concluding erroneously both that the person who is best qualified to opine on a condition is always the person who has it; and that the person responding is doing so truthfully, without bias.

Of course, the response is hogwash. Doctors know that normal limb development is not a "made up term" and that there are distinct differences between people who are born without limbs and those whose bodies are artificially altered. They know that someone with a somatic delusion is delusional. They treat the statements of the patient skeptically, as data rather than as knowledge, because they know that the response of the patient is likely to be biased in favor of "normality". Few people want to be "abnormal"... not even Napoleon Bonaparte in a roomful of Bonapartes. And many patients are simply incapable of accurate self-assessment.

Yet, while professional ethics should demand that the surgeon assess the patient scientifically and objectively, you will still find surgeons willing to amputate the patient's perfectly normal limbs. Rather than looking at the bulk of the literature, the Google searcher may cherry-pick these outliers as "proof" that the "medical establishment" sees this somatic dissociation as a normal condition best addressed by body modification. The patient will dismiss science and preferentially select opinions from others within their own "bubble".

--==//oOo\\==--

But you don't have to go to extreme case studies to recognize that laypersons are often simply wrong. They haven't studied (hence "laypersons") and repeat what they have heard or what they suppose as fact. And unlike in this blog, where I insist that everything is an expressed opinion that you should verify, they fail to label their statements as opinion. Hence, it's important that you learn the difference between reputable and non-reputable sources.

The effective practice of medicine is not done through public consensus, but through science. Google is NOT a doctor.


https://www.irishexaminer.com/viewpoints/columnists/terry-prone/no-medical-cure-yet-for-doctor-google-and-the-know-it-all-patient-424923.html

NEW GAME: Lyra

Let me tell you about Martian Cake: Through his telescope, a Martian sees an Earthman approaching in a rocket, and wants to make him feel at home. So he bakes a cake. Unfortunately, all he knows about cake is what he's seen through his telescope, so he substitutes local ingredients. It looks beautiful, but the Earthman is immediately poisoned upon eating it.

That's the design conceit of the game of Lyra. What might Chess look like if it were "re-created" by someone who's had glance at the game, but never learned the rules and doesn't even quite remember what the pieces look like, or even what size the board is? He knows that the pieces move differently from one another, and one piece is more important, but that's about it. As a result, this game is played on a 6x6 board and the movement of every piece has changed (other than the General, which moves as a King).

As might be expected, this isn't as good as "Earth cake" (Chess). However, I'm tweaking the rules as gameplay, and may introduce variants. At the end of the rules pdf I've noted a few that I'm playtesting. So far I particularly like "Pyrrhic Victory".

UPDATE: In extensive play-testing, the game wound up being too cautious. To fix this, I've added an element of chance using dice. The conceit here is that the game is 'properly' played with actual armies in combat. While in Chess, the only difference in the strength of the pieces are in their movement, in Lyra, the pieces also differ in their attack strength. Each piece attacks and defends using dice.

WHY?

Lyra game in progress

"Design conceit" aside, I wrote the game purely because I had built a very beautiful 6x6 physical board and pieces, and just wanted something different to play on it. I made the pieces visually unique because playing it with Chess pieces is mildly confusing (though it can be done).

It's named Lyra merely because I like the name.


HOW TO PLAY

You can download the rules here: Lyra-rules.pdf

Each army consists of the following:

• 1 General. The general moves like a Chess King (one square in any direction). It attacks with a d12 and defends with a d10.
• 1 Assassin. This moves one square diagonally or horizontally (not forward or back. It attacks with a d10 and defends with a d8. When the Assassin captures another piece, it takes on that piece's movement in addition to its own.
• 2 Captains.  The Captain moves 1 or 2 squares orthogonally, or 1 square diagonally. It may jump friendly pieces (but not enemy pieces). The Captain attacks with a d8 and defends with a d6. A Captain cannot be promoted.
• 2 Lieutenants. The Lieutenant moves 1 or 2 squares diagonally, or 1 square orthogonally. As with the Captain, it may jump friendly pieces (but not enemy pieces). The Lieutenant attacks with a d6 and defends with a d4.
• 6 Soldiers. The Soldier moves 1 square forward or sideways, and captures the same way. It attacks and defends with a d4. Upon reaching the back rank, the Soldier is promoted to Lieutenant.

To deal with attack and defense, each player should have one each of the following dice: d4, d6, d8, d10, and d12. It's best if these are colored dark and light, similar to the playing pieces. Combat is as follows:

1. The attacking player threatens an opposing piece.
2. The players choose the appropriate dice as described above and roll simultaneously.
3. If the attacker's roll is higher, the defending piece is removed. Otherwise, it's a 'push', no one wins, the pieces stay where they are, and the attacker's turn is over. (You may think that the attacker's piece should be removed if the defender's roll is higher, but playtesting shows that it's enough of a penalty that the attacker has effectively wasted a turn on the attack. I've seen the defender ignore several failed attacks in order to strengthen his position. It's a big advantage.)

STRATEGY

The game itself has some interesting features:

• The Assassin piece takes on the movement of the last piece it captured in addition to its own. 
• Soldiers do not move or capture like pawns. 
• Officers (Lieutenants and Captains -- and Assassins who have captured either of them) can step over friendly pieces. 
• The pieces are designed to have weak spots. Proper play should find and exploit them.

The most important thing to remember is that this is not Chess. Very little of what you know about Chess is going to help you here, beyond some very general rules of thumb such as maximizing your mobility and keeping pieces defended. In particular, there is no onus whatsoever for a player to announce check. There is no checkmate here. It's a fight to the death, and in combat the General is the strongest man on the board.

There are two basic strategies that can prove effective. The first is to take advantage of the leaping ability of your officers to get them onto the field quickly. This allows you to clear some room to allow Soldiers to promote to Lieutenants in the endgame. The second is to use your Soldier early, holding back higher ranking officers for the endgame. Even though a Soldier is relatively weak in battle, it does stand a good chance against a Lieutenant, and has a better-than-nothing chance against any other piece. In either strategy, you'll probably find your Lyran General much more active than a Chess King would be. Because of his advantage in combat, you may find it advantageous to get him into striking distance when threatened by an officer.

With a smaller board, the pieces engage much more quickly than in Chess, so there is no en-passant. Also, since officers can step over friendly pieces at any time, there is no castling, and nothing like a Knight. And since movement is generally limited to a maximum of two steps, you won't generally find a lot of back-field infiltration in this game. It's very much a field of battle with a definite front, and draws are common. When played without dice, since the pieces are more similar in strength than in Chess, a game tends to be either cautious dancing or a bloodbath. Without the dice it's a fairly boring game. With them, it's a nail-biter.

When playing with dice, you'll find aggressive play is rewarded. Your pieces are stronger when attacking. Although a General greatly outmatches a Soldier (d10 to d4), it's possible for the Soldier to prevail. An attacking Assassin is on equal footing with a General (d10 to d10). Nevertheless, it's possible to lose the game due to chance, even if your strategy is perfect. Stuff like that happens in war. For best results, you'll want to cherish your high-ranking officers to give yourself the best chance of delivering a finishing stroke.

EQUIPMENT:

As for equipment, you can play it just fine on a chessboard. Just set the knights aside and ignore the outer ranks and files of the board. But if you'd like to make a set like mine for yourself, I'm not going to pretend this was difficult. I cut a 12 x 12" inch sheet of plywood, glued some 2" tiles (from Home Depot) onto it, and then grouted it as you would a floor. I affixed it to a 12 x 12" picture frame in place of the glass and backing. The pieces are made from bits of craft wood that I got from Hobby Lobby: balls, eggs, doll pin stands, and screw-hole caps. The dice can be gotten from any gaming or hobby store or online.

Or, you could play against a computer using Zillions of Games. Here's the file containing the game: [Lyra.zip]. Keep in mind that you'll need a copy of Zillions of Games to run it. Registration is only about 25 bucks and for that you get, as the name implies, a potentially unlimited supply of boardgames, card games, and puzzles.

I just finished creating the ruleset for Zillions this morning (Christmas Eve!). It actually plays a decent game, and follows all the basic rules, including the wonky captures of the Assassin piece, and the fact that officers can jump over friendly pieces.

I'll add some variants later, but I wanted to get this out as a Christmas present to anyone who reads this.

A nice box completes the set!

--==//oOo\\==--

If you have Zillions of Games, you might try my other games for it:

• Jedi Chess pits a powerful Sith Lord and his apprentice against the Jedi Order. The Apprentice moves like a Chess Queen; the Sith Lord combines the moves of the Chess Queen and the Knight.

Jedi Chess

• A variant of Jedi Chess (found in the same file) called Rebel Chess pits the Emperor and his new apprentice, Darth Vader, against an army of familiar freedom fighters. Vader moves as a Queen. The Emperor's power is waning: here he combines the moves of the Chess King and Knight.

Rebel Chess variant

• Qui-Vive challenges you to place five pieces in any of the following arrangements: V, +, X, /, \, ̶, or |. It's harder than it sounds, because the computer is doing the same thing, and it's very good at setting two different patterns at the same time. I would say Zillions plays this at expert level. Of course, you can choose to dumb it down.

Pressure!

I saw the attached pic in a Facebook group, and of course someone cried "sexism!" Someone always cries "sexism" at the sight of the female form, though sweaty images of Conan never elicit the same criticism. Apparently, it's only the sight of women that these people hate. Sexist, indeed. If you think it's sexist that women are shaped differently than men, you should take it up with God... or your psychiatrist.

Of course, they have convinced themselves that the "sexism" is that the women are depicted as having female shapes rather than being hidden under bulky suits. But does that criticism have legs?

FUN FACT: to be effective, a pressure suit does not have to provide air to the skin. It has to provide pressure. The pressure provided by an elastic, form-fitting garment will do. Don't take my word for it; believe NASA. Here's a link to the Bioastronautics Data Book, second edition. 200 mm Hg is barely tolerable; but look at page 5: a properly fitted elastic suit can protect you down to 15 mm Hg.

So, trope though it may be, those tight form-fitting reflective suits of the fiction of yesteryear have a certain plausibility. And of course, we don't know what they're made of, and whether they're constructed of some memory material that's more responsive to pressure changes than mere elastic. This would be a minor advance that is far more believable than, say, the magic gravity deck plating of Star Trek and damned near every other sci-fi darling. Granted, you still have to provide temperature regulation and protection from radiation, but that could be done with a relatively svelte oversuit; you don't really need a huge bulky space suit to do the job. Inside the ship, where the oversuit isn't needed, it would be entirely plausible that the skintight pressure suit alone would be used as safety equipment.

Indeed, it would be somewhat easier to provide said pressure to the female form than the male in certain areas due to the nature of the ... er... "baggage" inherent in the male form. And yes, it may very well have that "thong" to keep it tight. And men's suits would of necessity be constructed a little differently, being bulkier around the nethers. If you'd like to argue that point, I'll happily discuss your own sexism. Even in the future, some men will have balls. Nevertheless, concerning these "space catsuits", where in my youth I might have said, "That's ridiculous," I now know better.

The Mother of all Weird Dreams

HOLY FREAKIN' MOLEY! I took a nap and had a weird dream that was the mother of all weird dreams. I just now woke up, not because it was a nightmare, but literally so I could say "what the f...."

Way too many details to even write down, but I'm going to put down some of it before it's gone.

It involved my parents selling the farm and buying renovations for their suburban house. It wasn't just that they were alive in the dream. I was genuinely surprised to find them not dead, and they knew they had been, but didn't seem concerned about that. The renovations involved installing sunlamps in the ballroom (which we never had), and the sunlamps making everything grow. And when I say everything grew, I mean everything. The house became a mansion. Not gradually... it had always been a mansion, except that everyone remembered when it became always-been-a-mansion. And somehow we had a verb tense for that. Peanuts became worms, and inanimate objects like furniture became weird living parodies of themselves. Not cute ones, either. They bit and shit and pissed on the floor, and smelled horrible. My little sister (who doesn't even exist) started turning into a bison, and a friend-of-mine-who-I-don't-know turned into a turtle who offered the bison a ride on his back. We tried to get away, but the mountains were right next door, and it would take a week to get there on turtleback. The scope of the renovations had grown as well, and now workmen and painters were balancing on two-by-fours (stood on end), and my parents saw nothing weird at all. They simply insisted that when you do renovations you're bound to have a few setbacks.

This thing was wall-to-wall "Lewis Carroll meets The Sound of Thunder". What the hell did I eat?

--==ooOoo==--

That all sounds nice and linear when I read it back, and I'm happy to have the benefit of a moveable cursor instead of quill and ink. In experience, it was anything but linear. And some of it, I don't even have vocabulary to describe. The change to the house was quick, but everything else was gradual, and history kept changing with the physical changes. So in part it was history-changes-reality and in part it was the other way 'round. And you could tell which was which, and describe it, but I don't know whether upon waking I've lost the language of the dream, or whether I merely dreamed its existence and took for granted that the words were there.