Use Time Machine over SMB to a ZFS-backed drive. Works great, even remotely. See my longer comment elsewhere in this thread.

For the last several years I've very happily used it over SMB to ZFS (with autosnaps) for this very reason, and wrote an AppleScript to automatically "verify" it every week or so.

Once or twice a year it gives a verify error (i imagine this is because a plug gets pulled halfway through a backup on one side or the other), and I just have to go find the last verified date, zfs rollback, and then re-verify. Afterwards it picks up where I left off, and the historical backups are preserved.

Wish it didn't require this extra effort in the first place, but much better than having to nuke and pave every time.

Even better, it's working great over Tailscale so I can even use it remotely. Only big hiccup I ran into was figuring out some ZFS setting about quota vs refquota (something like that) to have the Time Machine's (artificial) space limit match the ZFS quota so that Time Machine would prune the oldest backups appropriately (otherwise the ZFS snapshots took up an unpredictable amount of space and Time Machine would unexpectedly get out of space errors before hitting its space limit).

To cocaine? By "lose a kid" I assume you mean death and not some euphemism for addiction.

I really wish Guix worked on macOS. Nix-Darwin and home-manager have been game changers -- sharing much config and tooling between my Mac, arch, and nixos machines has been a blessing.

I do a ton of work on low-power devices over SSH. Helix launches almost instantly; neovim with a similar level of functionality (via plugins) has considerably more startup lag and considerably more maintenance cost (config / plugin updates). I also know enough rust to try to help fix bugs but don't know any C family languages; I have a strong preference to use open-source projects written in languages I know.

EDIT: for context I'm a hobbyist who use n/vim for 12 years or so before switching to helix for the last couple of years. There are several things about nvim behavior that I still miss quite a bit and still feel more natural, but the instant startup of helix vs a second or two for nvim configured to a similar level of functional makes it totally worthwhile for me.

My most recent septic patient had literally zero SIRS criteria, and I strongly did not suspect a bacterial source of infection. Isolated hypotension, nothing else. Said she felt great and asked to go home To date she's grown out GPCs on 8/10 blood cultures. Sepsis actually is hard. Also, it sounds like a bacterial source was not suspected in this case (and was validated by the cultures being negative and the autopsy), so AFAICT this was not sepsis.

> Also, it sounds like a bacterial source was not suspected in this case (and was validated by the cultures being negative and the autopsy), so AFAICT this was not sepsis.

Am confused by this. Sepsis can be a response to bacterial, viral, or fungal infection, no?

As an ER doc I look at a lot of my own studies, because I'm often using my interpretation to guide real-time management (making decisions that can't wait for a radiologist). I've gotten much better over time, and I would speculate that I'm one of the better doctors in my small hospital at reading my own X-rays, CTs, and ultrasounds.

I am nowhere near as good as our worst radiologist (who is, frankly... not great). It's not even close.

As a working diagnostic radiologist in a busy private practice serving several hospitals, this has been my experience as well.

We have some excellent ER physicians, and several who are very good at looking at their own xrays. They also have the benefit of directly examining the patient, "it hurts HERE", while I am in my basement. Several times a year they catch something I miss!

But when it comes to the hard stuff, and particularly cross-sectional imaging, they are simply not trained for it.

I’m fascinated. What makes a great radiologist so much better than the average?

Calling the edge cases correctly, I would think.

I hurt my arm a while back and the ER guy didn't spot the radial head fracture, but the specialist did. No big deal since the treatment was the same either way.

Im not the OP and I’m an MR tech.

I rate techs against non-radiology trained physicians in terms of identifying pathology. However techs aren’t anywhere near the ability of a radiologist.

Persuading junior techs not to scan each other and decide the diagnosis is a reoccurring problem, and it comes up too often.

These techs are trained and are good. I have too many stories about things techs have missed which a radiologist has immediately spotted.

You're specifically trained to look at the scans, and not to do 75 other things as well, only to use scans to aid your whatever you're doing.

Can you clarify -- if you're comfortable sharing additional details -- did you have an "occlusion MI" heart attack, involving balloons / stents in the cath lab?

Most people assume that "heart attack" is a distinct clinical entity, but the majority (~80%) of elevated troponin levels are not exactly what comes to mind when people say "heart attack," but will often be described to patients as a heart attack (sometimes out of ignorance and others out of convenience, as the actual explanation for what is going on takes a lot more time and effort).

There are still things in (neo)vim that I miss, even a year or so later (particularly persistent undo files), but helix's startup time is so much faster (and LSP integration so good), I hardly use anything else.

Nix is the escape hatch!

More packages than any other package manager you're likely to encounter.

If something isn't packaged for nix, it's often simple to package yourself. Even when this isn't simple, it's often simple to use nix to bring the build dependencies into your environment and then follow the usual (non-nix) build instructions.

I'm a lowly self-taught hobbyist who works in an entirely unrelated industry. If I can do it, you can.