I'm a huge physics nerd. It fascinates me. I consume so much pop physics stuff on a regular basis. Can't do the math, but I love it anyway. And one fundamental principle in physics is that theory is useless until it is confirmed experimentally. Experiments are the key to everything. And medicine can't do them. Clinical trials are the closest they can get and they are so incredibly mediocre and inaccurate compared to physics experiments, literally many orders of magnitude off. Thus they have no real ways of validating their models. Only experiments where all other things are equal can do that. It would help so much if they could accept this. It would invalidate the whole of psychosomatic medicine, and a lot of models. And it's probably too much to bear. But science needs experiments, and medicine is the worst discipline to do those, so they're stuck with having to do things differently, but choose not to. For years we heard the same claptrap from the ideologues about how they're not saying this, the trials prove it. Of course they said it first, for many years. And since the trials have been largely invalidated they're back to simply asserting it, while pretending that the trials still hold. This is the real problem: sticking to what's wrong. Being wrong is fine. Sticking to it is unacceptable. Make a mistake and learn from it. But don't repeat it. Not even once. And we face much of the same as programmers, where debugging is very close to an investigative-diagnostic process. That was always one of my biggest strengths. You need accurate immediate feedback. If it's not immediate, it at least needs to be accurate. And seeing how all-over-the-place clinical trials, medicine is very poorly equipped to debug, made even worse the stubborn refusal to listen to a damn thing patients tell them, most of the time anyway.
@rvallee will be well familiar, but for non-programmers, there's a term called "caveman debugging" (perhaps now more inclusively termed "cave-dweller debugging"). Crude but effective, leading to the programmer exclaiming "ugh, me done bad", which is why I think the term was coined. The idea was simply for the program to do its thing, but to also print out what it was doing and when into a text file log, so you can see where it was and what it was doing leading up to when it crashed or misperformed. Patients have this facility built-in. Nearly all of them will tell the doctor what is happening to them. The problem is on the medical side where the "programmer"/doctor often simply refuses to even read the logs to correct their error in coding - or in this case their medical management. I.e. GET works roughly like this, in old-fashioned pseudocode — 10 distance = 200 20 go_for_walk(distance) 30 distance = distance + 100 40 if distance > 5000 then print("patient is cured"); exit 50 goto 20 But in reality you've actually got this — 10 distance = 200 20 go_for_walk(distance) 25 print(report_whether_symptoms_better_or_worse) 30 distance = distance + 100 40 if distance > 5000 then print("patient is cured"); exit 50 goto 20 So if you read the log you might see the "program" reporting "I'm getting worse" (even if it started off with "I'm getting better"). So you'd know to add another line to your GET program for safety — 10 distance = 200 20 go_for_walk(distance) 25 print(report_whether_symptoms_better_or_worse) 27 if report_whether_symptoms_better_or_worse == "I'm worse" then print("patient is non-responder - program failure/unsafe"); exit 30 distance = distance + 100 40 if distance > 5000 then print("patient is cured"); exit 50 goto 20
A few lifetimes back I dabbled in writing processor code in hex. Frequent printouts of the code was a big help in tracking what was going on. So much easier to keep track on paper than in your head.
WOW One word in these three sentences on this thread in particular, combined with watching other discussions recently, has led me to what I believe is the last link in the chain that are the events of 2023 - which explain the situation we are now in. That word is 'code'. It impacts Singapore, Australia, Canada, USA, Ireland and the UK who share similar laws. I now have to read through a 300 page document so I may be out of the global tent for some time! But, I think it leads to a credible, fulsome and enforceable argument to counteract the push back across several areas which people with ME/CFS are experiencing. The art of patients listening to other patients evidenced here in practice. I'll be back. Thank you @Sean
LOL. As a former programmer myself many, MANY moons back, this is a good analogy. No need to possess the pesky logic to write a program that works correctly, instead just stick their own beliefs in it and write EXIT.
