3 ms·

If you had written this comment at the beginning instead of https://news.ycombinator.com/item?id=11651110 https://news.ycombinator.com/item?id=11651110 , I woul

If you had written this comment at the beginning instead of https://news.ycombinator.com/item?id=11651110 https://news.ycombinator.com/item?id=11651110 , I would have had no reason to take exception. This comment makes perfect sense to me. Can you see the difference between the two?

arkades 11y ago
Honestly, no, but I'm glad we reached a point of mutual understanding.
- haberman 11y ago
  I am too. The first I would paraphrase as: "The patient refuses to accept that his condition is psychological, and we do him a disservice by validating the idea that it might not be." The second I would paraphrase as: "While there is always the possibility that this is a new condition we don't yet understand, statistically speaking it is far more likely to be psychological. Given finite resources, diagnosis and treatment for depression/anxiety is by far the best bet for giving the patient real relief." To me the certainty of exclusion in the first message just immediately sets off alarm bells.
  - arkades 11y ago
    I think part of the miscommunication may lie in professional idiom. In medicine, all diagnosis is provisional and statistical - which both elevates "probably" to "certainly" in casual conversation, and renders most absolute statements hollow. It's just an automatic translation that has to happen: when you tell someone with a three-day sniffle that they have a cold, it's an absolute statement aloud, but in your head you have to honestly say "99.999% cold; 0.0009% HIV; 0.0001% cancer." And you have to treat them accordingly, until proven otherwise, because if you try to rule out cancer on everyone with a sniffle you're going to actually kill more people with complications than you'll ever save. "This person has X" most of the time means "X has a strong statistical advantage in explaining this patient's symptoms, so we're going to pursue treatment for X until accruing evidence suggests we shouldn't." I guess that's not always true, given a few things that exist by definition, but it's mostly true. And that's generally good enough, since... well, statistical masses tend to obey statistical properties.

arkades 11y ago

Honestly, no, but I'm glad we reached a point of mutual understanding.

haberman 11y ago
I am too. The first I would paraphrase as: "The patient refuses to accept that his condition is psychological, and we do him a disservice by validating the idea that it might not be." The second I would paraphrase as: "While there is always the possibility that this is a new condition we don't yet understand, statistically speaking it is far more likely to be psychological. Given finite resources, diagnosis and treatment for depression/anxiety is by far the best bet for giving the patient real relief." To me the certainty of exclusion in the first message just immediately sets off alarm bells.
- arkades 11y ago
  I think part of the miscommunication may lie in professional idiom. In medicine, all diagnosis is provisional and statistical - which both elevates "probably" to "certainly" in casual conversation, and renders most absolute statements hollow. It's just an automatic translation that has to happen: when you tell someone with a three-day sniffle that they have a cold, it's an absolute statement aloud, but in your head you have to honestly say "99.999% cold; 0.0009% HIV; 0.0001% cancer." And you have to treat them accordingly, until proven otherwise, because if you try to rule out cancer on everyone with a sniffle you're going to actually kill more people with complications than you'll ever save. "This person has X" most of the time means "X has a strong statistical advantage in explaining this patient's symptoms, so we're going to pursue treatment for X until accruing evidence suggests we shouldn't." I guess that's not always true, given a few things that exist by definition, but it's mostly true. And that's generally good enough, since... well, statistical masses tend to obey statistical properties.