What Happened to Lee(wired.com)
wired.com
What Happened to Lee
https://wired.com/story/lee-holloway-devastating-decline-brilliant-young-coder/
298 comments
One story that didn't make it the article:
In September, after we'd released our S-1 but before Cloudflare's IPO, I took two weeks off and went back to my home town of Park City, Utah. (It's actually where Lee and I had been roommates many years before.) That two week period before you go public is known as the quiet period, so I was generally avoiding social media or answering my phone or doing anything other than resting and getting ready for the pre-IPO road show.
We hadn't talked much publicly about Lee's disease, but Michelle and I had written a bit about it in the S-1 Founders Letter:
"Finally, there are two of us signing this letter today, but three people started Cloudflare. Lee Holloway is our third co-founder and the genius who architected our platform and recruited and led our early technical team. Tragically, Lee stepped down from Cloudflare in 2016, suffering the debilitating effects of Frontotemporal Dementia, a rare neurological disease. As we began the confidential process to go public, one of the early decisions was to pick the code name for our IPO. We chose 'Project Holloway' to honor Lee’s contribution. More importantly, on a daily basis, the technical decisions Lee made, and the engineering team he built, are fundamental to the business we have become."
One evening my phone rang and the called ID came up as "Lee Holloway." I checked the number and it was his. I didn't answer and the caller didn't leave a voicemail. My first reaction was that somehow his phone had been hacked or his number was being spoofed and someone was using it to somehow screw with me. Figured someone had read about his disease in the S-1 and was being a jerk.
I reported the call to Cloudflare's security team to investigate. I also texted Lee's wife to let her know to be on the lookout. She wrote back: "No, that's Lee. Sometimes I think when he's feeling nostalgic he reaches out to old friends. He never says anything, but I think it's his way to let you know he's thinking about you."
So I still shoot him text messages from time to time to let him know I'm thinking about him. And I hope, somewhere inside his mind, there's a part of him that still knows that.
In September, after we'd released our S-1 but before Cloudflare's IPO, I took two weeks off and went back to my home town of Park City, Utah. (It's actually where Lee and I had been roommates many years before.) That two week period before you go public is known as the quiet period, so I was generally avoiding social media or answering my phone or doing anything other than resting and getting ready for the pre-IPO road show.
We hadn't talked much publicly about Lee's disease, but Michelle and I had written a bit about it in the S-1 Founders Letter:
"Finally, there are two of us signing this letter today, but three people started Cloudflare. Lee Holloway is our third co-founder and the genius who architected our platform and recruited and led our early technical team. Tragically, Lee stepped down from Cloudflare in 2016, suffering the debilitating effects of Frontotemporal Dementia, a rare neurological disease. As we began the confidential process to go public, one of the early decisions was to pick the code name for our IPO. We chose 'Project Holloway' to honor Lee’s contribution. More importantly, on a daily basis, the technical decisions Lee made, and the engineering team he built, are fundamental to the business we have become."
One evening my phone rang and the called ID came up as "Lee Holloway." I checked the number and it was his. I didn't answer and the caller didn't leave a voicemail. My first reaction was that somehow his phone had been hacked or his number was being spoofed and someone was using it to somehow screw with me. Figured someone had read about his disease in the S-1 and was being a jerk.
I reported the call to Cloudflare's security team to investigate. I also texted Lee's wife to let her know to be on the lookout. She wrote back: "No, that's Lee. Sometimes I think when he's feeling nostalgic he reaches out to old friends. He never says anything, but I think it's his way to let you know he's thinking about you."
So I still shoot him text messages from time to time to let him know I'm thinking about him. And I hope, somewhere inside his mind, there's a part of him that still knows that.
This Wired piece was amazing: full of sadness, humanity, and hope. One thing that really stood out to me was how incredible the people around Lee are. You all really care for him, and that says a lot about the type of person he is, even in the midst of this disease and the toll it must be taking on all of you.
Cloudflare is a great platform, and I'm glad, thanks to Ms. Upson, I got to know one of the folks responsible for it a little bit. I'll be sure to keep chasing the hard problems in my own day-to-day code, and keep a thought for Lee while I do it.
Cloudflare is a great platform, and I'm glad, thanks to Ms. Upson, I got to know one of the folks responsible for it a little bit. I'll be sure to keep chasing the hard problems in my own day-to-day code, and keep a thought for Lee while I do it.
Can I ask you, when Lee’s personality began to change drastically, did he maintain the same level of technical proficiency (in coding or gaming)? It is a wonderful piece on a very sad story, and after reading it that’s one of the things that I’m interested to know more about, to understand the general condition.
I don't know about gaming, but I do about coding. First, if I look back over the 18 years I knew him, I can see some things that make me think he had the disease the whole time. He was a brilliant coder when he first started working with me out of college, but I think he really hit his peak ability to focus and do amazing things around 2014 — right as we were rolling out Universal SSL. But, even to the end, he was great at coding. In fact, I was told that the doctors said one of the things that was unique about his presentation of the disease was that while most people lose the ability to complete complex tasks first, Lee almost seemed to do the opposite — still thriving on the complex. We brainstormed whether there were coding challenges we could keep sending him after his diagnosis to keep that part of his mind active. It never ended up happening in part because he lost a lot of his verbal communication skills around the same time, but I wonder when you hear him counting under his breath what puzzle he's still solving in his head.
I spent most of my time with him when he only starting a family and his business tasks were few. Most of the symptoms described in this article happened after his family and work responsibilities grew, which both reduced his time for MMORPG / RTS gaming. When his older son was old enough, they would play casual games together, but that's a completely different realm of proficiency required.
Which RTS games did he play?
> The neurologists delivered their verdict: He appeared to have a textbook case of frontotemporal dementia—known by the shorthand FTD
Oh man, was that a kick in the guts when I got to that bit. My Dad was diagnosed with that in the past year, (after obviously struggling for a while), and declined rapidly. He had a different variant, and indeed the one thing that DIDN'T change was his personality. In fact, that's what kind of fooled me for a while. He would still trot out his usual bad jokes and regular phrases, but after a while you realize these are almost like reflexes, and often wouldn't really make sense in context.
It was interesting to see for Lee how this seemed amplified after heart surgery. My Dad had really bad "post-operative delirium" for about a month after major heart surgery, and while he recovered somewhat, that was definitely the start of his major decline.
Sadly, after moving into a care facility in mid-March, within a couple weeks he was in hospital after contracting Covid-19. He passed away on the 4th of this month from it. The only good to come out of all this was that I'd visited him many times over the past couple years and said "goodbye" many times thinking it might be the last time, even if just mentally and not physically, I'd get to see "my Dad", as I knew him.
Apparently it is often a genetic disorder that can be hereditary, and you can get tested for the genetic markers. As a coder/manager myself who depends on my mind for work, and enjoys being mentally challenged and active, (and I also have young kids), something like this scares the crap out of me. I'm not sure I want to know if I might have it. For one thing, being in the U.S. healthcare system, if I did have the markers, would that then count as a "pre-existing condition" I'd have to disclose?
Oh man, was that a kick in the guts when I got to that bit. My Dad was diagnosed with that in the past year, (after obviously struggling for a while), and declined rapidly. He had a different variant, and indeed the one thing that DIDN'T change was his personality. In fact, that's what kind of fooled me for a while. He would still trot out his usual bad jokes and regular phrases, but after a while you realize these are almost like reflexes, and often wouldn't really make sense in context.
It was interesting to see for Lee how this seemed amplified after heart surgery. My Dad had really bad "post-operative delirium" for about a month after major heart surgery, and while he recovered somewhat, that was definitely the start of his major decline.
Sadly, after moving into a care facility in mid-March, within a couple weeks he was in hospital after contracting Covid-19. He passed away on the 4th of this month from it. The only good to come out of all this was that I'd visited him many times over the past couple years and said "goodbye" many times thinking it might be the last time, even if just mentally and not physically, I'd get to see "my Dad", as I knew him.
Apparently it is often a genetic disorder that can be hereditary, and you can get tested for the genetic markers. As a coder/manager myself who depends on my mind for work, and enjoys being mentally challenged and active, (and I also have young kids), something like this scares the crap out of me. I'm not sure I want to know if I might have it. For one thing, being in the U.S. healthcare system, if I did have the markers, would that then count as a "pre-existing condition" I'd have to disclose?
I'm so sorry for your loss.
Dementia and schizophrenia are present in my family as well and caring for those in the later stages has been really hard.
I found myself torn by the same question of whether to test for genetic predisposition. After reading The Gene by Siddhartha Mukherjee, whose author is in a similar position, I have found some comfort in deciding not to test for now. As he says in an NPR interview:
> There's no one-to-one correspondence between a genome and the chances of developing schizophrenia. And until we can create that map - and whether we can create that map ever is a question - but until I - we can create that map, I will certainly not be tested because it - that idea - I mean, that's, again, the center of the book. That confines you. It becomes predictive. You become ... a previvor (ph). A previvor is someone who's survived an illness that they haven't even had yet. You live in the shadow of an illness that you haven't had yet.
https://www.npr.org/2017/05/12/528097708/the-power-of-genes-...
Dementia and schizophrenia are present in my family as well and caring for those in the later stages has been really hard.
I found myself torn by the same question of whether to test for genetic predisposition. After reading The Gene by Siddhartha Mukherjee, whose author is in a similar position, I have found some comfort in deciding not to test for now. As he says in an NPR interview:
> There's no one-to-one correspondence between a genome and the chances of developing schizophrenia. And until we can create that map - and whether we can create that map ever is a question - but until I - we can create that map, I will certainly not be tested because it - that idea - I mean, that's, again, the center of the book. That confines you. It becomes predictive. You become ... a previvor (ph). A previvor is someone who's survived an illness that they haven't even had yet. You live in the shadow of an illness that you haven't had yet.
https://www.npr.org/2017/05/12/528097708/the-power-of-genes-...
Schizophrenia seems like a tricky one given that its triggers are less well understood and trauma seems to be part of it (so maybe knowing would lead to increased anxiety/stress which could make onset more likely?).
Otherwise it seems like whether or not you test the reality is set independent of your knowledge of it. I'd like to think that I'd want to test given that, but I suppose it's hard to know how I'd act without really being in that position.
I loved his book, but I think I disagree with him on this - feels like a rationalization of an irrational thing.
Otherwise it seems like whether or not you test the reality is set independent of your knowledge of it. I'd like to think that I'd want to test given that, but I suppose it's hard to know how I'd act without really being in that position.
I loved his book, but I think I disagree with him on this - feels like a rationalization of an irrational thing.
My experience was similar to the author's in that I grew up around family members who were in advanced stages. The possibility of inheritance stares you in the face whenever they're around.
If there was a conclusive test, I would definitely take it for the sake of future offspring. Otherwise, it would likely give me more anxiety than useful information.
If there was a conclusive test, I would definitely take it for the sake of future offspring. Otherwise, it would likely give me more anxiety than useful information.
FYI, preexisting conditions stopped being a major issue with heath insurance after the Affordable Care Act (Obama Care) got passed: https://www.policygenius.com/health-insurance/pre-existing-c...
Insurers cannot deny health coverage, cannot charge higher costs, or subject people with pre-existing conditions to a waiting period
You may be better off getting life/long term care insurance before getting tested, but other than that there is little reason to avoid being tested.
Insurers cannot deny health coverage, cannot charge higher costs, or subject people with pre-existing conditions to a waiting period
You may be better off getting life/long term care insurance before getting tested, but other than that there is little reason to avoid being tested.
I don't know if we can count on the ACA staying around forever.
It survived both political parties in power. It might get chipped away over the next 30 years or replaced with public option etc, but bringing back the preexisting condition issue would be extremely unpopular. Also, it does not actually cost insurance companies much money as they can all just raise premiums.
So you're confident that the Supreme Court will overturn the 5th Circuit's decision to throw it out? The Supreme Court will be hearing the case this autumn.
And you must be confident that Trump will lose, since the 5-4 majority that saved Obamacare last time will not survive a few more Republican appointments.
And you must be confident that Trump will lose, since the 5-4 majority that saved Obamacare last time will not survive a few more Republican appointments.
In terms of appointments, republicans have had control of the Supreme Court for years. In terms of the actual judges and their rulings that’s anybody’s guess. They could easily remove the tax while keeping the rest of the law unchanged or do just about anything.
I don't really know what to make of "republicans have had control of the Supreme Court for years." Overturning Obamacare was their number one priority during the Obama administration. The Supreme Court chose not to. The five justices who chose not to are still seated. Some control.
Scalia and Kennedy where both republican appointments and replaced with Republican appointments. So if you’re saying they have 5-4 control now they also had 5-4 control then.
https://en.wikipedia.org/wiki/List_of_justices_of_the_Suprem...
That said, many justices have not voted as expected. In other cases political parties have swapped positions on various issues etc.
https://en.wikipedia.org/wiki/List_of_justices_of_the_Suprem...
That said, many justices have not voted as expected. In other cases political parties have swapped positions on various issues etc.
the 5-4 majority that saved Obamacare last time will not survive a few more Republican appointments
So what? The Chief Justice can write the minority opinion next time. That 5-seat majority includes some who will almost certainly retire in the next four years.
CSF leaks/hypotension are also potentially implicated in frontotemporal dementia: https://journals.lww.com/neurotodayonline/Fulltext/2002/0900...
>> It was interesting to see for Lee how this seemed amplified after heart surgery. My Dad had really bad "post-operative delirium" for about a month after major heart surgery, and while he recovered somewhat, that was definitely the start of his major decline.
That is a strange coincidence. Could changes in bloodflow have an impact on brain cells?
That is a strange coincidence. Could changes in bloodflow have an impact on brain cells?
It could be something physical. My sense was it was something else in Lee's case: a change in his routine. I think the routine of coming into work kept him in a pattern that kept him from deteriorating quickly (or, at least, kept us from recognizing his deterioration). When he had heart surgery, he took several months off to recover. When he returned, he seemed dramatically different. I also noticed a dramatic change immediately after he took time off for his wedding/honeymoon. And, after he left Cloudflare, the article talks about how it seemed like the effects of the disease accelerated. I'm not a doctor, and there very well may be some other connection, but my sense in this case was the routine of work actually allowed him to hold the effects of the disease off and, at those times when he didn't have it, those effects accelerated.
I researched it at the time (I'd not heard of it when it occurred) and it is apparently quite common.
A quick search finds a few hits, e.g. from https://perioperativemedicinejournal.biomedcentral.com/artic...
> Delirium is associated with negative hospital outcomes including a tenfold increased risk of death, a fivefold increased risk of nosocomial complications (Inouye 2006), poor 1-year functional recovery, and postoperative cognitive decline (Saczynski et al. 2012). The long-term cognitive decline seen in some patients after the development of delirium is similar to that of Alzheimer’s patients (Pandharipande et al. 2013). With reports of up to 50 % of patients over 60 years old developing postoperative delirium following cardiac surgery (Rudolph et al. 2009), this patient population poses a major burden for healthcare.
A quick search finds a few hits, e.g. from https://perioperativemedicinejournal.biomedcentral.com/artic...
> Delirium is associated with negative hospital outcomes including a tenfold increased risk of death, a fivefold increased risk of nosocomial complications (Inouye 2006), poor 1-year functional recovery, and postoperative cognitive decline (Saczynski et al. 2012). The long-term cognitive decline seen in some patients after the development of delirium is similar to that of Alzheimer’s patients (Pandharipande et al. 2013). With reports of up to 50 % of patients over 60 years old developing postoperative delirium following cardiac surgery (Rudolph et al. 2009), this patient population poses a major burden for healthcare.
When you go on bypass(needed if the heart is stopped to replace a valve) air emboli (very small air bubbles) go into the brain and can get lodged in capillaries cutting of blood flow. Personality changes are documented to occur after bypass and correlate with areas of the frontal cortex that die. Typically though this kind of injury is not progressive.
My suspicion would be that the general anesthetic is the primary cause.
I have been sedated a few times for minor procedures, propofol, I think, with no issues, and I’ve had a general once, for a laparoscopic cholecystectomy - about as trivial as abdominal surgery comes, only a few hours under.
It had side effects.
For the better part of a year afterwards, I kept finding myself unconsciously substituting completely incorrect words into written correspondence, I was irritable almost constantly, my short term memory was shot, and I had hallucinations and attacks of aphasia - I’d be walking down the street, or in the shower, or in a damn meeting, and I’d not only forget where I was but I’d lose object permanence and recognition - couldn’t tell taps from cats, cars from shoes.
It got better, over time, but there was very definitely a long mental hangover from it. I do have medical quirks, like I can’t tolerate opioids (they worsen pain and make me vomit), and I’m a carrier of a whole bunch of degenerative diseases (thanks, inbred aristo dad), and when I had surgery I was weakened from years of still mysterious illness - they thought my GB was the root cause, but no - stress - leaving tech fixed me.
Anyway. I can readily see how, with someone with a poised avalanche of genetic mental disorder, it can be enough to completely push them into the abyss.
It had side effects.
For the better part of a year afterwards, I kept finding myself unconsciously substituting completely incorrect words into written correspondence, I was irritable almost constantly, my short term memory was shot, and I had hallucinations and attacks of aphasia - I’d be walking down the street, or in the shower, or in a damn meeting, and I’d not only forget where I was but I’d lose object permanence and recognition - couldn’t tell taps from cats, cars from shoes.
It got better, over time, but there was very definitely a long mental hangover from it. I do have medical quirks, like I can’t tolerate opioids (they worsen pain and make me vomit), and I’m a carrier of a whole bunch of degenerative diseases (thanks, inbred aristo dad), and when I had surgery I was weakened from years of still mysterious illness - they thought my GB was the root cause, but no - stress - leaving tech fixed me.
Anyway. I can readily see how, with someone with a poised avalanche of genetic mental disorder, it can be enough to completely push them into the abyss.
I've experienced this too. I had a tumor removed from my head. It was pretty serious. I'm not sure if it's due to the anesthesia, physical stress of the operation, changes to brain blood flow or radiation that my brain was hit with.
Either way my memory has not been great since. My wife is disappointed when I forget meaningful conversions from a week ago. I struggle at times to notice trivial errors, really struggle. I can look over the same email and miss several mistakes. Other days I'm clear, I don't make many mistakes and I can spot them easily.
I still managed to get an Engineering degree and hold down regular employment as a software developer. But there are periods of time where my focus and productivity are just not there. I suspect this will hold me back in my career. But I'm thankful I can function as well as I can and have survived to this point.
Either way my memory has not been great since. My wife is disappointed when I forget meaningful conversions from a week ago. I struggle at times to notice trivial errors, really struggle. I can look over the same email and miss several mistakes. Other days I'm clear, I don't make many mistakes and I can spot them easily.
I still managed to get an Engineering degree and hold down regular employment as a software developer. But there are periods of time where my focus and productivity are just not there. I suspect this will hold me back in my career. But I'm thankful I can function as well as I can and have survived to this point.
I'm sorry, that sounds awful. I think it definitely could be any combination of those things. The brain is a very delicate and sensitive machine.
I don't have specific recommendations, but I think that the potential for recovery should be much higher than what people with neurodegenerative diseases suffer from, like what was described in this article.
There're a lot of risk and uncertainty trade-offs, and everyone reacts to things differently due to their genetics and what they're suffering from, but nootropic substances could potentially help here. They could possibly help as a short-term aid that improves memory and attention to detail while the nootropic is in effect, and some can actually potentially create long-term improvements.
They're very under-studied, and they definitely require a lot of careful research, gradual self-testing, and acceptance of some risk (some nootropics have almost no risk, and some have a moderate level), but it could be worth looking into.
I don't have specific recommendations, but I think that the potential for recovery should be much higher than what people with neurodegenerative diseases suffer from, like what was described in this article.
There're a lot of risk and uncertainty trade-offs, and everyone reacts to things differently due to their genetics and what they're suffering from, but nootropic substances could potentially help here. They could possibly help as a short-term aid that improves memory and attention to detail while the nootropic is in effect, and some can actually potentially create long-term improvements.
They're very under-studied, and they definitely require a lot of careful research, gradual self-testing, and acceptance of some risk (some nootropics have almost no risk, and some have a moderate level), but it could be worth looking into.
> The brain is a very delicate and sensitive machine
Something as simple as a prion can completely destroy it and then there's Phineas Gage, someone whom all neurobio students learn about on day one of their course. Neuroplasticity can be quite amazing.
https://en.wikipedia.org/wiki/Phineas_Gage
Something as simple as a prion can completely destroy it and then there's Phineas Gage, someone whom all neurobio students learn about on day one of their course. Neuroplasticity can be quite amazing.
https://en.wikipedia.org/wiki/Phineas_Gage
Yep. A lot of it is personal biology and a lot is also chance. You can be shot in the head and survive with not much cognitive impairment, or you could hit your head against something and be unable to speak or feed yourself for the reset of your life. We are very pliable but it's sad that we're also still so fragile, at the level of the "mind" / "soul". Hopefully there'll eventually be a day where consciousness can be hosted in a much more safe way, for both biological and total immortality.
I don't think it's exactly correct to say "a prion" can destroy it. One single prion I don't think would cause significant damage in most cases, if there could somehow be only a single one. The issue is that it's believed a prion will gradually cause nearby proteins to misfold and also become prions, and then it probably starts recurring exponentially like a pathogen infection, and your brain physically deteriorates and falls apart with no way to stop or reverse it. A very similar deterioration process appears to happen with other disorders like Alzheimer's and the form of dementia discussed in this article, though the root cause still isn't understood.
I don't think it's exactly correct to say "a prion" can destroy it. One single prion I don't think would cause significant damage in most cases, if there could somehow be only a single one. The issue is that it's believed a prion will gradually cause nearby proteins to misfold and also become prions, and then it probably starts recurring exponentially like a pathogen infection, and your brain physically deteriorates and falls apart with no way to stop or reverse it. A very similar deterioration process appears to happen with other disorders like Alzheimer's and the form of dementia discussed in this article, though the root cause still isn't understood.
I just wanted to say that I'm sorry you're going through this. It must be very difficult. I hope you do recover. Best of luck!
Neuroplasticity is an extraordinary thing. With proper consistent mental exercise and training, you can improve your working memory and focus back to what it used to be if not better.
Inspirational messages are good, and there's certainly a good chance that you're right in this case, but I also don't think it's a great idea to speak with such certainty.
I mean, they had a brain tumor which could've been causing damage itself, plus radiation to the brain, invasive brain surgery, altered brain blood flow during the surgery, general anesthetic... That's serious stuff affecting the most complex machine we're aware of.
The brain can be capable of amazing feats of recovery, but it's always going to vary based on someone's pre-existing genetics, environment, age, and the specific damage they might have incurred. Recovery back to baseline absolutely may be possible for them, but there's really no way to know that for sure when dealing with something so serious and without knowing many other factors. Hope is good, but sugarcoated false hope isn't.
I mean, they had a brain tumor which could've been causing damage itself, plus radiation to the brain, invasive brain surgery, altered brain blood flow during the surgery, general anesthetic... That's serious stuff affecting the most complex machine we're aware of.
The brain can be capable of amazing feats of recovery, but it's always going to vary based on someone's pre-existing genetics, environment, age, and the specific damage they might have incurred. Recovery back to baseline absolutely may be possible for them, but there's really no way to know that for sure when dealing with something so serious and without knowing many other factors. Hope is good, but sugarcoated false hope isn't.
Sorry, I didn't see this until just now. I wish HN had some kind of notification feature (cough dang save us please cough).
I don't think I'm sugarcoating, at least not in the sense of how the word is usually defined. We know neuroplasticity is real. It isn't just some placebo. Regardless of what part of the brain was affected, because of neuroplasticity, he/she can recover functionality through exercise and training. I agree with you that this won't always be the case, and at some point, brain dead is pretty much brain dead like in the case of survivors of gunshot wounds to the head for example. But given the eloquence of the poster's comment, I think the kind of situation we're looking at here is of a different class.
I don't think I'm sugarcoating, at least not in the sense of how the word is usually defined. We know neuroplasticity is real. It isn't just some placebo. Regardless of what part of the brain was affected, because of neuroplasticity, he/she can recover functionality through exercise and training. I agree with you that this won't always be the case, and at some point, brain dead is pretty much brain dead like in the case of survivors of gunshot wounds to the head for example. But given the eloquence of the poster's comment, I think the kind of situation we're looking at here is of a different class.
Omg. I've been under 4 times. I think the last two had similar impacts, and I still have a hard time finding proper words from time to time.
I think cardiac surgery is the worst offender because they often have to bypass the heart while performing the surgery, and this can result in blood supply issues while diverting/restoring flow through the heart.
It might be the anesthetic.
There has been, for several years now, concern that general anesthesia may have a negative impact on the brain and, in particular, Alzheimer's Disease but also general cognitive damage.
Here's a 2018 piece discussing research from the Mayo Clinic focused on apparent anesthetic damage in patients older than 70.
https://www.sciencedaily.com/releases/2018/07/180719112024.h...
Here's a 2018 piece discussing research from the Mayo Clinic focused on apparent anesthetic damage in patients older than 70.
https://www.sciencedaily.com/releases/2018/07/180719112024.h...
Serious medical interventions can make a patient "age" quite a bit and this exacerbates other medical conditions they may have, I doubt there was any direct connection between the two conditions
I'm so sorry for your loss.
Sorry about your loss! My father got diagnosed with this about a year and a half ago, and the first paragraph of your post sounds very familiar. Not a clear (or rapid anyway) change in personality, but certain aspects of it seem to somehow become amplified. He's still able to do a lot of the same things as always, but they seem to turn into reflexes and mannerisms.
At this point he often falls into the verbal loops described in the article, and hasn't really been able to hold a conversation for quite a while. Exacerbated by his poor hearing. He's also extremely restless, and wants to run the washing machine and dishwasher and go for groceries many times a day. When my parents still owned a dog he'd take of for a three minute walk every hour, and he drives my mother nuts by constantly wanting to help out with housework but then being unable to comprehend the simplest of instructions.
He currently spends about a week every month in an assisted care facility, and my mother seems to have finally let herself be talked into looking for a permanent spot for him, though with Covid-19 is hard to tell what will happen and when.
It was a relief when we finally got the diagnosis after he was repeatedly hospitalized for unrelated stuff in late 2018 though. It had been obvious to everyone that knew him for at least five years prior that something was wrong, but he didn't display any of the obvious signs of Alzheimer's. I guess it took extended time spent around medical professionals and a thorough checkup for them to see that something was wrong.
Also to all the young people freaking out about the inability to concentrate: Relax! From everything I've seen and heard a telltale sign of FTD is complete obliviousness on the part of the patient.
At this point he often falls into the verbal loops described in the article, and hasn't really been able to hold a conversation for quite a while. Exacerbated by his poor hearing. He's also extremely restless, and wants to run the washing machine and dishwasher and go for groceries many times a day. When my parents still owned a dog he'd take of for a three minute walk every hour, and he drives my mother nuts by constantly wanting to help out with housework but then being unable to comprehend the simplest of instructions.
He currently spends about a week every month in an assisted care facility, and my mother seems to have finally let herself be talked into looking for a permanent spot for him, though with Covid-19 is hard to tell what will happen and when.
It was a relief when we finally got the diagnosis after he was repeatedly hospitalized for unrelated stuff in late 2018 though. It had been obvious to everyone that knew him for at least five years prior that something was wrong, but he didn't display any of the obvious signs of Alzheimer's. I guess it took extended time spent around medical professionals and a thorough checkup for them to see that something was wrong.
Also to all the young people freaking out about the inability to concentrate: Relax! From everything I've seen and heard a telltale sign of FTD is complete obliviousness on the part of the patient.
Sorry you're going through this too.
The gradual decline slowly conditions you, like the proverbial frog in the pot of water. It was strange going back and reading some of his old emails and letters recently to try and find some info I needed. It was like, "Wow! He used to be really articulate and lucid and funny". I almost forgot that guy by the end :-(
The gradual decline slowly conditions you, like the proverbial frog in the pot of water. It was strange going back and reading some of his old emails and letters recently to try and find some info I needed. It was like, "Wow! He used to be really articulate and lucid and funny". I almost forgot that guy by the end :-(
GCSAQCMIYI(2)
I find the Obamacare rule about preexisting conditions confusing.
I’ve been managing a chronic condition for decades, and I’ve never had coverage denied because it was “preexisting.”
Maybe it was only if you were buying coverage outside a group it would be an issue, but I don’t know.
Regardless I many people who had preexisting conditions pre-ACA, and it never affected coverage.
For disability insurance, or life insurance, it’s probably a different story.
I’ve been managing a chronic condition for decades, and I’ve never had coverage denied because it was “preexisting.”
Maybe it was only if you were buying coverage outside a group it would be an issue, but I don’t know.
Regardless I many people who had preexisting conditions pre-ACA, and it never affected coverage.
For disability insurance, or life insurance, it’s probably a different story.
> Regardless I many people who had preexisting conditions pre-ACA, and it never affected coverage.
This mostly affected the individual and small-group markets, in which a pre-existing condition either disqualified you for coverage, made it prohibitively expensive, or explicitly excluded coverage for that condition (sometimes, the exclusion was only for a set period of time).
Typical failure modes were: individuals unable to get coverage on the open market; small businesses and non-profits that offered employees health insurance being forced to fire people because they got expensive illnesses and their insurance providers threatened to 10x their premiums; etc.
It made entrepreneurship and freelancing a much harder choice for many (typically older-than-30) folks, especially since you risked getting fired & losing insurance if you worked alone or for a small-ish firm.
Some states had remedies for these issues -- either through a high-risk pool for people who were rejected in the individual market (though often these policies had coverage limits that made them not ideal), or through guaranteed-issue insurance in the small group market (i.e., if you and a partners start a business, insurance companies in your area who serve small groups HAVE to a) insure you, b) not charge you more than 10% the average rate, and c) renew your insurance when it's up for renewal, usually annually).
California in particular had both these in place pre-ACA.
Ask me how I know. :/
This mostly affected the individual and small-group markets, in which a pre-existing condition either disqualified you for coverage, made it prohibitively expensive, or explicitly excluded coverage for that condition (sometimes, the exclusion was only for a set period of time).
Typical failure modes were: individuals unable to get coverage on the open market; small businesses and non-profits that offered employees health insurance being forced to fire people because they got expensive illnesses and their insurance providers threatened to 10x their premiums; etc.
It made entrepreneurship and freelancing a much harder choice for many (typically older-than-30) folks, especially since you risked getting fired & losing insurance if you worked alone or for a small-ish firm.
Some states had remedies for these issues -- either through a high-risk pool for people who were rejected in the individual market (though often these policies had coverage limits that made them not ideal), or through guaranteed-issue insurance in the small group market (i.e., if you and a partners start a business, insurance companies in your area who serve small groups HAVE to a) insure you, b) not charge you more than 10% the average rate, and c) renew your insurance when it's up for renewal, usually annually).
California in particular had both these in place pre-ACA.
Ask me how I know. :/
The Obamacare rule about preexisting conditions was specifically to fix the individual insurance market. The pre-Obamacare individual insurance market was really broken -- you need the "three-legged stool" (pre-existing condition coverage, universal mandate, subsidized premiums) to have a functioning individual market, and that didn't exist until Obamacare.
I posted this hours ago and then stepped away. The story captures so much about the Lee I knew so well. I'll add one piece of praise for Lee's early architecture of Cloudflare.
Everything was controlled by a single Postgres database that made very heavy use of stored procedures, that called other procedures, that called others. It was one giant program inside the database. It took me a while to comprehend what he'd done but it was really great. The database ran everything and all those functions made sure that audit logs were kept, that the calls were allowed for the user ID being passed in, and some of these procedures made external calls to APIs including getting things like SSL certificates.
It was a magnificent monolith inside a database.
I worked on the periphery of the database (it was truly Lee's domain) and he'd tell me what output to expect or API to create and I'd code to his spec. and we'd just hook it up.
If any single artefact represents what he did at Cloudflare, it's that database. And he used to code it on a laptop we called "The Beast" because it was so crazily heavy and overloaded with memory etc. that he'd carry around a mini, test Cloudflare wherever he went.
Everything was controlled by a single Postgres database that made very heavy use of stored procedures, that called other procedures, that called others. It was one giant program inside the database. It took me a while to comprehend what he'd done but it was really great. The database ran everything and all those functions made sure that audit logs were kept, that the calls were allowed for the user ID being passed in, and some of these procedures made external calls to APIs including getting things like SSL certificates.
It was a magnificent monolith inside a database.
I worked on the periphery of the database (it was truly Lee's domain) and he'd tell me what output to expect or API to create and I'd code to his spec. and we'd just hook it up.
If any single artefact represents what he did at Cloudflare, it's that database. And he used to code it on a laptop we called "The Beast" because it was so crazily heavy and overloaded with memory etc. that he'd carry around a mini, test Cloudflare wherever he went.
I’m sure he did a great job, but I’ve seen those things be a huge nightmare for anyone other than the irreplaceable genius code wizard who created them.
I guess you're using the word genius ironically, but I've also seen such things be radical in the sense that they're built in a way that no one else would have done, yet it ends up working perfectly for the business and being far more successful than anyone would have predicted. There's a certain type of mind that is immune to fashionable or normal technical choices, that often goes along with remarkable productivity. I suppose the word 'genius' might be a good fit for that.
The interesting thing is that such cases can also actually be the huge nightmare you write about, in the sense that there are tradeoffs in the original design that originally made sense but become harder to deal with later, but also in the sense that their nonstandardness can be hard for more typical engineers to work with. (This is often referred to as the 'hiring problem', though that can be misleading.) The trouble with the typicalness of more typical engineers is that they're steeped in a technical culture which they regard as the proper and obvious way to do things, but which really is mostly just the set of conventions they're used to. Those two things are easy to conflate when all your peers agree on what's proper and obvious (for example that you should never build a complex system entirely in Postgres stored procedures, or whatever the weird thing is). Those conventional assumptions are at least part of what makes such systems a 'nightmare', because if you're working on a system that feels 'wrong', then you fight it rather than blend with it, and that makes it harder to maintain. Everything that's objectively wrong with it will loom larger in your experience than it would if you didn't have the feeling that it should never have been built that way in the first place. Worse, many things that aren't objectively wrong with it, in the sense that they aren't intrinsic to the system or the domain, end up blowing up into major issues because people find they can't work with this system in the way that they're used to, and it's too hard to abandon ways that you're used to—it always feels like the system is at fault. Meanwhile, everything it got right will fade into the background as you assume that any system that had been built 'properly' (i.e. the way you'd have done it) would have gotten all those things right too, at the same cost or better.
It's hard for the later engineer who experiences the 'nightmare' to fully appreciate that if it weren't for that weird, obviously 'wrong' system, they wouldn't have their job in the first place (nightmare and all), because the business that succeeded was built on the weird system.
I don't know anything about this case other than what John posted above, but I've seen something like it in other situations, and in fact I would say that PG and YC have this in common with the case of Lee and Cloudflare as John describes it—as remote from one another as Postgres procedures and custom Lisps must be in every other respect.
What I wish we could teach younger engineers is: when you run across a system like this, pause. Then, pause. Then pause again. The creativity at the core of it can be remarkable. Often you see things that one person did which would have required a large team in other hands, and therefore would never have happened otherwise. Maybe that's one reason why these systems tend to be found at the start of companies: more conventional approaches wouldn't have worked at a stage when hiring a team wasn't an option yet; and on the other hand, the teams you do hire at the later stages tend to have more conventional engineers whose minds (or rather, whose conditioning) can't grok why you'd ever have built something so weirdly.
Usually the later engineers bond with each other around how much they dislike the 'legacy' system, and lobby to replace it, and usually get their way in the end. That's a cycle-of-life thing, but it's also sad when we prefer our conventions and assumptions over seeing, and honoring, the creativity in what came before. Sometimes masterpieces get paved over because of that. Of course, not every nightmare system is an unappreciated masterpiece. But some are, and the bias in our industry is extremely strong toward perceiving them as nightmares. I've seen people take chainsaws to masterpieces without realizing that that's what they were doing, and it makes me sad to think of it. But it makes me happy to read what John wrote to honor Lee, because that's how I'd want someone to write and feel about something I'd built, if I built something like that.
The interesting thing is that such cases can also actually be the huge nightmare you write about, in the sense that there are tradeoffs in the original design that originally made sense but become harder to deal with later, but also in the sense that their nonstandardness can be hard for more typical engineers to work with. (This is often referred to as the 'hiring problem', though that can be misleading.) The trouble with the typicalness of more typical engineers is that they're steeped in a technical culture which they regard as the proper and obvious way to do things, but which really is mostly just the set of conventions they're used to. Those two things are easy to conflate when all your peers agree on what's proper and obvious (for example that you should never build a complex system entirely in Postgres stored procedures, or whatever the weird thing is). Those conventional assumptions are at least part of what makes such systems a 'nightmare', because if you're working on a system that feels 'wrong', then you fight it rather than blend with it, and that makes it harder to maintain. Everything that's objectively wrong with it will loom larger in your experience than it would if you didn't have the feeling that it should never have been built that way in the first place. Worse, many things that aren't objectively wrong with it, in the sense that they aren't intrinsic to the system or the domain, end up blowing up into major issues because people find they can't work with this system in the way that they're used to, and it's too hard to abandon ways that you're used to—it always feels like the system is at fault. Meanwhile, everything it got right will fade into the background as you assume that any system that had been built 'properly' (i.e. the way you'd have done it) would have gotten all those things right too, at the same cost or better.
It's hard for the later engineer who experiences the 'nightmare' to fully appreciate that if it weren't for that weird, obviously 'wrong' system, they wouldn't have their job in the first place (nightmare and all), because the business that succeeded was built on the weird system.
I don't know anything about this case other than what John posted above, but I've seen something like it in other situations, and in fact I would say that PG and YC have this in common with the case of Lee and Cloudflare as John describes it—as remote from one another as Postgres procedures and custom Lisps must be in every other respect.
What I wish we could teach younger engineers is: when you run across a system like this, pause. Then, pause. Then pause again. The creativity at the core of it can be remarkable. Often you see things that one person did which would have required a large team in other hands, and therefore would never have happened otherwise. Maybe that's one reason why these systems tend to be found at the start of companies: more conventional approaches wouldn't have worked at a stage when hiring a team wasn't an option yet; and on the other hand, the teams you do hire at the later stages tend to have more conventional engineers whose minds (or rather, whose conditioning) can't grok why you'd ever have built something so weirdly.
Usually the later engineers bond with each other around how much they dislike the 'legacy' system, and lobby to replace it, and usually get their way in the end. That's a cycle-of-life thing, but it's also sad when we prefer our conventions and assumptions over seeing, and honoring, the creativity in what came before. Sometimes masterpieces get paved over because of that. Of course, not every nightmare system is an unappreciated masterpiece. But some are, and the bias in our industry is extremely strong toward perceiving them as nightmares. I've seen people take chainsaws to masterpieces without realizing that that's what they were doing, and it makes me sad to think of it. But it makes me happy to read what John wrote to honor Lee, because that's how I'd want someone to write and feel about something I'd built, if I built something like that.
and in fact I would say that the case of PG and YC have this in common with the case of Lee and Cloudflare as John describes it—as remote from one another that Postgres procedures and custom Lisps may be in every other respect.
Oh, you reminded me of something fun. I had a lot of freedom under Lee when I first joined Cloudflare (that's partly how Cloudflare became a Go user) and one of my first jobs was writing a new WAF service... I made an entire working version in Arc. I almost made all our customers write rules using it.
Oh, you reminded me of something fun. I had a lot of freedom under Lee when I first joined Cloudflare (that's partly how Cloudflare became a Go user) and one of my first jobs was writing a new WAF service... I made an entire working version in Arc. I almost made all our customers write rules using it.
And those conventions change over time. So you might write something using Java EJBs at some point and then the world moves on and engineers no longer know how those things work. What looked like a great architecture is now confusing for most engineers.
That's true, and weird unorthodox architectures can actually end up being more stable in the long run, especially if their design was an intrinsic fit for the domain. A weird architecture that is a good fit for its domain often has simple ways of meeting key requirements that would have been more costly to develop with more conventional techniques. I'm just hallucinating this from your comment upthread, but a requirement like "making sure audit logs are kept" is the sort of thing I mean. Any architecture can do that, but some make it much easier. When a business starts out with a weird architecture in its early days and ends up succeeding, it's possible that that weirdness gave some competitive advantage.
I think there is a lot of truth to this caricature, but it rubs me wrong the way you are painting the "later" programmers as blinded by fashion or tradition. "Geniuses vs ignorant sheeple" is a false dichotomy.
Yes, in some similar situations, some programmers will see things that way. But have some faith and respect for individuals' abilities to reason and apply their experience. As you implied, these kinds of systems are often optimized so that one person could run them.
So it's often a trade off — "this would not be easy for a medium or a large team to work on, but it's the easiest thing for me as an individual to maintain by myself that gets the job done." And that's OK. And yes, it is natural to shift over time. But this is precisely because you now want 40 developers maintaining it instead of 1.
Overengineering is real. But architectural tradeoffs that don't work well for large teams are real too.
Yes, in some similar situations, some programmers will see things that way. But have some faith and respect for individuals' abilities to reason and apply their experience. As you implied, these kinds of systems are often optimized so that one person could run them.
So it's often a trade off — "this would not be easy for a medium or a large team to work on, but it's the easiest thing for me as an individual to maintain by myself that gets the job done." And that's OK. And yes, it is natural to shift over time. But this is precisely because you now want 40 developers maintaining it instead of 1.
Overengineering is real. But architectural tradeoffs that don't work well for large teams are real too.
> as remote from one another as Postgres procedures and custom Lisps must be in every other respect.
Just a fun fact: Parts of postgres (before the SQL days, I think) used to be in lisp. To this day we still have some weird function/macro names stemming from those (e.g. lcons).
Just a fun fact: Parts of postgres (before the SQL days, I think) used to be in lisp. To this day we still have some weird function/macro names stemming from those (e.g. lcons).
* Once upon a time, parts of Postgres were written in Lisp and used real
* cons-cell lists for major data structures. When that code was rewritten
* in C, we initially had a faithful emulation of cons-cell lists, which
* unsurprisingly was a performance bottleneck. A couple of major rewrites
* later, these data structures are actually simple expansible arrays;
* but the "List" name and a lot of the notation survives.Thanks for the touchingly poignant homage to creative problem solving. Even if we appreciate the effectiveness of such a solution, the sheer artistry in it is highly under-appreciated. Most people sadly walk around with so many blinders that they cannot really _see_. _"[...] pause. Then, pause. Then pause again."_ indeed.
I actually think that doing things in stored procedures could be a great hack to squeeze out some extra performance, and I'm sure that a system like this can accomplish some important business goals.
However, in the example I'm thinking of, it was much more dysfunctional. The advantage of stored procedures there was that the organization's release process was so broken that it was much faster for sales and marketing to get features added by going through Carl, the DBA, instead of submitting the request to the dev team. This was because Carl was able to add the logic by sending one query rather than going through the broken months-long release process.
Carl was actually a real nice guy, although hard to get a meeting with due to his great importance and busy schedule.
However, in the example I'm thinking of, it was much more dysfunctional. The advantage of stored procedures there was that the organization's release process was so broken that it was much faster for sales and marketing to get features added by going through Carl, the DBA, instead of submitting the request to the dev team. This was because Carl was able to add the logic by sending one query rather than going through the broken months-long release process.
Carl was actually a real nice guy, although hard to get a meeting with due to his great importance and busy schedule.
Reading code is harder than writing and separating taste from business logic is even harder. Often what looks like an ugly wart was a very compact representation of domain knowlege for a special use case. Untangling that knowlege and re-mastering that use case in a refactoring or even rewrite goes wrong far too often.
Yeah, stored procedures making API calls to external services, sounds like a nightmare of tech debt to unwind.
I'm sure when you have a brilliant engineer like this you can make it work though.
I'm sure when you have a brilliant engineer like this you can make it work though.
Step back and take an honest look, and in the vast majority of systems, it's hard to deny that stored functions and/or procedures are one of the most powerful tools in the toolbox. If anything, they're widely underutilized. This is especially the case with Postgres -- it has built-in support for functions in several non-SQL languages (including Python).
In practice, the aversion to stored funcs/procs mostly arises from political concerns. Most devs don't understand databases very well, and in most companies, independent DBA teams and independent dev teams end up burning tons of energy fighting for turf.
One of the advantages of a startup is that the smart people are free to utilize the best tools in the toolbox for the problem at hand, rather than having to conform to the social mores around "don't use that tool because it's under the control of the other team and we'll never be allowed to touch it again".
In practice, the aversion to stored funcs/procs mostly arises from political concerns. Most devs don't understand databases very well, and in most companies, independent DBA teams and independent dev teams end up burning tons of energy fighting for turf.
One of the advantages of a startup is that the smart people are free to utilize the best tools in the toolbox for the problem at hand, rather than having to conform to the social mores around "don't use that tool because it's under the control of the other team and we'll never be allowed to touch it again".
I personally think consideration of this apprach speaks of the technical range and sophistication of the practitioner. It is unusual, but we're in agreement that this is due mostly due to soft and orthogonal issues.
(Tooling could be improved to make the development and debugging process more seamless.)
(Tooling could be improved to make the development and debugging process more seamless.)
Working with stored procedures is just the pits. I wonder why you would describe that as "great". Maybe it's optimized, but so would be a giant executable written in assembly.
As long as you have the necessary tooling for source control, versioning, code search, etc. -- why is it the pits?
I mean, if you stick to a rigorous procedure of automatically exporting your stored procedures to files and committing them to git with messages... how is that different from any other development?
Serious question -- I've done tons of database work but only a little bit with stored procedures, so wondering if I'm missing a crucial detail here.
I mean, if you stick to a rigorous procedure of automatically exporting your stored procedures to files and committing them to git with messages... how is that different from any other development?
Serious question -- I've done tons of database work but only a little bit with stored procedures, so wondering if I'm missing a crucial detail here.
I'd highly recommend playing around with stored procedures. They, at a minimum, can provide data integrity guarantees that you can't get with anything else. As an example, for ages the only way to do a reliable (pseudo atomic) upsert call on most databases was through a stored procedure. Once I discovered stored procedures, I started using them everywhere. After a while I realised that you need to put your logic in the appropriate place for all of the usual reasons (performance, maintainability, security etc) and resisted the temptation to dump all business logic into stored procedures, but I still use them a lot. They're like the bridge between the dba world and the traditional developer world.
"An elegant weapon, for a more civilised age..."
"An elegant weapon, for a more civilised age..."
Not OP, but I want to say there's a lot more that goes into the development process than just source control, versioning, and code search. There's linters, and dozens of different kinds of tests, and ways of automatically running those tests, and layers of procedure before code changes go public. This seems much harder to do for stored procedures. Especially considering that stored procedure languages are fragmented between different databases; you don't just pay the cost of having to change the stored procedures when changing databases, you are also paying for the fact that it is harder to build automated tools to analyze the stored procedures, because the API for each database is going to be different.
That being said, there are lots of factors that influence how maintainable a specific stored procedure is. Team size, business needs, company culture, etc. Stored procedures get a bad rep from the places where they are train wrecks. YMMV.
That being said, there are lots of factors that influence how maintainable a specific stored procedure is. Team size, business needs, company culture, etc. Stored procedures get a bad rep from the places where they are train wrecks. YMMV.
Let's say that when you deploy, you want to direct 1% of traffic to the new code, then 5%, then 25%, then 50%, and finally 100%. And if monitoring metrics go red at any point, automatically roll back. A typical canary deployment.
How do you do that with a sproc? With normal application code, you can have the load balancer send an arbitrary percentage of traffic to the new instances of the service. A sproc binds the code and the data together. But you only have one database, so there's no way to do a gradual deploy of the code. That would be like doing a gradual deploy of a schema migration. It's only possible if you have a lot of databases.
Also unless you're using MS SQL server, debugging sprocs is a pain. The only workaround I've seen is to add a debug or loglevel arg to the sproc. But actually pausing execution and inspecting data? Good luck.
How do you do that with a sproc? With normal application code, you can have the load balancer send an arbitrary percentage of traffic to the new instances of the service. A sproc binds the code and the data together. But you only have one database, so there's no way to do a gradual deploy of the code. That would be like doing a gradual deploy of a schema migration. It's only possible if you have a lot of databases.
Also unless you're using MS SQL server, debugging sprocs is a pain. The only workaround I've seen is to add a debug or loglevel arg to the sproc. But actually pausing execution and inspecting data? Good luck.
> Let's say that when you deploy, you want to direct 1% of traffic to the new code, then 5%, then 25%, then 50%, and finally 100%. And if monitoring metrics go red at any point, automatically roll back.
> How do you do that with a sproc?
Wrap the real sproc (well, the set of real sprocs, since old and new will sometimes coexist) with a wrapper sproc that probabilistically directs to the appropriate working sproc based on a table value (or anything else the sproc can read) that is updated to reflect the current stage in the conversion process, including any monitoring-based reversals.
> How do you do that with a sproc?
Wrap the real sproc (well, the set of real sprocs, since old and new will sometimes coexist) with a wrapper sproc that probabilistically directs to the appropriate working sproc based on a table value (or anything else the sproc can read) that is updated to reflect the current stage in the conversion process, including any monitoring-based reversals.
How do you correlate those errors at the application level? If only 1% of sproc calls are the new sproc, any elevated error rates in the application will be hard to see over typical noise.
> How do you correlate those errors at the application level? If only 1% of sproc calls are the new sproc, any elevated error rates in the application will be hard to see over typical noise.
By using the DBs error reporting features to report back errors to the application, including information about which ultimate implementation was handling the request.
By using the DBs error reporting features to report back errors to the application, including information about which ultimate implementation was handling the request.
That only covers errors that occur inside the sproc, not errors that are caused by the sproc. For example: What if the new version of the sproc succeeds, but the data it returns causes the application code to fail in some way? The sproc metrics would report 100% success and the application error rate wouldn't get above noise until a significant fraction of traffic was using the new buggy version of the sproc.
It's possible to add more epicycles to try and correct for these deficiencies, but the truth is that sprocs are dangerously double-edged. Yes, your code runs next to your data, but to get parity with application code (canary deploys, debugging, logging, etc) you must reinvent lots of tooling.
It's possible to add more epicycles to try and correct for these deficiencies, but the truth is that sprocs are dangerously double-edged. Yes, your code runs next to your data, but to get parity with application code (canary deploys, debugging, logging, etc) you must reinvent lots of tooling.
@ggreer, the grand-grand...parent, wrote:
> there's no way to do a gradual deploy of the code
There could be version numbers?
> there's no way to do a gradual deploy of the code
There could be version numbers?
some_procedure_v1()
some_procedure_v2()
Version numbers work great as schemas. You could have v1.proc and v2.proc.
Also, for an API schema, only exposing views + stored procedures and hiding tables in private schemas makes the SQL easier to refactor. This is something we recommend at postgrest.org: http://postgrest.org/en/v7.0.0/schema_structure.html#schema-...
Sharing in case this is useful to you.
Also, for an API schema, only exposing views + stored procedures and hiding tables in private schemas makes the SQL easier to refactor. This is something we recommend at postgrest.org: http://postgrest.org/en/v7.0.0/schema_structure.html#schema-...
Sharing in case this is useful to you.
Interesting idea — I had never thought about that (I mean, looking at tables as internals, and procedures + views as the public interface). I'll think about that the next time I'm doing a data migration.
Thanks for sharing, Postgrest looks like intended for people building a web app, and who don't want to write application server code, instead, they install just a database?
Also, I imagine Postgrest is nice for internal admin apps? then one "just" needs to write Javascript and connect to Postgrest via REST?
Actually, it'd be nice if https://postgrest.org homepage explained some different use cases :-) I had to think for a little while, still not sure if I understand all cases when Postgrest can be useful.
Edit: Now I see there're explanations here: https://postgrest.org/en/v7.0.0/ " Motivation Using PostgREST is an alternative to manual CRUD programming" etc, if I just scroll down ab bit. — I didn't do that until now, I probably stopped reading at the "Sponsors" text & images previously, or I thought it was a documentation page.
This is quite cool: "Creating new views happens in SQL with known performance implications. A database administrator can now create an API from scratch with no custom programming".
It looks a bit like GraphQL also: https://postgrest.org/en/v7.0.0/api.html#resource-embedding
Nice that it's written in Haskell, was my favorite language long ago :- )
(PS. http://postgrest.org redirect to: http://postgrest.org/en/v6.0/ which is not the latest version (& not https), maybe you'd like to redirect to: https://postgrest.org/en/v7.0.0/ instead)
Thanks for sharing, Postgrest looks like intended for people building a web app, and who don't want to write application server code, instead, they install just a database?
Also, I imagine Postgrest is nice for internal admin apps? then one "just" needs to write Javascript and connect to Postgrest via REST?
Actually, it'd be nice if https://postgrest.org homepage explained some different use cases :-) I had to think for a little while, still not sure if I understand all cases when Postgrest can be useful.
Edit: Now I see there're explanations here: https://postgrest.org/en/v7.0.0/ " Motivation Using PostgREST is an alternative to manual CRUD programming" etc, if I just scroll down ab bit. — I didn't do that until now, I probably stopped reading at the "Sponsors" text & images previously, or I thought it was a documentation page.
This is quite cool: "Creating new views happens in SQL with known performance implications. A database administrator can now create an API from scratch with no custom programming".
It looks a bit like GraphQL also: https://postgrest.org/en/v7.0.0/api.html#resource-embedding
Nice that it's written in Haskell, was my favorite language long ago :- )
(PS. http://postgrest.org redirect to: http://postgrest.org/en/v6.0/ which is not the latest version (& not https), maybe you'd like to redirect to: https://postgrest.org/en/v7.0.0/ instead)
> Postgrest looks like intended for people building a web app, and who don't want to write application server code, instead, they install just a database?
Besides usual webapps, I've also used it for building an IoT project(sensors logic in the db) and a GIS project(postgis/pgrouting). Some users have also used it for open data projects(OpenAPI is provided).
It's also great for internal admin apps and there are ready-made libs like https://github.com/Wellers0n/react-admin-postgrest-client.
Those are some of the use cases off the top of my head. In general, I think it's good for cases where you'd like to use the database as a "processing engine" instead of a "dumb storage".
The docs definitely need a lot of improvement. Thanks a lot for your feedback!
Besides usual webapps, I've also used it for building an IoT project(sensors logic in the db) and a GIS project(postgis/pgrouting). Some users have also used it for open data projects(OpenAPI is provided).
It's also great for internal admin apps and there are ready-made libs like https://github.com/Wellers0n/react-admin-postgrest-client.
Those are some of the use cases off the top of my head. In general, I think it's good for cases where you'd like to use the database as a "processing engine" instead of a "dumb storage".
The docs definitely need a lot of improvement. Thanks a lot for your feedback!
Exactly this. Treat the DB schema as you would any typical API schema. A lot of the techniques used for evolving application APIs can be used for sprocs and views as well, e.g. versioning for breaking changes, adding optional parameters or new result fields for non-breaking changes. Fundamentally I don't think there's much difference between say, a DB schema defined with sprocs/view or an HTTP schema defined with OpenAPI. Both describe an API contract between two remotely communicating processes, the former case just happens to use a SQL dialect/transport to do it.
Interesting that you mention doing this (version numbers) with views too, I didn't think about that ...
... Maybe that could be a way to "perview" a database migration, before running the migration for real. There could be a table 'Some_table_view_v2' that shows how that table would look, after an upcoming data migration. And then v2 app server code, would use that new view. — Then one could be more certain that the data migration, will work fine.
(At the same time, one might need to be careful to let just a small a fraction of the requests, use the new View, if the view is a bit / a-lot slower than the real table.)
... Maybe that could be a way to "perview" a database migration, before running the migration for real. There could be a table 'Some_table_view_v2' that shows how that table would look, after an upcoming data migration. And then v2 app server code, would use that new view. — Then one could be more certain that the data migration, will work fine.
(At the same time, one might need to be careful to let just a small a fraction of the requests, use the new View, if the view is a bit / a-lot slower than the real table.)
>Let's say... you want... 1%... then 5%, then 25%
Honestly though, it feels like the argument you are making here is that it's impossible in general to incrementally roll out database changes? Sure, it's definitely not as simple or easy as spinning up new cloud application instances and diverting http requests, but it's not impossible or infeasible by any means. The problem with databases is that the best solutions are always so subjective and context specific. It's very hard to write out simple, easy-to-understand, "rules," or "concepts," or whatever. Every answer, to every hard problem, is "it depends."
What are we rolling out here? Does the sproc write data or read data? Both? From the same table/schema/server/etc? Does it move data around? How much data? Do you already have read-replicas? How is data replicated to those? Do you have any parallel-write setups with eventual consistency? What parts of the higher level application/platform utilize this part of the database that we want to change? Can we spin up a new DB instance, with the new sproc, and establish data replication/change resolution with the legacy system as we are rolling out the change? Should we move everything to the new system and set up the compat piece as a _forward_ compat on the legacy side instead? etc, etc, etc.
>But actually pausing execution and inspecting data? Good luck.
There are plenty of ways to do this. Copy-paste the code of the proc into your DB IDE of choice, and execute it line by line. If the proc is using temp tables or @variables or anything else you should be easily able to instantiate those locally too and see what the values look like. Use a transaction and rollback and you can run this stuff over and over on prod if you really want to be sure of what it does. As long as you aren't locking stuff in the DB improperly.
There's also the idea of writing sprocs in a more testable/verifiable way. Maybe you have progress tracking tables with status id columns and timestamps. Maybe you split up a long sproc into phases which each write their outputs into "intermediate tables" in some sort of "processing" schema. Maybe you write things to files somewhere to be consumed by some federated monitoring system. Idk, I could think of random ideas all day here. A lot of them probably sound dumb at face value, but I really don't think any of these goals sound infeasible.
Honestly though, it feels like the argument you are making here is that it's impossible in general to incrementally roll out database changes? Sure, it's definitely not as simple or easy as spinning up new cloud application instances and diverting http requests, but it's not impossible or infeasible by any means. The problem with databases is that the best solutions are always so subjective and context specific. It's very hard to write out simple, easy-to-understand, "rules," or "concepts," or whatever. Every answer, to every hard problem, is "it depends."
What are we rolling out here? Does the sproc write data or read data? Both? From the same table/schema/server/etc? Does it move data around? How much data? Do you already have read-replicas? How is data replicated to those? Do you have any parallel-write setups with eventual consistency? What parts of the higher level application/platform utilize this part of the database that we want to change? Can we spin up a new DB instance, with the new sproc, and establish data replication/change resolution with the legacy system as we are rolling out the change? Should we move everything to the new system and set up the compat piece as a _forward_ compat on the legacy side instead? etc, etc, etc.
>But actually pausing execution and inspecting data? Good luck.
There are plenty of ways to do this. Copy-paste the code of the proc into your DB IDE of choice, and execute it line by line. If the proc is using temp tables or @variables or anything else you should be easily able to instantiate those locally too and see what the values look like. Use a transaction and rollback and you can run this stuff over and over on prod if you really want to be sure of what it does. As long as you aren't locking stuff in the DB improperly.
There's also the idea of writing sprocs in a more testable/verifiable way. Maybe you have progress tracking tables with status id columns and timestamps. Maybe you split up a long sproc into phases which each write their outputs into "intermediate tables" in some sort of "processing" schema. Maybe you write things to files somewhere to be consumed by some federated monitoring system. Idk, I could think of random ideas all day here. A lot of them probably sound dumb at face value, but I really don't think any of these goals sound infeasible.
It's a completely valid question, so I'll try to give a serious answer, from my perspective. Firstly, I'd like to say that SPs can be quite awesome, for several of the reasons already stated. It is normally one of the few ways one can truly enforce integrity, access controls, and logging at the DB level. (Also, most of my experience is from an MS SQL and C# background, so some of this may not translate over to PostgreSQL quite so well)
1. Verbosity and fitness for purpose: while there is a kind of beauty in pure set-based SQL querying, stored procedures by their nature tend to be a procedural paradigm, and in my opinion, they are not particularly well suited to it. They are insanely verbose by today's standards, and doing anything typically requires several times more code than the equivalent in most modern languages (your mileage may vary with different database engines!). This results in large, monolithic SPs, which are difficult to read, understand, and test. The "standard library" is generally far less extensive than mainstream languages, leading to sub-standard, verbose, slow implementations (string concatenations and manipulations are a good example in MS SQL).
2. Code navigation, dependency management: the inverse of point 1 - in general, the tooling around databases for code searching, navigation, etc, is quite woeful in comparison to non database languages. In MS SQL, dependency management is so unreliable, that the official tooling misses several classes of dependencies, just depending on the type of syntax you happened to use. In your question, you start by saying that if you have the necessary tooling already obtained, it's all good. In my experience, rarely are even "barely good enough" tools in place, let alone anything close to what exists in other environments.
3. Unit testing: since databases tend to be stateful, the very concept of unit testing is a bit of an alien one. People don't tend to write SPs with unit tests in mind, and at least in the MS SQL world, the few "unit testing" frameworks that did exist tended to be incredibly painful to use - to the point that they were generally not worth it. Brittle, expensive integration tests are not the same.
4. Execution plan caching: the way databases handle caching of SP execution plans leaves much to be desired - generally the first set of parameters that an SP gets called with end up determining the execution plan for all future calls. Even in well managed code bases, this ends up being an issue, occasionally needing a DBA to manually go in, identify a misbehaving execution plan, and evict it. Vary by param, and no-cache options do not fully solve this. While the need for such mechanisms is obvious, it is surprising that these have been a pain for 20+ years. Now, execution plan caching also happens for normal SQL too, so my point is rather that the culture around SPs tends to have an unreasonable fear of dynamic SQL, which would be far more appropriate _where the query actually is of a dynamic nature!_
I can imagine people replying "but clearly, you're doing things that you shouldn't be - that's not what SPs are for!". And I agree, in a large part that is my point too. But then, what exactly should SPs be used for?
1. Verbosity and fitness for purpose: while there is a kind of beauty in pure set-based SQL querying, stored procedures by their nature tend to be a procedural paradigm, and in my opinion, they are not particularly well suited to it. They are insanely verbose by today's standards, and doing anything typically requires several times more code than the equivalent in most modern languages (your mileage may vary with different database engines!). This results in large, monolithic SPs, which are difficult to read, understand, and test. The "standard library" is generally far less extensive than mainstream languages, leading to sub-standard, verbose, slow implementations (string concatenations and manipulations are a good example in MS SQL).
2. Code navigation, dependency management: the inverse of point 1 - in general, the tooling around databases for code searching, navigation, etc, is quite woeful in comparison to non database languages. In MS SQL, dependency management is so unreliable, that the official tooling misses several classes of dependencies, just depending on the type of syntax you happened to use. In your question, you start by saying that if you have the necessary tooling already obtained, it's all good. In my experience, rarely are even "barely good enough" tools in place, let alone anything close to what exists in other environments.
3. Unit testing: since databases tend to be stateful, the very concept of unit testing is a bit of an alien one. People don't tend to write SPs with unit tests in mind, and at least in the MS SQL world, the few "unit testing" frameworks that did exist tended to be incredibly painful to use - to the point that they were generally not worth it. Brittle, expensive integration tests are not the same.
4. Execution plan caching: the way databases handle caching of SP execution plans leaves much to be desired - generally the first set of parameters that an SP gets called with end up determining the execution plan for all future calls. Even in well managed code bases, this ends up being an issue, occasionally needing a DBA to manually go in, identify a misbehaving execution plan, and evict it. Vary by param, and no-cache options do not fully solve this. While the need for such mechanisms is obvious, it is surprising that these have been a pain for 20+ years. Now, execution plan caching also happens for normal SQL too, so my point is rather that the culture around SPs tends to have an unreasonable fear of dynamic SQL, which would be far more appropriate _where the query actually is of a dynamic nature!_
I can imagine people replying "but clearly, you're doing things that you shouldn't be - that's not what SPs are for!". And I agree, in a large part that is my point too. But then, what exactly should SPs be used for?
Thank you so much for writing that up!
I've found the opposite. It can take a long time to get your head into that space but it produces much more maintainable and robust systems in my experience.
I have a similar experience. I've worked with a product that consists of tens of thousands of stored procedures implementing all business logic. Because you are right next to the data you can get away with doing many thing you would have not otherwise.
Also it acted like a barrier, the core team who understood the business well worked on the stored procedures, keeping things fast and stable.
Another team was doing the tech to interface with the database and UX/UI was then implemented in various technologies in parallel and changed/got recycled every few years to whatever was in fashion.
The difference in culture between the two teams was huge, it seemed to work out well in their case.
Also it acted like a barrier, the core team who understood the business well worked on the stored procedures, keeping things fast and stable.
Another team was doing the tech to interface with the database and UX/UI was then implemented in various technologies in parallel and changed/got recycled every few years to whatever was in fashion.
The difference in culture between the two teams was huge, it seemed to work out well in their case.
It also saves a lot of extra work. Often with more conventional systems you have to pull the data out. Move it into a structure native to the language doing the processing.
In the database you don't need to do any of this. The data is there. The type information is there.
In the database you don't need to do any of this. The data is there. The type information is there.
It is great: your code runs right near the data it’s working with.
If it’s the pits, you need a better suited development environment. I use emacs and interactively code inside the DB. Python, Lua, JavaScript, PGSQL, whatever.
If it’s the pits, you need a better suited development environment. I use emacs and interactively code inside the DB. Python, Lua, JavaScript, PGSQL, whatever.
I'm a journeyman in this space, and don't know emacs well. Can you help me unpack your comment here? You write python in the database directly?
not OP but likely:
1) coding via repl - e.g. one emacs buffer has stored procedure code, send functions over via keyboard shortcut to SQL repl buffer connected to DB to evaluate it 'live' (jupyter notebooks are basically a copy of this mode of operation in a more consumer-friendly package)
2) w/r/t python in db, as OP mentions pgsql, pgsql has support for in-db extensibility using a variety of languages, of which python is one: https://www.postgresql.org/docs/current/plpython.html probably referring to this
1) coding via repl - e.g. one emacs buffer has stored procedure code, send functions over via keyboard shortcut to SQL repl buffer connected to DB to evaluate it 'live' (jupyter notebooks are basically a copy of this mode of operation in a more consumer-friendly package)
2) w/r/t python in db, as OP mentions pgsql, pgsql has support for in-db extensibility using a variety of languages, of which python is one: https://www.postgresql.org/docs/current/plpython.html probably referring to this
Thanks!
Last time I worked with stored procs with an Oracle 8 database, over 20 years ago. PL/SQL was awful.
I work with one extremely large application written in Oracle stored SQL procedures. It is a pain, but pretty efficient.
Terrifying.
As a software engineer, shit like this scares me. I've felt like I'm on a steady, slow, decline for the last ~4 years.
Is it just burnout? Do I need a new hobby?
I used to love programming... Spent 12 hours a day jamming on it. Now, I struggle to keep my mind on a line of code for more than 5 minutes.
At what point is it just burnout, or at what point is it something more? That's what's terrifying to me. I imagine that was a challenge for those close to Lee.
We just know so little about the human body. Our ability to easily query the state of the body, to assess which functional components are working, and which need help, is dismal.
I just hope that Lee, in whatever state he is in, isn't suffering.
As a software engineer, shit like this scares me. I've felt like I'm on a steady, slow, decline for the last ~4 years.
Is it just burnout? Do I need a new hobby?
I used to love programming... Spent 12 hours a day jamming on it. Now, I struggle to keep my mind on a line of code for more than 5 minutes.
At what point is it just burnout, or at what point is it something more? That's what's terrifying to me. I imagine that was a challenge for those close to Lee.
We just know so little about the human body. Our ability to easily query the state of the body, to assess which functional components are working, and which need help, is dismal.
I just hope that Lee, in whatever state he is in, isn't suffering.
After reading this I had to do a quick self-assessment.
For the last few years or so (I'm 33, also a software engineer) I've noticed a pretty big decline in my mental state. I can't focus. I immediately forget what I just looked at, read or did. I completely zone out when people talk to me. I am just not present in any situation. What is strange is that I can actually notice it, not in real-time however. It's been worrying me for the last few months so much so that I started meditating which I've never done before. My wife mentioned seeing a therapist because she thought maybe I was depressed so I scheduled an appointment but it's been rescheduled due to the virus.
I keep hearing about other programmers experiencing similar issues (yourself included) and I wonder if the nature of what we do somehow damages our brain in some capacity and we just don't know it yet. Obviously Lee's case is different but it's certainly scary. I hope he doesn't suffer as well.
For the last few years or so (I'm 33, also a software engineer) I've noticed a pretty big decline in my mental state. I can't focus. I immediately forget what I just looked at, read or did. I completely zone out when people talk to me. I am just not present in any situation. What is strange is that I can actually notice it, not in real-time however. It's been worrying me for the last few months so much so that I started meditating which I've never done before. My wife mentioned seeing a therapist because she thought maybe I was depressed so I scheduled an appointment but it's been rescheduled due to the virus.
I keep hearing about other programmers experiencing similar issues (yourself included) and I wonder if the nature of what we do somehow damages our brain in some capacity and we just don't know it yet. Obviously Lee's case is different but it's certainly scary. I hope he doesn't suffer as well.
Also how is your sleep. 6hrs/day in your 20s is different than 6hrs/day in your 30s.
I’d second this. Check you sleep. #hours. Get a sleep study, make sure you don’t have sleep apnea. Also review your diet and any substances you consume. In my case it was sleep apnea in my 40s that took me from “coding like a m’fing riot” to barely able to concentrate long enough to code a for loop. good luck.
I don’t have the same issue with focus, etc. but I’m a couple years into my software career and have noticed a drastic shift in my cognitive abilities. Not negative per say, but it’s clear that being focused and working on a logic puzzle all day is changing how my brain is wired. You can imagine that our brain, after years of programming, starts to find shortcuts and such to make the tasks easier, but I find it’s coming at the expense of my ability to clearly communicate ideas and thoughts to others. I don’t like it, and I’m very curious if other people experience this.
I've always felt I have to be extra careful about explaining/communicating, as the direct translation of my thought process doesn't deliver. I don't mind it much; I feel it's just a quirk I have to be aware of.
On the other hand, after a long and tiring coding session just talking normal stuff gets cumbersome but that, I figure, is just tiredness and passes soon enough.
On the other hand, after a long and tiring coding session just talking normal stuff gets cumbersome but that, I figure, is just tiredness and passes soon enough.
I have similar problems. Some of it might be because of underlying issues we'll probably never learn about it, but some of it is also social media and information overload.
There's so much shit bombarding us every day, all engineered to provide a dopamine fix and I 100% believe it's affecting our brains.
There's so much shit bombarding us every day, all engineered to provide a dopamine fix and I 100% believe it's affecting our brains.
This. I agree with.
I have to force myself to only check my phone at certain times, and ensure that I don't use it too often. Ever since I have enabled night mode on my iPhone I find myself less distracted and getting better sleep. I also put apps like instagram, snapchat inside folders on a different page so they are always out of my sight.
I have to force myself to only check my phone at certain times, and ensure that I don't use it too often. Ever since I have enabled night mode on my iPhone I find myself less distracted and getting better sleep. I also put apps like instagram, snapchat inside folders on a different page so they are always out of my sight.
I'm 33 also.
I'm starting to form a theory that it could be dopamine depletion. [1]
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791340/
I'm starting to form a theory that it could be dopamine depletion. [1]
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791340/
Anecdotal, but having the same in early 30s. Was diagnosed with ADHD, low-dose long-form Adderall has basically reversed my symptoms, which from my understanding involves dopamine or dopamine receptors. Sleeping better and exercise are both also good boosts.
Check your blood sugar and blood pressure. That is what got me, for a long time I had a lot of brain fog and just was operating at around 50% which was enough to get me by but once those issues were resolved I feel fine now.
Blood pressure has been tested, and is normal (120/70).
I'd be surprised if I had a blood sugar problem. No family history of Type-1 diabetes. I'm thin/muscular. Workout regularly (lift+run).
I suppose it's possible, but I would be surprised. Human body is a weird thing.
I'd be surprised if I had a blood sugar problem. No family history of Type-1 diabetes. I'm thin/muscular. Workout regularly (lift+run).
I suppose it's possible, but I would be surprised. Human body is a weird thing.
Can you elaborate on the theory?
I tried reading the article but can't make too much sense of it.
I tried reading the article but can't make too much sense of it.
They studied motivation & effort in rats, essentially asking the question:
"What makes you work hard for a big (but delayed) reward, when you could just take the easy (but smaller) reward?"
I think of my current state as, always seeking the easy reward. I utterly lack the motivation, energy, and focus, to pursue prolonged difficult tasks (like good programming takes).
When you think about it, we (humans) face this question every day. Why do you get up, and work on hard problems, when you could just sit and watch YouTube? There's got to be something motivating you to sit down, and do the work.
What they found in the study is that if they blocked D1 and D2 receptors, the rats stopped working for the big reward. They would just sit there, and take the small reward. Or, they'd do nothing at all. They became lazy, unmotivated, blobs.
If they supplemented with D-Amphetamine they were able to reverse the effect. Thereby demonstrating, that it's actually the failure to activate D1 and D2 receptors that causes rats to give up on hard work. DOPAMINE is responsible for activating these receptors, and it's these receptors that give you the "OOMF" to get up, and get shit done.
Historically dopamine is seen as the "reward" but that's not really the case. Dopamine is the fuel. It's the catalyst. It's the "mental energy" that gets you off your ass.
So my theory is that, in myself, something is either blocking D1 and D2 receptors... or I've "used up" my dopamine reserves in the brain my continually slamming them with YouTube, gaming, and general computer use. My brain now looks for this high everywhere. Reading a book stands no chance, as it doesn't release anywhere near the dopamine of clicking through YouTube or playing video games.
My baseline is fucked, essentially. So, I am going to begin the hard work of reseting this baseline... No YouTube, no Games. Will report back in a few months.
"What makes you work hard for a big (but delayed) reward, when you could just take the easy (but smaller) reward?"
I think of my current state as, always seeking the easy reward. I utterly lack the motivation, energy, and focus, to pursue prolonged difficult tasks (like good programming takes).
When you think about it, we (humans) face this question every day. Why do you get up, and work on hard problems, when you could just sit and watch YouTube? There's got to be something motivating you to sit down, and do the work.
What they found in the study is that if they blocked D1 and D2 receptors, the rats stopped working for the big reward. They would just sit there, and take the small reward. Or, they'd do nothing at all. They became lazy, unmotivated, blobs.
If they supplemented with D-Amphetamine they were able to reverse the effect. Thereby demonstrating, that it's actually the failure to activate D1 and D2 receptors that causes rats to give up on hard work. DOPAMINE is responsible for activating these receptors, and it's these receptors that give you the "OOMF" to get up, and get shit done.
Historically dopamine is seen as the "reward" but that's not really the case. Dopamine is the fuel. It's the catalyst. It's the "mental energy" that gets you off your ass.
So my theory is that, in myself, something is either blocking D1 and D2 receptors... or I've "used up" my dopamine reserves in the brain my continually slamming them with YouTube, gaming, and general computer use. My brain now looks for this high everywhere. Reading a book stands no chance, as it doesn't release anywhere near the dopamine of clicking through YouTube or playing video games.
My baseline is fucked, essentially. So, I am going to begin the hard work of reseting this baseline... No YouTube, no Games. Will report back in a few months.
That seems to make sense and seems to be happening to a lot of us. I think the dopamine-being-reward hypothesis has been proven to be an oversimplification[1]:
"Dopamine was originally thought of as critical in the pleasure" systems of the brain. It was thought that dopamine makes you feel enjoyment and pleasure, thereby motivating you to seek out certain behaviors, such as food, sex, and drugs. But then research began to show that dopamine is also critical in causing seeking behavior. Dopamine causes you to want, desire, seek out, and search. It increases your general level of arousal and your goal-directed behavior. Dopamine makes you curious about ideas and fuels your searching for information."
I've also noticed that if I try listening to music and my brain is being very picky with my playlist, then I know that the day will probably be filled with apathy and anhedonia.[2]
How much do you think the instant gratification society that we're living in plays a role in this behavior? The internet has made food, sex, goods, etc so easy to get, which may cause issues with dopamine management that our ancestors didn't have.
[1] https://www.psychologytoday.com/us/blog/brain-wise/201802/th...
https://www.wired.com/2011/07/sapolsky-on-dopamine-not-about...
[2]https://www.pnas.org/content/116/9/3793
"Dopamine was originally thought of as critical in the pleasure" systems of the brain. It was thought that dopamine makes you feel enjoyment and pleasure, thereby motivating you to seek out certain behaviors, such as food, sex, and drugs. But then research began to show that dopamine is also critical in causing seeking behavior. Dopamine causes you to want, desire, seek out, and search. It increases your general level of arousal and your goal-directed behavior. Dopamine makes you curious about ideas and fuels your searching for information."
I've also noticed that if I try listening to music and my brain is being very picky with my playlist, then I know that the day will probably be filled with apathy and anhedonia.[2]
How much do you think the instant gratification society that we're living in plays a role in this behavior? The internet has made food, sex, goods, etc so easy to get, which may cause issues with dopamine management that our ancestors didn't have.
[1] https://www.psychologytoday.com/us/blog/brain-wise/201802/th...
https://www.wired.com/2011/07/sapolsky-on-dopamine-not-about...
[2]https://www.pnas.org/content/116/9/3793
> How much do you think the instant gratification society that we're living in plays a role in this behavior?
Yea, my theory is that for some people (like myself), the instant-gratification society has been terrible for mental health. I have effectively retrained my brain to be stimulated by only exciting + novel things. Things that illicit huge dopamine releases due to their nature being inherently novel/new.
Take YouTube as an example. Pull down on the page, and it's like a slot machine. Page loads a whole new grid of fresh - potentially click worthy - videos!
The eyes/brain scan the page looking for a hit. BINGO you see a video that catches your interest. Click. Ahh, satisfying transition instantly to the video. Boring? Click back at the home page, and start the slot machine again. Rinse, repeat.
That cycle of chance (load the grid) --> seek (search the grid visually) --> instant reward (click the video) is what's so dangerous. Takes almost no mental, or physical effort, to carry out this cycle.
IMO, it's exploiting a very primitive system:
chance (randomness) --> stimulates effort --> get reward.
You will naturally tend toward systems that minimize effort, and maximize reward. Everything else will feel like a giant burden, or will lack a stimulating effect entirely.
You can see this same cycle in things like Facebook, Instagram, Google News, or any video game. Minimal effort required, to capture your attention (effectively blasting dopamine).
Yea, my theory is that for some people (like myself), the instant-gratification society has been terrible for mental health. I have effectively retrained my brain to be stimulated by only exciting + novel things. Things that illicit huge dopamine releases due to their nature being inherently novel/new.
Take YouTube as an example. Pull down on the page, and it's like a slot machine. Page loads a whole new grid of fresh - potentially click worthy - videos!
The eyes/brain scan the page looking for a hit. BINGO you see a video that catches your interest. Click. Ahh, satisfying transition instantly to the video. Boring? Click back at the home page, and start the slot machine again. Rinse, repeat.
That cycle of chance (load the grid) --> seek (search the grid visually) --> instant reward (click the video) is what's so dangerous. Takes almost no mental, or physical effort, to carry out this cycle.
IMO, it's exploiting a very primitive system:
chance (randomness) --> stimulates effort --> get reward.
You will naturally tend toward systems that minimize effort, and maximize reward. Everything else will feel like a giant burden, or will lack a stimulating effect entirely.
You can see this same cycle in things like Facebook, Instagram, Google News, or any video game. Minimal effort required, to capture your attention (effectively blasting dopamine).
I like the way you think. You should write a blog!
Sometimes the internet is so small. I’ve had a bad time lately with my attention span, some depression, etc. I looked around and found the same theory. This has legs since I game a lot, sit at a pc a lot, and browse the web constantly.
In an effort (prayer) to help fix it, I am selling my iPhone 11 Pro for a SE. I am selling my PC and iPad for a small laptop. I am also purchase 2-3 books that look interesting and plan to try reading those.
My goal is to slow down my brains access to dopamine for a time and see where that leaves me.
Just a theory!
In an effort (prayer) to help fix it, I am selling my iPhone 11 Pro for a SE. I am selling my PC and iPad for a small laptop. I am also purchase 2-3 books that look interesting and plan to try reading those.
My goal is to slow down my brains access to dopamine for a time and see where that leaves me.
Just a theory!
Hmm, I've experienced the same thing. My hunch is that this is related to spending long periods of time in front of a computer, with internet addiction gradually making my ability to focus worse and worse. I honestly think I was better at reading difficult material when I was a teenager.
I think you just have to retrain your brain to focus in other ways - exercise is shown to improve learning and brain function. There's definitely a relationship between physical health and mental health, and I'm guessing that physical health is an area that a lot of us software devs are neglecting.
I think you just have to retrain your brain to focus in other ways - exercise is shown to improve learning and brain function. There's definitely a relationship between physical health and mental health, and I'm guessing that physical health is an area that a lot of us software devs are neglecting.
This is very similar to my situation, although I'm a bit younger. I've tried therapy and she recommending getting back on ADHD medication and experimenting with that. Haven't gone ahead with it.
Welcome to maturing. Most people I've talked to have noticed things.
The positive part is that experience counts for something.
The positive part is that experience counts for something.
I bet there are some aspects to this that lots of people could self-identify with.
I have a bad habit of remembering a past that never was. I think, man, the code used to just flow so easily, and now it requires effort. But I'm just remembering the highlights; if I try a little harder, I can start to remember other days when it wasn't so easy. I forget my missed deadlines and remember my last-minute saves. Revisiting old code now and again helps to shake the illusion loose.
Arranging life to spend a little bit less time on things that feel like work and making a little more time for things that excite you is a good medicine for this feeling and probably something everyone should do anyway.
I have a bad habit of remembering a past that never was. I think, man, the code used to just flow so easily, and now it requires effort. But I'm just remembering the highlights; if I try a little harder, I can start to remember other days when it wasn't so easy. I forget my missed deadlines and remember my last-minute saves. Revisiting old code now and again helps to shake the illusion loose.
Arranging life to spend a little bit less time on things that feel like work and making a little more time for things that excite you is a good medicine for this feeling and probably something everyone should do anyway.
I think the fact that you're reflecting on it means there's no actual degradation. Someone with Lee's disorder doesn't seem to be capable of self reflection at all.
To me it doesn't really sound like he's suffering, especially given the fact that he doesnt really have meltdowns and freakouts. It sounds more like he's just reverting to a state where his behaviors and consciousness coming from the cerebellum/brainstem, i.e. living much more instinctually and in the present, like all other beings in nature. Yes it creates a big disconnect between him and average human society, but at the same time it seems like he's also freed from a lot of the shackles that come with the human mind, free to live moment to moment.
To me it doesn't really sound like he's suffering, especially given the fact that he doesnt really have meltdowns and freakouts. It sounds more like he's just reverting to a state where his behaviors and consciousness coming from the cerebellum/brainstem, i.e. living much more instinctually and in the present, like all other beings in nature. Yes it creates a big disconnect between him and average human society, but at the same time it seems like he's also freed from a lot of the shackles that come with the human mind, free to live moment to moment.
This feels right. Even when he could express himself in a way I could understand, he never expressed himself as frustrated or suffering. The disease at some level seems to rob its victims from the ability to suffer. It’s hard to comprehend.
I'm curious. Before his disease got bad, when he was still working but maybe starting to show some of the first signs...
Did he ever express any concern? Or was it entirely other people who noticed his decline, but he was oblivious?
Did he ever express any concern? Or was it entirely other people who noticed his decline, but he was oblivious?
He did not ever express concern. The weird thing about the disease is it’s not like Alzheimer’s where you realize you’re forgetting things. Instead it seems you lose the ability to realize. I think by the time he’d be concerned he had lost the ability to be concerned, if that makes any sense.
Lots of people around him did. However, I don’t think any of us thought it was a disease. We just thought he was becoming a jerk or “couldn’t scale” as Cloudflare became a bigger organization. I was angry at him when he left. Felt like he’d abandoned this project we’d started together.
I feel incredibly sad and guilty I didn’t even question whether he could be sick until when I heard his diagnosis about 6 months after he’d left the company.
Lots of people around him did. However, I don’t think any of us thought it was a disease. We just thought he was becoming a jerk or “couldn’t scale” as Cloudflare became a bigger organization. I was angry at him when he left. Felt like he’d abandoned this project we’d started together.
I feel incredibly sad and guilty I didn’t even question whether he could be sick until when I heard his diagnosis about 6 months after he’d left the company.
I was walking down a street in London when you called me to tell me about the diagnosis. I stopped on a street corner (corner of Adeline Place and Bedford Avenue) and talked to you.
Everything I'd seen Lee do and especially some of the last meetings I had with him at work that were so difficult and I kept wondering why he seemed like such a jerk, all that suddenly made horrifying sense.
I felt so awful for my own reaction to him. And guilty.
Everything I'd seen Lee do and especially some of the last meetings I had with him at work that were so difficult and I kept wondering why he seemed like such a jerk, all that suddenly made horrifying sense.
I felt so awful for my own reaction to him. And guilty.
While obviously neurodegerative disorders manifest somewhat differently for everyone, I have some anecdotal evidence pointing the opposite direction. I've known people starting to undergo dementia (as a general term, may have been Parkinson's, etc.) that were aware of their decline. I think the most common example of that was the feeling among them that "I used to be able to do this..."
I'm by no means qualified to make any actual statements about this case, but I don't think that the ability to reflect on degradation is perfectly coupled with a lack of it.
I'm by no means qualified to make any actual statements about this case, but I don't think that the ability to reflect on degradation is perfectly coupled with a lack of it.
How old are you? I'm about to hit 45 and have been on that path for about 2 years now. It started with sleep apnea but I've had that under control for 16 months now. I feel like I'm becoming too slow to be a proficient coder, and I lack the people skills to move to management. I'd pick a lower-stress career, but I've got alimony and need the income.
I've tried getting fit. I've tried improving my sleep. Vitamins, herbs, etc. The only things that work are tobacco(not nicotine, it just makes me sick) and armodafinil in small doses.
I've tried getting fit. I've tried improving my sleep. Vitamins, herbs, etc. The only things that work are tobacco(not nicotine, it just makes me sick) and armodafinil in small doses.
Yoga/Breathing?
I'm a 43 year old software engineer. I definitely do not have the ability to focus on coding (and mathematics) the way I did 20 years ago. It's difficult to describe why exactly, but it's sort of like my ability to reason formally is more prone to breaks in concentration and lapses. I can still do what needs to be done but it takes longer and I have less patience, especially for bit-twiddling.
At the same time, I think I'm a better programmer than I ever was. The programming abstractions I design are better for years of work with different systems. Also, not being able to fit everything in my head as easily helps me write code that is more modular with simpler pieces.
So I feel like I've lost the ability to do the trickiest stuff, but that is a small part of coding and I'll take the skills in overall design any day.
At the same time, I think I'm a better programmer than I ever was. The programming abstractions I design are better for years of work with different systems. Also, not being able to fit everything in my head as easily helps me write code that is more modular with simpler pieces.
So I feel like I've lost the ability to do the trickiest stuff, but that is a small part of coding and I'll take the skills in overall design any day.
I'm here with you, I still love the idea of software, but I can't get myself to sit there and code even the most fun projects. I had a great idea for a project to start a business, I know people would need it, but I just can't get myself to do it. It's frustrating and makes me really depressed that I'm like this.
I had this feeling for many years then finally put together 6 months of effort on an MVP that got zero traction. That great idea? Not so great in reality, I’d been kidding myself. So if it’s any consolation, great idea and great executions are really rare. The common advice is to build a landing page and get x number of signups for a beta before writing a line of code. Makes sense in retrospect.
I think this is pretty natural. When it's fresh and you're learning a lot, programming is easy to keep fixated on. It's very instant-gratification early on. As you progress, the low hanging fruit dries up and goals have longer gratification cycles
I'm in the same boat. Sometime in late spring 2018 my productivity plummeted. Same did my activity on StackOverflow.
However I think what's a huge contributing factor is gaining experience. With every structure we come up with, every function and/or abstraction we also build a mental picture of all the possible dependencies it comes with. We see the bigger picture. And we see the same (potential) paths of failure again and again and again…
I found that another favorite activity of mine didn't suffer: Designing electronics. I can still (productively) spend hours on tinkering with SPICE simulations, soldering in-situ projects, and so on.
And recently I also discovered that it's not programming itself that has become harder for me. It is programming in domains I am extremely familiar with that I'm less productive in. If it's in an area I'm not familiar with, things are much easier, because I don't see the big picture yet.
However I think what's a huge contributing factor is gaining experience. With every structure we come up with, every function and/or abstraction we also build a mental picture of all the possible dependencies it comes with. We see the bigger picture. And we see the same (potential) paths of failure again and again and again…
I found that another favorite activity of mine didn't suffer: Designing electronics. I can still (productively) spend hours on tinkering with SPICE simulations, soldering in-situ projects, and so on.
And recently I also discovered that it's not programming itself that has become harder for me. It is programming in domains I am extremely familiar with that I'm less productive in. If it's in an area I'm not familiar with, things are much easier, because I don't see the big picture yet.
I'm the same. Often incapable of grasping a solution which I know is just within reach. With some problems I can "feel" my brain just blocking, I can't visualise complex data structures. I'll spend days staring at a problem until I give up and ask a colleague who quickly points out the obviously solution. Pretty embarrassing.
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Sounds like you're ready for your next career. If you're fortunate enough to lead a life and live somewhere that doesn't systemically lock you in, maybe think about starting over at something different.
This is horrifying.
Conversations soon became impossible. Lee started chattering in repetitive, unceasing loops. He would tell Kristin: “We met at Cloudflare. We got engaged in Rome. We got married in Maui, Hawaii.” He repeated it hundreds of times a day. Then the loops got shorter, more cryptic. He spoke fewer sentences, instead muttering sequences of numbers or letters.
At the same time, given the flashes of lucidity pointed out in this article, you have to wonder if others talking about his condition so much might make him feel like a walking corpse when those hit.
Conversations soon became impossible. Lee started chattering in repetitive, unceasing loops. He would tell Kristin: “We met at Cloudflare. We got engaged in Rome. We got married in Maui, Hawaii.” He repeated it hundreds of times a day. Then the loops got shorter, more cryptic. He spoke fewer sentences, instead muttering sequences of numbers or letters.
At the same time, given the flashes of lucidity pointed out in this article, you have to wonder if others talking about his condition so much might make him feel like a walking corpse when those hit.
It was incredibly sad to watch. The last time I saw him while he was still speaking — he is still alive but doesn’t speak or seem to recognize me anymore — he would repeat the same questions from the same conversation in the same order on a 30-minute loop. Over and over.
I’ve really struggled to wrap my mind around his condition. I don’t think it’s frustrating for him. He seems to have lost the emotion to be frustrated.
I think we all have a sense of Alzheimer’s because we’ve all forgotten something. This isn’t that. Lee’s memory, if anything, seemed to improve and he’d bring up little details from when we first worked together I’d long since forgotten. What seemed to go away was his ability to process those memories into something more.
It’s hard to imagine losing the ability to imagine. And, as his friend and colleague, it was incredibly frustrating when we just thought he was checked out. And then devastating when we learned all this time he’d actually had a disease.
I do wonder if some of his genius came from his ability to shut down some of the other noise in his life. And if the disease, for some time before it became debilitating, was almost a superpower. I’ve never met an engineer like him.
I miss him every day.
I’ve really struggled to wrap my mind around his condition. I don’t think it’s frustrating for him. He seems to have lost the emotion to be frustrated.
I think we all have a sense of Alzheimer’s because we’ve all forgotten something. This isn’t that. Lee’s memory, if anything, seemed to improve and he’d bring up little details from when we first worked together I’d long since forgotten. What seemed to go away was his ability to process those memories into something more.
It’s hard to imagine losing the ability to imagine. And, as his friend and colleague, it was incredibly frustrating when we just thought he was checked out. And then devastating when we learned all this time he’d actually had a disease.
I do wonder if some of his genius came from his ability to shut down some of the other noise in his life. And if the disease, for some time before it became debilitating, was almost a superpower. I’ve never met an engineer like him.
I miss him every day.
The thought of someone I love (in the broadest sense of the word) being affected by this is horrific. I'm really sorry for his family and friends :(
I think that you're kind of right: I know one engineer who is like that and he it's his autism which makes him brilliant. He could operate in deep-thought mode all the time - he is extremely intelligent and extremely focused. There are other people who can hit it for patches - I could do it for 3-4 weeks at a time when I was 21. At 39 I struggle to do it for an hour a month (kids change you more than anything else).
We really know so little about how our minds and bodies work and that's something we need to change. We should be able to identify and fix conditions like this.
Makes me think that some of us here are wasting our abilities on start-ups and systems when we could be working on fixing much more complex systems.
I think that you're kind of right: I know one engineer who is like that and he it's his autism which makes him brilliant. He could operate in deep-thought mode all the time - he is extremely intelligent and extremely focused. There are other people who can hit it for patches - I could do it for 3-4 weeks at a time when I was 21. At 39 I struggle to do it for an hour a month (kids change you more than anything else).
We really know so little about how our minds and bodies work and that's something we need to change. We should be able to identify and fix conditions like this.
Makes me think that some of us here are wasting our abilities on start-ups and systems when we could be working on fixing much more complex systems.
Life is short and slips away quickly. Use your abilities to further the things that mean the most to you, not on a possibly misguided sense of what you "should" be doing.
And also: have pity on the person who outwardly seems to be an asshole or checked out. You don't know what they're going through.
Reminded me of this quote often misattributed to Plato[0]:
"Be kind; everyone you meet is fighting a hard battle."
and Patrick Farley's version from his series "The Spiders"[1]:
"Show kindness to every person you meet. No matter how ill-tempered a man may seem, you have no idea what private agony he may secretly be struggling with."
[0] https://quoteinvestigator.com/2010/06/29/be-kind/
[1] http://www.electricsheepcomix.com/spiders/3.5/01_hospital.ht...
"Be kind; everyone you meet is fighting a hard battle."
and Patrick Farley's version from his series "The Spiders"[1]:
"Show kindness to every person you meet. No matter how ill-tempered a man may seem, you have no idea what private agony he may secretly be struggling with."
[0] https://quoteinvestigator.com/2010/06/29/be-kind/
[1] http://www.electricsheepcomix.com/spiders/3.5/01_hospital.ht...
Makes me think that some of us here are wasting our abilities on start-ups and systems when we could be working on fixing much more complex systems.
This can go in the wrong direction. Nobody wants to be McNamara, though being Zuckerberg isn't that bad.
This can go in the wrong direction. Nobody wants to be McNamara, though being Zuckerberg isn't that bad.
I'm sorry for the loss you and his other friends/loved ones have experienced.
Do you feel like the article was accurate and fair to the people involved?
Do you feel like the article was accurate and fair to the people involved?
Yes. Very. It was important to me and Michelle that it be a tribute to Lee’s genius and contribution to Cloudflare. We spent a long time looking for the right reporter and publication. Wired seemed appropriate given Lee’s love of technology. And Sandra was a total class act. We opened up fully to her, spending nearly a year letting her get to know us. Lee’s family was incredibly giving of their time. It takes a really talented and empathetic writer to have people feel safe and to open up to such a personal story like they did.
I got the advance copy of the article last night and it’s been an emotional 12 hours reliving a lot of the last 18 years I’ve known Lee. But I’m happy we helped create something Lee’s two sons will be able to read and see a little bit of what an incredible person their dad was.
I got the advance copy of the article last night and it’s been an emotional 12 hours reliving a lot of the last 18 years I’ve known Lee. But I’m happy we helped create something Lee’s two sons will be able to read and see a little bit of what an incredible person their dad was.
Thank you for this post. It reminded me of the one line in “General Magic” where Marc Porat tells the documentary producer that the reason he agreed to make himself very available and open for the film was so that his (presumably somewhat estranged) children can get to know him and the story and the work they did, better.
Terribly sorry for you and your friends and colleagues’ loss. Thank you and everyone else for doing this for his children.
Terribly sorry for you and your friends and colleagues’ loss. Thank you and everyone else for doing this for his children.
Had same reaction when I saw Marc in the General Magic doc. We’d already started working with Sandra when I saw it. But think it’s part of why Marc’s story was so emotional for me. Both stories of opportunity, genius, and loss.
Maybe it was the direction or the editing, but there was so much romance in it for me as a kid growing up in SV during that era. I had Misty eyes for an era mostly gone by.
Thanks again for your work, both on the company and the article.
Thanks again for your work, both on the company and the article.
Thanks for sharing that. It sounds like first and foremost, everyone wanted to do right by their friend. That alone is touching, and I'm glad that the final article was the tribute you all hoped for. It was heartbreaking and beautiful, and was an honor to be let into the lives of everyone involved.
My prayer is that while this time is emotional, the process and article also provide a degree of healing as well. Again, thanks for sharing.
My prayer is that while this time is emotional, the process and article also provide a degree of healing as well. Again, thanks for sharing.
This was one of the most incredibly tragic and moving pieces I've read recently, and serves as a reminder of the fragility of consciousness and being. Thank you for sharing his story.
Thank you.
> I do wonder if some of his genius came from his ability to shut down some of the other noise in his life.
Yes. I can think of a few examples of this.
Yes. I can think of a few examples of this.
Can you expand?
Mostly due to a few small things.
Lee bought a few material things, but he was mostly able to live out of his backpack for years at a time, at least before he got married. He didn't have many material desires (no fancy car, clothes, or big gaming computer). He periodically lived on other people's couches (including mine) between starting university and getting married.
I remember he drove through at least a few red lights because he was in the zone deep in thought processing some coding concepts / business plans in his mind while driving. Once I noticed this, I didn't let him drive me; instead he started to code on his laptop in my passenger seat.
When we were waiting in line to rent a UHaul-type truck, he was pacing the retail waiting area thinking through some coding for a future Unspam feature. I remember it because the guy standing behind me saw him as a stranger threat and started to get anxious that Lee was pacing in a hoodie nearby. I mention it because he never concentrated much on the small daily tasks like waiting in line and mostly overloaded those tasks to optimize his long term goals (eg. startup success).
He didn't write big architecture docs (possibly the part of his work that didn't scale much), but his mental capacity to juggle lots of small facts and tasks was pretty incredible. It worked great with a small team with very low turnover. I miss those days when I just checked in with him 2-3 times a day rather than having to spend a lot of mental effort to figure out how to serialize lots of trivial stories/subtasks into Jira.
Lee bought a few material things, but he was mostly able to live out of his backpack for years at a time, at least before he got married. He didn't have many material desires (no fancy car, clothes, or big gaming computer). He periodically lived on other people's couches (including mine) between starting university and getting married.
I remember he drove through at least a few red lights because he was in the zone deep in thought processing some coding concepts / business plans in his mind while driving. Once I noticed this, I didn't let him drive me; instead he started to code on his laptop in my passenger seat.
When we were waiting in line to rent a UHaul-type truck, he was pacing the retail waiting area thinking through some coding for a future Unspam feature. I remember it because the guy standing behind me saw him as a stranger threat and started to get anxious that Lee was pacing in a hoodie nearby. I mention it because he never concentrated much on the small daily tasks like waiting in line and mostly overloaded those tasks to optimize his long term goals (eg. startup success).
He didn't write big architecture docs (possibly the part of his work that didn't scale much), but his mental capacity to juggle lots of small facts and tasks was pretty incredible. It worked great with a small team with very low turnover. I miss those days when I just checked in with him 2-3 times a day rather than having to spend a lot of mental effort to figure out how to serialize lots of trivial stories/subtasks into Jira.
That’s what I wondered too. If it was all part of a particular kind of brain. He reminded me too much of my ex-husband, also a high level programmer, and his sleep habits and growing apathy and irritability while we were together (though he might point to me as the cause). Not to say my software engineer ex has the same condition, but maybe he has a touch of it. So many of us have just a touch of something that is clinical in someone else.
His old college roommate met up with Lee when the "looping thoughts" symptoms first started to present and the roommate (who had been overseas for 10 years before that) commented that he almost called 9/11 because he thought Lee was having some sort of a stroke. Lee's short term memory seemed to wipe and he restarted the same conversation 3 times in an hour lunch (this symptom is pretty common in my experience with other dementia sufferers).
I met back with them a year later and he was very dependent upon his cell phone to look up people on Facebook, places on Google Maps, movies on IMDB, etc. (basically all nouns) in real time during the conversation to fill in the gaps in his memories. I lived with him for maybe 5-6 years and he had to look up my Facebook profile and pictures to try to pick up on any nostalgia that might catalyze a memory.
I suspect there is an underlying current of frustration, but probably not a high level cognitive realization (at least not a sudden one) that his mind is degrading.
I met back with them a year later and he was very dependent upon his cell phone to look up people on Facebook, places on Google Maps, movies on IMDB, etc. (basically all nouns) in real time during the conversation to fill in the gaps in his memories. I lived with him for maybe 5-6 years and he had to look up my Facebook profile and pictures to try to pick up on any nostalgia that might catalyze a memory.
I suspect there is an underlying current of frustration, but probably not a high level cognitive realization (at least not a sudden one) that his mind is degrading.
I come from a family of extremely gifted visual thinkers (PhDs from MIT/Stanford/etc) and in the last year one of us had a heart issue that coincided with a month long bout of psychosis, where dream-like real visualizations were overlaid onto the real world.
I’m convinced that the genetic effects that provide us with extreme visualization and problem solving skills are related to this particular failure mode, where schizophrenia is also common in the family tree.
I’m convinced that the genetic effects that provide us with extreme visualization and problem solving skills are related to this particular failure mode, where schizophrenia is also common in the family tree.
The ability to make strong abstract connections transforming into misassociations?
I think about this one a lot, how easy it is for pattern recognition to misfire and synthesize conclusions and connections that are partially rational and correct, but with one bad piece of input data skewing them into fantasy. Sometimes the conclusion may be right, but its magnitude, impact, or applicability are grossly overestimated. Part of what makes such gifted people is the ability to imagine, hypothesize, and use hypotheticals. This giftedness often coincides with the ability to make many parallel what if thoughts and identify the most probable. At some point, hypotheticals morph into faith and what was once a thought experiment becomes belief. What ifs break down into belief "this is actually happening, this is reality." It becomes its own compounding feedback loop, as faulty conclusions layer on top of each other over time.
I think about this one a lot, how easy it is for pattern recognition to misfire and synthesize conclusions and connections that are partially rational and correct, but with one bad piece of input data skewing them into fantasy. Sometimes the conclusion may be right, but its magnitude, impact, or applicability are grossly overestimated. Part of what makes such gifted people is the ability to imagine, hypothesize, and use hypotheticals. This giftedness often coincides with the ability to make many parallel what if thoughts and identify the most probable. At some point, hypotheticals morph into faith and what was once a thought experiment becomes belief. What ifs break down into belief "this is actually happening, this is reality." It becomes its own compounding feedback loop, as faulty conclusions layer on top of each other over time.
My father is an entrepreneur, with multiple successful companies under his belt. He's got a knack for seeing opportunities others don't, synthesizing those connections. Anybody who's had a conversation with him can tell you that.
His younger brother, my uncle, was diagnosed with schizophrenia at age 20 after becoming severely erratic while away from home on an LDS mission. The diagnosis devastated their family, and has been followed by decades of difficult treatment and heartbreak.
What is it about my uncle that pushed him over the edge? Environment? Genetics? Pure chance? I wish I could know. My dad says that there's not much left of him except for a few moments here and there.
My dad had a big family, and he's said that his younger brother always showed the most promise, growing up. Smart, charming, super friendly. 30 years on he continues to greet everybody with a smile and hug, even if he doesn't know them!
It's sobering to see it in my own family, and it keeps thoughts like the one you articulated so well in the back of my mind constantly.
His younger brother, my uncle, was diagnosed with schizophrenia at age 20 after becoming severely erratic while away from home on an LDS mission. The diagnosis devastated their family, and has been followed by decades of difficult treatment and heartbreak.
What is it about my uncle that pushed him over the edge? Environment? Genetics? Pure chance? I wish I could know. My dad says that there's not much left of him except for a few moments here and there.
My dad had a big family, and he's said that his younger brother always showed the most promise, growing up. Smart, charming, super friendly. 30 years on he continues to greet everybody with a smile and hug, even if he doesn't know them!
It's sobering to see it in my own family, and it keeps thoughts like the one you articulated so well in the back of my mind constantly.
One idea mentioned in the article that I've seen elsewhere is this:
"The gist, then, is that someone is “himself” because countless mental artifacts stay firm from one day to the next, anchoring that person's character over time."
I have read reports that latent schizophrenia is often revealed when people travel abroad. Maybe if your environment and surroundings change drastically, your mind loses its sense of "self" that was based around anchors to the rest of the environment.
This journal article touches on this:
"Long distance travel has long been known to aggravate pre-existing psychosis.... Travel can be a destabilizing life event7 with many potential hazards to mental health, from the effects of drugs used for prophylaxis against infection, to homesickness, to disrupted circadian rhythms, to culture shock." http://www.ijtmgh.com/article_33029_738f7bb0f6124261891cf610...
"The gist, then, is that someone is “himself” because countless mental artifacts stay firm from one day to the next, anchoring that person's character over time."
I have read reports that latent schizophrenia is often revealed when people travel abroad. Maybe if your environment and surroundings change drastically, your mind loses its sense of "self" that was based around anchors to the rest of the environment.
This journal article touches on this:
"Long distance travel has long been known to aggravate pre-existing psychosis.... Travel can be a destabilizing life event7 with many potential hazards to mental health, from the effects of drugs used for prophylaxis against infection, to homesickness, to disrupted circadian rhythms, to culture shock." http://www.ijtmgh.com/article_33029_738f7bb0f6124261891cf610...
Yes, evolution often seems to result in these sorts of trade-offs. It seems pretty rare to get a genetic "free ride", so to speak. It's like different ways of balancing the same equation using the same resources.
I don't know if abstract problem solving is related to schizophrenia but genes that increase schizophrenia risk are generally correlated with lower iqs.
Saying this as someone whose mother scored in the top 1% on the SAT and was schizophrenic.
Saying this as someone whose mother scored in the top 1% on the SAT and was schizophrenic.
Indeed, I believe IQ is found to be protective for development of schizophrenia (hence lower IQ correlation) -- if you have the genetic disposition but high IQ chances of developing the disease are lower I believe.
Schizophrenia is different that it is at least partially behavioral. The brain is more like an adaptive neural network, so it's sometimes hard (or impossible) to disentangle hardware from "behavioral configuration". In the case of schizophrenia I think (not a doctor!) there is a (perhaps structural) disposition toward modes of thinking, psychosis, delusion etc. -- thought and behavioral patterns that develop if there is inadequate self-assessment in place (which is how I would explain identical twins differentially developing the condition), and experiences of stress and trauma that can disrupt benign thought.
It is a terrible condition... I have close family members with psychosis too (that's somewhere in the spectrum of bipolar to schizophrenia). For me it appears quite clear why intelligence has a protective effect (and one of the many reasons I value, and cherish, intellectual activities of all kinds so much).
Counter to opinions elsewhere (where you shouldn't live in the "shadow of the disease" through genetic screening, family history, etc.), I personally do think it's important to be mindful of it. That way at least symptoms may be recognized early and treatment can be more effective (since it is at least partially treatable and has a large behavioral aspect). Here's hoping we never develop it.
Schizophrenia is different that it is at least partially behavioral. The brain is more like an adaptive neural network, so it's sometimes hard (or impossible) to disentangle hardware from "behavioral configuration". In the case of schizophrenia I think (not a doctor!) there is a (perhaps structural) disposition toward modes of thinking, psychosis, delusion etc. -- thought and behavioral patterns that develop if there is inadequate self-assessment in place (which is how I would explain identical twins differentially developing the condition), and experiences of stress and trauma that can disrupt benign thought.
It is a terrible condition... I have close family members with psychosis too (that's somewhere in the spectrum of bipolar to schizophrenia). For me it appears quite clear why intelligence has a protective effect (and one of the many reasons I value, and cherish, intellectual activities of all kinds so much).
Counter to opinions elsewhere (where you shouldn't live in the "shadow of the disease" through genetic screening, family history, etc.), I personally do think it's important to be mindful of it. That way at least symptoms may be recognized early and treatment can be more effective (since it is at least partially treatable and has a large behavioral aspect). Here's hoping we never develop it.
You are likely right, this is a fascinating insight.
When I was a medical student on my psychiatry rotation we had a patient who was a history professor at a local college. He was actually admitted to the hospital after reporting himself for molesting his neighbor’s children, but this was investigated and turned out to be impossible. Nonetheless, he was convinced he had done it, and was very impulsive and saddened by it (he would tearfully confess over and over). In the end, we imaged his brain and diagnosed him with frontotemporal dementia. The most strangest aspect was that you could look on rateaprofessor.com and see how he gradually changed over the semesters. I remember a comment saying that he came in on day one, told the class they would all get A’s, and left without coming back for weeks.
I have a chronic neurological condition that may eventually affect my ability to walk (though it is stable and the current prognosis is good and the drugs work for the pain) but when I was going through the process of finding out what it was and how bad it was the one question at the front of my mind was "will this affect me mentally?", I could live with the thought I may one day need a wheelchair but I don't think I could live knowing I was going to lose my essential sense of self.
This is a beautifully written article but it hit me pretty hard, I can understand the terror having faced it for a few months, I think if I got a diagnosis of dementia I'd head to Switzerland at the point where I still could.
My heart goes out to Lee and his family.
This is a beautifully written article but it hit me pretty hard, I can understand the terror having faced it for a few months, I think if I got a diagnosis of dementia I'd head to Switzerland at the point where I still could.
My heart goes out to Lee and his family.
Losing your mental faculties is a profound fear especially for smart people. After falling down stairs in the early stages of his ALS, Stephen Hawking went to his local Mensa center to take an IQ test to make sure he was still "all there" and smart enough to do physics.
I'm so sorry for your loss. This hit especially close to home because my grandmother has been suffering from degenerative mental disease for the last few years. I don't live in the same country as her anymore and every time I return, it's horrifying to witness just how fast a person loses their sense of "self".
I think degenerative mental disease like the one here is especially traumatizing since to most of the world, you're physically/visually still the same person. Also, the characteristics that formed your personality often morph into these harrowing alternations - in the case of my grandma - she was always immensely active and always on her feet. She now cannot sit for more than 30 seconds at a time and attempts to run away from home (with no particular destination in mind). She was (it feels strange to write past tense here) a great cook but now she enters the kitchen and has no idea what she's cooking or what step she is on. It is extremely difficult to keep her mind at ease at all. Her mind is so unable to focus or string thoughts together that she has resolved to loud abject shouting of gibberish (much like a toddler) since she has no idea how to convey what or how she got somewhere. But then for the briefest of moments she has complete lucid clarity and will ask me about my job and life, and offer to cook me my favorite dish.
Much like Lee's wife, I don't really know when my grandma's last "real" day was and what my next trip is going to bring sadly. It's a sad and slow torment.
I think degenerative mental disease like the one here is especially traumatizing since to most of the world, you're physically/visually still the same person. Also, the characteristics that formed your personality often morph into these harrowing alternations - in the case of my grandma - she was always immensely active and always on her feet. She now cannot sit for more than 30 seconds at a time and attempts to run away from home (with no particular destination in mind). She was (it feels strange to write past tense here) a great cook but now she enters the kitchen and has no idea what she's cooking or what step she is on. It is extremely difficult to keep her mind at ease at all. Her mind is so unable to focus or string thoughts together that she has resolved to loud abject shouting of gibberish (much like a toddler) since she has no idea how to convey what or how she got somewhere. But then for the briefest of moments she has complete lucid clarity and will ask me about my job and life, and offer to cook me my favorite dish.
Much like Lee's wife, I don't really know when my grandma's last "real" day was and what my next trip is going to bring sadly. It's a sad and slow torment.
Lee interviewed me at Cloudflare. At that time he was still quite active and very interested in his work. It was definitely a noticeable decline, but we all just attributed it to burn out.
I think everyone at Cloudflare was heartbroken when Matthew announced his diagnosis. It was hard to take in.
We love you Lee, you are a champ! You've left a legacy and made the world a better place. Thanks for the opportunity you and the team gave me to work at Cloudflare.
I think everyone at Cloudflare was heartbroken when Matthew announced his diagnosis. It was hard to take in.
We love you Lee, you are a champ! You've left a legacy and made the world a better place. Thanks for the opportunity you and the team gave me to work at Cloudflare.
An old family friend was a brilliant engineer. He then had a stroke and recovered (early 50s), but within a few months started acting strange. He started making really inappropriate statements, and generally acting weird, started buying commemorative coins and not paying his bills. Then he started talking gibberish and couldn't understand people. His motor functions eventually deteriorated and he passed away a few weeks ago. Absolutely horrifying. By the time we all figured it out, it was a couple of years in.
I'd like to add to discussion [1] which shows relation between stress and autoimmune disease, [2] (Russian) case study of a Russian businessman who burned out (lost a part of cortex due to autoimmunte disease) and [3] encephalitis provoked by emotional stress.
[1] https://www.health.harvard.edu/blog/autoimmune-disease-and-s...
[2] https://www.forbes.ru/karera-i-svoy-biznes/392253-kukushechk...
[3] https://www.shmabstracts.com/abstract/stress-is-the-enemy-a-...
And he was clearly overworked, by my guess.
[1] https://www.health.harvard.edu/blog/autoimmune-disease-and-s...
[2] https://www.forbes.ru/karera-i-svoy-biznes/392253-kukushechk...
[3] https://www.shmabstracts.com/abstract/stress-is-the-enemy-a-...
And he was clearly overworked, by my guess.
It is also known that stress increases white blood cell count [1] which is essentially a mechanism behind autoimmune manifestations.
Overwork leads to a stress. No wonder useful body cells can be attacked producing a whole range of resulting diseases.
The risk of a heart attack also significantly increases when white blood cell count gets high as their presence fuels inflammatory processes in obstructed blood vessels. Eventually this may lead to a full occlusion which is essentially what heart attack is.
[1] https://carrington.edu/blog/researchers-discover-link-mental...
Overwork leads to a stress. No wonder useful body cells can be attacked producing a whole range of resulting diseases.
The risk of a heart attack also significantly increases when white blood cell count gets high as their presence fuels inflammatory processes in obstructed blood vessels. Eventually this may lead to a full occlusion which is essentially what heart attack is.
[1] https://carrington.edu/blog/researchers-discover-link-mental...
What an ignorant I was.
March last year (2019), I wrote an email to Lee Holloway asking him how he could bootstrap such a great company. Now I know why I haven’t received the answer.
EDIT: I found an email:
Dear Lee Holloway,
Excuse my curiosity, as an Engineer I am not writing this kind of emails a lot, but I have read the blog series by John Graham-Cumming about the company, and it would really help me if you can answer my question about the constant flow of engineering innovations from your company.
I am a security engineer from Europe and would like to know how is it possible, that security team will start producing such a stream of innovative things like Keyless SSL, CFSSL, SIDH implementation, Red October key management server and many more your company already published?
When the "lift and shift" from the open source or vendor stops and internal building start to happen within an organization? Is it a cultural thing where only a small startup can succeed and scale later? Is it about the budget or is it a cultural shift that is non forcible upon them? Is a prerequisite to the innovation, that almost everything is developed in house? That came to me as a contra productive strategy. I have read Skunk Works and other books, but I am still impressed how that happens regarding to the modern leading IT/infra companies.
Thank you for your time,
...
EDIT: I found an email:
Dear Lee Holloway,
Excuse my curiosity, as an Engineer I am not writing this kind of emails a lot, but I have read the blog series by John Graham-Cumming about the company, and it would really help me if you can answer my question about the constant flow of engineering innovations from your company.
I am a security engineer from Europe and would like to know how is it possible, that security team will start producing such a stream of innovative things like Keyless SSL, CFSSL, SIDH implementation, Red October key management server and many more your company already published?
When the "lift and shift" from the open source or vendor stops and internal building start to happen within an organization? Is it a cultural thing where only a small startup can succeed and scale later? Is it about the budget or is it a cultural shift that is non forcible upon them? Is a prerequisite to the innovation, that almost everything is developed in house? That came to me as a contra productive strategy. I have read Skunk Works and other books, but I am still impressed how that happens regarding to the modern leading IT/infra companies.
Thank you for your time,
...
I know someone with this disease as well. The saving grace seems to be that he doesn't seem to notice his own ongoing demise. He was fired from work and divorced from his wife before the diagnosis, so obtaining coverage from work has required lawyers and is still unresolved. His care is expensive. It's such a tragic story because this happened in the prime of life, and like the article said the adverse behaviors were initially thought to be a mid-life crisis.
Coming to this late, but wanted to offer my condolences and a friendly ear if anyone reading this is dealing with FTD in a friend or relative.
My dad was diagnosed in his 60’s with FTD and declined for years until he passed away in January. It has been really difficult, and even more so for my mom, as she had to deal with him becoming aggressive in later stages of FTD.
It’s an ugly disease, not well-known, and hits people younger than typical Alzheimer’s symptoms would. I’m so sorry to those who have to go through FTD with relatives. It’s just extremely difficult from all angles. :(
If you are dealing with this, whether with the person in the article or someone else, my contact info is in my profile.
My dad was diagnosed in his 60’s with FTD and declined for years until he passed away in January. It has been really difficult, and even more so for my mom, as she had to deal with him becoming aggressive in later stages of FTD.
It’s an ugly disease, not well-known, and hits people younger than typical Alzheimer’s symptoms would. I’m so sorry to those who have to go through FTD with relatives. It’s just extremely difficult from all angles. :(
If you are dealing with this, whether with the person in the article or someone else, my contact info is in my profile.
Thank you.
It's a tragic story. In some way, he'll live on in his contributions to a better and safer internet, for whatever that's worth. Thank you for your contributions, Lee, and I hope you have the best life you can.
Late Dr. Oliver Sacks in his book "musicophilia" spent a chapter on Frontotemporal Dementia (FTD). That's chapter 28: "irrepressible: music and temporal lobes".
The question that occurs to me is: if you knew that was in your future, would you spend your last 10 good years toiling at a startup?
I don’t think Lee ever toiled. He was a “maker” in the best sense of the word. And, to this day, when he expresses himself in the limited ways he still does, he searches Google or YouTube for “Cloudflare.”
In Lee's case, at least when he started his career; the answer to that is definitely "yes". He didn't "toil", and he was working on something he believed in and was passionate about.
While Lee's personality changed a lot over time, he was always the guy who got more out of hanging out in a garage building something than someone touring France/Italy/etc.
While Lee's personality changed a lot over time, he was always the guy who got more out of hanging out in a garage building something than someone touring France/Italy/etc.
Yes. His family are financially secure, thanks to his Cloudflare millions. I could die much more easily knowing my family were safe after I'd gone.
That's the answer to "Would you spend your last 10 years securing a guaranteed multi-million dollar payout?" not "Would you work your tail off for a gamble?"
Startup != assured success.
Startup != assured success.
I should have been more specific with my hypothetical. I only meant having knowledge of the disease, not of any kind of startup mega-success.
10 good years is a long time. As a founder I would guess he truly believed in the mission, at least before FTD took hold, and I think that kind of pursuit would be more fulfilling than a 10 year vacation.
He seemed to love his work. I would.
Yes. It would probably make me do so harder because it’s my life’s work and I have only that much time to do it.
And people don't understand why I fell into a two week existential crisis after I saw 'The Notebook'
> many of the neurologists who study it believe it is underdiagnosed
This is a tragedy. Of course it's underdiagnosed. Everyone around you would just think you're an asshole. In the article, it sounds like so many people fought right and were patient and loving. How many cases do we never hear about, get fought abusively, and push the last shattered remnants of a person into drugs, suicide, etc.
> many of the neurologists who study it believe it is underdiagnosed
This is a tragedy. Of course it's underdiagnosed. Everyone around you would just think you're an asshole. In the article, it sounds like so many people fought right and were patient and loving. How many cases do we never hear about, get fought abusively, and push the last shattered remnants of a person into drugs, suicide, etc.
> And people don't understand why I fell into a two week existential crisis after I saw 'The Notebook'
Thank you. I watched that movie with my wife 15 years ago, now, and it remains the scariest, saddest movie I've ever seen.
Thank you. I watched that movie with my wife 15 years ago, now, and it remains the scariest, saddest movie I've ever seen.
So sad and bleak to read.
Are there any remotely promising paths to treating or preventing neurodegenerative diseases like these in the future? Or at least to slow down the progression? Are there any experimental drugs? Will we likely just need to wait until targeted in vivo genetic engineering is understood and mastered?
I know those are broad questions, but suffering from something like dementia, Alzheimer's, or Parkinson's, or having a loved one suffer from it, seems like one of the cruelest fates imaginable. The helplessness of the doctor saying there's basically nothing you can do other than to try to eat healthy and exercise... If I was given such a diagnosis while still lucid, I think I would want to try every experimental treatment available, if any exist. I'd accept almost any risk over that horrifying, inevitable outcome.
Are there any remotely promising paths to treating or preventing neurodegenerative diseases like these in the future? Or at least to slow down the progression? Are there any experimental drugs? Will we likely just need to wait until targeted in vivo genetic engineering is understood and mastered?
I know those are broad questions, but suffering from something like dementia, Alzheimer's, or Parkinson's, or having a loved one suffer from it, seems like one of the cruelest fates imaginable. The helplessness of the doctor saying there's basically nothing you can do other than to try to eat healthy and exercise... If I was given such a diagnosis while still lucid, I think I would want to try every experimental treatment available, if any exist. I'd accept almost any risk over that horrifying, inevitable outcome.
A cocktail of neural herbals, exercise, meditation, extra therapy - I hope he got all these early on.
That's basically what the doctor said, though. I personally doubt those slow it down very much. I also think the science is still so poorly understood that certain supplements or foods could potentially even worsen things. (Just to throw out a totally made up scenario, maybe some compound found in some plant, and its metabolites, cause a small increase in monoamine release. This may be perceived as a mild stimulating effect in healthy people, but could hypothetically potentially speed up some feedback loop which leads to faster neuron death in people with certain neurodegenerative diseases.)
Exercise and healthy eating is probably still a good idea, but basically it just seems like hoping for the best without real knowledge of what may or may not be helping or hurting.
Exercise and healthy eating is probably still a good idea, but basically it just seems like hoping for the best without real knowledge of what may or may not be helping or hurting.
I've always wanted to work at Cloudflare because of Lee. He was probably the first one from my high school who actually made something that people want (and I also use everyday).
Wow, I had no idea Lee was an alumni–I graduated a little too early to really know of Cloudflare at that point. I’ve occasionally been asked if about notable graduates; I guess I have someone to point to now. It’s sad to hear about Lee’s diagnosis; it would have been great to meet him: aside from talking about technical stuff, I’m sure it would have been interesting to hear about his time in high school.
Yeah I think Lee is probably the most notable (other than DJ Patil) in the tech space.
Initially found this a few years ago when I was doing a "deep dive" on Cloudflare.
Interesting nonetheless!
Initially found this a few years ago when I was doing a "deep dive" on Cloudflare.
Interesting nonetheless!
My father-in-law has FTD. I was just a few paragraphs into the article before I started wondering.
Search the NYTimes for "Frontotemporal Dementia", and you'll find several stories, all similar :-(
Search the NYTimes for "Frontotemporal Dementia", and you'll find several stories, all similar :-(
Remembered me at the end when HAL-9000 said "My mind is going. I can feel it.". But HAL-9000 at least knew :(
This was a sad article that hit pretty deep. I think those kind of stories are even more terrifying for us, programmers, because we can normally lose everything but as long as we have our mind intact we can earn our living and start from zero anytime.
For me the saddest thing in life is the loss of potential, when someone could have done so much more, actually wanted to do more and was even trying to do more, but then something tragic happens.
For me the saddest thing in life is the loss of potential, when someone could have done so much more, actually wanted to do more and was even trying to do more, but then something tragic happens.
Watching a family member fade and the glimpses of them here and there can be horrific.
My father died when I was 9.
Decades later I watched my mother in law dissolve (and she was very much aware / terrified all the time) over the course of a decade. I think it altered and traumatized my wife's entire family in a way I'm not sure they understand or have dealt with.
Sudden death seems so much more humane.
My father died when I was 9.
Decades later I watched my mother in law dissolve (and she was very much aware / terrified all the time) over the course of a decade. I think it altered and traumatized my wife's entire family in a way I'm not sure they understand or have dealt with.
Sudden death seems so much more humane.
That sounds horrific, I'm so sorry
Sad and real story :-( Very well written article worth the read. I won't spoil it with what happened to Lee.
Incredibly saddening to read. I wish Lee, Kristin, and their son all the best.
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Reflecting on the horror, how much worse is this condition for the families who aren't healthcare-wealthy enough to afford diagnosis?
Those victims likely get written off as a worthless drain on society.
Those victims likely get written off as a worthless drain on society.
Although the brain is one of our most important organs it seems we neglect it the most. It seems appropriate to also get a brain check when we do our regular health checks, but most of us don't.
We spend lots of money on medical research but tiny amounts on researching brain illnesses. I'm not saying that we should spend less on other medical conditions - that's not such thing as an unimportant disease, but we should do much more towards ameliorating brain diseases.
We spend lots of money on medical research but tiny amounts on researching brain illnesses. I'm not saying that we should spend less on other medical conditions - that's not such thing as an unimportant disease, but we should do much more towards ameliorating brain diseases.
The behavior described in the article can be seen in all dementia patients.
The article is written like it is a rare and unfortunate story which we watch from the sidelines, but only the age of Lee makes it unique. Many of us will experience exactly the same with a beloved one ( probably a parent, maybe a significant other).
Every single part of the story except the age, all the changes in the behavior —small and large—, how hard it is to live and/or manage someone with dementia, how difficult it is to come to terms with it, etc, happens to an awful lot of people. It's just that it's not a subject people talk easily about.
Last but not least, doctors are often the worst offenders in the progress of this disease. Most doctors only care about the "now", solve the problem at hand, send the patient home and be done with it. Surgery, psychotropic drugs and other forms of treatment can speed-up dementia progress. Alas, there is no incentive to research, document and act on this.
The article is written like it is a rare and unfortunate story which we watch from the sidelines, but only the age of Lee makes it unique. Many of us will experience exactly the same with a beloved one ( probably a parent, maybe a significant other).
Every single part of the story except the age, all the changes in the behavior —small and large—, how hard it is to live and/or manage someone with dementia, how difficult it is to come to terms with it, etc, happens to an awful lot of people. It's just that it's not a subject people talk easily about.
Last but not least, doctors are often the worst offenders in the progress of this disease. Most doctors only care about the "now", solve the problem at hand, send the patient home and be done with it. Surgery, psychotropic drugs and other forms of treatment can speed-up dementia progress. Alas, there is no incentive to research, document and act on this.
You should read this
https://www.nytimes.com/2017/11/02/magazine/why-was-their-br...
IIRC "dementia" is literally just a description of symptoms.
The real truth seems to be that we just barely have the slightest fucking clue most of the time.
https://www.nytimes.com/2017/11/02/magazine/why-was-their-br...
IIRC "dementia" is literally just a description of symptoms.
The real truth seems to be that we just barely have the slightest fucking clue most of the time.
I’m sure you mean well, but your comment came across as a little harsh to me, reducing the very real and very saddening decline of such a talented person, along with the people close to him that witnessed this decline firsthand, to a “so? This happens to everyone”. I agree it’s something that we should continue researching, but I don’t think it’s really fair to claim that doctors are apathetic to the issue.
I viewed it more as a warning about the frequency of dementia, rather than an attempt to minimize Lee's experience.
This was devastating to read. The family were neighbors of ours for many years, and my wife was a close friend of Lee's mother.
While reading this, I could not stop thinking about how much it parallels the story of Ravel. RadioLab did an episode on it: https://www.wnycstudios.org/podcasts/radiolab/articles/unrav...
Thank you for referring to this episode, I found it really resonated with the article.
This is one of the saddest thing I read today and a good reminder that life is always finite.
Neurodegenerative diseases scare me out of my wits. All I can hope is whatever takes me is swift, or at the very least leaves my mind intact. Regardless of who you were and how rich and famous you might be, all what matters is what you'll be.
[deleted]
I am in deep sadness over what has happened to Lee, and I feel for his family, especially Kristin.
I can't help but draw parallels between this story and Flowers for Algernon. It's just sad to see such a young brilliant mind be broken down by this disease.
I wasn't expecting him to be diagnosed with FTD, I will admit that reading the first part of the article painted a very different picture of what might be causing his issues.
Also, since he had a heart condition, I wonder if for some reason that might have accelerated his condition?
I can't help but draw parallels between this story and Flowers for Algernon. It's just sad to see such a young brilliant mind be broken down by this disease.
I wasn't expecting him to be diagnosed with FTD, I will admit that reading the first part of the article painted a very different picture of what might be causing his issues.
Also, since he had a heart condition, I wonder if for some reason that might have accelerated his condition?
I just finished reading this and I'm weeping. I'm so sorry.
devastating to read. any decline into dementia is a tragedy but in your 30's? taupathies suck.
This story is sad and tragic. It reminds me that whenever someone comes hard at you, they probably need more help than you do. Best of luck to Lee and his family.
Thank you Lee. Happy travels, until the sunset.
The idea that we’d eventually come to a day when we can no longer see ourselves. That is hell for most, a gift to few.
Tragic. Hope you live your life to the fullest Lee. And thanks for making the web safer.
Incredible article, and really makes me appreciate how lucky I am to have my cognitive faculties. We really don't have as much time as we think; seize the day and make the most of what you have!
Turing Award winner Robert Floyd also had FTD (the variant earlier called Pick's Disease). He died of it.
Really shows you about how little (if any) free will exists.
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Flowers for Algernon
What a read.
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If this story moves you, and you have the means, consider donating to CSF Leak research at Stanford.
Cerebrospinal Fluid Leaks are something that can completely mimic a large amount of FTD symptoms, and even in the care of utmost professionals, can be near undetectable - and somehow, treatment can be as beautifully simple as a one and done injection... to a hellish guessing game and years of attempts. As Dr. Ian Carrol of Stanford's research has indicated, they seem to be highly misdiagnosed/undiagnosed as well.
I know HN has had posts about CSF Leaks before. I truly believe they're one of the worst things we face in this age that can actually be treated with 100% recovery in some cases. However, for far too many, that really means nothing as they'll be sent to a psych facility, nursing home, or become homeless, and die as a whithered husk of what was once a human before they have the slightest indication of what is actually wrong with them, let alone make their way to one of the few places that truly treat the condition.
Cerebrospinal Fluid Leaks are something that can completely mimic a large amount of FTD symptoms, and even in the care of utmost professionals, can be near undetectable - and somehow, treatment can be as beautifully simple as a one and done injection... to a hellish guessing game and years of attempts. As Dr. Ian Carrol of Stanford's research has indicated, they seem to be highly misdiagnosed/undiagnosed as well.
I know HN has had posts about CSF Leaks before. I truly believe they're one of the worst things we face in this age that can actually be treated with 100% recovery in some cases. However, for far too many, that really means nothing as they'll be sent to a psych facility, nursing home, or become homeless, and die as a whithered husk of what was once a human before they have the slightest indication of what is actually wrong with them, let alone make their way to one of the few places that truly treat the condition.
How DOES one get diagnosed for this? Is there a test?
I had a CSF leak repaired by Dr. Schievink at Cedars-Sinai. My diagnosis happened after I had an acute attack of intracranial hypotension shortly following a long and bumpy session of riding mowing. This attack involved a 'worst headache of my life' that was somewhat relieved by being horizontal. Getting to the hospital seemed too painful, so I stuck it out at home and the headache went away. A couple days later I developed a left sixth cranial nerve palsy, which persisted for around two weeks before I finally went to the ER. After a few days in the hospital and tons and tons of tests for infections, MRIs, lumbar punctures, etc, they decided that I had idiopathic hypertrophic pachymeningitis. That was the working diagnosis for about a week, when my neurologist called me back and told me that they thought they had found CSF leaked into the spinal canal, and so they believed I had a CSF leak.
So, the short answer is that diagnosis will be difficult, and there isn't really a test, but MRI with gadolinium contrast will show enhancement of the dura, and hopefully someone looking at it can see a leak if it is obvious. There are also cases of leaks being caused by a venous fistula, which does not image well.
For what it's worth, I had back-of-head-and-neck headaches intermittently for a while before this, most notably when riding rollercoasters (which I do miss). That is the only long term subtle 'sign' I can remember.
Hope this helps.
Edit: I should also probably add that my case is somewhat weird, caused by a bone malformation in my thoracic spine and difficult to localize with imaging. I had a T1 laminectomy to correct this. However, I'm not sure there are really 'standard' cases, except those that are iatrogenic due to LP or epidural in delivery.
So, the short answer is that diagnosis will be difficult, and there isn't really a test, but MRI with gadolinium contrast will show enhancement of the dura, and hopefully someone looking at it can see a leak if it is obvious. There are also cases of leaks being caused by a venous fistula, which does not image well.
For what it's worth, I had back-of-head-and-neck headaches intermittently for a while before this, most notably when riding rollercoasters (which I do miss). That is the only long term subtle 'sign' I can remember.
Hope this helps.
Edit: I should also probably add that my case is somewhat weird, caused by a bone malformation in my thoracic spine and difficult to localize with imaging. I had a T1 laminectomy to correct this. However, I'm not sure there are really 'standard' cases, except those that are iatrogenic due to LP or epidural in delivery.
If you don't mind answering, how old were you at the time and what was your proximity to Cedars-Sinai?
I have slight regret with not double booking an appointment with Schievink when he personally called me. For some likely completely unreasonable reason, I feel like Dr. Carroll is a bit better of a choice having had a child with a leak. Had an appt with Carroll a small ways out - was in San Diego for strange reasons at the time - was going to be gone by the date of the appt and have to fly in. Schievink very much thought I had a leak from history and others diagnosis (EDS & POTS) - but thought I may be in better hands with Stanford as I already had an appointment - the main reason I went after Schievink was because I was hoping to be seen before I left SD. For some reason, I made the choice to agree with him and stick with only Carroll.
Anyways... A ton of unfortunate things fell thru with some misscheduling at Stanford, and I'm still on a list to be seen by Carroll :(
While both doctors think it's likely that I have one, which is something they've both said they typically don't say over the phone, either way - I see Dr. Carroll as an absolute hero in these strange times we seem to be living in. As selfish as it sounds, I can only hope that man pioneers research into this for the rest of his life. Being on the receiving end of at least one (possibly two with CSF) medical diagnosis in which there's less quality researchers/surgeons in the Western World than can be counted on one hand, you grow to have very strange ideals as to what's truly important in life.
I have slight regret with not double booking an appointment with Schievink when he personally called me. For some likely completely unreasonable reason, I feel like Dr. Carroll is a bit better of a choice having had a child with a leak. Had an appt with Carroll a small ways out - was in San Diego for strange reasons at the time - was going to be gone by the date of the appt and have to fly in. Schievink very much thought I had a leak from history and others diagnosis (EDS & POTS) - but thought I may be in better hands with Stanford as I already had an appointment - the main reason I went after Schievink was because I was hoping to be seen before I left SD. For some reason, I made the choice to agree with him and stick with only Carroll.
Anyways... A ton of unfortunate things fell thru with some misscheduling at Stanford, and I'm still on a list to be seen by Carroll :(
While both doctors think it's likely that I have one, which is something they've both said they typically don't say over the phone, either way - I see Dr. Carroll as an absolute hero in these strange times we seem to be living in. As selfish as it sounds, I can only hope that man pioneers research into this for the rest of his life. Being on the receiving end of at least one (possibly two with CSF) medical diagnosis in which there's less quality researchers/surgeons in the Western World than can be counted on one hand, you grow to have very strange ideals as to what's truly important in life.
I was 30 when all of this transpired initally (I had my surgery at the beginning of last September). I actually live quite far away from Cedars, in Illinois, but forwarded my local medical records to Dr. Schievink after a lot of online research. Post-surgery I stayed with a friend from college who lives in Santa Monica, which was an enormous help, but it also wouldn't be so bad to post up in a hotel. From initial inquiries to the surgery took ~2-3 months, which surprised me.
I haven't interacted with Dr. Carroll, but my general impression of Dr. Schievink was very positive. Everyone in the whole process at Cedars was awesome. That said, I do still have some lingering issues recently that superficially seem spine-related, despite being assured that my saga was over. It has definitely been an improvement, though, relative to pre-surgery.
I'm sorry to hear to you're going through all of this, but there really is light at the end of the tunnel, and I hope you get there sooner than later.
If you have other questions, you can email me at my HN handle @ gmail and I will try to help as I can.
I haven't interacted with Dr. Carroll, but my general impression of Dr. Schievink was very positive. Everyone in the whole process at Cedars was awesome. That said, I do still have some lingering issues recently that superficially seem spine-related, despite being assured that my saga was over. It has definitely been an improvement, though, relative to pre-surgery.
I'm sorry to hear to you're going through all of this, but there really is light at the end of the tunnel, and I hope you get there sooner than later.
If you have other questions, you can email me at my HN handle @ gmail and I will try to help as I can.
If you have zero external support system and literally no money/income... it's an absolute shitshow, and that's about all I can tell you.
Dr. Ian Carroll is arguably the best resource in the world. Starting here is probably a good choice.
https://profiles.stanford.edu/ian-carroll
https://www.mdedge.com/neurology/migraineresourcecenter/arti...
https://youtu.be/QyvWxobqKrc
https://youtu.be/g5lsFIDzazc
No idea why I currently can't find a non walled version of the first link. It's important - and general googling would be "when to suspect a CSF Leak Ian Carroll"
Secondary to Dr. Carroll
Dr. Wouter Schievink at Cedars-Sinai also has good information... He's actually the pioneer of research IIRC.
Saved a dude from a diagnosis of dementia and spending the rest of his deluded days in a nursing home.
https://www.nytimes.com/2017/11/02/magazine/why-was-their-br...
IIRC - in the end, based on decades of patient history, he just opened this guy up as a last resort and nearly missed - but did find the leak. Near full recovery.
It seems to be that there are some very high risk groups, like those with connective tissue disorders - specifically, Ehlers Danlos. Also, from Carroll's findings, a lot of people diagnosed with POTS are often misdiagnosed and truly have some small CSF Leak. Ehlers Danlos and POTS often go hand in hand as well...
Dr. Ian Carroll is arguably the best resource in the world. Starting here is probably a good choice.
https://profiles.stanford.edu/ian-carroll
https://www.mdedge.com/neurology/migraineresourcecenter/arti...
https://youtu.be/QyvWxobqKrc
https://youtu.be/g5lsFIDzazc
No idea why I currently can't find a non walled version of the first link. It's important - and general googling would be "when to suspect a CSF Leak Ian Carroll"
Secondary to Dr. Carroll
Dr. Wouter Schievink at Cedars-Sinai also has good information... He's actually the pioneer of research IIRC.
Saved a dude from a diagnosis of dementia and spending the rest of his deluded days in a nursing home.
https://www.nytimes.com/2017/11/02/magazine/why-was-their-br...
IIRC - in the end, based on decades of patient history, he just opened this guy up as a last resort and nearly missed - but did find the leak. Near full recovery.
It seems to be that there are some very high risk groups, like those with connective tissue disorders - specifically, Ehlers Danlos. Also, from Carroll's findings, a lot of people diagnosed with POTS are often misdiagnosed and truly have some small CSF Leak. Ehlers Danlos and POTS often go hand in hand as well...
Great references. Anonymous browser page works well when trying to get a non-walled access to "when to suspect a CSF Leak Ian Carroll":
https://www.mdedge.com/neurology/migraineresourcecenter/arti...
https://www.mdedge.com/neurology/migraineresourcecenter/arti...
Perhaps this is too philosophical, but for anyone who has dealt with someone with a long decline into dementia, it's very difficult for me to understand a belief in God after going through that (I certainly understand some people have the exact opposite reaction, so I'm in no way saying this belief is correct).
It's just difficult for me to envision a crueler God if that is indeed the case. A person who has died long before their body gives way, only to be a constant burden, with virtually no joy, and a constant reminder that your loved one is dead, yet still here.
In the worst cases I say unreservedly that it is a huge relief when the person's body finally joins their mind in death.
It's just difficult for me to envision a crueler God if that is indeed the case. A person who has died long before their body gives way, only to be a constant burden, with virtually no joy, and a constant reminder that your loved one is dead, yet still here.
In the worst cases I say unreservedly that it is a huge relief when the person's body finally joins their mind in death.
Not to be cruel, but the preexisting, running total of human suffering and tragedy in this world points to the fact that transcendent reality, the realm of God or a God, must have an alternative interpretation for human events, one which humans cannot fathom.
So for example, the tragedies which occur in your nightmares, after you wake, are given a different interpretation- the interpretation of "non-reality", i.e. it didn't really happen in some basic way that puts them into the category of "life non-tragedy".
From God's (or "a god's", for our dedicated atheists) POV, there is some enclosing context to the events of our lives that makes this mess we call reality "make sense". We don't have that perspective, so we think we suffer, pointlessly.
Along the chain from amoeba to goldfish to humans the understanding of events in our shared environment by each species changes. We think of that change as progressively achieving a "deeper understanding" of reality. The zinger in this recitation of prosaic facts is: your consciouness is not the last one in the chain.
This is what Christians experience (and think of) as "faith". Faith in the wisdom or sense-making of a transcendent God and His plans.
So for example, the tragedies which occur in your nightmares, after you wake, are given a different interpretation- the interpretation of "non-reality", i.e. it didn't really happen in some basic way that puts them into the category of "life non-tragedy".
From God's (or "a god's", for our dedicated atheists) POV, there is some enclosing context to the events of our lives that makes this mess we call reality "make sense". We don't have that perspective, so we think we suffer, pointlessly.
Along the chain from amoeba to goldfish to humans the understanding of events in our shared environment by each species changes. We think of that change as progressively achieving a "deeper understanding" of reality. The zinger in this recitation of prosaic facts is: your consciouness is not the last one in the chain.
This is what Christians experience (and think of) as "faith". Faith in the wisdom or sense-making of a transcendent God and His plans.
> the preexisting, running total of human suffering and tragedy in this world points to the fact that transcendent reality, the realm of God or a God, must have an alternative interpretation for human events
You're begging the question. It doesn't point to that at all.
Furthermore, I'd feel terrible accepting that "fact" if I were faithful. It would reduce my faith to that in a demiurge who can't (ergo impotent) or won't (ergo ignorant or malicious) build/maintain a reality that (1) makes sense in the enclosing context and (2) doesn't require the depth of horror and pain for its components/participants that this one does.
You're begging the question. It doesn't point to that at all.
Furthermore, I'd feel terrible accepting that "fact" if I were faithful. It would reduce my faith to that in a demiurge who can't (ergo impotent) or won't (ergo ignorant or malicious) build/maintain a reality that (1) makes sense in the enclosing context and (2) doesn't require the depth of horror and pain for its components/participants that this one does.
Exactly, unless one sees the suffering of others as suffering of NPCs or punishment for a former life, I cannot understand how one can believe in a benevolent omnipotent god. The cruelty that some have to endure is simply not explainable with a such a god. It cannot be benevolent AND omnipotent by definition. It becomes far far far more likely that there is simply no such a god. It's not like this dilemma is new so there should be a better explanation by now.
It's a deep problem with a long history of attempts at answering it, some more satisfying than others. One answer that appeals to many faithful is the idea that all this suffering will be "redeemed", or made to be worth it at the end. Augustine, for example, would take the "NPC" prong of your dilemma by saying that our earthly existence "in time" is not a full experience of reality at all. Indeed, you can find this view, that our conscious experience of reality-in-time is somehow illusory, in many non-Christian sources anywhere from Buddhism to Daniel Dennet. In Augustine's view it's only outside of time, with God, that human beings can fully exist - thus earthly suffering is nothing compared to the joy of being in Heaven. Obviously this is not a foolproof argument, but HN deserves to know the best answers Christian thinkers have come up with.
All religions have a mystic branch which describes an awareness , usually transient, of a higher order to reality in which the suffering of people is "redeemed" or put into perspective or somehow negated.
One interesting thing is that the language and imagery used by the mystics of these different and separated religious traditions are often indistinguishable from each other- it's not clear if it was St. John of the Cross or Augustine or Zen Masters Ikkyu or Dogen who is saying them.
On thing they refer to in this transcendent reality is apprehension of "the coincidence of opposites". So for example, the obvious fact that a thing cannot both be and not be at the same time is itself contradicted or "resolved". In logic we say "not both A and not A" (or else a contradiction is permitted and from there literally anything can be proven).
If I were a goldfish, no matter how right the math you read to me was, I would not understand it, you or anything it referred to. Even as the atomic bomb it described exploded, I still would not understand the nature of reality which now quite literally impinged itself on my flesh.
What would it feel like to be confronted with that kind of knowledge? Would we recognize some formulation of it but reject it, as in: both A and not A?
Would it be something impossible, existing outside of what appears to us to be exhausted possibilities?
Not A Not not A Not both A and not A Not not both A and not A. etc?
We can feel the limits of our own thinking when we reach something which is logically impossible. We just can't get our thinking around these things; contraditions seem like an absolute dead end, leading everywhere and nowhere.
Are there things in our lives which we literally experience, like an atomic bomb disntegrating a goldfish, which even as they touch us and we feel them, we simply fail to comprehend the "real" meaning of them? The breeze? A look? A birth? Suffering?
Spirtual insight may be a thing like mathematicqal talent- some people have a talent for it and some people don't. Such a talent may be completely disconnected from normal intelligence. To people who don't have it, it seems like garbage, i.e. self-contradictory, self-pacifying wishful thinking.
One interesting thing is that the language and imagery used by the mystics of these different and separated religious traditions are often indistinguishable from each other- it's not clear if it was St. John of the Cross or Augustine or Zen Masters Ikkyu or Dogen who is saying them.
On thing they refer to in this transcendent reality is apprehension of "the coincidence of opposites". So for example, the obvious fact that a thing cannot both be and not be at the same time is itself contradicted or "resolved". In logic we say "not both A and not A" (or else a contradiction is permitted and from there literally anything can be proven).
If I were a goldfish, no matter how right the math you read to me was, I would not understand it, you or anything it referred to. Even as the atomic bomb it described exploded, I still would not understand the nature of reality which now quite literally impinged itself on my flesh.
What would it feel like to be confronted with that kind of knowledge? Would we recognize some formulation of it but reject it, as in: both A and not A?
Would it be something impossible, existing outside of what appears to us to be exhausted possibilities?
Not A Not not A Not both A and not A Not not both A and not A. etc?
We can feel the limits of our own thinking when we reach something which is logically impossible. We just can't get our thinking around these things; contraditions seem like an absolute dead end, leading everywhere and nowhere.
Are there things in our lives which we literally experience, like an atomic bomb disntegrating a goldfish, which even as they touch us and we feel them, we simply fail to comprehend the "real" meaning of them? The breeze? A look? A birth? Suffering?
Spirtual insight may be a thing like mathematicqal talent- some people have a talent for it and some people don't. Such a talent may be completely disconnected from normal intelligence. To people who don't have it, it seems like garbage, i.e. self-contradictory, self-pacifying wishful thinking.
It always seems to me that faithful people just don't confront themselves with the suffering that is happening and has happened. When you know about such events it seems to me to be either a lame escape or maliciously ignorant to claim there might be a god who sees the big plan and is still omnipotent. When there is not even a glimpse of a reason for certain acts against children I refuse to accept any far fetched esoteric excuse.
> earthly suffering is nothing compared to the joy of being in Heaven
Now the demiurge is a utility monster.
> this is not a foolproof argument
Argument? It's an admission.
Now the demiurge is a utility monster.
> this is not a foolproof argument
Argument? It's an admission.
> Now the demiurge is a utility monster.
How is the demiurge taking utility from humans if humans ending up in heaven is the optimal outcome for both humans and diety?
> Argument?
It’s an argument that a diety can both be omnipotent and benevolent if humans don’t know true pain or pleasure in their earthly lives. After all, both earthly pleasure and pain are temporary, so if you can conceive of eternal happiness it might render earthly suffering negligible in comparison.
How is the demiurge taking utility from humans if humans ending up in heaven is the optimal outcome for both humans and diety?
> Argument?
It’s an argument that a diety can both be omnipotent and benevolent if humans don’t know true pain or pleasure in their earthly lives. After all, both earthly pleasure and pain are temporary, so if you can conceive of eternal happiness it might render earthly suffering negligible in comparison.
I always hear this back from people, but it's a failure in understanding what's being said. You can't conceive of any future "knowledge" or state of being or most broadly, "configuration of reality" which could retroactively justify or "make right" proven and real human suffering already suffered. That is just not possible to you.
That is what you're saying. It's isomorphic to your argument; it is your argument's essence.
Expressed that way, the issue becomes apparent. We cannot conceive of something; it is inconceivable. But that inconceivability is exactly what the original argument is asserting - it's a thing beyond human conceptualization. Exactly.
All parties to the argument find agreement on this point.
That is what you're saying. It's isomorphic to your argument; it is your argument's essence.
Expressed that way, the issue becomes apparent. We cannot conceive of something; it is inconceivable. But that inconceivability is exactly what the original argument is asserting - it's a thing beyond human conceptualization. Exactly.
All parties to the argument find agreement on this point.
I have no wisdom to share, and certainly no opinion on higher power that I would consider profound. What you describe is an unbelievably trying experience.
If you are hoping to make some sense of it all, I found Man's Search for Meaning by Viktor E. Frankl really altered how I see suffering and my place in the world. It's a very concrete book, and outlines a way to live with meaning without needing God (though totally compatible with faith).
Stay strong friend, I believe in a tragic optimism[0] like that outlined in Frankl's 1984 postscript.
[0]: https://www.goodreads.com/quotes/6807951-i-speak-of-a-tragic...
edit: corrected the quote and added a link
If you are hoping to make some sense of it all, I found Man's Search for Meaning by Viktor E. Frankl really altered how I see suffering and my place in the world. It's a very concrete book, and outlines a way to live with meaning without needing God (though totally compatible with faith).
Stay strong friend, I believe in a tragic optimism[0] like that outlined in Frankl's 1984 postscript.
[0]: https://www.goodreads.com/quotes/6807951-i-speak-of-a-tragic...
edit: corrected the quote and added a link
I truly feel for your loss. Two of my grandparents have gone or are going through dementia.
I don't think that this has any bearing on the existence of God, however. Humans are the ones who have created such an overwhelming and toxic physical environment and disconnected social one. For God to truly endow us with free will, He had to allow us to fail, even this miserably, and to cause our contemporaries and descendants to suffer for our failures. We have the hope of Christ's return and eternal life but only after everyone has been given the opportunity to turn to God for hope on earth.
I don't mean to prosthletize — this is how I understand the world and helps keep me hopeful in times of grief, and I hope it helps you too.
I don't think that this has any bearing on the existence of God, however. Humans are the ones who have created such an overwhelming and toxic physical environment and disconnected social one. For God to truly endow us with free will, He had to allow us to fail, even this miserably, and to cause our contemporaries and descendants to suffer for our failures. We have the hope of Christ's return and eternal life but only after everyone has been given the opportunity to turn to God for hope on earth.
I don't mean to prosthletize — this is how I understand the world and helps keep me hopeful in times of grief, and I hope it helps you too.
> Humans are the ones who have created such an overwhelming and toxic physical environment and disconnected social one
This argument isn't really theologically sound. If God exists, he's the one that created a biological system that allows for something as horrific as dementia. That literally has nothing to do with anything humans have done. It's pointless suffering.
> and to cause our contemporaries and descendants to suffer for our failures
Who's failures caused dementia? Certainly wasn't our ancestors fault.
Personally, I gain more comfort from the idea of an impartial universe, than a God who thinks this level of suffering is necessary.
This argument isn't really theologically sound. If God exists, he's the one that created a biological system that allows for something as horrific as dementia. That literally has nothing to do with anything humans have done. It's pointless suffering.
> and to cause our contemporaries and descendants to suffer for our failures
Who's failures caused dementia? Certainly wasn't our ancestors fault.
Personally, I gain more comfort from the idea of an impartial universe, than a God who thinks this level of suffering is necessary.
If freewill is so sacred why does the OT and NT have so many examples of freewill being removed? Like in 2 Kings 1:10 and other places, if God is fine with freewill being ignored, and God never changes, then he can act, and if he can act would he not be considered unjust by Jesus words in Luke 18:1-8? Not a gotcha or academic question, just something on my mind recently.
I'm not positive that the 2 Kings example is exactly free will being removed, because Elijah asks God for what happens, and God does respond to prayer (praying with faith is another issue).
But I do see what you're asking — how God seems to step in more often in the OT. Thinking of all of human history from ~4000BC until now where Mankind "grows up" over time, the concept of God as Father works — parents put a lot of restrictions on their kids when they're young to keep them safe, and remove those restrictions over time. Even if the child does something unsafe at a certain point a parent just has to say "now that you know the consequences, you have to live with them."
But I do see what you're asking — how God seems to step in more often in the OT. Thinking of all of human history from ~4000BC until now where Mankind "grows up" over time, the concept of God as Father works — parents put a lot of restrictions on their kids when they're young to keep them safe, and remove those restrictions over time. Even if the child does something unsafe at a certain point a parent just has to say "now that you know the consequences, you have to live with them."
I mean the people who got torched had their freewill removed without warning, death by direct action of God. The issue is not with boundary setting, the issue is with Jesus seemingly calling himself (God) unjust, since freewill doesn't seem like an inviolable issue, if God doesn't have a hard restriction on effecting freewill (which seems to be the case) then he is seemingly the same as the unjust judge? I understand the argument from Job that people aren't to question God because we are simple clay to him, or the argument that people are evil and deserve nothing less than eternal suffering, but since Jesus set the expectation and made the connection directly in Luke it seems like a non-upheld internal measure/standard of God's own?
[deleted]
Great question. Lots of history on this topic, here is an interesting overview in regards to the Lisbon Earthquake[1]:
https://youtu.be/vx8ZMkWL8hw
[1] https://en.m.wikipedia.org/wiki/1755_Lisbon_earthquake
https://youtu.be/vx8ZMkWL8hw
[1] https://en.m.wikipedia.org/wiki/1755_Lisbon_earthquake
I'm sorry you had to watch that happen to someone on the long decline. Occuring alongside a number of other conditions, my mother's dementia only ran a brief course before she passed away. That brief window was terrifying and heartbreaking. I understand some of the relief you mentioned. It felt like a war had ended.
This is a question as old as religion, of course, with plenty of answers of all sorts: because He has a plan we cannot see, because He is punishing you/us/him, because He is testing you/us, because The Evil is really responsible, etc etc...
In the end, is it really that cruel, when compared to creating a universe that is effectively trying to kill us all every single day...? From animals and plants in the jungle, to solar flares and asteroids, everything in nature is to us what a garrison of armed Stormtroopers is to Han Solo: they might miss most of the time, but it’s not going to be for lack of cruelty or intent.
In the end, is it really that cruel, when compared to creating a universe that is effectively trying to kill us all every single day...? From animals and plants in the jungle, to solar flares and asteroids, everything in nature is to us what a garrison of armed Stormtroopers is to Han Solo: they might miss most of the time, but it’s not going to be for lack of cruelty or intent.
It's a very strange thing. For instance, the Bible is full of horrifying events, and the life of Jesus, a seemingly innocent, well intentioned man who is crucified in an excruciating death for no good reason, also seems to be in line with denying the existence of a good God. In fact, Jesus seems to agree with this in his last moments on the cross, saying "my God my God why have you forsaken me?" It is very mysterious why one of the world's largest religions has its foundation in such God denying aspects of reality.
The weirdest thing was when in one of Oliver Sacks' book (maybe The Man Who Mistook His Wife for a Hat), after countless stories of people losing their personality, their mind, almost their humanity in some cases, he talked about his continued belief of the existence of an immortal soul, when I precisely myself find his stories vivid evidences that such a thing as a "soul" is a complete absurdity and an illusion.
Shouldn’t have an expectation of god making everything well. Otherwise there’s be no war. If that is your requirement to believe in god, you will never
G-d is a human construct.
Every person is a door to your happiness, and you have the choice to serve their happiness or to treat them callously or even cruelly.
There is no religion without the person actively trying to be a better person to every single person around them. It doesn't matter what spiritual practices they do or don't do, we are each measured by our hearts with respect to how we treat every person we encounter.
Religion's only goal is to get us to work together cooperatively across all divisions of humanity (from form of religion, to gender identification or sexual preference, to ethnicity or culture) to create caring, accepting societies. Right now, our world's state is the result of our societies being based on competition. That is why there are so many destitute homeless people. The system itself doesn't give a shit about them because the system itself only cares about money.
And this is all the result of human making choices based upon their selfish desires, humans in their packs taking as much as they can for themselves while callously ignoring out-group members. That is not human, and is literally inhumane. For that same society to produce Jeff Bezos demonstrates its brokenness that is also its design.
The problem is that the vast majority of so-called religious folks are only doing so to be a member of the alpha group, instead of being interested in how they can be a better member of a better, all-inclusive society. We have mammalian bodies and those structures inform our potentials. To be human is to rise above that animal heredity and embrace the virtues of humanity: caring, active, effortful compassion being essential.
This is why a prominent Rabbi spoke at Muhammed Ali's funeral. They were both Men of God who spread love and unity amongst and between their different cultures. Anywhere you find universal love and respect for all others, you find God's Religion, whichever form it takes in its society.
And legion are those that selfishly deceive in the name of religion or even try to create their own religions. The child rapist Catholic Priest does not denigrate the Message of Love present in Jesus' form of God's Religion; he only proves his perfidy and that of the organization that hides his sins and felonies from his prey's society.
There is no religion without the person actively trying to be a better person to every single person around them. It doesn't matter what spiritual practices they do or don't do, we are each measured by our hearts with respect to how we treat every person we encounter.
Religion's only goal is to get us to work together cooperatively across all divisions of humanity (from form of religion, to gender identification or sexual preference, to ethnicity or culture) to create caring, accepting societies. Right now, our world's state is the result of our societies being based on competition. That is why there are so many destitute homeless people. The system itself doesn't give a shit about them because the system itself only cares about money.
And this is all the result of human making choices based upon their selfish desires, humans in their packs taking as much as they can for themselves while callously ignoring out-group members. That is not human, and is literally inhumane. For that same society to produce Jeff Bezos demonstrates its brokenness that is also its design.
The problem is that the vast majority of so-called religious folks are only doing so to be a member of the alpha group, instead of being interested in how they can be a better member of a better, all-inclusive society. We have mammalian bodies and those structures inform our potentials. To be human is to rise above that animal heredity and embrace the virtues of humanity: caring, active, effortful compassion being essential.
This is why a prominent Rabbi spoke at Muhammed Ali's funeral. They were both Men of God who spread love and unity amongst and between their different cultures. Anywhere you find universal love and respect for all others, you find God's Religion, whichever form it takes in its society.
And legion are those that selfishly deceive in the name of religion or even try to create their own religions. The child rapist Catholic Priest does not denigrate the Message of Love present in Jesus' form of God's Religion; he only proves his perfidy and that of the organization that hides his sins and felonies from his prey's society.
The True Scotsman, I know...
Well, correct me if I'm wrong, but words have meaning and, as a father-to-son Scotsman, I'm pretty fucking sure that a Scotsman has to have some branch of their ancestry come from Scotland.
Also, a priest can't honestly say they love you and serve Jesus if they're raping your children in the back room.
There is truth and there are lies and falsehoods. Nuance is required to discern between them. Most people are just too intellectually lazy to even try. That ignorance leads to many of the systemic problems of our world, not the least of which are religious groups like ISIS/ISIL and the Catholic Church deceiving people with their lies, hypocrisies and oppressions.
Dunning & Kruger, dude. I know where you land on the chart, and I know that you don't know where you land yet think you do.
Also, a priest can't honestly say they love you and serve Jesus if they're raping your children in the back room.
There is truth and there are lies and falsehoods. Nuance is required to discern between them. Most people are just too intellectually lazy to even try. That ignorance leads to many of the systemic problems of our world, not the least of which are religious groups like ISIS/ISIL and the Catholic Church deceiving people with their lies, hypocrisies and oppressions.
Dunning & Kruger, dude. I know where you land on the chart, and I know that you don't know where you land yet think you do.
hwc(7)
If I start with God, any conclusion I will care to make will be true.
I feel that our profession, software engineering, might actually cause this sort of problem. Like the movie 'Concussion' the hyper focus on solving logic problems might cause brain damage. I've experienced something like this after multi day long bouts of coding, where at the end I become incapable of understanding simple greetings from other people. It is like the 'social signal processor' part of my brain just shuts down.
And, it is this 'social signal processor' that helps keep me sane. God knows what I'd be like if I only lived in my own head 24/7. So, what kind of brain damage could it do to a person to become completely consumed by coding 24/7 (even though I'd love to do so)?
"The madman is the man who has lost everything except his reason." - GK Chesterton
And, it is this 'social signal processor' that helps keep me sane. God knows what I'd be like if I only lived in my own head 24/7. So, what kind of brain damage could it do to a person to become completely consumed by coding 24/7 (even though I'd love to do so)?
"The madman is the man who has lost everything except his reason." - GK Chesterton
This story convinced me that I need some sort of legal document stating my desire to be euthanized if I ever reached this point. Ideally, I'd like to leave this world with an extremely high dose of a psychedelic drug. Not hooked up to machines in a hospital bed.
> Ideally, I'd like to leave this world with an extremely high dose of a psychedelic drug.
I'd be afraid of the potential for a bad trip.
IMO this is why brain scans should be more common / part of a normal physical every few years.
kabacha(1)
Oh wired, hijacking my back button. Never change from the horrible thing you are
Right Click > Open in new tab
Could it be that Lee's productivity frenzy eventually led to this disease?
I tend to practice the same style of getting things done during crunch time. I have the same behavior afterwards. Sometimes I can sleep a few days in a row after making a software release. And yes, taking a vacation with my girlfriend sometimes took the same shape: she was running circles in a new city while I was chilling at the hotel room trying to enjoy a few rare moments of rest.
Reading the whole story rang a few bells to me.
I tend to practice the same style of getting things done during crunch time. I have the same behavior afterwards. Sometimes I can sleep a few days in a row after making a software release. And yes, taking a vacation with my girlfriend sometimes took the same shape: she was running circles in a new city while I was chilling at the hotel room trying to enjoy a few rare moments of rest.
Reading the whole story rang a few bells to me.
Second had information from Lee's doctors suggest that there's a genetic component.
From what I remember, he was also born prematurely and spent weeks in a NICU.
Also worth noting that the disease didn't ease up after he stopped working, so the suggestion that "working less" might have avoided it is not clear.
From what I remember, he was also born prematurely and spent weeks in a NICU.
Also worth noting that the disease didn't ease up after he stopped working, so the suggestion that "working less" might have avoided it is not clear.
The way they describe this disease and his behavior, bending over backwards to keep him alive is just going to draw out the suffering of him, his family, his friends, etc. There's nothing bad on the other side of existence/nonexistence anyway, so why not just mercy kill what's left of the poor guy? It's either a quick and painless death or painful, slow disintegration from here on out.
Some additional info that might be of interest to this crowd:
He was fantastic at video games (RTS and RPG) and chess. He had impeccable hand-eye coordination. He co-founded a gaming clan. None of that is relevant anymore.
There is nothing to be done. His condition can't be solved (within his timeframe) by medicine or technology. eastdakota offered to spend whatever it took, but the least worst option was to move him across the ocean and turn him into a test subject for tests that he probably wouldn't tolerate in his current state.
He was deliberate in "minimizing toil". His university projects morphed into patents and a job at UnSpam and Project HoneyPot. Project HoneyPot's technology unlocked the core value to CloudFlare, which he cofounded. His projects and stacks were deliberately chosen for maximal reuse and to minimize wasted effort.
I thank Matthew and Michelle for keeping the story of his journey alive. I can't imagine the tech periodicals are knocking down their doors to write stories like these. Connie Loizos had another piece on him at TechCrunch in 2019[1]
[1] https://techcrunch.com/2019/08/15/cloudflare-has-a-third-cof...