The other thing is when it comes over the intercom: Forget about Freeman! Anyone still down there is on there own!
The worldbuilding in Half-life was so good. You weren't a character walking into rooms and enemies would attack you, like Doom and Quake. There was a big event happening, and you were just a part of it.
This idea is the natural conclusion of interventionist medicine culture where preventative measures and working the root causes are both disliked.
It has been shown, for example, that statins prevent much of the heart disease that kills middle-aged people, but this medication needs to be taken for decades before. And yet in many countries, although it is a known fact and statins are safe, doctors don’t prescribe it until people have heart failure and it won’t help much anyways.
Our approach to pain management has also shifted a lot in the last 2-4 decades. Managing pain was about finding the root cause and treating it. Now its about hiding the symptoms with paracetamol and ibuprofen.
Exercise is a known and very effective treatment for obesity. Many cultures in the East accept it and group exercises in public are common. We in the West also know the science, but more often than appropriate make fun of Asians exercising in the parks every morning. Then we medicate for all the symptoms of diseases that obesity brings. Doctors do not even prescribe exercise to most obese people. That is a prescription which is very effective with $0 monthly costs.
The goal is not quality of life. It is not to prevent disease, or to holistically treat it. The goal is to do interventions to prevent death.
And maybe that’s more liberal in a way — people can live their lives more consequence-free, enjoy unhealthy habits, and know that some % will be bailed out of their coffins just before things get bad enough. Ozempic is such a bail-out.
Yes, Ozempic is an effective drug in reversing obesity. It is a great drug. It will give people back many years of their lives that would have been lost to obesity. Maybe it is even as effective as good exercise habits, which cost $0 and have about 0 side-effects. It is definitely not a better option than exercise for most of the population. But if it’s the only option possible in our healthcare culture, then it is still very valuable. It just won’t end the obesity epidemic. A health culture that only prevents death simply does not concern itself with improving the quality of life.
Unfortunately, we are also quite proud to have such a dysfunctional culture.
> Exercise is a known and very effective treatment for obesity. Many cultures in the East accept it and group exercises in public are common.
The second sentence. What does this mean? Are you talking about elderly Chinese people doing Tai Chi? It is neither building muscle (resistance training) nor improving cardiovascular health. Sure, it might help with mental health, like yoga, but not for muscles/heart/lungs. And the rest of "the East"? Have you seen India? There are an incredible number of obese people in that country. I would guess that Korean, Japanese, and Vietnamese have lower obesity rates because of portion control and caloric density in their traditional diets. However, in the urban populations of Korea and Japan, obesity is rapidly increasing as processed food increases in their diets.
I was not taking about specifically Tai Chi. But I remember from public health classes in medschool that it is known for increasing flexibility and mobility, as well as improving balance and reducing falls in elderly. I also remember something about backwards walking/sageru exercises in Japan, but it is difficult for me to find much online about it.
I was talking about the broader culture that values Tai Chi. Tai Chi is one of “morning exercises” in China. Others include just walking. But my point was about a culture that incorporates morning exercises as a norm. Japan has “radio taiso”, which is a similar phenomenon. I think the West had a similar culture in the 80s and 90s. I was actually growing up in the Central Europe then, and it was normal in elementary and middle school to start the day with a 30-minute exercise lead by school staff.
I don’t know how to label this culture but “culture where it is the norm to exercise daily”.
Yes, as you say, obesity also has many, many other causes. And many other cures. It’s definitely not so one-dimensional. But exercise is very effective, and a culture that promotes exercise daily for everyone, at all paces, would benefit us a lot in the West.
I think people tremendously underestimate what 30 minutes of daily body weight exercises like push-ups, squats, and sit-ups, plus a little bit of walking can do for the said weight. There are many, many technology workers that now just work from home and barely walk at all. Not the majority, but many. There are many more office workers that just commute to work with their cars and never walk more than that demands. In that context, 30 minutes of morning exercise is quite a lot.
Yes, exactly right. Because they don’t work that well in this interventionist mode when they are prescribed to already treated patients.
The study you shared talks about primary and secondary prevention in a clinical setting. So this is for people who either have heart disease or are likely going to develop it. At that point, it seems like it is already too late and I would say primordial prevention[0] is better. When I say prevention, I speak as not a medical professional, and I mean it in the common sense of the word, which aligns with primordial prevention.
There seems to be extensive research that they work well if prescribed preventatively decades in advance, and it’s covered in a few recently popular books by doctors on the topic of lifespan vs. healthspan. For example, Outlive: The Science and Art of Longevity by L. Attia.
Moreover, the study you quoted shows a 9-29% relative reductions of the outcomes. About 1% is absolute. For the entire population, 1.3% fewer will die from a myocardial infarction. But it is a 29% reduction in the sub-population that would die from it. And those are fantastic results with only primary and secondary prevention. Unless I misunderstand something.
The study you provided is relevant and valuable for critical reading of such books as the aforementioned. Thank you.
The healthier answer simply isn't feasible, unfortunately: it means bulldozing the suburbs, confiscating most cars and handing out bicycles in exchange, and building new, walkable cities and forcing Americans to live in them. Also needed would be strict regulations on food quality, and banning some ingredients.
The drug may be a band-aid solution, but if it actually works for making people lose weight, it's better than telling them to eat better and get more exercise and then being shocked when they don't.
I very strongly disagree. Fixing our food, transit, and social systems is absolutely worth it. There are very simple measures we can take like offering a subsidy for e-bikes like we do for electric cars that would get more people outside. Taking measures to make more healthy food more accessible to people who need it would absolutely be worth it.
Cities all over the country are already assessing which roads can be converted from four lane stroads to two lane streets with protected bike lanes on either side. We can provide federal funds to encourage more of this.
Weight isn’t even the only problem with our culture. Being stuck in cars and eating unhealthy food also affects rates of heart disease and depression. Making those people lose body fat might help with those factors, but I suspect it would do so less than actually making healthier food options more accessible.
For those that really feel medication is their best choice, when we have made sure other options are available, we should also offer free medical care to all people. But that should not be the primary solution to this problem for most people!
The "simple measures" you name are things that require political will, and America doesn't have it. That's why these things are infeasible: American voters have to want them, and have to elect people who will enact them. They're not going to do that, outside of a few select municipalities (where obesity probably isn't a big problem anyway, because the people there are wealthy and educated). Even worse, America is almost certainly going to elect Trump for a 2nd term; the country is swinging conservative, so these "simple measures" you name definitely aren't happening any time soon. Look at NYC for instance: the Democratic state governor just scrapped their congestion charge program, so living in blue states and electing Democrats isn't any kind of guarantee of positive change either.
Honestly most of the stuff I mentioned is pretty in line with Bidens infrastructure plan which did actually pass! But even if you say my proposal is pure political fantasy, so is giving everyone ozempic. If we’re actually going to dream of fantasy proposals, “give everyone drugs to mask one symptom of our many problems” seems to me an impoverished fantasy.
It’s not the cars and it’s not the walking. Ignore the unique cities like LA and NYC, and daily suburban life is the same in Santa Clara or Little Rock or St. Louis or Charlotte. But some cities are full of morbidly obese people, while some (e.g. Bay Area, where you drive everywhere) have basically none of it.
Also exercise really doesn't burn as many calories as people think. You usually need to work out as much as a pro athlete or olympian to burn a noticeable amount of calories from exercise. The reality is that a lot of Americans just eat too much.
Building walkable cities (at large scale) in the US is impossible. Not because of physics or resources, but because of politics and American voters' preferences.
Sure, there's a small portion of the electorate that wants this, but they're a minority and not powerful enough to get real change outside of a few localities.
100 years ago the US had ~76m inhabitants - a fifth of what we have today - plus horses and buggies were used broadly throughout the country. The streets in our older cities weren't born from nothing but aether when cars were invented.
I'd dig one deeper and look at the reasons why it's "not feasible" and the change that first. If people propose "national emergency" as a solution, clearly such options should be on the table.
It's not feasible for various reasons, but they mostly boil down to "political will". There's two main causes I see: food/nutrition, and lifestyle (i.e. not enough exercise, and using cars, which is caused by urban design). There simply isn't enough political will to make any significant change on either of these fronts. Don't forget, the US is almost certainly going to elect Trump for a 2nd term, so obviously there isn't going to be any positive change in either nutrition or urban design for quite some time.
So, basically the US electorate chooses to be obese? If so, the underlying question is: why do they choose this?
I can think of several reasons, but to me the most obvious cause is "runaway capitalism", where a few big corporations lobby and market and (mis)inform, to make people think this is what they want, just so they can sell more cars, sugar, processed (high marging) foods and so on.
Not to make this an anti-capitalist rant, to be clear. Just that I'm fairly sure we're seeing a clear limitation of "free markets", where people simply aren't the rational homo-economicus that many promised we'd be.
There's tons of healthy food options available to consumers these days, even in regular supermarkets. They all have "organic" food aisles now. Some Americans have become more conscious of this and have adjusted their diets. (Of course, there's also some companies trying to profit off this unfairly, like advertising "gluten free" on foods that would never contain gluten anyway, and also pushing gluten-free foods as "healthier" when there's really no evidence for that, they're healthier of course for people with a gluten allergy or sensitivity but that doesn't extend to everyone.)
In a democratic society, it's the people's responsibility to be educated about issues, so they can vote accordingly. Most Americans are making conscious choices to eat bad foods, not exercise, live in suburbs with car-dependent lifestyles, etc. They could move to inner cities and/or push locally for more density and anti-car measures, but they don't, outside of a few select places.
Instead, a large chunk of American society "educates" itself about conspiracy theories and the "importance" of guns and religion, and votes accordingly, and what you get is the society you see now.
Why? It works and is (so far as we can tell, except for a few exceptions like thyroid cancer) completely safe. It would have immediate results. Sure, it would be better to fix the root causes. But we are so far from being in a position where that is feasible.
The general consensus seems to be that obesity is not lifestyle related, those affected can't do anything about it, and the only option is taking a drug (that has other severe side effects imo).
Caloric restriction and exercise of course do not work because thermodynamics are subjective.
Describe as you see it the process and ideal timeline that sees every 500lb and under American lose weight and regain the health benefit that comes from it.
Do you support the use of statins and diabetes medications in this population for this process or do you consider that cheating as well?
This sentiment was was represented in probably any generation ever.. fact is we don't have any clue what will be in 50 years.. be it a positive or negative development.
I've talked with applicants about their private projects. It gave me great insights. Also take home tasks with a discussion afterwards are a good thing and can be an alternative if candidates don't have private projects to talk about.
Theoretically, I agree these are a great way of generating some signal where there's not enough to be found by other methods. But, in practice, what I've found is that most of these types of exercises are way overscoped, and even those which are not put a hugely disproportionate time burden on the candidate with minimal return for most of them. In other words, nobody wants to take the time to properly review these things.
I've had much better experiences when people give me code and ask me to review it rather than when they give me a "spec" and ask me to write code based on it. One big red flag for the latter type of assignment is the phrase "production ready," as that can mean so many different things it's a borderline meaningless criterion.
I could really go on and on about this, but I'm going to stop here.
I absolutely agree with you. There are many take home tasks that are way overblown and expect too much. But I am convinced that you can scope it for say 1-2 hours and I think that's a reasonable time investment for an application.
And yes the interviewer has to review that stuff and ask good questions but nobody said this was easy. But for me it showed better outcomes than the usual live leet code interviews.. (I did them too).
Even in the US, "$400k" is almost certainly an outlier and not the typical case. Ever notice how people making these claims never provide data about actual comp distributions? I've been an engineer for almost 10 years and never had an offer come close to $400k per year.
Everyone on HN knows someone whose brother's uncle's girlfriend's nephew's former roommate works at Facebook and made $400K as a developer. And they'll point to that one person and say "See, it is possible to make $400K in tech." Yes, it is technically possible, just like it's possible to do plenty of difficult things. That doesn't make these salaries common. For every 1 person making $400K-800K at FAANG in the Bay Area, how many dozens are working outside the Bay Area and/or for some no-name company making $120K?
I dunno man. A good third of my class seems to be working at FAANG and we're all from an unremarkable university in Eastern Europe. I'd imagine the prospects are much better if you start in the States already.
The official estimate of software developer positions in the United States was 1,656,880 in 2023.[1] 10% of that would be a high estimate of FAANG software developers in all countries. And most in those companies make less.
It probably depends. I know at a very senior level in a lot of companies, you can hit a base salary around half that for Staff/Principal positions and some Architect roles, especially in higher paying areas. The value of stock offerings and other compensation, bonuses etc will vary a lot though. You may grind out 5-10 years to reach that level, then 5 years to fully vest at half that pay to see a $1M stock payout at 5 years bringing the average to $400k. Who knows. Different arrangements work differently.
As an aside, when the market is relatively good, don't be afraid to straight up ask where compensation is on given roles when recruiters reach out, or to ask for more than you think you might get. You're pretty unlikely to get $400k or anywhere near it as a base... but you'd be surprised how reachable say $150k+ is as a base salary for a remote position when you aren't in SF or another major/expensive city.
It's the typical case for Bay Area-HQ tech companies, at essentially all levels for Tier-1 companies, higher levels at Tier-2/3 companies, and specialist roles beyond that.
"software engineering" doesn't print money any more than being "in finance" does, you'll make more or less depending on what company you do it for.
The numbers are real. I was in a similar incredulous position 4-5 years ago. Hiring is still relatively weak, but you can always try to get an offer yourself. Or even just talk to and ask recruiters; they have no reason to lie. You don't have to take your cousin's girlfriend's uncle's word for it.
A giant proportion of developers have no idea wtf “levels.fyi” is and are quietly writing Java or some shit in some suburban office park in a city you wouldn’t ever bother to visit, for $80k-160k/yr.
I often think about what you could learn from trying to run games back in the old days. It was a huge motivation to fix some problem to get a game running. Optimizing the memory in ms-dos because the game needed more etc. Most often getting a game was a journey on its own.
Today kids just have 1 gazillion games on their phone. There is no more connection to the system beneath. No work or effort needed. Just download and play the next best thing.
Today's kids also play Roblox, Garry's Mod, Minecraft and Fortnite, all of which allow them to create their own games and tools and write code alongside it, like Verse for Fortnite [0], LUA for Roblox [1], IDK what language it is but there's something for Minecraft bedrock edition [2] and of course the old Java edition, and also LUA for gmod.
This is how thousands, if not millions of people will have their first foray into coding, and it's a much, MUCH larger amount of people that get in touch with the deeper levels of tech than "our" generation had.
Don't underestimate "this generation"; don't generalise them either by trying to state they only spend mindless time on their phone.
This is a good point. If I would have grown up today I would possibly have done other things that aligned with the same kind of interests, and perhaps even have gotten further. Kids these days can, and do, build actual robots and UAVs with onboard processors with more FLOPS than you could even dream of back in the old 75MHz pentium days.
And this is why I setup a mister fpga running an atari st for my 3 years old son's first foray into using his own computer. Eventually, we can also use the 486 core to run ms dos :)
I think old computers have a certain amount of simplicity that I think make the user less passive when using them. I also think that older games tend to be both less addictive and leave more to imagination.
Of course that won't be sustainable forever eventually he'll be influenced by his peers to play whatever they're currently playing but I'm hoping that having been exposed to older computers will be beneficial.
The biggest culprit was the cd-rom drivers and the mouse driver.
Our PC “only” had 4mb of RAM which was the minimum for Doom, but exiting Windows into DOS after boot left a lot of cruft in memory.
The first time I tried starting the computer and bypassing autoexec.bat (which I learned from reading on a BBS) I was scared it was going to be permanent. Luckily it wasn’t.
All I can think about was trying to muck with IRQ conflicts or messed up awful windows 95 drivers later on to get my game working. I'm not sure I miss either of those much but I also switched to Windows NT early and kept an old decked out Pentium 1 for dos games that ntvdm wouldn't play nice with.
Nodding though, oh man that got me into developing things like you wouldn't believe.
Quake 1, 2 had a huge community around coding or map making. Tribes 2 was absolutely all about mods. Command and Conquer with it's rules.ini or StarCraft with its gui scripting stored in map files I spent so many hours messing with. It was all about making something crazy to show off when you went back to school or later to a lan party to wow everyone.
When I was young, my parents bought me a copy of X-Wing (CD-ROM) for our Win95, Pentium 100 machine. My parents were not computer savvy, and being only 13 myself, I didn't know much about computers. My dad couldn't get it to work, and so the box sat on the shelf for months, maybe even a year. (Time's warped when you're a young kid. =P ) I'd leaf through the manual and gaze longingly at the box art, and look through the little technical leaflets that were included. The latter of which may have been written in hieroglyphs. I set it aside, played the Descent demo over and over that came with out PC, and surfed AOL.
I kept learning more about the computer in the meantime.
One day I was performing my old ritual, when I noticed one of the paper leaflets in the box. Rather than being hieroglyphs, I knew now what it was saying. X-Wing needed DOS EMS (Expanded memory), and this paper was telling me I needed to edit CONFIG.SYS on Windows 95 machines to get this to work. My parents had forbid me from touching anything in the "WINDOWS" folder (there be dragons, according to them) and after having wiped a lot of my mom's files on our earlier Tandy, they didn't want me messing with things I didn't understand that they couldn't fix.
But I was confidant. I edited the file, and hoped for the best. The computer restarted, and just as I'd done countless times before to no avail, tried to start up the game.
Listening to the Star Wars theme play MIDI over the speakers, I jumped up, ecstatic. It was late at night, and my parents were watching TV in the living room. I ran downstairs. "I GOT X-WING WORKING!!!!!!"
It was a feeling of accomplishment, that to this day I look back on and say "that's when it started". I think I knew it then, to some tiny degree, that this was going to be my path.
I'm 40 now. I'm a solutions architect at AWS. My computers were all built by me. And my X-Wing box sits on my shelf still.
I've talked with my niece, and with some other kids over the years about their gaming, experience with PCs, and the like. There's not much to figure out. I don't blame them; I don't shake my fist at these kids. After all, I recall the frustrations too. Building PCs that wouldn't start for no reason (well, this still happens), the unreliability of early home routers. Many early games that just wouldn't start on your PC but run just fine on your buddies. I remember LAN parties with my colleagues with a combined technical know-how in the room of several CCNAs, MCSEs, etc, and we still can't get our Unreal Tournament server to be seen by everyone's PC. Don't get me started on copy protection woes.
But there was a joy in finally getting it working, and through the stress, we learned a lot about how it all worked. The current internet and computer environment doesn't have that in that you need to know how it works in order to enjoy it. I wouldn't reverse the state of affairs; things are much more mature and stable now. And it's not as simple as saying "well go off and do these projects". We can motivate some to do so as a stretch, but nothing was motivating the same way as sheer necessity like we had it.
So I see it as just something to observe and note and appreciate for how we had it then, both maddeningly frustrating yet glorious in how genuine and unrefined it all was. Hopefully later generations will find their own versions of what we experienced.
I'm glad to have lived through it. It kick-started a love of computing and a lifelong career.
And then the company just lays off Bob and Jane and thousands of others. Now Jane is angry because she committed a lot of her personal time for the company but was laid off anyways..
