theturingnerd

Mudge is great. Super smart guy. He, too, left, rather tired of the mess. People like him are exceedingly rare and never appreciated.

Speaking as an Army Cyber guy who is also a reservist (about to get out, so FWIW); the Army Cyber programs are not good. The (US) Army Culture is bad, very bad. Sure, if you're intelligent and enterprising you can have a path to getting some awesome training; however, the reality is most of the Army is really, really, really dumb. Senior Leaders at the G-Staff level (O6 & >) will have very little understanding of the value to the mission, will constantly think Cyber <> Tech. are interchangeable disciplines and will be FAR FAR more focused on how high you can score on the fitness test than your actual ability to do the work (mission).

The missions I've gotten to be a part of were awesome; however, I could have experienced just as much "cyber knife fighting" in the civilian world had I taken that track (perhaps more, because less rules) and I would have had a lot less bullshit.

Now, I'm a physician, and I'd say this - my residency was more bearable than the last 19 years in the army guard. I'm happy to be getting out soon, and while I will miss the friends I've made, I won't miss the organization as a whole.

I'll say the unpopular but hard truth. Relative to other nations, US DoD Cyber Forces by and of large part are woefully inadequate and unprepared for the real cyber fight. Sure, bright exceptions exist at the 3 letter agencies, and the occasional few people in the uniformed services - but these folks are rare, and they rarely stick around long. There is a lot of Cyber "showmanship" and BS, and most people are dis-incentivized from telling the truth about how bad at is - because they all want the prestige to help them attract high paying civilian jobs. I get it. But, I'll say the US taxpayer should be very concerned about how so much money was spent for frankly so very little.

The average US Army Cyber soldier can't even explain how an exploit works, technically. Moreover, they have a complete lack of cloud training or concepts or really any depth at all. Yet, they have all convinced themselves that if "cyber 9/11" happened - they'd somehow be useful to civilian companies, city governments and utilities beyond getting the people who know what they're doing some coffee. And this is a shame, because 15 years ago the potential existed for this to be much better; but a lack of new leaders who understand tech, greed and the DIB machine have made the situation unbearable.

I feel sorry for the United States. We could have done so much better, but real systemic change in the Army seems absolutely impossible. I still hear racist, homophobic and sexist jokes on the regular - despite the big push for "zero tolerance". The DOD hasn't, and likely won't ever change. It is simply too big and too slow and too entrenched.

Quality work! Sidebar, it's crazy to see you on the front page of HN; hope you're doing well man! --t--

(physician here) Vents can be quite tricky to get right; primarily because as disease progression continues on many things change. We are always trying to balance the deleterious effects of the intervention (in this case, the vent) with the goals of care.

What most people don't know is that vents cause a lot of injuries on their own. (See ARDS). Hypoxemic respiratory failure is serious stuff, and it's almost always not the only insult we're dealing with. So, it's about balance.

In the feedback loop is a lot of things. Certainly, oxygen saturation is a core measure, but we are also thinking about things like hypercapnia (and acidosis); overall perfusion status (blood circulation); infection management; etc.

Gas exchange is important, but there are a lot of things that have to go right for the lungs to take oxygen in, get it into the right transport, and get carbon dioxide back out. You can over-optimize for any of those at the expense of the other (see: hypercapnia).

In short, it's complex and there isn't a solid formula that will work for every patient. It's actually the subject of a lot of debate on details (some of it quite passionate in our Critical care / pulmonology community). This is why we call it PRACTICING medicine ;)