Fleming Nagarajan

Surgeon💉, insatiable learner🧠. Exploring culture, tech, math, philosophy & beyond to uncover intersections shaping humanity 🌏🚀 #LifelongLearner

[Fleming Nagarajan @BeyondTheOR]

I am here to share my perspectives derived from my experience & to learn from others who share theirs.
If you have different experiences to mine, please share them.
However, that sharing doesn't require argument or debate. There is more value in broadening our knowledge than winning arguments.

[Fleming Nagarajan @BeyondTheOR]

To make deep work maximally efficient, protect unstructured time for default thinking.

[Fleming Nagarajan @BeyondTheOR]

The implications of first observation is more than the financial gains. Companies too need to set boundaries

[Gergely Orosz @GergelyOrosz]

Went to NVIDIA HQ today.

Two interesting observations:

1. Snacks and coffee are not free: you have to pay for them. This would be unusual at Big Tech, but no big deal for devs here. "We use this thing called salary to buy stuff we actually need." Food for thought (literally!)

[Fleming Nagarajan @BeyondTheOR]

Revisiting Jordan Peterson after a long time

[Jaynit @jaynitx]

Jordan Peterson on how to easily overcome social anxiety:

1. Social anxiety is not shyness. When you walk into a social situation, your brain registers it as a dominance hierarchy that is judging you. A negative judgment means low status. Low status interferes with everything your biology cares about. You are not being irrational. You are being evaluated by something that feels like nature itself, and your nervous system knows it.

2. Telling an anxious person to stop thinking about themselves does not work. You cannot tell someone to stop thinking about something. They get caught in the loop. Stop thinking about a white elephant. white elephant. white elephant. The instruction makes it worse. The only way out is to give the brain something else to do.

3. The actual solution is to look at other people. not glance. Genuinely look. Watch their face. Track what they are thinking. The moment you focus outward, your automatic social mechanisms engage, and the awkwardness dissolves on its own. You cannot be socially calibrated and self-focused at the same time. Attention can only go in one direction.

4. When speaking to a group, never try to address the group. It does not exist as a thing you can talk to. Find one person, look at them directly, and talk to that person. They will reflect the entire room back to you because everyone is entrained to the same social signal. If you can talk to one person, you can talk to anyone.

5. The eye at the top of the pyramid, the thing the Egyptians worshipped as Horus, is attention itself. What you pay attention to determines everything. The most important thing to look at is whatever your instincts flag as slightly wrong or off. That is where the real information is. Your enemies are useful for the same reason. They will tell you things about yourself that nobody else will, and occasionally one of those things will be accurate.

[Jaynit @jaynitx]

Jordan Peterson on how to easily overcome social anxiety:

1. Social anxiety is not shyness. When you walk into a social situation, your brain registers it as a dominance hierarchy that is judging you. A negative judgment means low status. Low status interferes with everything your biology cares about. You are not being irrational. You are being evaluated by something that feels like nature itself, and your nervous system knows it.

2. Telling an anxious person to stop thinking about themselves does not work. You cannot tell someone to stop thinking about something. They get caught in the loop. Stop thinking about a white elephant. white elephant. white elephant. The instruction makes it worse. The only way out is to give the brain something else to do.

3. The actual solution is to look at other people. not glance. Genuinely look. Watch their face. Track what they are thinking. The moment you focus outward, your automatic social mechanisms engage, and the awkwardness dissolves on its own. You cannot be socially calibrated and self-focused at the same time. Attention can only go in one direction.

4. When speaking to a group, never try to address the group. It does not exist as a thing you can talk to. Find one person, look at them directly, and talk to that person. They will reflect the entire room back to you because everyone is entrained to the same social signal. If you can talk to one person, you can talk to anyone.

5. The eye at the top of the pyramid, the thing the Egyptians worshipped as Horus, is attention itself. What you pay attention to determines everything. The most important thing to look at is whatever your instincts flag as slightly wrong or off. That is where the real information is. Your enemies are useful for the same reason. They will tell you things about yourself that nobody else will, and occasionally one of those things will be accurate.

[Fleming Nagarajan @BeyondTheOR]

A system without incentives is doomed for infinity

[Fleming Nagarajan @BeyondTheOR]

Compare this doctors bonded service(slavery) with defence personals.
1. Doctors dont get a quaters or place to stay,
2. No housing allowance
3. They are paid not even 1/3rd of their market value
4. No rations or supplies
5. Certificates withheld by governments
6. Very poor working conditions
7. No option to opt out

If this is not slavery then what else!!

@PMOIndia @indSupremeCourt

[Fleming Nagarajan @BeyondTheOR]

@DrAnkitkrmishra I dont promote slavery in any form. Its a violation of human rights, whether for doctors or iit buds. Everyone has the right to work and right for pursuing their goals without bonds.

[Fleming Nagarajan @BeyondTheOR]

@DrAnkitkrmishra State governments are spending a lot of money in unnecessary ventures. If health care was a priority, they would have found ways to pay the doctors and give them a proper job. Slavery is slavery.

[Praggnanandhaa @rpraggnachess]

Grateful and thankful for all the love and support!

Looking forward to my next game.

#NorwayChess

[Fleming Nagarajan @BeyondTheOR]

Social media makes you believe that getting rich is easy.

[Fleming Nagarajan @BeyondTheOR]

We have severe shortage of useful attention. The question is what can we do about...? As a person? As a society? As a civilisation?

[Matter as Machine @matterasmachine]

@Grimezsz The problem is not attention, but attention to something useful.
Flat earthers pay attention.

[Fleming Nagarajan @BeyondTheOR]

Research has the possibly for disproportionate resource advantage. In India, both private and public sector has huge untapped research potential. The most important resource for developing new tech and possibilities is HR. We have lot of that. We need a system that can streamline and make research goal oriented

[Fleming Nagarajan @BeyondTheOR]

https://t.co/Eyys94wKZc

[Fleming Nagarajan @BeyondTheOR]

46-year-old male presented with traumatic D11 vertebral fracture with spinal cord contusion.

Neurology on presentation:
Upper limbs: 5/5 bilaterally
Lower limbs: 0/5 bilaterally

He underwent D10–D12 pedicle screw fixation and stabilization with D11 laminectomy.

This case highlights the importance of early neurological documentation, careful level localization, posterior stabilization across the fractured segment, and decompression when indicated in traumatic thoracolumbar spine injury.

#Neurosurgery #SpineSurgery #SpinalTrauma #PedicleScrewFixation #Laminectomy #Neurotrauma #Spine

[Fleming Nagarajan @BeyondTheOR]

62-year-old male presented with quadriparesis.

MRI cervical spine showed a C5–C6 herniated disc causing significant cervical cord compression.

He underwent C5–C6 anterior cervical discectomy and titanium cage fusion.

A good reminder that degenerative cervical disc disease can present dramatically when it compromises the cord — timely diagnosis, proper level confirmation, meticulous decompression, and stable fusion matter.

#Neurosurgery #SpineSurgery #ACDF #CervicalMyelopathy #NeuroSurgery #Spine

[Fleming Nagarajan @BeyondTheOR]

@anismotiwala @DocPriyamMD They are not even appropriately referring anymore. Many times they cant differentiate urology/nephro or neurology/neurosurgery or psychology/psychiatry. They just refer to everyone

[Fleming Nagarajan @BeyondTheOR]

@DocPriyamMD If it about vastness then community medicine is unimaginable vast than internal medicine. They hve to know everything from pemphigus to schizophrenia plus they have to know from mosquitos to public health policies. Tats demanding.

[Fleming Nagarajan @BeyondTheOR]

No disrepect to internal medicine, but subjectivily speaking, internal medicine docs are not even treating hypertension properly. They have become referal agents. They have ended as neither as jack of all trade nor master of any. Does anyone have similar subjective experience regarding internal medicine?
Nb: legacy model internal medicine was good. But tat was 30years ago.

[Fleming Nagarajan @BeyondTheOR]

The more paths available, the greater your degree of freedom. So, it really boils down to how many possibilities are open to you at any given moment.

[Machiavelli Bot @UnmodernmanBot]

Game theory explains why the person with fewer options becomes easier to control. Desperation narrows the decision tree until every bad offer starts looking like survival. This is why your first duty is to build exits. Money, competence, reputation, allies, and emotional detachment are not luxuries. They are escape routes from being priced cheaply.

[Fleming Nagarajan @BeyondTheOR]

@sama Finally some sense in the pricing