thelastpsychiatrist.com - Bad At Math. Adnotated.

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how much is this worth

The doctor was at work doing the usual, which means patients, and a 20 year old hispanic man bursts through the door and right away the doctor knew he was in big, big trouble.ⁱⁱ

The man wore sunglasses, the kind of one solid plastic band around the eyes that you don't wear unless you're insane.ⁱⁱⁱ He locks the door behind him and shouts, "if you give me any shit, I'm going to fucking kill you."^iv That was his opening line, the next few lines were derivatives of the same.

He was yelling in English, but at about three threats in he says, "I want a translator--" so he opens the door and the secretary (hispanic) that had come to the door to see what the yelling was about steps in, no, he pulls her in, locks the door again, and goes back to yelling. "You're fucking dead, do you hear me? Fucking dead!"

One other thing: he has a gun.

Putting it together later, yes, there will be a later, the doctor had seen that man, Juan, once before. He had demanded Xanax max dose three times a day, and in the subsequent negotiations it was agreed that as long as the guy could provide clean urines he could get one Xanax half dose a day, along with the other medications. Deal? Deal. So he got a script for 14 days, "come back then and we'll see how things are."

Somehow Juan had taken the 14 tablets as a personal insult, he expected 90, even though it was clear that it was only for two weeks, and however he figured it in his brain the doctor was screwing him. So he came back -- three months later -- looking to show the doctor he messed with the wrong guy. "You think you're going to play me?"

The room they were in was the size of a large closet, about 8x8 square.^v The door opened inwards, then there's a desk, and then the doctor -- so the desk is in between the doctor and the door. The waiting room is full and it's right outside that door, so everyone can hear the yelling, but no one can see the gun. Not yet, anyway.

The problem, logistically, was that even if the doctor wanted to jump him, he couldn't -- Juan is blocking the door, and the desk is between them.^vi If he comes over to hit him, then they're close^vii, but with that desk in between, the doctor was completely at his mercy.

The other problem, the GIGANTIC problem, is now there's a woman in there with them, and she can't get out because she would have to open the door into herself (she'd end up behind the open door) and then move towards him to get out.

Patients yelling at the doctor to give them Xanax is nothing new -- they threaten, they yell, they posture, and it's all part of the game. The doctor had always played the game respectfully, cool, calm, no anger, and he let them, nonverbally, understand that he respected the power that they had -- if they wanted to, they could kill him -- but that the job is the job, nothing personal, you're not getting Xanax not because I hate you but simply because I don't think it's right. And he let them know that he'd do whatever else he could for them. Sure some people left angry, but they left.^viii

And when they yelled he let them, let them go on for so that they felt like they had delivered their message, and eventually cut them off; ultimately they just need to feel that they chose to let him go, not that they were turned away or rejected but that it was their choice to move on, and when they left that would be the end. It happened about once a week to him and all the other doctors, it's just the nature of the business^ix and there's no billing code for "pissed off xanax seeking guy."

But this guy was different, this guy wasn't looking to get something. This guy came with the specific intention of killing him, he wasn't looking for more xanax or anything else.^x

And he wasn't psychotic, he was logical, specific -- just very threatening. "You think I'm playing?" "I'm going to tell you what's what." "You think you know me?" Every gangbanger movie cliche, as if he was reading from a script^xi, but if that guy stayed true to his character then this was going to end very badly.

So Juan locks them all in, and she's scared, and the doctor is scared. Because now, with her there, he was completely sure he meant to kill them.^xii Before she came in, it was between him and Juan only, and he might be able to talk him down, but when Juan brought her in it was clear he wasn't worried about being caught or identified or collateral damage, he just wanted to kill.^xiii

So he yells for about 30 seconds (it felt like an hour) and then the doctor tells him that perhaps he can get him some Klonopin, which is a lot like Xanax. The Klonopin was incidental to the argument, but he figured that if he could get this maniac to focus on something concrete, turn it into a treatment or at the very least a transaction, in which he could be "given" something, the guy might back down just enough to not kill everyone.

But the problem was the woman. She was scared but also... irrational. Would she try and run? Would she try something stupid?^xiv Was he going to kill her, too? He had to get her out.

So the doctor turns to Juan and says, "but I need your insurance card to make sure I can give you Klonopin." That was a lie, but it was a distraction, turn the focus to something else.^xv Juan gets his wallet out muttering, "he wants my card now, my card, this fucking (something) wants my card." And he gives it to the doctor, and the doctor hands it right to the woman and says, "I need a copy of this immediately. Immediately." She hesitates, she's unsure, she moves towards the door slowly but Juan lets her pass. Thank God, he thinks. It's going to be okay.

Wrong. As soon as Juan closes the door behind him, he goes ballistic. It was like he remembered what he was there for. "You fucking [this], I'm going to fucking [that]!" and etc. Whereas before he was waving the gun around^xvi, now he kept his arm locked, gun pointing towards the floor. He's still yelling, cursing, threatening. The gun is there and it's pointing down and it's simply waiting for him to decide to raise it.

Again, even if the doctor could disarm him, he can't because of the desk. He can't throw anything, there's nothing else on the desk. He can't run. If he stands up, he'll get shot in the chest. If he ducks down, it forces Juan to lean over the desk, which means he'll get shot in the back of the head or the spine.^xvii

This was the plan: turn to the side and let him shoot him in the shoulder or arm.^xviii

What did he think about? He thought about his kids, how sad they'd be that their father was dead.^xix They would cry.^xx He thought about how this nut would eventually get caught and the kids would have to face the man who did it and listen to his words and the words of everyone else. The kids would have to look around at an insane world that tried to explain everything with lies. And then they'd have to go home and grow up. "That's life," someone would tell them, because it's true and that helps.^xxi

He also thought about how stupid this guy was, how terrible he was at valuing things, he had decided that his life was worth throwing away over... what?^xxii He wasn't stealing his car, there wasn't anything of value at stake. Xanax? He could have gotten it anywhere else, easily, anytime. Revenge? It wasn't like the doctor had raped his sister, he had just not given him something. But somehow in his calculus this grudge was worth carrying for three months, worth killing someone over, worth 25 years in jail. This wasn't psychosis, this was a man who was bad at math.^xxiii

The plan is to give him the shoulder, take it in the shoulder, and not turn, not go down.

Then the woman comes BACK. What caused this woman to come back is unknowable^xxiv, but she opens the door and it bumps him because he's in front of it. So he turns around to see who's coming in and he grabs the paper out of her hand and he sort of flings it at the doctor.

But everything is different now, because the door is wide open, and everyone in the waiting room can see them.

So the doctor, as calmly and with as much authority as he can muster, looks at the paper and says "ok, I can give you 30 tablets of Klonopin with this." He tried to make it sound like that was what they had been talking about the whole time, a treatment, a transaction. It wasn't about the doctor, it was about the pills.

Juan reflexively says, "no, Xanax," and the doctor responds, "no, all I can give you without a urine (drug test) is Klonopin,"^xxv and Jaun says, "I want 90 of them." And the doctor says, "only after the urine."

Whatever calm exterior he displayed was not mirrored on the inside, and while he was trying to show steady penmanship he made a mistake- and he wrote Xanax instead of Klonopin. It just came out. So now Juan sees the doctor writing that, and the doctor has to decide if he was going to give it to him that way or not. But if the reason he was still alive was that he had turned it from something personal into a treatment, then handing him the Xanax was an admission that it was, after all, not a treatment but a stick up. And maybe that would remind Juan that the doctor had screwed him the first time. So the doctor says, out loud, "dammit," tears up the script and rewrites it. Doing the job correctly.^xxvi

Juan took it, made a few more threats, and left. 20 minutes after that the police finally came, and while they were there he called the clinic and said he was coming back to kill the doctor because he only got 30 tablets. A man who is terrible at math.

When the doctor went back to see the patients who stuck around, all of them, men and women, told him the same thing: "Yo, man, I had your back, if anything happened, I was going to bust in here." Of course they would have.^xxvii

What's unsettling, however, is that Juan had been in the waiting room for an hour before the doctor even got there, muttering to other people that he was going to "fuck him up." But no one said anything.

There's not much more to the story, except that the doctor went home, felt a little shaken, had a drink or three, debriefed^xxviii with some people and not with others, and eventually 3am came and he went to bed. And when he woke up it was gone, merely a memory, it all felt like it happened a decade ago. That's life.

1. Holy shit, we made it to the Bs! 68 done, 630 to go, 10% here I come!

   (We're actually slightly over the 10% mark by bytecount, which I suppose shows the great power of statistics : notwithstanding that his articles are all over the place, lengthwise, all that's really needed is a few dozen sample out of a few grosse total to obtain very close fit between article count and character count.) [↩]

2. Hispanic, amirite.

   No kidding, for some reason big town practicing psychiatrists are at risk from deranged Latino dudes like big town convenience store clerks are at risk from unintelligent black dudes. Coincidences everywhere. [↩]

3. How's that for a dead fucking culture -- they don't even have a word to denote that thing. They use it, they make it, they just don't know what it's called. Suppose you go into a shop and wish to communicate the item to the clerk, what word do you use ? There's words for soup and stu, to distinguish soup and stu ; there's words for car and truck, to distinguish cars and trucks. You don't walk on a lot and start gesturing, "I need vehicle, like this but big and with dump trunk", do you ?

   Well ? [↩]

4. Pro tip : "I'm going to fucking kill you" almost never means he'll kill you. [↩]
5. And here I thought they made bank in USGistani bureaucratic services! [↩]
6. Herpitty derp, Ballas was about to kung-fu the puerto rican, if only his feet weren't glued to the floor by those darn kids such that he just couldn't sidle discreetly that way while talking to the horse. [↩]
7. Or rather : if he asks the time and you punch him, someone could accuse you, but if you wait for him to punch first then nobody could accuse you, this "could accuse" nonsense being the only actually important part in dreamer ideology.

   PS. Look at that, first logs.nosuchlabs linkage! Mazel Tov! [↩]

8. This is so fucking naive, I don't even see it's worth approaching. As the expression goes, the fish may throw up no matter how many meters of line, but never the hook. [↩]
9. The "business", rather. It's the nature of being female and trying to build socialism.

   What, psychiatry can't exist practiced by men, that's the fantasy here ? Gimme a break, back then it actually somewhat worked. [↩]

10. Sounds rather like dominance than any specific intention to murder him (which is definitionally a sex crime). The guy came in with a vague, non-verbalized intention to dent the femstate, but lacking for better strategy or any leadership he just ended up ineffectually hassling some lowly USGistani bureaucrat instead. [↩]
11. Part and parcel of the socialist script is to misrepresent anything not in their script as... a script. It well fucking isn't. [↩]
12. This is such fucking nonsense... Seriously, what forensic psychologist looks at this description and draws the same conclusions, I wish to fucking see this wonder. How do they reason ?

    Leaving aside how the dude's sliding all over the place -- first Juan wanted to kill him, now he wants to kill them, which is exactly not how the fuck any of this works... There's precisely zero percent chance dominance crimes end up with a compliant female dead just as there's precisely zero percent chance sexual crimes end up with a compliant male dead.

    As a matter of fact, amply documented without counterexample in the lengthy history of breaking the law, if the response of the female shop clerk being held up (ie, dominance crime) is overtly sexual ("Oh maaan... you're so fucking cool... I think I'm in love. May I suck you off ?") the would-be perp will likely be too confused to carry on his original intention in the first place ; but the woman is certainly not getting hurt. (And spare me the "these don't exist" moronisms. Of course they do ; more so than you exist, in any case.)

    Contrarywise, if the male half of a couple being home invaded (sex crime kind of home invasion) eggs on the attackers, providing assistance and helpful hints, they'll likely not stop, but they'll also likely take him along next time they go for a spot of fun. He's sure as fuck not getting hurt, not even a little.

    The dominance and sexual pathways for paroxistic behaviour are very well separate in normal humans. It's true that abnormal humans also exist, and that in some vanishingly rare cases might confuse the two (this is so unlikely in reality, especially if you're talking functional as opposed to catatonic abnormal humans, that you're stuck taking for a mental model the shy homosexual in Dog Day Afternoon) -- but these almost never act alone, they're always someone's sidekick. Not to say "almost never" means "never" -- Tarantino's villain (Gandolfini) in True Romance is so fucking scary specifically and precisely because he does confuse the two, and he is functional, and he does act alone. Have you noticed we're stuck with discussing constructed, synthetic beings ? You're not going to meet one of these. Not in this life. [↩]

13. No, actually, he just wanted to express his dominance over the field. They don't train psychologists these days, I take it ?

    Someone who just wants to kill takes two SMGs into subway during rush hour, goes into a middle car sorta midway, opens fire between stations taking care to mow down everyone in his car, drops the guns and runs off through the door yelling and screaming bloody murder. Good fucking luck even distinguishing the one excited maniac from the rest of them coming through the tunnel, let alone ever pinning it on him. Oh, wait... actually... the sheeple've been trained to stay in the car should this occur, yes ? Guess why.

    Juan just wants nobody to give him any shit, what's so hard to grok about this ? Or rather -- why does the author want to pretend something this simple is nevertheless overwhelming his powers of comprehension ? New slavegirls try this "not understanding" tack too, you know ? Before sufficient beatings inform their basal ganglia of the unwiseness of this course of pretense, that is. [↩]

14. The irony of socialism is that while it is modeled after the worst qualities of women, it's always modeled by men. Women don't like it, don't feel well in it, want no part of it. Consequently the sort of men that tend towards socialism also tend to distrust them<.

    Why, pray tell, is the secretary "...irrational" ? What's so fucking rational about dying for a totem to stupidity that gives Ballas the standing to discuss others' rationality ? [↩]

15. No, actually, Ballas is quite willing to die, and in the process kill some random latino secretary naive enough to come and work for him just so that the skirts of the Great Inca he worships are preserved. For just as long as nonsense Inca tokens are still involved in the world, he'll go to meet his maker gladly, that's what he lives for, the spread and perpetuation of marauding idiocy and its totems. [↩]
16. Did I ever recount the bus slapping incident ? Seems I did. The fish may throw up no matter how many meters of line, but never the hook, you see. Juan is respectful towards women, you see. He's sure as fuck not about to mistreat them or anything. In fact.. Juan's not really that different from Christos, they have no substantial disagreement. Inca prevails! [↩]
17. Or Juan will just leave. Either way.

    Apparently they don't mention the whole "play dead" thing to psychologists anymore, notwithstanding it enjoys a certain... centrality, let's say, in nature. But Inca alt-psychology as a pseudo-scientific discipline is pointedly not at all about nature, is it now. [↩]

18. Honestly, pulling cock out and starting to jack off while drooling frothily out of the corner of the mouth would have been a better plan. I don't mean thereby it's a good plan, but look what we're dealing with here, the pencilneck strategist. [↩]
19. Actually, the chances for the father to be dead if Juan-the-dork actually shot at him (a 20 to 1 shot in the first place) were no better than one in ten. Most people shot at don't die from it, not just because "denn traf' jede Kugel apart ihren Mann, wo kriegten die Konige ihre Soldaten dann!" and wartime bullet expenditure per kill goes into the millions of rounds, but also because the body is so constructed and, importantly, the human mind is so programmed. On one hand, while all mammals fight for supremacy none of them actually seriously wound each other. The bucks push head to head instead of attempting to gore each other, yes ? Why do you think this is different with humans ? And on the other hand, Juan's still "respectful to women", yes ? You expect he was amenable to learning that cultural castration code, but yet he's magically immune to the much more basal harm-avoidance circuitry in his same species ? Really, not how this works, at all. Well trained, intelligent people who are motivated to shoot to kill actually shoot to kill, and sometimes (though not always) manage. Average dorks shoot to shoot.

    The same goes about his earlier "spine" wank. The odds of random derp spray-and-pray-ing past a desk hitting a spine are similar to the odds of Juan having a long-term girlfriend that worships him. It's not strictly speaking impossible, but it's fucking improbable (while the very dorky "omg, not the glasses" approach to life is outright unseemly). [↩]

20. They'd also be okay. That's the one thing about kids -- they don't actually give a shit, and it makes no difference to them, whatever it is. I am aware the pretense to the contrary's a big part of what your dreamlife's built out of, but if the kids actually cared the species would have ended long ago. As it is, children care even less than the females do. [↩]
21. More interestingly, a certain 16yo'd have never had the opportunity. Now that'd have been a pity -- and to think, this was March, Brittany's probably happening early June, that's... not even three months away.

    I know it sounds like made-up bullshit when they say it to suicidal folk, "for all you know, the best thing in your life's about to come around next week". It sounds like "exactly what you'd say". Yes.

    Nevertheless, here it is, excavated out of unrelated and disinterested record, most likely against the informant's own will. Had Ballas been shot dead by Juan, therefore Ballas'd not have had to go through his internal hell over young cunt a few weeks later. That's life. [↩]

22. The eternal problem of pencildicks, this imagined "value" of "their life". What value does pencildick life carry ? None at all. [↩]
23. What does the author wish to be true ?

    Yes, that's right : he wishes for me to write science on my penis first. If Juan is "bad at math" Juan is not therefore standing up against the femstate, and the femstate doesn't, therefore, have to exist in Ballas' own thoughts. He himself explains how this works, and does it quite well, actually. So yes, sure, if only every Juan in the world could somehow get a complimentary subscription to Less Wrong Illustrated... If every Juan "got better at math" and thereby internalized delusions and hallucinations of "value of life" intrinsic to the Great Inca without, preferably, having to have them out in the open, where they're vulnerable, where they can be (horrible dictu!) discussed...

    Zombies "live" to spread zombie, that's how this goes. [↩]

24. What the fuck are you talking about, she did what she was told. What did you think women were for, anyways ?! [↩]
25. Alprazolam is a benzodiazepine, which means it has significant abuse potential. Clonazepam is a different benzodiazepine, with has more pronounced undesirable side effects, such that it's not nearly as likely to be abused recreationally (then again, thats what we thought about ketamine twenty years ago, also).

    The fundamental problem with benzo withdrawal is that it induces a psychotic state quite close to murderous rage, along with restleness, irritability, etcetera. For this reason (and quite defensibly) any doctor confronted by an angry male demanding Xanax will give them something -- it's out of the question to just kick the maniac out in the street where he can go put the same question to someone much less prepared to answer it. The reasons they'll try (again, quite defensibly) to get away with clonazepam are that a) it binds the same receptors but moreso, and for longer ; b) it is more impairing. He's not kidding around, Klonopin is legitimate treatment in this context.

    The reason for the urine sample is that a) alprazolam is intended for occasional use against anxiety, not constant use for keks and giggles ; and b) in the normal body it clears through urine within ten or so hours, whereas in the overexposed body it may take as long as a hundred. Thus, practically speaking, if your urine shows alprazolam metabolites you're taking too much of it. [↩]

26. I can feel how proud he is of himself, and sure, why not. Small things can be just as perfect as big things can be. [↩]
27. It is technically possible that the events looked a lot more inconsequential to the more experienced patients than to their evidently naive doctor captive in his dreamskins. Then again, it is also possible they're just the usual sort of idle wanker, why not. I can't call this situation, and the ambiguity is a dark mark on Ballas, rather than on the herd of whatevers populating his office. That's how life goes. [↩]
28. Oh, he debriefed, did he. [↩]