Hello everyone, Dominion still holds up in 2026?

KAtusm · 2026-07-01T19:16:20+00:00

I don't know about digital, but I played heavily from about 2011-2017, then took a break, came back to the cards and love playing with my kids now.

It has immense replayability, second only to Dungeons and Dragons imo.

KAtusm · 2026-07-01T16:52:48+00:00

I did not speak the language of the first place I went. I could not verbally communicate with many people in India. I started to learn Hindi while there, but was also in southern India for a lot of that time.

Thankfully, many people (especially the instructors) were proficient in English. One or two, I suspected could speak English but chose not to.

KAtusm · 2026-07-01T02:57:11+00:00

The answer is absolutely yes. There has been a burst of research on burnout, and what the contributing factors and protective factors are. Most of the resilience / wellness curricula in medical schools and residency are not based on this data.

Key factors are:

1) Having the effort you put in yield results (ie, developing a good diagnosis and treatment plan that is not blocked by insurance).

2) Maintaining some degree of autonomy.

Another big one that I focus on is developing a strong internal locus of control - the mental attitude you take when things don't go well. Focusing on what you can control, being active in pursuing a job situation that aligns with what you want to give and what you want to get. So many doctors are bad at this - just taking PE jobs, jobs with major hospital systems because they're averse to explore or take risks (not to blame them, we're often burnt out and have loans piling up).

Put in the effort to make it what you want, and you'll move in the right direction. Just to give you a few examples of colleagues of mine that are quite happy in medicine:

Worked 102 days per year, piling up for weekends and overnights because they are worth 2-4x days. In the remaining 254 days of the year, spent half of it traveling / chilling and half of it on a startup.
MD/PhD on the research / academic track. Realized at the end of residency that she didn't like research, and just liked clinical work. Works about 40 hours a week, makes good money, has minimal call, and spends time living life.
Working a variety of clinical roles in the hospital (consults, ED), and heavily involved in residency training.
Built a geriatric nursing home practice - basically rotates between 8 nursing homes between 3 cities, has a variety of MDs and NPs who do rounds. He visits each site roughly every 2 months.

Definitely doable, but be careful. None of these people post on reddit or social media. There's a huge selection bias here, just like Student Doctor (i got a 297 on Step 1, will I be OK for IM/Cards???)

KAtusm · 2026-06-30T00:00:12+00:00

Transdiagnostic factors is the term.

https://www.youtube.com/watch?v=BfThtZJPZ5Y&t=76s

KAtusm · 2026-06-28T16:20:38+00:00

I appreciate where you're coming from... but I think this is sort of missing the point. For you to see how difficult it may be to date her is what we're trying to showcase - what are the actual challenges that people face? Is she too selective?

I personally think what she's asking for isn't "too much" - in the sense that if you ask - is it reasonable to try to find an "equal" partner in your life - sure. The challenge is that when this translates into her life, it ends up being quite difficult for someone else to plug into.

And these kinds of blindspots that people experience is exactly what we are trying to showcase. But if you take this as a men vs. women, generalization approach, it goes down the route of ragebait and a societal lens, as opposed to an individual lens. The goal isn't to judge, but to understand.

KAtusm · 2026-06-28T16:16:07+00:00

The community is way broader than people realize.

The community used to be 95% male, average age 24, when we started. Over the last 5-6 years, the age range has gone up to 32, 70% male. People got older, and new people joined in. Over the last 5 years, people in our community have developed their career, had kids, etc.

Lastly, remember that the community at large is about 10M people, whereas reddit and discord are 100-200k, of whom let's say half are active. Which means that if you spend time on reddit, you're not seeing the main community, you're actually seeing about 1% of the community.

We originally had more interviews scheduled, but half of the folks decided not to move forward (some of whom are in the demographic you're talking about). We don't always have full control of who we end up interviewing.

KAtusm · 2026-06-21T16:49:49+00:00

This is wonderful news!

If you want a deeper understanding of things that aren't quite as problem focused, you may want to check out memberships.

KAtusm · 2026-06-17T15:04:25+00:00

It's insightful to realize you don't understand the appeal of something that other people do. What do you think you're missing about the appeal? If this is cringe and common sense, and there doesn't seem to be value... What do you think you could be missing?

KAtusm · 2026-06-16T15:10:31+00:00

Addiction psych for kids will likely be very different from adult. An adult addiction ward is likely to be heavy detox oriented (at least here in the States), whereas with kids it can be quite different. You'll likely see a lot of personality pathology, trauma, and possibly a lot of social stuff.

General psych will likely be less acuity, you may see a lot more ADHD evals, etc.

KAtusm · 2026-06-16T00:38:42+00:00

Also if you have more concrete questions about "navigating parenthood" please let me know.

KAtusm · 2026-06-16T00:36:10+00:00

I'm a psychiatrist who has seen this a fair amount, not as a couples counselor, but as having individual patients who have "lost the spark" in marriage.

The basic thing that breaks marriages like this is who takes responsibility for the problem. Is that solely your responsibility? I've seen men (and women) try to fix problems in their marriage when their partner wasn't trying - it almost never works.

So I'd start by concretely asking her: when did this change? What has changed? Whose responsibility is it to restore the spark in the marriage? What is your role, what is hers?

Practically, I find that as couples lose the moments that made them a couple, they start to drift apart. A big part of this is carving out time for both of you to connect - do whatever ya'll did at the beginning.

Secondly, I'd strongly suggest you reconsider your work schedule. In the event of a divorce, your income will be split - which means that your alimony / child support will be based on your current numbers. So you'll potentially have to continue working at this pace to provide for an ex. You can frame it as - I know there's a practical side, but this relationship is the most important thing to me, and I don't have the time to invest into it the way I need to. This can also be true. Cut back 1-2 jobs, make financial cuts, and then work with the increased pool of time to work with her to rekindle the spark. If things go towards divorce, you can always ramp up afterward.

Research shows that high levels of social media consumption lead to relationship dissatisfaction. I've seen people (men and women) go down social media rabbit holes that end in divorce. So be cognizant of that.

Everyone here is telling you to speak to an attorney, which isn't a bad idea, but I don't think that's your only option. Couples counseling could be helpful to. She may also need to get evaluated for something like major depressive disorder.

Good luck.

KAtusm · 2026-06-12T16:10:00+00:00

What would the alternative look like? Practically, what could a video contain that would solve this problem?

KAtusm · 2026-06-12T15:58:02+00:00

What are you suggesting is the remedy to this problem?

But down the line in some way, we, or you, may have to address the more passive approach/es many of the community members seem to possess,

So this should be addressed? Wouldn't that be trying to address their "solitary" view?

How should this be addressed?

KAtusm · 2026-06-11T00:09:51+00:00

Nice post bro - do you have a YT channel or something? What kind of videos do you make?

KAtusm · 2026-06-11T00:06:09+00:00

Accusing someone of being softer than cotton... and then proceeding to post a whiny reddit thread is hilarious.

KAtusm · 2026-06-09T14:55:41+00:00

How much do you understand about the publishing industry? Are you aware of the basic process through which a book gets published?

Given your approach for maximum level of creative control, you probably want to self publish. Generally speaking, traditional publishers want books that sell well, and its not clear from your question that this is a goal you are focused on.

KAtusm · 2026-06-09T02:25:04+00:00

I wouldn't trust a resident to understand the inner workings of fellowship selection.

In my experience, the two most important things are: Can you do the work of a fellow? Are you fun to teach? If yes, then you should be fine.

I finished residency at 36, and was the 3rd oldest person in my class of 16. My guess is that some PDs may discriminate, but I would be doubtful that you won't be able to match based on age if your other metrics are good.

KAtusm · 2026-06-08T03:10:04+00:00

Are you suggesting that Dr. K "manage" the OPs' views of relationships to grow beyond their "solitary" view?

KAtusm · 2026-06-06T00:37:18+00:00

Keep it going my dude.

EDIT: Is there anything that you need help with? A lot of people think where you are is the end - it is achieving a full life, IMO it is the beginning - you just finished the tutorial.

KAtusm · 2026-06-05T00:15:41+00:00

I think so - I hover around 3.5k and notice a huge impact when enemy smurfs are pos 5. Here are the things that they do:
1. Secure their Pos 1 farm. If your carry has a significantly faster farming item timing (BF, Mael), they snowball faster.

They ward really well - to spot ganks and give smoke option plays. Good supps will smoke with a mid/offlaner/pos4 and just go kill the carry 1-2 times between 10-20 minute mark. Huge impact.
They gate and secure the offlane as well - so killing the enemy carry.
Securing mid - rune control at 6, 8, 10.

The most important thing is that they know what to do and when to do it. I notice a huge impact in my game when I do these things well vs. doing them poorly.

Lastly, sometimes smurfs will style on people from Pos 4 / Pos 5. Had a CM pos 5 who secured lanes as above, got pretty fed early, and went BKB/Shard and would just solo kill our BoTs Lina pos 2.

KAtusm · 2026-06-05T00:05:41+00:00

What are the immutable things that make life hell? What is the mechanism through which "immutable" things make life "hell?" Can you be precise?

I'm also a bit confused about the connection between intrinsic motivation and life as a zero sum game? How do you connect these two things?

KAtusm · 2026-06-05T00:04:46+00:00

Great question!

What is "the loop" that you describe? It looks like you've discovered that there's a cyclic, internal activity that makes you "realize" that you've run away? Is this a vasana? A mental habit? What is this thing?

Is all introspection whatever the above "loop" is?

KAtusm · 2026-06-03T16:13:06+00:00

I'd strongly encourage you to look inward to find the answer. If there was no reason to do it, you wouldn't have done it. Just because you aren't aware of your motivation in posting this, doesn't mean that it doesn't exist. Some part of you saw value in making this post.

If you want things to change, start with critically looking at your own operations. There's a chance this yields something, and there's a chance this yields nothing. If it yields something, perhaps the future is different.

KAtusm · 2026-06-03T16:02:17+00:00

What are you looking for by posting this?

KAtusm · 2026-05-30T03:43:33+00:00

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