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_thoracic  ·  640 days ago  ·  link  ·    ·  parent  ·  post: Cape Town runs out of water on April 22.

What do you foresee happening when/if the water runs out? The assumption seems to be that it'll lead to sizable unrest, at a minimum. What are your thoughts?

DWol  ·  640 days ago  ·  link  ·  

Perhaps. It will depend so much on the implementation. Keep in mind that about a fifth of the city already receives their water through communal taps which is essentially what will happen for everyone. I also think the fact that it has been approaching so slowly means it will be more... orderly - at least in contrast to other disaster scenarios where everything happens at once and authorities are left scrambling. I can only speak for myself but I have made peace with having to queue for water and I guess most others people have too.

    ...when does a person accept that their ambition is leading them in the wrong direction?

    I think there's an important difference between hardship due to you being on the wrong path, and hardship due to bad conduct by people with power you encounter along that path. I also think conflating the two smacks of victim-blaming, so getting the difference right is important.

      For example, say a medical student is distressed because an attending physician frequently overreacts at small, med student-type mistakes and berates them mercilessly. I think we could all agree that the problem here lies not with the student's ambition of being a doctor, but with the attending's poor temper. If the student can't overcome their distress at seeing blood or other bodily fluids, then the problem is with their choice of direction and the fact that their capabilities don't match their ambition.

        In this case, Bond's ambition to be a lawyer doesn't appear to be the problem. The problem is a judge like Kozinski who would take advantage of his power over his clerks' careers.

          I think we need to be careful not to roll human misconduct (sexual and otherwise) into the list of things that we accept as obstacles to achievement. There is a point of distress and suffering where a person should stop and reevaluate if their ambitions and choices aren't right for them, but we shouldn't accept it when the malice or misconduct of a person's superior leads them to that point.

          One of the most frustrating things about working in healthcare, for me, is the assumption of conspiracy. The idea that because I wear scrubs and hand out bandaids, I'm in on some grand scheme that entraps people into unnecessary/harmful treatment, (or purposefully denies them necessary treatment) is a recurring theme among patients and the public. It's incredibly frustrating.

            Part of the reason it's incredibly frustrating is that I too get the gut feeling that there are bad actors in the healthcare system. Hell, it's not even a gut feeling, it's frequently proven to be true (Looking at you, Purdue, Mylan and Kaleo).

              But because the average person's contact point with the healthcare industry is a primary care doc, ER staff or EMS personnel, and not insurance or pharma execs, us grunts get tarred with the same brush. And let me tell you, we didn't go into these jobs because we have a sadistic interest in hurting you for cash. There are more lucrative jobs that are easier, require less training, and involve much less poop.

                To get around to my point: Please don't treat the American College of Cardiology and a thuggish life insurance company as the same entity. Believe me, those of us on the other side of the stethoscope think insurance companies suck too. The cardiologists who worked on these revisions have doubtlessly each had countless conversations with patients trying to convince them that cutting some salt and going for a run once in a while will literally extend their lifespan, and have seen most of those conversations go nowhere. So now they're trying harder.

                  “We're recognizing that blood pressures that we in the past thought were normal or so-called pre-hypertensive actually placed the patient at significant risk for heart disease and death and disability,” said Robert M. Carey, co-chairman of the group that produced the new report. “The risk hasn't changed. What's changed is our recognition of the risk.”

                The intent here pretty clearly appears to be to try and get Americans to pull their heads out of the sand a bit and realize that we treat our bodies horribly. Hell, taking lower levels of hypertension seriously might even lead to stopping serious cases before they start, possibly reducing the number of new prescriptions!

                  Will insurance companies find a way to profit off of this? Probably yes, because they're run by scum. Is your average practitioner happily skipping hand-in-hand with them as they do so? No. And as mentioned:

                    The four main classes of drugs for blood pressure have generic versions and can be as cheap as a few dollars a month.

                  Probably not gonna be an oxycontin-style surge of scummy marketing for these drugs any time soon. And if the sudden surge in prescriptions you posit does come to pass, and some Shkreli type buys them and jacks the price, you can believe that among the first groups to yell about it will be docs and nurses.

                    It's not as simple as "Oh, hey, let's make more people hypertensive and write more scripts so that our buddies at Cigna can buy another boat". It's easy to play the cynic here and to plaster over the truth in the nuance, but sometimes healthcare providers do things because they care about people's health.

                    kleinbl00  ·  703 days ago  ·  link  ·  

                    I own a half million dollar medical facility.

                    My wife was a benefits administrator for a multinational employee benefits firm.

                    She is now a doctor.

                    Don't hector me as if I have no understanding of the dynamics at play. I've had to give over 9 months of my life creating 300 pages of documentation so that an industry lobbying group can charge me $7k so that an insurance company will underpay us by 50% rather than simply not covering us in network. Just because you wear a stethoscope does not mean you have a more refined or broader understanding of the medical industry.

                    FUCK the American College of Cardiology. They're the ones who lowered the cholesterol guidelines in 2004 to put more people on Lipitor. results were predictable.

                    Fourth paragraph in:

                      But the report's authors predicted relatively few of those who fall into the new hypertensive category will need medication. Rather, they hope that many found with the early stages of the condition will be able to address it through lifestyle changes such as losing weight, improving their diet, getting more exercise, consuming less alcohol and sodium and lowering stress.

                    Further down:

                      The guidelines suggest that doctors recommend lifestyle changes for people found to have elevated blood pressure. Those with Stage 1 hypertension should be assessed for their 10-year risk of heart disease or stroke under the parameters of a widely used matrix for cardiovascular health. Those with more than a 10 percent chance, or other complicating factors, should try medication.

                      “An important cornerstone of these new guidelines is a strong emphasis on lifestyle changes as the first line of therapy. There is an opportunity to reduce risk without necessarily imposing medications,” said Richard Chazal, the immediate past president of the American College of Cardiology.

                    A revision of hypertension guidelines with an eye towards encouraging better early lifestyle intervention seems like a pretty solid idea to me. I'm not seeing the drive towards greater prescription of antihypertensives that you are here. Frankly, with the amount of deaths from cardiovascular problems in this country (not to mention the preventable load on the healthcare system they create), giving cardiologists and general practitioners more leeway to tackle hypertension sounds like a great idea.

                    kleinbl00  ·  703 days ago  ·  link  ·  

                    You fundamentally misunderstand the health-industrial complex.

                    Increasing the number of hypertensive patients from 23% to 46% means increasing the number of medical conditions from 23% to 46%. That means doubling the number of people paying higher premiums for their medical conditions, which means a radical increase in the number of people falling into the high-risk pool. More than that, it means a radical increase in the number of prescriptions for heart medication.

                    I was refused a life insurance policy (which was required by our commercial underwriter) because a russian thug came to our house and read 128/70. The insurance company told me they would reconsider if I faxed them a copy of my prescription for blood pressure medication. Meanwhile, when I asked my doctor for a prescription for blood pressure medication, she refused because she measured me at 118/60.

                    The insurance company did not care.

                    Now - I sorta get along with my doctor. She's patient enough to take my blood pressure when I'm calm and haven't been surprised in the middle of having my coffee by a russian thug who shows up two hours early. But the insurance companies do not care.

                    _thoracic  ·  703 days ago  ·  link  ·  

                    One of the most frustrating things about working in healthcare, for me, is the assumption of conspiracy. The idea that because I wear scrubs and hand out bandaids, I'm in on some grand scheme that entraps people into unnecessary/harmful treatment, (or purposefully denies them necessary treatment) is a recurring theme among patients and the public. It's incredibly frustrating.

                      Part of the reason it's incredibly frustrating is that I too get the gut feeling that there are bad actors in the healthcare system. Hell, it's not even a gut feeling, it's frequently proven to be true (Looking at you, Purdue, Mylan and Kaleo).

                        But because the average person's contact point with the healthcare industry is a primary care doc, ER staff or EMS personnel, and not insurance or pharma execs, us grunts get tarred with the same brush. And let me tell you, we didn't go into these jobs because we have a sadistic interest in hurting you for cash. There are more lucrative jobs that are easier, require less training, and involve much less poop.

                          To get around to my point: Please don't treat the American College of Cardiology and a thuggish life insurance company as the same entity. Believe me, those of us on the other side of the stethoscope think insurance companies suck too. The cardiologists who worked on these revisions have doubtlessly each had countless conversations with patients trying to convince them that cutting some salt and going for a run once in a while will literally extend their lifespan, and have seen most of those conversations go nowhere. So now they're trying harder.

                            “We're recognizing that blood pressures that we in the past thought were normal or so-called pre-hypertensive actually placed the patient at significant risk for heart disease and death and disability,” said Robert M. Carey, co-chairman of the group that produced the new report. “The risk hasn't changed. What's changed is our recognition of the risk.”

                          The intent here pretty clearly appears to be to try and get Americans to pull their heads out of the sand a bit and realize that we treat our bodies horribly. Hell, taking lower levels of hypertension seriously might even lead to stopping serious cases before they start, possibly reducing the number of new prescriptions!

                            Will insurance companies find a way to profit off of this? Probably yes, because they're run by scum. Is your average practitioner happily skipping hand-in-hand with them as they do so? No. And as mentioned:

                              The four main classes of drugs for blood pressure have generic versions and can be as cheap as a few dollars a month.

                            Probably not gonna be an oxycontin-style surge of scummy marketing for these drugs any time soon. And if the sudden surge in prescriptions you posit does come to pass, and some Shkreli type buys them and jacks the price, you can believe that among the first groups to yell about it will be docs and nurses.

                              It's not as simple as "Oh, hey, let's make more people hypertensive and write more scripts so that our buddies at Cigna can buy another boat". It's easy to play the cynic here and to plaster over the truth in the nuance, but sometimes healthcare providers do things because they care about people's health.

                              kleinbl00  ·  703 days ago  ·  link  ·  

                              I own a half million dollar medical facility.

                              My wife was a benefits administrator for a multinational employee benefits firm.

                              She is now a doctor.

                              Don't hector me as if I have no understanding of the dynamics at play. I've had to give over 9 months of my life creating 300 pages of documentation so that an industry lobbying group can charge me $7k so that an insurance company will underpay us by 50% rather than simply not covering us in network. Just because you wear a stethoscope does not mean you have a more refined or broader understanding of the medical industry.

                              FUCK the American College of Cardiology. They're the ones who lowered the cholesterol guidelines in 2004 to put more people on Lipitor. results were predictable.

                              oyster  ·  703 days ago  ·  link  ·  

                              Ya, I read that part of the article as well just with a dash more pessimism.

                              When I was a very healthy fit teenage girl I was put on Omeprazole, a proton pump inhibitor for acid reflux with doctors making literally no other attempt to understand why I was having issues in the first place. My first doctor decided that if I started having issues yet again after stopping them we would look at actually trying to figure out what the problem was. He left and the doctor I returned too just gave me a prescription for a years worth of the drug.

                              And that’s the story of why I don’t trust doctors anymore. Actually just one of them.

                              _thoracic  ·  735 days ago  ·  link  ·    ·  parent  ·  post: Today's Writing Prompt: This Is What It's Like

                              Thank you! Glad you enjoyed it.

                              _thoracic  ·  736 days ago  ·  link  ·    ·  parent  ·  post: Today's Writing Prompt: This Is What It's Like

                              “This is what it’s like” says your instructor, watching you carefully for mistakes

                                      Training you on bandages, splints, and the cruel rhythm of chest compressions

                              Teaching you what kills right away, and what takes a while longer.

                              Telling you that sometimes all you can do is hold a hand and say something kind.

                              And you listen, wide-eyed.

                              “This is what it’s like” says your crew chief, pulling you up into the ambulance.

                                      Showing you streets, the bad stretches of interstates, the homes of frequent fliers. 

                              Reminding you to check pockets for knives and arms for track marks.

                              Relaying experience’s thousand little lessons, unteachable in the classroom.

                              And you listen, working hard to show your worth.

                              “This is what it’s like” say your patients, pointing to where it hurts.

                                      Screaming with pain, clutching an extremity turned the wrong way. 

                              Groaning and sweating, grabbing at their chest saying it’s just like the last one.

                              Lying still and silent, unknowingly trusting a stranger with everything.

                              And you listen, replying with soothing words.

                              “This is what it’s like” says your gear, speaking in clicks, beeps and error messages.

                                      The defibrillator whines its way up to 300 joules, saying it’ll try but no promises. 

                              The ambulance growls, bouncing and rattling over potholes as you try to start an IV

                              The BVM whooshes, fighting to push breath into a ruined airway.

                              And you listen, hoping that together it’ll make a difference.

                              “This is what it’s like” says the nick in your shears, bearing witness.

                                      Reminding you of that one, the one no one could have saved. 

                              Pulling you back into the dirt and blood of the scene, unbidden.

                              Making you feel old, far older than you should be by now.

                              And you listen, wishing you didn’t have to.

                              “This is what it’s like” says the calendar, slowly passing time

                                      Marking out your shifts, 12-hour gambles on what’ll come your way. 

                              Quietly telling you it’s almost time to renew your license again.

                              Studded with anniversaries you’d prefer not to remember, but can’t quite forget.

                              And you listen, stunned that it’s been this long.

                              “This is what it’s like” you say to the newbies, watching them carefully for mistakes

                                      Training them on bandages, splints, and the cruel rhythm of chest compressions

                              Teaching them what kills right away, and what takes a while longer.

                              Telling them that sometimes all you can do is hold a hand and say something kind.

                              And they listen, wide-eyed.
                              lil  ·  736 days ago  ·  link  ·  

                              Astonishing!! My last badge -- I wish I had more for everyone of these contributions. "This Is What It's Like" should be an anthology.

                              _thoracic  ·  735 days ago  ·  link  ·  

                              Thank you! Glad you enjoyed it.

                              If you aren't one of the people that Trump-ism threatens, then no, there's probably no tangible benefit to following his moves in detail.

                              But you should still do it.

                              I'm also tempted to greet the next four years with cynicism, and to reject the political game as worthless. That really doesn't cut it though. The Trump presidency presents an affront to so many ideals I hold dear that to ignore it out of fatigue would be to pretend I didn't hold those values in the first place. Given your reaction above, I'm assuming that Trump somewhat irritates you as well. Good. Don't let go of that. Don't ignore that.

                              Beyond doing it for yourself, there's also a duty to it. There's a duty we owe to the country; that we care for the institutions we've benefitted from all our lives, and that we pay attention so as to keep them honest and doing their jobs. Ignoring the news shirks that. Theres's a duty to other citizens, especially those who may be targeted or abused under a Trump administration. By choosing disgust over determination, we give up our power in the system and abandon them to whatever fate Steve Bannon thinks befits them. Lastly, there's a duty to keep others awake. To remind people that this isn't normal, and to keep making noise, even if it's screaming into a void. Because if you silence yourself, then you've done Trump and his kind's work for them.

                              So, at a bare minimum, please keep following the news blackbootz. Because it's not about any one of us anymore. Not to be too melodramatic, but the future of the country(possibly the world) could change drastically in the next four years. That's too important to tune out.

                              _thoracic  ·  1138 days ago  ·  link  ·    ·  parent  ·  post: Sci-fi club no. 11

                              I agree with you. To me, the basis of being a person is being able to choose and not being a slave to instinct. Further, I think life is a whole lot easier to deal with when you get to make your own choices and forge your own purpose.

                              That being said, people are far from ideal and some will choose poorly. But I still think they shouldn't be forced to choose better, because who can objectively say what 'better' is?

                              _thoracic  ·  1138 days ago  ·  link  ·    ·  parent  ·  post: Sci-fi club no. 11

                              Thanks, glad it made an impression!

                              _thoracic  ·  1141 days ago  ·  link  ·    ·  parent  ·  post: Sci-fi club no. 11

                              Copy and pasting my misplaced reply from the last post.

                              About The Giving Plague:

                              Reading between the lines of his unreliable narration, you can see Forry getting more and more altruistic throughout the piece, matching/exceeding the infected. But it's clear this behavior arises from a very conflicted inner process, in sharp contrast to the biological imperative that ALAS places on its hosts. This is underscored by Forry's final line, that suffering for others is what he chooses to do.

                              This presents a neat dichotomy between conflicted, cynical and extremely reluctant altruism, and altruism that's born of an unquestioned dogmatic drive. It seems to me that Brin's asking us which is better. If the behavior is the same, does it matter whether it arises by choice or by default?

                              By setting Forry up as a savior, it seems that Brin's saying choice is the better option. Then again, Forry is only a hero due to circumstance. If CAPUC hadn't cropped up, his choices would have instead led him to being a murderer and a thief. In contrast, the ALAS carriers contribute to civilization reliably and unfailingly, rain or shine, for years. So perhaps the message is that you need to have both. Dogmatic altruism can keep society slowly improving for years, but when shit hits the fan, you need the determination and drive brought by those who have CHOSEN to fight for their fellow humans.

                              I'd love to hear other people's thoughts! If you had the choice to keep ALAS contained or help it grow to a pandemic, which do you think you'd choose?

                              Dala  ·  1139 days ago  ·  link  ·  

                              I would say choice is always the better option, people just work better mentally when they feel that they have some control over their actions. This probably explains why the people in the story who become infected by ALAS try to become more altruistic outside of the blood-giving, so that they can tell themselves a story about their choices, and then maybe not feel so alarmed by their sudden need to give.

                              That said, I would personally be very tempted to take Les' view and let the virus spread, because people are jerks and could use a hand in being kinder to their fellow humans. And now I am not sure how I feel about my desire to turn people into puppets even if it is 'for the greater good.'

                              _thoracic  ·  1138 days ago  ·  link  ·  

                              I agree with you. To me, the basis of being a person is being able to choose and not being a slave to instinct. Further, I think life is a whole lot easier to deal with when you get to make your own choices and forge your own purpose.

                              That being said, people are far from ideal and some will choose poorly. But I still think they shouldn't be forced to choose better, because who can objectively say what 'better' is?

                              zebra2  ·  1141 days ago  ·  link  ·  

                              Cool. I meant to remind you to post this. Thinking about this did influence what I ended up putting for the "discussion prompt" blurb for this story.

                              _thoracic  ·  1138 days ago  ·  link  ·  

                              Thanks, glad it made an impression!

                              _thoracic  ·  1147 days ago  ·  link  ·    ·  parent  ·  post: Seattle's $20 Epipen replacement

                              Devac, b_b, you're both right. Prepping an IM Epi injection isn't super difficult, and some AlS(AEMT and paramedic)providers I know say basics should already have it. Five minutes to mastery is low-balling it though.

                              Where the difficulty would likely arise is in training a state's worth of basics on a new skill that involves sharps and one of the more powerful meds we keep on the truck. Given the potential complications like Devac mentioned, you want to be well practiced at it. Lots of my state is covered by volunteer EMS services that don't get a ton of calls, and even fewer anaphylaxis calls. Staying sharp with your sharps can be a little difficult in that kind of situation, but it will probably be ultimately doable.

                              _thoracic  ·  1147 days ago  ·  link  ·    ·  parent  ·  post: Seattle's $20 Epipen replacement

                              The cost of epipens really is hitting some ambulance services hard. In my state, advanced EMTs and Paramedics can draw up and administer Epi from ampules like this, but basic EMTs only have epipens.

                              There's some rumors floating around that our state protocols may change to let basics do it, mostly because an amp of Epi + an IM needle is ludicrously cheaper than an epipen.

                              I'm a basic and I'll welcome it if it goes through, but it's sad to see our protocols change based on med prices and not research.

                              kleinbl00  ·  1146 days ago  ·  link  ·  

                              That's the game, though. Whenever you have capitalists making money off of a social service there will be jousting across the 50 yard line.

                              - Army develops Mark IV as a way for total newbs to deliver life-saving neurotoxin antagonists

                              - Private sector spins that technology off as a way for total newbs to deliver life-saving steroids to prevent anaphylaxis

                              - Public sector adopts private sector solution

                              - Private sector sees monopoly opportunities, extends monopoly in order to increase profit

                              - Public sector bends under the weight of the private sector and adopts

                              It's like with cholesterol. Under heavy lobbying the cholesterol guidelines were lowered in 2008 right about the time a new class of statins came out. 13 million more people were put on anti-cholesterol medication. Those statins got more and more expensive and fewer and fewer doctors stuck to the guidelines so eventually the guidelines changed again. It's not like all of a sudden cholesterol was worse for you and then suddenly better; it's that all of a sudden, someone wasn't making enough money and then suddenly they were making too much.

                              enginerd  ·  1139 days ago  ·  link  ·  

                              Can't they switch to Adrenaclick? It's basically the same thing

                              b_b  ·  1147 days ago  ·  link  ·  

                              But seriously, how difficult is delivering a shot? You could learn it in five minutes. Epipen price is now reflective of regulatory arbitrage than any thing else. If I were in a situation where my life was in danger, if wouldn't care if a "basic" EMT administered my medicine.

                              Devac  ·  1147 days ago  ·  link  ·  

                                But seriously, how difficult is delivering a shot?

                              Source: my mother, recently retired medical doctor. You guys got a "Hello" from her by the way. Feel free to ask follow-up questions, just keep in mind standard disclaimer that this is not in any way a medical advice, just fact checking.

                              Intramuscular injections that are recommended for adrenaline/epinephrine in case of shock are up there among the easiest ways for untrained person to break needle. It's not common, but happens mainly due to lack of experience. Neither of us knows precisely what are the competences of 'basic EMT' in USA, but through know-how on IM injections is a must. Panicked person who probably does it for the first time in a life-threatening situation is much more likely to mess up than fairly used to it nurse or EMT.

                              Main problem with needle breakage is the fact that it can be brushed off as pronounced after-effects of condition that required fast administration of medications (seizure, anaphylactic shock). Muscle pain, general discomfort, muscle spasms or cramps (EDIT: and in case of anaphylaxis it can even potentially not show a typical immune response for foreign object) that often occurs after such situation can 'hide' the pain caused by needle tip in some cases. We don't know how it looks in USA, but in Polish hospitals it's among reasons why many routine procedures are done in pairs. For example one nurse preps the patient, the other prepares and makes an injection and in the end you have two sets of eyes capable of catching errors. In this case: procedural errors and results like the mentioned needle breakage.

                              _thoracic  ·  1147 days ago  ·  link  ·  

                              Devac, b_b, you're both right. Prepping an IM Epi injection isn't super difficult, and some AlS(AEMT and paramedic)providers I know say basics should already have it. Five minutes to mastery is low-balling it though.

                              Where the difficulty would likely arise is in training a state's worth of basics on a new skill that involves sharps and one of the more powerful meds we keep on the truck. Given the potential complications like Devac mentioned, you want to be well practiced at it. Lots of my state is covered by volunteer EMS services that don't get a ton of calls, and even fewer anaphylaxis calls. Staying sharp with your sharps can be a little difficult in that kind of situation, but it will probably be ultimately doable.

                              _thoracic  ·  1147 days ago  ·  link  ·  
                              This comment has been deleted.
                              _thoracic  ·  1147 days ago  ·  link  ·    ·  parent  ·  post: Scifi club No. 10

                              Ah, my bad. I'll get into the next thread when it shows up.

                              Good point on the 'true altruism' thing. That may have been what the author was going for. Funny what different people can get out of the same text.

                              Sorry, this comment is private.
                              _thoracic  ·  1148 days ago  ·  link  ·    ·  parent  ·  post: Scifi club No. 10

                              Just got through The Giving Plague, I'll take a crack at Allamagoosa tomorrow.

                              Warning, some spoilers for TGP follow

                              Reading between the lines of his unreliable narration, you can see Forry getting more and more altruistic throughout the piece, matching/exceeding the infected. But it's clear this behavior arises from a very conflicted inner process, in sharp contrast to the biological imperative that ALAS places on its hosts. This is underscored by Forry's final line, that suffering for others is what he chooses to do.

                              This presents a neat dichotomy between conflicted, cynical and extremely reluctant altruism, and altruism that's born of an unquestioned dogmatic drive. It seems to me that Brin's asking us which is better. If the behavior is the same, does it matter whether it arises by choice or by default?

                              By setting Forry up as a savior, it seems that Brin's saying choice is the better option. Then again, Forry is only a hero due to circumstance. If CAPUC hadn't cropped up, his choices would have instead led him to being a murderer and a thief. In contrast, the ALAS carriers contribute to civilization reliably and unfailingly, rain or shine, for years. So perhaps the message is that you need to have both. Dogmatic altruism can keep society slowly improving for years, but when shit hits the fan, you need the determination and drive brought by those who have CHOSEN to fight for their fellow humans.

                              I'd love to hear other people's thoughts! If you had the choice to keep ALAS contained or help it grow to a pandemic, which do you think you'd choose?

                              zebra2  ·  1147 days ago  ·  link  ·  

                              Cool! In the past we've had discussion in the following week's post, so that everyone's talking in the same post, but I won't stop you. Since we are changing some stuff about the formatting of the club this time around there may be some need for rearrangement. We'll have to play it by ear there.

                              For The Giving Plague, I hadn't really given much though to the choice angle of altruism given by the scenario. Forry was like the devil on one shoulder and Les was the angel on the other in the altruism/selfishness scale. We know from Forry's narration that he's always got his eyes on the prize and rules-out no deed that would help him get it. We don't truly know what's going through Les' head. Forry does become a saint though, it's all part of his carefully executed facade though. I think the story nudges you to question if there's any true alturism. After all, it's implied the infected aren't really made altruistic, but that they go through some mental gymnastics to define themselves as altruists given the urge to donate blood. Once you have an image of yourself, you go though steps to maintain that image. It's basically what Forry does in a way.

                              _thoracic  ·  1147 days ago  ·  link  ·  

                              Ah, my bad. I'll get into the next thread when it shows up.

                              Good point on the 'true altruism' thing. That may have been what the author was going for. Funny what different people can get out of the same text.