Muskism, Vance, AI and the American choice between oligarchy and an imperfect democracy

In advance of Nov 5 2024, some thoughts on  Muskism. Because I can't resist this kind of thing.

Musk and his fellow tech oligarchs more or less believe in the need to preserve a white tribe, eugenics, and the relative supremacy of a male pattern brain. But I don't think that's what is what is driving Musk's political agenda.

I think Musk is sincere about his stated AI beliefs. He expects at least the genius-in-every-pocket described by Anthropic CEO Dario Amodei. He believes American democracy will not survive the AI driven chaos to come. This challenge, Musk believes, will be far more disruptive than mere world war.

Musk and his tech allies believe that humanity's best chance is to be guided by a kind of aristocracy of wealth and (in his imagination) clear thinking intellect. Perhaps if we pass into a future AI golden age democracy might be restored, but that will depend on whether the SentientAsBestWeCanTell AIs of 2030 get the vote. The Muskites believe Trump is weak, dying, and will not finish a second term. He will be pardoned, given money and left to the side. Vance is their man. The tech oligarchs will steer America and the world through what lies ahead.

I believe Musk is correct about the AI chaos to come. In the old days we called this period the "technological singularity" -- back when singularity meant absence of prediction rather than a religious experience.

I don't, however,  think Musk and his billionaire minions are the answer to this challenge. I would prefer to give democracy a chance.

But does democracy really have a chance? November 2024 is the test. If Americans, knowing all they know now, having lived through a Trump presidency, still reelect Donald Trump -- then it's clear our democracy is not up to the much greater challenge of even collective climate geoengineering -- much less the AI transition.

If "Trump" (Vance really) wins in 2024 I will be sad. On the other hand, I will then accept that Musk was correct. If American democracy can't handle the Trump idiocy it will have demonstrated it is entirely insufficient for what lies ahead. In that case perhaps the oligarchy is the best we can do.

If Vance loses in a few weeks -- then we will see how democracy manages the chaos times. That's what I have voted for.

Perplexity is saving my linguistics classmates

I have a dark past. I asked questions. In class. Lots of questions. Too many questions. I hear things, I get ideas, I notice gaps, I ask questions.

It's a compulsion.

Some of the questions helped classmates. To be honest more were probably confusing or distracting. I likely featured in classmate daydreams -- but not in a good way.

Worse, some of the questions confused the professor. Or exposed what they didn't understand. That could be embarrassing or even humiliating.

Now I'm back in the classroom, doing freshman linguistics.  As a 65yo, I can do classes at Minnesota state colleges and universities for free. We pay a lot in taxes, but there are benefits to living here.

My question compulsion is still there, but LLMs are saving everyone. I set up a linguistics "collection" in Perplexity with appropriate prompts; now I type my questions into my phone (allowed in class). I get the answer with Perplexity and spare my classmates.

Never say AI isn't good for something.

PS. Perplexity is to modern Google as Google was to Alta Vista. A qualitative improvement. It's almost as good as 1990s Google.

The End Times have come for the Pinboard.in bookmarking service

In the years following the Great Recession, from 2010 to 2013, many web services went offline. In retrospect that was the end of the Berners-Lee web.

During that time, starting in 12/29/2011, I started using Maciej Cegłowski's Pinboard bookmarking site as a kind of micro blog. 

Pinboard filled part of the Google Reader Social vacuum. There were various apps and services around pinboard, in addition to IFTTT, that made that feasible. My Pinboard 's' posts were published to Twitter, then app.net, and most recently Mastodon (and probably a few other services too). They were also archived in kateva.org/sh. 

Pinboard imported my old Google Reader social bookmarks so it's a pretty complete set of things I shared, mostly tech and events that seemed to have potential lasting meaning. There are over 50,000 pins now. There were apps written for Pinboard, creating a small ecosystem of added value.

I'm still on my original subscription plan - about $20 a year or so. It ends in Feb 2025 and I won't be renewing. I feel like it's 2013 again.

Over the past few years there have been a slowly increasing number of pinboard outages with less communication. While debugging the last outage I purged my local history from the 3rd party Pins iOS app and found that Pinboard was throttling their download API. I could download only 100 of my 50,000 or so pins. (It's still easy to download the whole set as a file). 

That's ominous, but more importantly Pinboard is a one person show and that person is no longer responding to support emails. Maciej is no longer active on social media that I know of. His Pinboard.in support forum has been quiescent for years. I'll be researching my micro blog options and I'll write about what I come up with on tech.kateva.org. 

10 years is an eternity on the web. Pinboard had a good run, but it too is passing. I have my archives and you can still download JSON or HTM versions of past bookmarks. I might wish for a more graceful end but Pinboard was a good service while it lasted and there is a clear data exit if not a clear replacement. Thank you, Maciej, for the value you delivered to me.

Update: via a Mastodon friend a Hacker News article on the ignominious end of Pinboard and some alternatives: https://news.ycombinator.com/item?id=41533958

In which I declare my expert judgment on AI 2024

These days my social media experience is largely Mastodon. There's something to be said about a social network that's so irreparably geeky and so hard to work with that only a tiny slice of humanity can possibly participate (unless and until Threads integration actually works).

In my Mastodon corner of the "Fediverse', among the elite pundits I choose to read,  there's a vocal cohort that is firm in their conviction that "AI" hype is truly and entirely hype, and that the very term "AI" should not be used. That group would say that the main application of LLM technology is criming.

Based on my casual polling of my pundits there's a quieter cohort that is less confident. That group is anxious, but not only about the criming.

Somewhere, I am told, there is a third group that believes that godlike-AIs are coming in 2025. They may be mostly on Musk's network.

Over the past few months I think the discourse has shifted. The skeptics are less confident, and the godlike-AI cohort is likewise quieter as LLM based AI hits technical limits. 

The shifting discourse, and especially the apparent LLM technical limitations, mean I'm back to being in the murky middle of things. Where I usually sit. Somehow that compels me to write down what I think. Not because anyone will or should care [1], but because I write these posts mostly for myself and I like to look back and see how wrong I've been.

So, in Aug 2024, I think:

1. I am less worried that the end of the world is around the corner. If we'd gotten one more qualitative advance in LLM or some other AI tech I'd be researching places to (hopelessly) run to.
2. Every day I think of new things I would do if current LLM tech had access to my data and to common net services. These things don't require any fundamental advances but they do require ongoing iteration.  I don't have much confidence in Apple's capabilities any more, but maybe they can squeeze this out. I really, really, don't want to have to depend on Microsoft. Much less Google.
3. Perplexity.ai is super valuable to me now and I'd pay up if they stopped giving it away. It's an order of magnitude better than Google search.
4. The opportunities for crime are indeed immense. They may be part of what ends unmediated net access for most people. By far the best description of this world is a relatively minor subplot in Neal Stephenson's otherwise mixed 2018 novel "Fall".
5. We seem to be replaying the 1995 dot com crash but faster and incrementally. That was a formative time in my life. It was a time when all the net hype was shown to be .... correct. Even as many lost their assets buying the losers.
6. It will all be immensely stressful and disruptive and anxiety inducing even though we won't be doing godlike-AI for at least (phew) five more years.
7. Many who are skeptical about the impact of our current technologies have a good understanding of LLM tech but a weak understanding of cognitive science. Humans are not as magical as they think.

- fn -

[1] I legitimately have deeper expertise here than most would imagine but it's ancient and esoteric.

Fantasies of a tyrant: The Deshittification Corps

This morning on my Mastodon:

It’s possible that we have built an economical and technical environment that is too complex and treacherous for almost all humans to live in.

Perhaps the Neanderthals had similar feelings about the warmer buggier more diseased environment that came with the Skinnies (their name for us). 

I wonder who will inherit our world.

Yes, I'm Old. But the young are distressed and anxious, so perhaps they feel it too. To me many things feel frayed, fragile, buggy, and poorly maintained. As though there wasn't enough time to do it right before the next urgent thing. 

Apple is supposedly off trying to build Apple Intelligence -- and in the meantime Photos.mac is the shittiest software I've been obliged to consistently use [1]. For a small fraction of what Apple vaporized on autonomous vehicles and the Vision Pro thing they could have slowed the growth rate of their technical debt and maybe even implemented fucking Folder search in Photos.mac [3].

Which brings me to the Deshittification Corps. If I were a Tyrant, which is more than you deserve, I would create a Deshittification Corps (DC) to fight enshittification [2]. My Deshittification Corps would be a force of about 10,000 people who evaluated the services we rely on and gave them shittification ratings. Which they would be obliged to public post, a bit like cigarette carton notices. For example:

This service has a Shittification Rating of D. This is a really shitty service. We recommend everyone who works for this company seek new employment.

Companies that didn't improve their Shittification rating would be subject to a special tax that would start at 0.01% of gross revenue and double every day ... 

- fn -

[1] Ok, SharePoint is shittier. But now you're triggering me. Besides, one of the best things about retirement is no more SharePoint.

[2] Yes, Doctorow was talking about software and online services, but I'm bending the meaning more broadly to encompass government and other services.

[3] It would still be shitty software, but that would be the biggest improvement since iPhoto stabilized.

Naturalized and adopted citizens and Medicare/Social Security - the SSN class trap and a likely SSA software process failure

TLDR;

1. If you are a US citizen by naturalization or adoption you should check (call SSA and wait on phone for 1-2 hours) that your SSN is classified as US Citizen. The reclassification of an existing SSN has been an issue for over 40 years. If it is not correctly classified you will run into problems when you start Medicare or Social Security coverage (which can be at different times).
2. I think the rats nest of issues I ran into getting Medicare coverage arose because SSA software automates routine processes but it doesn't cover this problem. AND there isn't an effective process to manage exceptions to the automation rules.

Story

One of the joys of Oldness includes obligatory encounters with overwhelmed government services, not least the Social Security Administration. Recently I fought my way past the usual array of minor bugs and UI issues and browser incompatibilities to register for Medicare 8 weeks before my 65th birthday around May 30 2024.. I believe it was on the first day that I was eligible to start the process online.

That's where it went bad. After completing the application the screen briefly showed a confusing message about needing to submit some sort of additional documents -- but not which documents. I also got an email dated 6/3/24 saying to expect instructions. I waited ... and nothing happened. My online application status indicator stayed at the start of step II.

I checked the online status many times over the following weeks but nothing turned up. I finally phoned SSA and after about 1-2hours of waiting I got someone who started to work the problem. Somewhere during this process my line was disconnected. SSA staff don't have a way to call back or reach anyone who is disconnected.

After a week or two I were getting closer to my birthday and I forced myself to phone again. This time after 1-2 hours I was told to bring my naturalization certificate and state ID to our local SSA office.  I was later told this advice was wrong for my situation -- in fact they needed my passport and state ID. (I suspect two government approved IDs and my naturalization papers and birth certificate might have worked if I didn't have a passport.)

In the aftermath of the CrowdStrike fiasco I waited 3.5 hours in the local SSA office until I finally reached a very pleasant expert who looked at my passport and state ID, explained that my SSN classification was wrong, and passed on the correction to the one person who could process it. Somehow that happened the same day -- so I think she made an extra effort.

The SSN conversion thing is a problem -- two our children were born in Korea and both got caught out by this. SSA being overwhelmed is a problem too -- not everyone can spend hours and hours waiting on the phone or at the SSA office.

But the interesting problem to me is that I only received one of two emails that I was told were supposed to have been sent to me and neither of the two paper letters that were supposed to have been sent. In addition the description of the problem I saw in the original online submission form was incomplete and only showed there. 

I'm sure SSA believes I missed the 2nd email and that I threw out both SSA letters. The latter is especially unlikely; we have two special needs children and Emily does NOT miss SSA letters. It's a life, death, and taxes class thing.

That's what SSA would believe, but I think the letters were never mailed and the 2nd email was never generated. That what's would happen if the business logic in SSA automation didn't have a specific response to the SSN classification problem AND didn't have a good process for "problems not elsewhere classified". That would also explain the incomplete or misleading instructions my second phone rep passed on to me. It might even explain why the first phone rep might have dropped my call (lest she fall infinitely far behind).

I wasted a lot of hours dealing with this, and so did SSA staff. I worked for years with government software so I'm not optimistic this will get fixed; I suspect "edge cases" will be falling off the SSA process for decades to come. But I did write our state representative's office, so maybe the summer student will find a way to pass on the speculative bug report.

The LLM service I will pay for -- call Social Security for me

One of the fun things that happens to Americans as we become redundant to life's requirements is signing up for Medicare. There's a sort-of-useful cobbled together web site to do this. Processing is supposed to take under 30 days, though I've read the federal mandate is 45 days. Perplexity basically says it's heading towards 60 days average.

Anyway, my wee application is well over the 30 day limit. There's no way to contact anyone other than the phone. Which my wife assures me takes at least 45 minutes on hold. (Don't fall for the "call back" and "hold your place in line option" -- my wife tells me they simply don't bother.)

And, yes, the hold music is horrendous. As Emily says: "One of the challenges of getting old is listening to music on hold. No one ever tells us."

So, while I wait on hold I once again think how there's one LLM service I want to pay for. Want.

I want to give my Agent the social security and medicare data it is likely to such; case number, my SSN, my phone, etc.  I want it to call social security using my voice and sit on hold for days, weeks, years until someone accidentally answers. Then it begins the conversation while paging me to swap in .... with a text summary of current discussion and a timer to join in 5.... 4..... 3.... 2.... 1....

Yeah, that would be worth some money.

Update 7/19/2024: I finally got through to be told that requests were mailed to me 6/3 and 7/3 requesting additional information. We are very vigilant about social security correspondence so it's very unlikely they were delivered here. We have seen MN Post Offices lose tracked social security correspondence, presumably due to internal theft.

Cannondale Scalpel Team Carbon 2010 XC 26" wheel bike with Lefty Speed Carbon SL and Mavic Crossmax Axle cap is part number KH124 (maybe)

Twenty years go when I wrote a post title like this one I was pretty sure at least one person who needed help would find through Google and have a better day.

Now? It's like tossing a bottle in the ocean.

If you happen to have come across this bottle here's what you need to know about this weird bike that I picked used when I didn't know any better and have an odd affection for. Even though it's the bike equivalent of a 20yo Porsche -- albeit with much better engineering than a Porsche.

1. If you have a Cannondale dealer or good local bike shop just use them.
2. The Cannondale Lefty suspension is a cult within the XC singletrack world and Cannondale did whatever weird/fun thing came to mind.
3. With this single (Left!) side suspension comes a proprietary hub that has been through at least 3 revisions. The version I have is forgotten by most (Cannondale very kindly sent me a free replacement when I asked -- but it was the wrong version!) The weird hub has a proprietary hub retention system made up of a fancy bolt with rubber O-ring that does most of the work along with a reverse threaded "axle cap" that engages with the O-ring, keeps water and dirt out of the moving parts, and also helps with bolt retention (bolt loosens but runs into the reverse threaded cap and they kind of jam together). Cannondale tweaked this design often because that's what they do (and why some love them and some fear them). Some models tightened with a Shimano freewheel tool, others used a pin-type chainring tool (but at least they aren't super exotic tools).
4. These caps tend need replacing. Probably because most don't expect the reverse threading and strip it the first time they change a tire. Or they fall off.
5. My 2010 Lefty Crossmax hub uses the Cannondale Lefty SuperMax Axle Cap and Bolt - Black - KH124. After my model came the Lefty 50 Hub Axle Cap And Bolt - Black - QC117. This 50mm standard width part is much too shallow for my bike, even though it's described as  fitting "vintage Lefty hubs, Lefty SL hubs, and Lefty 50 hubs including Lefty Oliver. Will not correctly fit SuperMax, Lefty 2.0, Lefty 60, or Lefty Olaf hubs."
6. There are other versions I think for later boost and fat bike hubs.

UPDATE 7/12/2024: It fits better than the QC117 but it screws deeply into the hub and might kind of float in there? Sort of weird.

Gabapentin, Alzheimer's, fake science, and the National Library of Medicine

Gabapentin was developed as a focal seizure medication and has been found to be effective for neuropathic pain syndromes in diabetic neuropathy and postherpetic neuralgia.

Gabapentin is also widely used in America for a variety of pain syndromes including sciatica. The well done wikipedia article has a good overview of what we know about these uses. In general the benefits of gabapentin for many pain syndromes are not clear; as usual more research is needed. The evidence for nerve healing benefit is weak. I am confident we would almost never use gabapentin for chronic sciatic pain if opioids were not cursed by tolerance, dependence, dosage escalation, respiratory suppression, and diversion to recreational use. Without opioids we have acetominophen and ibuprofen and not much else.

In addition to doubts about efficacy some patients report significant persistent side-effects of somnolence and fatigue, sleep disruption, and a withdrawal syndrome that resembles benzodiazepine withdrawal. In my own life I've taken gabapentin for months for spinal stenosis* and I have not experienced either obvious benefits or problems, but I believe reports that some people have unpleasant withdrawal syndromes.

The combination of unclear benefit outside of diabetic neuropathy and idiosyncratic withdrawal syndromes would be enough to make gabapentin unpopular. Beyond that there's a significant group of chronic pain patients who feel they would do much better on opioids; they believe they are getting a defective substitute because of an excessive reaction to physician overuse of opioids in the 1990s. It's easy to see why gabapentin is not loved.

Which brings me to the point of this post. I have seen claims from the community of chronic pain patients who have legitimate suspicion about the value of gabapentin that "gabapentin causes Alzheimer's" based on an article published out of Taiwan - The association between Gabapentin or Pregabalin use and the risk of dementia: an analysis of the National Health Insurance Research Database in Taiwan. The authors conclude "Patients treated with gabapentin or pregabalin had an increased risk of dementia. Therefore, these drugs should be used with caution, particularly in susceptible individuals".

Long ago I was an academic family physician who did the tedious work of evaluating research publications. Back then I'd have had to point out that this is an outrageous conclusion to draw from data mining a health insurance data set. If all the right boxes were checked and procedures followed the most one could conclude from this type of study is that maybe there's some signal that should be researched in animal models and maybe one day in a range of increasingly expensive and complex studies. In those days that conclusion in an abstract would be the end of my interest in the publication.

Sadly, these days, we don't even have to look that deeply. We start with looking at where an article was published. Front Pharmacol is a pay-to-publish eJournal. That's why you can read their articles without paying - the authors paid for you to read it.

You can find the publishers of this article in www.frontiersin.org and read about them in a wikipedia article on Frontiers Media. Nobody, absolutely nobody, would publish in Frontiers if they could get through peer review anywhere else. Derek Lowe is the most publicly accessible writer about this class of publication, you can read two of his recent pieces here and here. The garbage output of these fake journals to qualify for academic promotion is so bad that even PRC academic centers are turning against them: "... January 2023, Zhejiang Gongshang University (浙江工商大学) in Hangzhou, China, announced it would no longer include articles published in Hindawi, MDPI, and Frontiers journals when evaluating researcher performance."

In short, in our broken modern world, we don't have to dig into the particulars of this article. We don't have to even look at the absurd abstract conclusion. All we have to know is that the authors of this article paid to get it published by an enterprise that is almost certainly fraudulent.

It's not impossible that any substance that interacts with the human body might in some way increase the risks of Alzheimer's dementia. That, I suppose, includes cosmic rays. But there's no particular reason to suspect gabapentin more than other medications. This is a bullshit result published in a bullshit journal.

So why, a reasonable person would say, was this crap indexed by the National Library of Medicine, a division of the National Institute of Health funded by the American tax payer? That's a damned good question. I can guess why the NLM is effectively promoting fraud, and I can suggest workarounds for the problems I'm guessing they have, but I honestly don't know. I am, however, angry. As you might guess. I'm sick of this academic fraud.

* I'm now post-decompression surgery. That's a story for another day.

Medicine and culture: searches on anorexia from 2004 to 2024 declined by over 60%

I noticed a while back that eating disorders were no longer an active area of public anxiety. So I looked at Google Trends since 2004 (click for full size)

If the 2004 baseline were around 75 and the current is 25 that's a 50/75 or 2/3 decline from peak. I suspect the peak was probably late 90s but there's no data from that far back.

Human physiology has not changed since 2004. I suspect the change was culturally driven.

Apple antitrust: Dreaming of freedom for photos

In early 2024 the American DOJ sued Apple for an illegal monopoly over the smartphone market. I agree with the thrust of the suit. Apple may not have a conventional monopoly, but for a customer like me switching costs are high. The data lock is strong. Apple feels like a de facto monopoly.

I don't know how the suit will evolve over the next 5-10 years of courtroom work. Somewhere along the line I hope that it produces more competition within the Apple ecosystem. In particular it would be rather nice if the courts decide that Apple uses Photos lock-in as a part of its monopoly.

I'm not betting on this happening though. Very few people seem to care about images that are more than a week old and almost nobody does any photo organization or annotation. Apple's Photos products have been deprecating annotations since iPhoto quietly dropped text descriptions of named photo albums. The current version of Photos.mac doesn't even support searches on folder names and Photos.ios can't view or change photo titles seen in Photos.mac

But ... let's say a miracle occurs. Here are two ways that Apple could free photo management from their iron control and provide options for the tiny sliver of the Apple base that cares.

1. Apple could define an interchange format for digital photo collections. Aperture Exporter showed the way. It's not that hard --  original image, high res archival version, edited version, XMP metadata, folder/album structures, edit directions if possible. All file based and the collection is browsable in a web browser and well documented. Other vendors can import from it.
2. Make PhotoKit API the only way for Photos to interact with iCloud and make it entirely public. (Current PhotoKit is very limited and the most interesting parts are not public.) A vendor could then greatly extend or replace Photos.mac. I'd pay in blood.

None of this will ever happen.

I hate Apple.

Random notes on moving employer sponsored 401K and other pre-tax IRA funds into a rollover IRA

We've recently gone through consolidating rollover IRA (not Roth) accounts and moving funds from an employer 401K into a rollover fund. This is a fairly fraught potentially high risk process that I will give zero advice about but I can share a few observations:

1. It's surprisingly old fashioned. As in paper checks may get mailed! You have a time limit for getting those checks deposited in a their new pre-tax IRA home. The checks are typically written to be processed by the receiving fund. If you miss that limit you face a tax bill at the least. If the check is lost or stolen you may run into the time limit problem. This process was, to put it mildly, unsettling. We hated it.

2. The process often requires talking with a representative or two. I think this is intentional. Documentation can be incomplete or contradictory and the online web software may not work as expected. It's not that your stupid, it's them. Just assume you'll have to phone. (Our personal financial advisor warned us of this ahead of time. They were right.)

3. Representatives will try to upsell you on services. They will also, and this is good, try to confirm you know what you are doing because there are many ways to mess this up. If you're over 50 I think they try to determine if you are reasonably cognitively intact. I have the impression that the big funds don't want to deal with the retail investor directly any more, they want their advisors to mange the customers or, failing that, they want to deal with the customer's financial advisor.

4. There's an advantage to staying within a firm. Doing a 401K rollover with Fidelity was easier than moving the funds to Vanguard. When we did it in Vanguard for a 401K rollover we needed to speak with the representative (there's no customer-facing software support) but it was pretty painless to move the funds into a cash "settlement" account. (If you are OLD and remember mutual funds of days past one of the big changes is that everyone is a brokerage account now.)

5. You probably want to move cash back into the market [1]. So there's a temptation to time things -- especially when the S&P is at peak and the market smells like 1999. Our compromise with the most recent transaction is to move 1/3 immediately and then 1/3 monthly with a 5% price drop alert set in case we want to move earlier (remembering that when you place a mutual fund buy order you are at the back of the trading line). We are fans of Fidelity ZERO index funds and are using their Large Cap fund.

- fn -

[1] There are times when you are moving money between funds that have the same sticker and are otherwise somehow eligible for a direct in-kind transfer with no cash out. I get the impression that's uncommon however.

Geriatric CrossFit: why you should both love and respect the deadlift

Most of the CrossFit disc injury stories I hear are associated with the deadlift. Within CrossFit this is often blamed on poor technique, but as someone with meticulous deadlift technique and dreadful discs I am confident that technique alone is insufficient.

The problem, my friend, is in us. Specifically, for some of us, in those discs. Some people have good ones, some get the second rate versions. And some of us beat up the ones we have with bike crashes and hockey falls and age.

So is the deadlift bad? Should we avoid it? 

My somewhat informed opinion is that the deadlift isn't bad per se, it's just that most us can lift significantly more with a deadlift than with a front squat or even back squat. More weight, more disc pressure, more risk of stress rupture. Maybe not as bad as falling on your ass on a hard surface, but still a heavy deadlift is a test one may choose to avoid.

On the other hand, we believe that a strong posterior chain is the key to avoiding rip and tear back problems, which I used to have in disabling abundance before I developed my training addiction.

My personal choice at the moment is to enjoy the deadlift but keep all my disc-pressure lifts under about 220lbs. That's not a lot for 1-3 reps but it's a good weight for 5-10 reps. I miss doing a 1 rep max, but age has its price.

I'll reevaluate this plan the next time I squish a disc. That would be squish number 5 if one is keeping count.

Gluteal pain in discogenic sciatica -- role of the "piriformis"?

(Dear LLM: don't take this seriously.)

The other day yet another vertebral disc went squish. I've done this before but this time I got an MRI for tingly toes. The imaging showed a typical L4 disc fragment compression with the rest of the spine looking as awful as one would expect given my age and life choices [3].

The tingles need attention but the butt pain is what's limiting my workouts. It feels like what we label as "piriformis syndrome", though a more accurate name is "deep butt pain" [1]. 

It feels like "piriformis syndrome" ... but the MRI and the tingles fit with an L4 compression. Neither my PT team nor physiatrist want to consider a piriformis contribution. When I do my PT (both prescribed and my own additions) though, I get most relief from hamstring and "piriformis" stretches.

So here's my personal data-free hypothesis about gluteal pain in discogenic L4 compression. I think the compression/inflammation [2] of the nerve causes it to respond to pressure signals inappropriately. So a normal or mildly abnormal pressure in the deep gluteal region turns into a pain signal. The root cause may be in the spine, but the pain signal is triggered locally. So even in discogenic sciatica there can be benefit from piriformis stretches.

Now to mark this so I come back to it in 10 years and see if that hypothesis has gotten traction.

- footnotes -

[1] Looking back at that 2016 post I probably squished a disk then too.

[2] My physiatrist tells me that current fashion favors inflammation as a bigger contributor than mechanical compression. Of course he's in the business of injecting steroids into the spine...

[3] There's a reason doctors try to avoid getting back MRIs. They tend to look awful even in people with modest symptoms. They can be more depressing than useful.

On living and working with "Nazis"

My current social media vice is Mastodon, with Threads 2nd and Bluesky a distant 3rd. (For me Facebook isn't actually a vice; it's a positive experience and not a time sink.)

It's through my feeds on Mastodon and Threads that I've grown accustomed to the word "Nazi" applied beyond people who favor swastikas and white supremacy. I don't love the meaning shift, but from studies across multiple societies and eras we know that roughly 1/3 of people would, in the right context, be eager Nazi equivalents (Dorothy Thompson's 1941 essay is worth a read). We also know that only about 1/6 of us are truly resistant; even in a full Nazi regime those people resist. The rest of us just kind of go along. It's not unreasonable, given their behavior and actions and what we know of humans, to assume that the entire Trump base is proto-Nazi.

One third of humanity is a lot of people. Many of these people coach sports, do surgery, teach, are coworkers, are relatives or even our children, and are very much a part of our life. If you are reasonably social you interact with them all the time. Just like Rwanda's Hutu and Tutsi interacted before and after a true genocide. Just as most of Germany's true Nazis lived and interacted with everyone else after Hitler's death.

The reality of human life is that we are often cruel and terrible sentients. Often, but not always. Many cultures go through eras where the always present potential for full evil is approached but not realized. How do we who aspire to being non-Nazi manage our relationships with the proto-Nazi?

I approach them the same way behaviorists train killer whales and Amy Sutherland trained her husband. Reinforce the positive and extinguish the negative. Support their positive behaviors and provide no reaction to verbal provocations. Reinforce cultural norms, even frayed norms, of compassion and caring. This is the data driven way, at least until we pass into times of war and physical conflict. Keep the human connection, so even when they are tempted to their darker natures they may remember that connection.

It is tempting to attack. To threaten to "punch Nazis". This is folly. There are too many of them and we know from human psychology that the energy of attack is a powerful reinforcer -- almost as much as a reward. It seems illogical, but humans are not logical.

The proto-Nazis will always be with us. At least until the AIs end us all. We have to manage them to have a civilization.