Update: The new GP took one look in my ear and said, and I quote, "You have a lot of . . . infection!"

And was baffled that urgent care hadn't given me antibiotics.

I imagine it had gotten significantly worse over those few days [ it had subjectively ], as I hadn't been able to stay supplied with garlic.

I'm now on doxycycline 200mg/day; Google says ear infections are usually caused by Streptococcus pneumoniae, and that this strain in America is resistant to tetracyclines around 1/5 of the time. But new GP said if it didn't work to come back and he'd try something else.

So barring further complications I seem to finally be in the clear.

New doc has been in the area for a while but doesn't look/talk like he's from around here; I would hazard a guess that's why he was a lucky roll.

No tissue samples, just external examination. Not even bothering to guess at a cause. "ETD -> use steroids to treat".

If the new GP acknowledges that I have signs of ETD and that it must be caused by something, and that something is probably not allergies [ otherwise the steroids plus azelastine plus certrizine would likely have done anything long-term, and/or I would have any other signs of seasonal allergies to speak of ], that'll be mission accomplished. So I'm trying to brainstorm ways to force him to acknowledge that syndromes have causes, which is not a standard most doctors I've ever talked with in this great state of Iowa have met.

I don't know what you mean by "specifically requesting the differential diagnoses". Care to elaborate?

I just had a conversation with an urgent care doc. I told the office I had a new ear infection, so they wouldn't look at my previous doctor's notes saying I'd been "somatizing" the ETD, and in the hopes that letting them come to the conclusion themselves would prevent them from having an allergic reaction to a patient's "self-diagnosis".

That worked, insofar as the doctor said he saw inflammation in my nasal passages and lymph nodes that looked like ETD. He explained what that was, and said I should try a nasal steroid. I said I'd tried two kinds [ Flonase and Nasacort ] and I'd been taking them for seven months, and the problem just kept getting worse. He said I should try a third kind of nasal steroid. I asked if I could try an antibiotic. He said no, he hadn't seen any signs of infection, and thus he couldn't conscion the risk of antibiotic resistance. I begged as sanely-sounding as I could. I said "I don't have allergies [ that could be causing the ETD ]", but he didn't seem interested in determining the cause of the ETD in the first place. He said no three times to my request to try an antibiotic, and repeatedly said "Steroids are the treatment for ETD".

I now have a follow-up with my new GP on Thursday. If you know magic words I can say to make that go better, I give you the floor.

I genuinely do not have the money at the moment to get my head scanned or pursue other options without a referral, unfortunately.

You know the phenomenon where men tend to score higher on mathematics tests and women tend to score higher on tests of verbal ability?

That's because men have more real estate allocated to the space-processing cortical areas, while women have relatively more space allocated to the verbal-associative cortical areas. The two cortical areas aren't morphologically-functionally adaptable or interchangeable. They genuinely do different things, and they trade off with each other for space in your skull. It's said that Einstein had massive parietal lobes on autopsy; it's also said he was somewhat dyslexic. It would make sense to me if both of those were true.

I've never met a "glance at a plate and see that there are 163 peas on it" type savant, but I've met "autistic geniuses", and the reality of that group of neurotypes seems pretty well recognized by normies who have little reason to make stuff up about it. Maybe you doubt the most extreme tales of savantism [ why? ] but dismissing marginal savantism as an artifact of practice is missing the forest.

I'm saying that the way I apprehend, or reflexively relate to, my past or present experiences, as belonging to "myself", is revealing of reflective access, which itself is suggestive of reflective storage.

If a hypothetical being never even silently apprehended an experience as theirs, that hypothetical being doesn't sound conscious. I personally have no memories of being conscious but not being able to syntactically describe my experiences, but as far as I understand infant development that's a phase, and it seems logically possible anyway.

you can get an elective MRI of your head if you really want to see what's going on in there

Ha, I've been trying to get my head scanned for four years. Haven't even come close to getting anyone to take me that seriously. Thank you, though.

Second, consider simulating fever

. . . Huh, that is a new one to me, thanks! I've been hanging out in the heat recently, so that's convenient. I'll see if it improves anything.

have you noticed any change in symptoms when taking antihistamines for other reasons

I'm actually taking certrizine, too, because I was prescribed that as well [ 80% of the doctors insisted it had to be allergies [ even though I don't have allergies ] or else neurological [ makes little sense IMO ] ]. If the certrizine has an effect, it's smaller than the effect of the antibiotics, garlic, and steroids.

prompted Claude (preferably Opus) to strategize with you for how to tell the truth from the specific angle that causes medical professionals to pay attention

This suggestion makes a lot of sense, thank you. Idk if you read either of my accounts of what went wrong [ Part 1 [google doc] ], [ Part 2 [blog post] ], but I [ perhaps arrogantly ] pride myself that I'm better at this than even Claude, for the moment.

[ These seem like real medical answers to me. ]

My perception of the wall is in reference to me simply in the course of belonging to me, in being clearly my perception of the wall, rather than some other person's.

If you just separated such a process and put it on repeat, just endlessly staring at a wall, I don't see a reason why would anyone would describe it as reflective.

Would anyone describe it as theirs? That access is reflective. It's pretty difficult to retrieve data in a format you didn't store it in.

For Charles Taylor, the first Axial Age resulted from the “great disembedding” of the person from isolated communities and their natural environment, where circumscribed awareness had been limited to the sustenance and survival of the tribe guided by oral narrative myth. The lifting out from a closed-off world, according to Taylor, was enabled by the arrival of written language — the stored memories of the first cloud technology. [ -- Nathan Gardels ]

There is an analogy to biological evolution that may be instructive. When all reproduction was asexual, gene variants/mutations were “embedded” in the genome in which they arose, and their spread depended largely on the fitness of their “host genome” (vertical/clonal reproduction). With the arrival of sexual reproduction and recombination roughly two billion years ago, genes could now free themselves from their native soil and spread (horizontally) to new genomic lands. Sexual reproduction also brought a new form of selection—sexual selection—that depended less on the physical environment and more on the composition of the gene pool.

But sexual selection means the gene is more constrained, more "embedded", not less, than it was under natural selection.

For asexual, species-less organisms, a gene codes for a thing and that's pretty much it. It probably happens to be more advantageous in some lineages of organism than others, and it'll be selected for in those more than others, but it won't end up having wildly different effects on different types of organism, because their genotype-to-phenotype pathways just aren't that complicated-and-mutually-contingent yet.

Sexually-reproducing species have "alleles"; a random substitution of a single nucleotide can become a problem for an organism so intricately typed. If you manage to find a mutation that helps one species, it won't help others. It'll screw with large parts of the hill they've delicately climbed.

Today I learned: [ brook, on the EA Forum, in 2023 ], independently [?] referred to sexual selection as one of the few available examples of mesa-optimization. Before writing [ this extensive treatment of the topic in 2024 ], I don't remember seeing anyone make the connection.

I searched "sexual selection" on LessWrong for other prior examples. In 2021 Oliver Sourbut said

I think examples of sexual selection are adjacent but don't qualify as gradient hacking

This search was also my first sight of the term "Fisherian runaway"; I think Fisher, like Darwin, had too narrow a concept of the spread of traits sexual selection ultimately controls, and Fisher's influence was probably part of why Sourbut said that.

[ Ryan Kidd, 2022 ] IMO falls prey to this, but still decides that narrow examples of "Fisherian runaway" are mesa-optimizers [!].

[ lemonhope, in 2023 ], says

creatures can do sexual selection on each other instead of just getting random mutations

which pretty well encapsulates the force I think is actually driving a large percentage of modern evolution.

Other references [ none of which I'd been aware of before today ]:

[ Jacob Falkovich in 2020 ]:

Geoffrey Miller lays out the case in The Mating Mind that human creative intelligence, art, morality, and storytelling, all evolved under the pressure of sexual selection

[ Eliezer Yudkowsky in 2008 ]:

The chimp-level task of modeling others, in the hominid line, led to improved self-modeling which supported recursion which enabled language which birthed politics that increased the selection pressure for outwitting which led to sexual selection on wittiness...

...or something. It's hard to tell by looking at the fossil record what happened in what order and why. [ ambiguous; I include it mostly because I saw it referenced elsewhere while searching ]

[ Also Eliezer Yudkowsky in 2008 ]:

In the case of hominids in particular over the last few million years, we may also have been experiencing accelerated selection on brain proteins, per se - which I would attribute to sexual selection, or brain variance accounting for a greater proportion of total fitness variance. [ ? last part is a confusing-to-me ambiguation ]

[ rogersbacon, 2023 ] has some comments on sexual selection which I think are just straight up backward:

For Charles Taylor, the first Axial Age resulted from the “great disembedding” of the person from isolated communities and their natural environment, where circumscribed awareness had been limited to the sustenance and survival of the tribe guided by oral narrative myth. The lifting out from a closed-off world, according to Taylor, was enabled by the arrival of written language — the stored memories of the first cloud technology. [ -- Nathan Gardels ]

There is an analogy to biological evolution that may be instructive. When all reproduction was asexual, gene variants/mutations were “embedded” in the genome in which they arose, and their spread depended largely on the fitness of their “host genome” (vertical/clonal reproduction). With the arrival of sexual reproduction and recombination roughly two billion years ago, genes could now free themselves from their native soil and spread (horizontally) to new genomic lands. Sexual reproduction also brought a new form of selection—sexual selection—that depended less on the physical environment and more on the composition of the gene pool.

But sexual selection means the gene is more constrained, more "embedded", not less, than it was under natural selection.

1. I mean, I think it's like when Opus says it has emotions. I don't think it "has emotions" in the way we mean that when talking to each other. I don't think the sense in which this [ the potential lack of subjective experience ] can be true of animals is intuitive for most people to grasp. But I don't think "affective pain-like response in octopuses in specific" is particularly compelling evidence for consciousness over, just, like, the fact that nonhuman animals seem to pursue things and react ~affectively to stimuli. I'm a bit puzzled why you would reference a specific study on octopuses, honestly, when cats and squirrels cry out all the time in what appears obviously-to-humans to be pain or anger.

2. Like with any other creature, you could just do some kind of mirror test. Unfortunately I have to refrain from constructing one I think would work on LLMs because people exist right now who would have the first-order desire and possibly the resources to just deliberately try and build an LLM that would pass it. Not because they would actually need their LLM to have any particular capabilities that would come with consciousness, but because it would be great for usership/sales/funding if they could say "Ooh, we extra super built the Torment Nexus!"