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My Dad has ALS and has participated in a couple trials for different treatments. It's hard to say if any of them made a difference at all, and the justification behind some of these drugs seems extremely flimsy (one he was doing was for a drug that had some weak correlation during covid for slightly slower progression in one symptom), and the quality life impact of participating in that trial (having to fly to Boston, drug side effects, multiple lumbar punctures) leaves me frustrated that doctors recommend these at all. I feel like they're trading favors to get patients into studies with doctors they know, meanwhile, there are more promising ones that are being tested that he should be a candidate for, but the doctor won't even have a conversation about trying to get him in those trials. It leaves a bitter taste in my mouth. I hope something comes from all this, but right now I don't have a high view of the drug research and treatment process for this condition.


I hope this is not inapropriate but I wanted to share this interview with a person using a high fat diet for ALS: https://youtu.be/GoF4GZ1NoBQ?si=Y-yEnquZsLXXb2po

Noting that ketogenic diets are already proven to improve outcomes in other neurodegenerative diseases.


It's not by design, but one thing I loved about living in Raleigh, NC is how many of the trees were preserved as it developed. It's quite nice (except during pollen season if you have allergies) and the shade is pretty valuable when dealing with those summers. It's especially noticable compared to Durham, which was not able to preserve as many trees close to it's downtown core and some big roads. Though Durham still has something like 52% tree coverage? The housing development craze in that area is definitely making a dent in the the coverage for the region as a whole though.


Reminds me of a place I used to work. Every time they asked for feedback, my refrain was "nothing here gets prioritized without a PIR (post-incident response)". Towards the end of my time there, whenever a PIR-related ticket showed up, I would mark it as a duplicate of whatever actual ticket I had dying in the backlog that would have prevented it. It really hurt team morale to have no influence in preventing foreseeable issues in our domain area. Most of the rest of the team had even stopped suggesting improvements altogether because management refused to let us pull our own tickets in.


They give zero feedback, so there are way better places to apply if that's all you're looking for.

The truth is the applicants have to have a story that resonates with whoever reviews your submission. Sometimes people jive over a shared problem space, sometimes they just like people who remind them of themselves or who come from "trust networks" they respect. The latter cases are where the bias keeps seeping in.

And just because they don't pick you for an interview doesn't mean you were disqualified forever. A lot of people reapply and have success. There are just so few slots compared to applicants that most don't hear anything.


There's also a great Adult Swim Infomercial satirizing this idea, "Live Forever As you Are Now with Alan Resnick"[1]. Apparently it came out the same year as that Black Mirror episode (2013) !

[I]https://m.youtube.com/watch?v=xg29TuWo0Yo


I like to boogie board


I think Inside No. 9 also had an episode on this theme. It’s a seriously underrated show and practically unknown. It sort of occupies a middle ground between Black Mirror’s dark satire and Resnick’s absurdist realism, now that I think of it.


I actually love games with weird mechanics, but I see this problem a lot when I try to teach certain games to friends and family. Even if they're sober and used to playing board games. Some that take at least one playthrough for us are usually: Terraforming Mars, Terra Mystica, Gloomhaven.


I spent a few months in Austin for the first time this year. I hadn't expected much from it, but by the time I had left it had grown on me. I loved that it still had 24-hr coffee shops, I couldn't even find those in Seattle this summer. I also met a bunch of really kind, fun, and ambitious people in my age group (30s) through board groups, including other people interested in founding startups. Overall, it's definitely way more exciting than Raleigh, and the music scene was great too. I think it will continue to attract talent, especially from tech/startup-oriented southerners who may not feel culturally at home on the West Coast. The only other southern city I've organically ran into founders was Nashville, which is nice, but also quite expensive and doesn't have the history of tech investment that Austin does.


What are board groups? Like board games?


Same question. And why in the world was this person downvoted for asking?

Austin may not have jumped the proverbial shark, but this place sure has. Very different audience than the people who were here just a few years ago.


Lots of jaded, unemployed SWE with free time here now


As in any such case, whether a city or a forum, it's not different people, it's the same people getting older.


Yep, I missed a word. Board game groups.


> 24-hr coffee shops, I couldn't even find those in Seattle this summer

In Seattle? If New York is the city that never sleeps, Seattle is the tiny city with a narcolepsy approaching that of the twin cities. With the exception of a few restaurants, only the bars are open late nights and they all close by 2 am.


There are a few coffee shops that open late (a Starbucks that opens 24h) but they're all on the east side (suburbs). I would have expected them be in the city, but I guess there's no late night coffee culture there -- it's bars or nothing.

Just a little bit north in Vancouver BC, there are a ton of coffee places that open late.


Durham is more exciting than Raleigh . That said I have found the Raleigh-Durham area a nice antidote to be in tech and not be in a hyper competitive, hustling , aggressive environment. There are a bunch of tech, pharma companies and universities which make the culture more research oriented and a little bit of what tier 1 tech cities were pre 2010. Personally I moved from the west coast after burning out and I have found the slower pace nicer but also enough tech opportunities to just continue as a programmer and not want to suddenly become a yogi or venture capitalist or reinvent myself as a farmer .


i'm in Canada but from the US and if I had to move back the RDU would be on the short list.


I don’t understand this tier 2 and tier 3 city tour

everything you like is in the densely populated tier 1 cities

fly over, it’s an objective crowded trade for a reason


This might sound crazy, but people also like houses they can afford. Good luck finding one within an hour's drive of NYC, LA, or Seattle if you don't have a spare million or so.


settling for less does sound crazy to me, but thanks for reminding me people do that and more should

OP sounded like they were randomly choosing areas around the entire continent and just skipping the big timeless beacons of living, as if everyone else was missing something, while OP simply hadn’t considered trying their hand at those places either.


You're reading way too much into the cities I mentioned! I work remote and have been city-hopping to places where I have friends and family, and none of my friend group are in tier 1 cities. I would love to do a long stay in LA and NYC in the future, but they're excluded from the housing program I use to bounce around.


props, hope you get to do that


That's been 100% my experience as well. The real choice for me is "do I want to sit in front of my keyboarding spiraling down further and being mostly useless (and feeling guilty about that), or do I want to spend a little time addressing the problem and come back when I can function." Often times even just 3-4 hours is enough to do that. Getting FMLA protection for my chronic health condition has been amazing for that as it removed the guilt I used to feel about taking time, and I'm more productive than I've been in years despite taking a few hours a week. Recovering from burnout is seriously hard and it honestly needs it's own DSM diagnosis at this point.


Most folks I work with don't take PTO for short appts like that. Usually they just put it on the calendar and communicate it to the team. Or they shift the schedule for the day to start later and work later to fit in a morning appt. That said, the dentist near me is open til 7pm so after work dentistry seems to be an option too.


Yep, near Spruce Pine, NC. My Grandad lived his whole life in that area and would tell stories about mining mica and riding the trains they used to transport it. There's still a bit of the train system left, at a local amusement park, Tweetsie Railroad.


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