subungual

Hey, thanks for asking! Kid is almost 4 now and doing great. She eats a pretty varied diet, fortunately-- if she were picky, I expect we'd have had to have made some changes early. We made the call after consulting with her pediatrician and a dietician, both of whom were on board. All check ups have gone well, and she's been ahead on all of her milestones. She's never had any clinical or lab evidence of any deficiencies. I'm a physician myself, and I take care to watch out for anything concerning. There's a reasonable body of literature out there now supporting the safety of a well-implemented plant-based diet in kids. We actively supplement B12 and DHA/EPA.

I call her diet plant-based rather than vegan, as she's not old enough to make the ethical calls herself, but it's been interesting watching as she notices the difference between our diet and others and begins to ask questions and comment on it. As she gets older and spends more time at friends' houses, we'll probably ask that parents/school/etc. not serve her meat, but we're not going to be militant about eggs or dairy. As she gets older and can make more of her own choices, she'll make her own calls on all fronts outside the house. As of yet, she's asked about other people's omni food, but she's always turned it down when offered. We've been careful to specify that these are our own personal choices and have encouraged her to start thinking about where she stands on them herself. We're curious to see how things go from here.

As a ~7 year vegan, I eat a fair number of substitutes. As others have said, I don't do it for my health or because I don't like the taste of meat.

That said, in line with the article, when I was in college, I had the Maddox "For every animal you don't eat, I'm going to eat three" image blown up as a poster on my dorm door. I had a "PETA: People Eating Tasty Animals" t-shirt that I wore around. My aim was to upset the vegetarians, and I made fun of them whenever I saw a window. I can't speak for others' motivations, but the fact that there was a group of people living a lifestyle that I thought was borderline impossible cast inherent doubt and judgment on my own choices. Having to confront the fact that they might be right led to a lot of unresolved cognitive dissonance and anger.

If you'd have told me that ~20 years later I'd be vegan, married to another vegan, and raising a child on an entirely plant-based diet, I'd have laughed in your face.

To be fair, the Simpsons poked fun at itself for exactly this:

https://www.youtube.com/watch?v=axHoy0hnQy8

Thank you! It's definitely worth dipping your toes, I'd say. I made the call to try it at 29 and matriculated at 32. There's one person in my class who is a decade older than me, another my age, and several who were in their late 20s when we started. The average age of med students is slowly climbing, and there are plenty of nontraditional students out there. I wish you success regardless of what you decide!

Great hearing from you! I think you're taking a wise approach. I inverted things from the way that you did them-- I spent a year studying for the MCAT alongside work (had taken all the prereqs 10+ years earlier as a part of my degree). I used MCAT prep as a litmus test for my seriousness about the whole thing, and after it went well I quit my job to stack up post-bac courses and tick the various remaining application boxes.

It's funny that you say that about the lottery-- my wife and I were unsatisfied in our careers and were very focused on financial independence/early retirement and had set a pretty aggressive retirement date. As we were each thinking through what we would do on the other side of retiring, I realized I'd probably make the run at med school that I'd been considering for a long time. At that point, it stopped making sense to wait.

There's no question that it's a pretty significant upheaval. Fortunately, my wife has been very supportive throughout and even encouraged me at several points to make the jump. We had to move across the country, and we've had a kid in the process. Timing with COVID ended up working out well, as we don't really have the feeling of lost time and opportunity that others seem to.

Good luck in making your decisions from here-- it sounds like you've been thoughtful and intentional about the moves that you've made, and I hope you figure out what's best for you and your wife.

I left tech ~6 years ago to pursue medical school. I'll be graduating and starting residency soon. A significant number of my classmates express regret for choosing medicine, and a lot of them fantasize about pursuing a career in tech, instead. I feel pretty well inoculated against this, having had a varied life and a collection of very different work experiences before med school.

I'm happy with my choice. My work still involves the computer, but I certainly don't spend most of my time on it. I get to interact with a wide variety of people, and sometimes I can make their days and lives a little better. My work is challenging and involves a lot of thinking and dealing with imperfect information. If I want to fold in skills gained from tech work in the future, there is no shortage of opportunities. Leaving tech for medicine was about the worst financial decision I could have made, but I would absolutely do it again. It's been a long road, but it was the right decision, I think.

I fully understand what you're saying, but it's somewhat skew to the point I'm trying to make. The people I'm talking about are the ones who have already baked health effects of their habits into their calculus and claim to acknowledge them. For someone who has already bought into the idea that their smoking or drinking will shorten their lives, an elevated BP reading, finding themselves having trouble taking more than one flight of stairs, or even having some chest or leg pain when they're walking around are unlikely to be major wake-up calls. My point is that people may know the end result, but they generally don't have a sense of what the path to that result looks like and underestimate its effects.

Not here to proselytize about your lifestyle choices, and I've certainly enjoyed my fair share of smoking and drinking myself over the years. That said, as someone who works daily with patients whose health has been destroyed by excessive drinking or pretty much any level of smoking, it's always been striking to me how surprised people tend to be by the results.

A lot of people performing the calculus of "eh, what's five to ten years off the end of my life as long as I'm enjoying it now" seem to think it works neatly like that-- they'll die earlier from cancer or a heart attack, and that's it. I'm struck by how often they are surprised and upset by the fact that instead of that, they're living the last 30 years of their lives with irreversible heart, lung, liver, and vascular issues that leave them unable to do the things they've enjoyed outside of smoking and drinking. Just a thought.

This person is right that hospitals, or health care systems in general should be working on this. It's more complicated than simply not helping people who won't help themselves. The difficulty is that no one knows the best, most effective systems or approaches for doing this, and emergency medicine resources are stretched very thin here in the United States. Emergency departments were designed for the stabilization of life threats, but in our modern collapsing medical system, limiting their scope to this falls short of community needs. There are many people whose only contact with the medical system will be the ED, and finding ways to treat and integrate them into more sustainable programs should be a goal. There are promising advancements being made, however, in initiating standard of care treatments in emergency department settings. On the opioid front, we can start suboxone in the ED, which has proven a pretty effective method of stabilizing people and increasing their participation in treatment down the road. (1)

As someone who is working on this, I don't think it's unfair for people who aren't experts in the field to recognize and call out the fact that something should be done differently. The experts agree, and many of us are trying to figure out a better path forward.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527523/

Yep, pain at the infusion site is an incredibly common complaint with potassium IV. The person you replied to is talking confidently outside of their expertise.

I think the piece you're both referencing is here:

https://kotaku.com/how-elmo-ruined-sesame-street-1746504585

It's fascinating to me that everywhere that I've traveled and lived in South America (including Colombia), people seem to have this narrative about the locals that they'll "just shoot you and go through your pockets after." I've not seen any evidence that it's based in anything except media-cultivated fear of their own culture. I'm not used to hearing it said about the US, but with the constant pushes here to keep us afraid and willing to give up civil liberties, it makes sense that I'd run into it one day.

I've not really encountered the idea that it's unnatural exploitation, to be honest, and I completely agree with your point there. The core ethical argument that I generally see presented for veganism is that once you've advanced past the point of requiring animal products to live a healthy life, consuming them becomes entirely a matter of convenience, taste, and preference. The argument follows, then, that it may not be ethical to subject animals to the realities of modern husbandry simply on account of these reasons.

The question of whether abuse is inherent is largely academic at this point. The fact of the matter is that almost all of the animal products we consume are the result of optimized industrial processes that result in shortened, low-quality lives for those put through them. Whether an animal could, under the right circumstances, be humanely raised for resource extraction or slaughter doesn't really apply in modern consumption.

Whoa, I'm an ethical vegan and pretty steeped in theory, and I've never encountered this wing before. I doubt I'll agree with them, but I'd be curious to read if you have anything you can link or cite.

Haha, yeah, fair. I imagine the cats that do live there are probably enjoying themselves through this but have had their capacity overwhelmed.

It sounds like the numbers they're dealing with may be well beyond what could be controlled by cats. Additionally, they may be wary, as Australia is already a case study in what can happen as a result of introducing one species to control another's population: https://en.wikipedia.org/wiki/Cane_toads_in_Australia

Yeah, your logic is pretty good here. Prions are a super interesting emergent phenomenon of a complex system. In a weird way, like cancer or viruses, they're just an inevitability of having enough of certain materials interacting for long enough time. Proteins misfold in just such a way that allows them to induce the same type of misfolding in other proteins, leading to propagation. It's less a definitional thing, and more a matter of the fact that something more stable will persist longer, encounter more opportunities to propagate and preserve its form. That said, surviving harsh environments isn't an entirely necessary condition, as not all prion generation requires transmission. Unfortunately, if you have the wrong gene(s) broken, you're at risk of just generating them yourself. That said, transmission is significant, and since it involves needing to be able to survive a harsh outside environment with no propagation between hosts, extreme durability is a definite boon, as you suggest.

So denaturing a protein generally involves interfering with the noncovalent interactions (e.g. hydrogen bonds, attractions between internal charges) that allow it to fold into the right functional shape. Often times, these proteins folded under conditions that carefully facilitated their coming out the right way, so simply removing the denaturing stimulus (e.g. allowing them to cool) won't result in a reversion to their former configuration. This is what you see, for example, in cooking, where there's a discrete change that doesn't revert.

Prions are generally much more stable and can revert back to dangerous form once denaturing conditions change back. It takes a lot more to denature them irreversibly than it does most proteins. This stability is part of what makes them so dangerous and difficult to remove.

Maximal extraction of resources would involve focusing on eating plants. Feeding the plants to animals and then eating them is tremendously inefficient in terms of both calories and nutrients.

Maybe I wasn't specific enough here. When I said "smaller peptides," I should have instead written "free amino acids, dipeptides and tripeptides." The two papers you cited refer to topical application, but your statement in your first comment said that it is easier to get collagen from dietary sources. What I'm asking for is what size of peptide you're calling a "collagen peptide" and a source supporting a mechanism of absorption. Most references I find to "collagen peptides" are for unvetted dietary supplements.

There is not good evidence that peptides larger than 2-3 amino acids can be absorbed into circulation via the gut in more than trace quantities (1). Digested collagen will be rich in certain amino acids (glycine and proline in particular), but calling something as small as a di or tripeptide a "collagen peptide" seems like an oddly arbitrary choice. I am a medical student with significant background in biochemistry, so please don't feel the need to dumb it down for me when you explain.

1. https://www.cambridge.org/core/journals/nutrition-research-r...

Do you have a source for this? As far as I know, there is no way for the body to uptake and employ collagen directly. It needs to be broken down into smaller peptides, absorbed, and rebuilt, just like any other protein.

Ha-- having been in that situation this past October, that simple description is incredibly evocative for me. Even in that dazed, sleepless state, though, I remember a sudden upwelling of intense sadness when I realized for the first time how expensive such a basic necessity was... and how they felt the need to keep it all locked up. Real moment of clarity about the state of this country (US).

The hunter-gatherer argument also fails an important sniff test for me. Evolutionarily-driven arguments fail to take into account that what may have been sufficient outcomes to drive selection (e.g. survival to/through reproductive prime) do not meet our current values and standards of acceptability. Heart disease, diabetes, cancer, etc. tend to strike after people are done reproducing but long before what we consider reasonable life expectancy.

I think it's just easier to call it meat because it makes clear what dietary/textural/taste role it is supposed to fill. The spot is already cut out in people's schemata. Maybe language will shift and a new word will emerge to better characterize substitutes in the future, or maybe the definition will ultimately be subsumed by replacements. Honestly, it's not ever really bothered me, so maybe it's just a question of individual language aesthetic preferences.

I'll give you that using "butcher" is a little weird, though for most places I've seen do that it's a marketing gimmick.

The overwhelming majority (95-99%, from what I can find) of cattle in the United States are fed corn or soy. 98% of soy and 48.7% of all corn grown in the United States are used to feed livestock. Corn is the top crop in the US and soy is #6. Replacing these monocultures with a variety of vegetables would do a great deal to improve farming sustainability in the country.

https://www.canr.msu.edu/news/where_do_all_these_soybeans_go....

https://iopscience.iop.org/article/10.1088/1748-9326/aad401#....

https://www.scientificamerican.com/article/time-to-rethink-c....

https://agamerica.com/power-of-10-top-10-produce-crops-in-th...

This study is a meta-analysis, so it works off of published research and does no original experiments of its own. By its nature, it incorporates systemic bias of earlier published studies. Often times, this kind of analysis leads to opposing biases being diluted or canceling out, but given widespread industry funding of this topic in particular, I'm not super optimistic about impartiality here.

Nutrition research is incredibly difficult to conduct, too. It often relies on participant reporting and is immensely complicated in terms of identifying and weeding out potential confounders. With how little we know about things that could play significant roles (e.g. gut microbiome), doing good science on this is super difficult.

True, but the number of people who focus on non-indo-european languages is a lot smaller than people who focus on languages "closer to home". Probably just comes down to numbers.

I think it's likely less a question of focusing closer to home and more a product of how the publishing industry operates, as you suggested earlier. Would certainly be an interesting question for more investigation. If it were just down to numbers, I'd expect at least one book written in a non-Western language-- English language readers assuredly aren't quite as insular as the list would suggest.

It would be interesting to see how culture impacts story/book. Russia seems to have so many amazing works of literature, but is that a function of their culture, or because of the intense focus the USA/UK put on Russia and learning their mindset during the Cold War, or because of something else?

This is also a really interesting question. There might even be some historians here who can chime in on it. It's common for certain countries' language and literature to become "in vogue" at different points in time (e.g. French was really popular in Russia in the 19th century, following the French Revolution). Maybe a similar effect played a role?

This is true. It's also one of the reasons that search phrase is cluttered with lists that look startlingly like this one.

Since the site is in English I think it is likely aimed at an English audience...

To be fair, fully half of the top ten books were not written in English. Non-Indo-European languages can be translated just as well as French and Russian can.