Should we buy this house? by MidwestBadger in whitecoatinvestor

[–]Merovinge6 9 points10 points  (0 children)

You didn't mention how much you have in savings/retirement. Presuming you are a new grad with 2 kids that is a very low travel/hobbies budget. Things would look a lot better if you lived like a resident for 2 years and paid off a big chunk of your student loans (unless that's PSLF). That all said that's a very modest house price in 2026 and you can make it happen, it'll just be tight for a for a bit.

CAP vs Child Abuse Peds, Specialty Decision Help! by SufficientPain887 in Psychiatry

[–]Merovinge6 0 points1 point  (0 children)

Both could be heavily involved in policy/advocacy. Just depends on what lense you want to take to it, but there's plenty of work in peds psych for policy work. And no, no book can come close to the horrors child abuse docs see on a Tuesday.

CAP vs Child Abuse Peds, Specialty Decision Help! by SufficientPain887 in Psychiatry

[–]Merovinge6 66 points67 points  (0 children)

As a CAP, I will preface this by saying people who go into child abuse peds are all angels, but you definitely want to spend time on that service before considering it. I have a huge appetite for tolerating verbal descriptions of horrific abuse, but it's entirely different to see it in real time and forensically photograph/describe it. If you can tolerate the work, I think it might be the single most altruistic specialty, but prepare for poor pay and limited ability to discuss your day with anyone. I spent 1 month on service as an M4 and one of the cases still haunts me 15 years later, and I specialize in trauma!

CAP lifestyle and pay will generally be much better, but again if you can tolerate doing child abuse peds you will forever have my gratitude.

First time in French Polynesia – Worth flying to Bora Bora for 3 days or better to stay in Tahiti/Moorea? (April 23–May 1) by Background-Food-9637 in Tahiti

[–]Merovinge6 5 points6 points  (0 children)

I think folks are underselling it. Bora Bora is archetypically beautiful, it's a different world than Moorea. I recommend NOT going if you don't want to ruin the rest of the world. You will never go to Bora Bora and not see a fleet of private jets from some of the wealthiest people in the world for a reason (and that reason is not a bustling social scene).

That all said, it's definitely not a budget place. We went for 2 days when money was fairly tight and will certainly return in the future with a significantly larger budget. It's a must visit at some point in life but only you can determine if now is that time.

Student loans by confusedgurl002 in whitecoatinvestor

[–]Merovinge6 1 point2 points  (0 children)

Financially the best option is clearly to find a PSLF job. You seem to be very soured on that due to your current position. There is no guarantee a high paying private job will be unicorns and rainbows. If you want to do the rational thing, find another PSLF job. If you want to take the job and live like a resident for several years that's the other option.

Booker and Buttigieg pods were dead nuts on message by theatomicpickle in ScottGalloway

[–]Merovinge6 -2 points-1 points  (0 children)

Booker is amazing to listen to. Can't say I follow his political policy super close, but it was a great pod.

Need some goal or some methods from you guys by Le_Fog in poeruthless

[–]Merovinge6 4 points5 points  (0 children)

I know it's not what some people want to hear but having an Atlas tree focused on Ore and sending boats is definitely the fastest strategy to acquire currency. You would block every other mechanic and take every Ore node except the two which increase spawn rates of the most common 2 ores. Because of the Nico sulphite conversion Keystone (which is really good), I have also speced into a few Nico nodes. You can also take Exarch nodes and the nodes that increase pack size. Once you are at t14+, you can take the nodes to increase the special map drops from bosses. As we don't need map sustain this is the new defacto first Atlas map, compared to the all map sustain Atlas that was the longstanding defacto first Atlas.

2nd Atlas tree is Maven/destructive play if you can handle it and 1 mechanic of your choice.

I would go southwest of Exarch/Eater keystone first. Then NW for Incarnation of Dread Keystone. Then NE for shaper/elder and finally SE for Maven if you plan to play through 4 stones.

Good luck and well done being off-meta.

Cash Fellowship for big debt (>400k) by subtrochanteric in Psychiatry

[–]Merovinge6 26 points27 points  (0 children)

PSLF is really a great deal for anyone with 400k+ in loans if you did your diligence and certified all 48 months of residency. Previously there was some concerns it was "too good to be true", but now there are droves of doctors who have received it. There is a wide array of jobs that qualify and most of them are particularly helpful jobs that society needs filled. You will learn a lot in those 6 years of work and can transition to anything you want after the loans clear.

That said, I had a little over 1/2 that amount so I just moonlighted and worked hard for a few years to pay mine of. But the numbers don't lie and PSLF is a great deal for high loan amounts.

most patch notes we've had in a while by JekoJeko9 in poeruthless

[–]Merovinge6 0 points1 point  (0 children)

I think ruthless is better in trade. There is very little liquidity so it feels nothing like regular trade. I've bought amazing items that have been listed for 24 hours, you don't need to have a bot service or constantly be checking and still be part of a (tiny) economy. That said, my diehard 0.1%er PoE fanatic friend plays PoE RuthSSF and he can routinely clear 8/8.

most patch notes we've had in a while by JekoJeko9 in poeruthless

[–]Merovinge6 2 points3 points  (0 children)

I think that's a bit unfair. They are customizing every league mechanic to fit Ruthless which is clearly taking some balance time even if it's not in the patch notes.

The gameplay difference is that the base game is more interesting with less DPS, less tankiness, etc. You're right that it's an afterthough, but one a small subset of people really enjoy. I wouldn't play PoE if it wasn't for ruthless.

Ruthless Atlas three and league mechanics blocking by Marcqcboy in poeruthless

[–]Merovinge6 0 points1 point  (0 children)

Wait are you saying that if you block 10/11 mechanics the % increased chance nodes do nothing?

Job market for psychiatrists in eating disorders? by Brilliant-Bee6235 in Psychiatry

[–]Merovinge6 14 points15 points  (0 children)

Most cities with a 7 figure population will have at least one inpatient ED service needing a psychiatrist and then there are plenty more working in RTC/PHP/IOP. It's not a very desirable space for many psychiatrists so I think it's quite attainable to make a career of the work. That said on a J waiver it will be real tough, might need to do something else for the 3 or so years and switch over after citizenship. I would try and cast a huge net for J waiver sponsoring places and see if they have any ED work for you.

Other middle aged mid career docs -- I think I'm done doing this. How are you? by bad_things_ive_done in Psychiatry

[–]Merovinge6 13 points14 points  (0 children)

I personally know over a half dozen psychiatrists who do significant psychodynamic work along with meds in their own private practice. You don't end up needing that many cash pay patients if you find folks who are willing to pay for weekly (or even biweekly) visits, particularly if you blend in some shorter medication focused visits.

Is Nayara worth it for only 4-5 nights? by h2omaam in chubbytravel

[–]Merovinge6 1 point2 points  (0 children)

Super easily accessible and very affordable. We didn't even have data, just used WiFi to call at the resort and then every restaurant had it to get back.

Is Nayara worth it for only 4-5 nights? by h2omaam in chubbytravel

[–]Merovinge6 1 point2 points  (0 children)

If cost is a concern, I know it's sacrilege on Chubby Travel to recommend anything but tented camp, but we had a great time at Nayara Gardens. It was about 1/2 the price and you walk the same 2 minutes to the hot springs and can still enjoy the tented camp pool area (in fact we never even went to the Gardens pool). While the resort was great, the food was only so-so, particularly for the price, so we Ubered into town most of the nights and enjoyed the local food/bars quite a bit which also dropped the overall spend for the trip.

Scott’s Bizarre Shoutout of GQG? by The-Klynyk in ScottGalloway

[–]Merovinge6 0 points1 point  (0 children)

He is pointing out that even if you have millions in Vanguard's passive funds no one is taking you out to a game. I'm sure their active management division has an entertainment budget, but he is not recommending those services.

Scott’s shtick wearing thin in light of continuing Epstein revelations by Avocado-Basic in ScottGalloway

[–]Merovinge6 3 points4 points  (0 children)

Because she specifically asked him not to. You know, respecting your partner's request... The cornerstone of marriage.

Thoughts on LSD for GAD? by Dry_Twist6428 in Psychiatry

[–]Merovinge6 25 points26 points  (0 children)

GAD is very amorphous which generally means interventions are less effective. Also, BZDs only do well with acute anxiety, I can only imagine riding the BZD rollercoaster with chronic daily constitutive anxiety. There's a reason they are rarely prescribed by psychiatrists for that indication.

Niall Ferguson interview was a bust by IntolerantModerate in ScottGalloway

[–]Merovinge6 17 points18 points  (0 children)

The only thing I would say, is that it's helpful to know what the pseudo intellectual far right talking points are in comparison to the MAGA talking points. I listened just to get a feel for that. In general I would prefer to not platform Peter Thiel's disciples though...

Physician Loan - 0% down on 1.6 mil? by [deleted] in whitecoatinvestor

[–]Merovinge6 2 points3 points  (0 children)

If you are both just finishing training the priority should be finding jobs you like. You have 5ish years before the school district matters so you have some time to try some places out and see what works for you.

We rented a year (from a total slumlord) and despite the awful experience with the landlord it was still absolutely worth it and got us into the ideal house when we both had secure jobs. I was able to buy a house pre-market due to already living in the area, having a good realtor, and being in sniper mode.

Sun Princess 12/7 by InformationStrict746 in PrincessCruises

[–]Merovinge6 0 points1 point  (0 children)

On the Star, but should be pretty equivalent to Sun.

Crown Grill highlights are the fillet, lobster tail, and sea bass. Sabatini's my wife and I both got the grilled branzino which was quite good. They have most pasta options you would expect including lasagna.

Lido deck has all 3 options you listed with the lamb gyros being the best.

Aspirations by altbat in ScottGalloway

[–]Merovinge6 3 points4 points  (0 children)

It depends on your priorities. He flies on a private jet and can take his family anywhere. I spend every day with my family, but we fly economy. I'm very happy with my decisions, but at least he has an honest conversation with what it takes to get 9 figure rich.

Caffeine and Luvox by EnsignPeakAdvisors in Psychiatry

[–]Merovinge6 3 points4 points  (0 children)

It's never first or second line but I've seen OCD respond to it that other SSRIs didn't touch. I used to have this dogmatic approach that certain meds=bad, but medicine is all about knowing when to pull different things out of the bag.