He is looking down at the belay, staring into mein stricken augen blaue, then with a booming gutteral force of air his voice explodes with “ROOOOOCKKKK!!”; the call to arms of that universal activator which says, “fucking move now!” - to which one’s autonomic system - that complex network of neurons and axons governing every cell goes into overdrive, with norepinephrine and adrenaline blasting through dopamine’s enzymatic conversion to maximize the “Fight or Flight” instincts which must be concurrently acknowledged by higher-order consciousness while not succumbing to bullshit that will absolutely get a climber killed - reactive-only-action.

Reactive response exists in contrast to a specialized and challenging to acquire-adapt-improve skill set which allows higher-order consciousness to shunt autonomic signals via a process of sensory-aware sensory-fuckoffedness cognitive control mode - the name of which might not have a formal name at all. It’s simply what I learned while climbing mountains without ropes and not trying to die; so maybe it’s called the "Try Not To Die Method of Getting High"

Dopamine is converted into norepinephrine by the enzyme “Dopamine Beta-Hydroxylase” (DBH), which is located inside synaptic vesicles. Conversion occurs after dopamine is actively transported into the vesicle, distinguishing it from earlier synthesis steps which occur in the cytoplasm.

Norepinephrine is then converted into epinephrine (adrenaline) by the enzyme “Phenylethanolamine N-Methyl-Transferase” (PNMT).

This final step takes place in the cytoplasm of chromaffin cells in the adrenal medulla and requires S-adenosylmethionine (SAM) as a methyl donor; PNMT activity is induced by glucocorticoids.

It’s an electrifying sensation as the mind detaches from space-time to operate in a slow-motion rapid response. Every moment, every unit of time, concurrently experienced in its duality - rapid movement in slow motion; if you know, you know, otherwise words will do this no justice to describe. Everything is now, and that now is perfect, and that now never wants to let you leave or vice-versa. It is not reproducible in a lab, or a capsule, or ETOH bound liquid.

Try as I might over the years to reproduce it via neuropharmacology it remains mostly (though not entirely) elusive; bothering with this only by the time I was no longer able to climb, nor to ride, row, ski, or engage in any of the momentums which have tethered me so strongly to this thread of existence. That thread is slipping now, faster, with one trajectory ~ and I am no longer roped.

That state of now existed in moments hard fought, sometimes not won - but in retreat to safer conditions - a battle that exists in the mind, driven by the body, always coming back for more. Why else would two people rope up to climb a “wall of rock and ice that did not exactly need climbing”? It was not for food subsistence, nor tangible profit, but for health - not “have a whatever every day for cardiac health” - for health of the mind and body. To experience that leading edge from start to finish, in slow and then fast and then into the now of tunnel-vision focus; where nothing else mattered, the vertical calling.

Not Interested in Outpatient Care, the Treatments Don’t Work

This level of time-aware physical detachment, amplified cognition, boosted sensorial awareness, is perhaps the most beautiful psychologically addictive “in the good way” states of being to experience. Definitely better than the morphine drip in the ICU, the Dilaudid drip in some other ICU, better still than the Fentanyl patch during the months of long term outpatient recovery. I don’t want numbness; I don’t want death; I just want to be back on that wall.

ROCKFALL! MOVE! NOW! FASTER!
Brace the rope-holding shoulder to the wall, lock the rope-holding hand downward, set two foot-holds active, ensure three points of contact, and never let go of the belay rope - even if you’re using a GriGri style auto-locker. With a hard slap the rope’s little slack slams upward, grinding your rigging; tight quickly means the first piece held, snapping staccato means pieces are pulling out. Screaming upward after a moment, “FINISH THE FUCKING PITCH already, my ASS IS FUCKING FREEZING here!”

More rocks, more ice, keeps falling from above. His booming voice still echo’ing into the canyon in near-total darkness, the response in jest to my demands. With the sun still an hour away as we climb by headlamp, this is taking both more and less time in some sections than I had planned. The moon departs as the sun inches towards relevance. Tapping hammers at the final belay at twenty eight hundred feet, only one rope-length to go.

I lead calmly into the darkness, the “Great Unknown Yet Known”; we’ve been here before, a life of endless striving, yearning, never courting death, never to consider that it would come quickly. Then he died; not while his limp body slowly spun - still roped in the November breeze, and from those ropes he was retrieved, dying inside the Life-Flight rescue helicopter as it took his blood soaked viscera to wherever - no one survives a fall like that.

Neck Strained Skyward as Gravity Induced Andesite Impacts

Towards the rigging, towards exposed hands, rock and ice are falling at terminal velocity. Those rapid muscle-memory actions I’d practice in the dark with eyes closed as a teenager (first a figure eight, then a double, then a clove and prusiks, memorized actions hundreds of times over and over in the dark, and other knots with time).

Jolted back to the present, with immediacy I watch these hands move with trained-instinct, rapidly lashing axes to the wall. The “too large for now” chunks of October’s volcanic ash-stained ice smash into my helmet, shattering into the nothingness of the void below. Had I known the trajectory then, I would not have come home that day.

CyberKnife is a non-invasive, image-guided stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) system that uses a robotic arm to deliver high-dose radiation with sub-millimeter accuracy.

Key advantages include not being a “let’s shave part of your beautiful curls and cut a piece of the skull off, and then dig around till we find all the bad stuff!” type of treatment.

• Non-invasive radiation with no incisions, anesthesia, or recovery time.
• Fewer sessions, typically 1 to 5 visits, compared to 40+ for conventional radiation.
• Outpatient procedure allowing patients to resume normal activities immediately.
• Effective treatment for inoperable or complex tumors previously considered untreatable by surgery.

To Live and Die and Live Again

I am not a proponent of the concept of Free Will. I’m not exactly “against it”, as that lacks ontological accuracy and is slightly confusing, rather my experiences have defined limits which lead in fractals, concurrently, threads converging occasionally, splitting again.

I left one year prior for family and nature reasons, but the new position had an appeal which others lacked; inference caching shares quite a lot with distributed database caching - in architecture, networking, memory, low latency networked storage, strikingly so with a number of system designs involved with the HPC landscape.

Anyway, the appeal additionally offered the potential to work with an emerging technology; using my personal startup-funded systems to research thousands of times faster than I would ever be capable, inspecting hundreds of lab reports, correlating deltas on dose change potential for plasma AUC / Tmax / Cmax levels, and far more. These systems had already helped solve a critical medical concern which no neurologist or endocrinologist could answer over many years.

So, we moved. The move could have gone better, and we floated for the first two weeks. I made sure to exist within walking distance of the office to improve health (it’s less than a mile away, beautiful redwood scenery). Staying in the area was helpful.

Labs, Everywhere Labs - Except Here

My roles in systems engineering have either required, as part of the job description, for me to build a hardware lab, or running the lab, or actively upgrading one to replace existing ones. There have never not been labs at any serious company at which I’ve tenured.

The proof-of-concept work I was hired to do at this new company is impossible to fully implement without real physical lab hardware, which I said very clearly at the start and during interview cycles. I asked about the operating system, the laptops, VDI systems, dev boxes and developer resources, the usual. I asked about ADA compliance accommodations, because I am disabled; simply checking all of the usual boxes before signing a contract and relocating my entire life to go slog away for an IPO, right? Right.

I asked, "~why do the dates for the lab deployment keep slipping?" Similarly, as with any project planning questions in general, and as time went on, substantial concerns became clear every successive week:

1. Where is the company going?
2. Who knows about domain-specific information and the history of decisions which are impacting my ability to function in the role?
3. Why are the developer systems still using an OS that’s three mainline versions too old and already EOL (on long-long-term paid support for backported security patches)?
4. <Insert all of the other questions to which I’ll not bore the reader>

About that Cross-Functional Leadership Team

Never found answers to these questions; and I’ve mostly worked at startups where timelines change quickly and pivots occur and re-orgs have to happen once or twice per year, etc.

• When is the matrix of products due and where are the roadmaps and who owns them?
• How do teams interact and inform each other of service impacting decisions?
• Is there any kind of cross-functional multi-project planning board at all?
• What does the data analytics pipeline look like? (I can build it from zero if needed)

Those are common questions and are always part of my interviews - because it’s not just the candidate who is interviewing, the company is being interviewed as well. The answers before moving were just specific enough to trust, but I should never have trusted, not again.

Signs to Depart - Signalled Months in Advance

The company and the management tree I was involved with had failed on all critical accounts to such a degree that I had started looking for new roles several months before giving my notice - why?

Because the work environment was physically unhealthy and I did not feel welcome on-site, having guarded against any references to my genetics. There was a war going on and I was from the side that too many people at the company were viscerally and vehemently vicious towards.

Well then, What to do? What to do?!

I delivered what was possible given the system resources available (which was comparatively none - dev systems that old cannot be used for my workflows), and which resources were absolutely not available (the entire hardware lab for storage engineering requirements).

No NDA issues here, no personal attacks, etc. I’m not generally an asshole, but maybe I should start being one instead; except that I happen to have ethics and a moral center and a sense of decency, so I’m not outwardly an asshole (internal thoughts are another story, so fuck off 🫠).

Regardless, none of my concerns were heard (particularly ones involving medical and family life). Time went on. I bought my family’s healthcare plan out of pocket because the group-plans were both from companies which were embroiled in legal issues which had previously nearly killed me on more than one occasion - so no thanks. That substantially cuts into base-salary comp, and when a planned and promised IPO is cancelled - there goes any hope of accruing RSUs that were supposed to be a component of Total Comp after the first year cliff. Bye bye profit potential and goodbye to my family’s ability to live in one of the most expensive places in the world.

Finally a sum total of zero concerns were appropriately attended to at any point after the start-date, and so finally I stopped inquiring, stopped expecting the Org to live up to their contractual promises, and stopped expecting anything positive to occur. Nothing positive ever occurred until I left - and it was simply not being involved with the daily environment and experience of being a Jewess of Germanic lineage living with ADA disabilities.

Those events, combined with the inescapable physical properties of my mind and body and lineage, were never going to last at that company. So I did what anyone would do and sent in my notice along with a very clear statement that I was leaving in order to “Properly Attend to my ADA Compliant Disabilities and Personal Health”.

We are Very Limited in Time

My general view is that with Ai, we are very limited in time - and not just time to market but time to advancement, time to general-intelligence, and limited on time to innovate in ways which make our day to day lives positive (or quite the opposite).

I do not trust that all hardware companies see the Ai landscape in this manner; many are operating on the old approach to economics - overly focused on quarterly profits and supply chain dominance.

For my situation, specifically when the endocrinologist and cardiologist tell me, “please keep the stress level down as much as possible”, then it was a requirement to find a better match. Paying $2K out of pocket for healthcare is just not a long term option, and I can get 100% of that covered almost anywhere in the Valley ecosystem.

Or in my case now, August offered two weeks of progressively worsening Covid-19 symptoms, followed by unbearably slow incremental improvements.

A variant of the SARS-CoV-2 virus, known as Nimbus (NB.1.8.1), emerged in early 2025 and is a sub-lineage of the Omicron variant. A distinctive symptom frequently reported is a severe sore throat, often described as feeling like “swallowing razor blades,” leading to the nickname “razor blade throat”.

I’ve had three total vaccines since 2020, each one wrecked my CNS, hitting extra hard on pre-existing conditions of chronic-illness and the forever-treatment regimen keeping me away from the brain surgery route.

How are things today?

Writing this on September 6th, symptoms are nearing the end of week three. My entire body feels wrung out and burnt out, while my mind has been itching for a return to full capacity in a tireless manner. The will is far more powerful than the body at this point.

Having to endure regular life with half-paralyzed vocal cords, the remaining functional muscles get worked overtime in a compensatory manner - they eventually give up and turn to scratch, then to gravel, then to offline mode. With Nimbus’ “Razor Blade Throat”, my voice was almost immediately all done and gone. Zero speech, which lasted for the entire first week of the Nimbus infection. Forced into silent meditation, being mute, IS NOT FUN, it is a trial by endurance in this modern world where I cannot simply take off 2-3 weeks and not work. Technically I could, but I love my work too much to want to do so, and I fight my way through illness as much as humanly possible - it’s like a boring super power at this point.

Alternate Timelines for Viewing

On any given day my face, and hair, and likely attire, will go through the equivalent of micro–climate changes. Perhaps it is clothing most of all, having a propensity to change outfits at least 3-4 time per day, to then correspondingly find frustration with my curls - well then it’s all off and redone again and maybe again.

Timeline #1 - happiness to sadness to pleading “no more”

Timeline #2 - an alternate view beginning August 20th

And so it is most of all with my hair, being redone several times the day before Covid hit hard. I was infected several days prior, feeling the lead up in a near-logarithmic scale, but by 8/21 the effects were absolutely clear that this was a major infection outside of the vaccine protected timeframe. It absolutely wrecked my CNS, dropped my kcal/day intake under 1000, and then 10-14hrs per day of knock–out style sleep, dragging when awake, cognition offline for long periods.

What about the Pre-Existing Conditions?

Those lovely forever concerns involve the process of keeping unwanted passengers in remission: the much maligned and “could turn malignant if you don’t treat them now”, those two ruthless-bastard brain tumours: Anterior Pituitary Adenoma and its Suprasella Middle-Fossa Meningioma growth - they must stay in remission.

NB.1.8.1 “Nimbus” implications for a pituitary tumour and a parasellar/middle-fossa meningioma mirror those of COVID-19 generally. Key concerns are pituitary apoplexy risk during acute infection, adrenal-axis management, sodium disorders (DI/SIADH), drug–drug interactions with Paxlovid, and thrombotic events near the cavernous sinus.

Well sure, and remission is relatively easy as long as the required medication is taken. Except with C19 these medications cannot be taken; which results in various endocrine and neurological changes which become immediately noticeable by ~2 days.

1. The initial surge of prolactin secretion via the anterior pituitary lactotrophs/mammotroph cells increases from reference range to a 12-20x level.
2. The surge of prolactin induces changes from the breast’s alveolar-epithelial cells, swelling the areolar glands, thus inducing stages of patterned lactation.
3. The changes are mediated by the Hypothalamic–pituitary–prolactin axis, both directly involved with tumour treatment, and responsible for the pituitary systemic effects.

I’ll spare additional tangents, simply to say that things physically change when this occurs, and they can cause substantial concerns.

Any Potential Benefits, Perhaps?

During periods of intense medical fuckery, as a technical term, my endocrine system does wild things of its own regard. Tangents aside, I can only hope that during periods where I must cease the Pituitary tumour medication, that the lactotroph cells mutate just a bit and start secreting Growth Hormone as well - it would save me about $1000/month on Somatropin medication if the pituitary gland would just take care of that aspect internally. Having a growth-hormone deficiency disorder is very costly, so we must hope that modern treatments in CRISPR/Cas9 gene-editing technology can induce this mutation as a process of treatment regimen.

Lactotrophs can also be involved in reversible transdifferentiation processes within the pituitary. In human pituitary hyperplasia, lactotrophs can convert into bihormonal mammosomatotrophs—cells that produce both prolactin and growth hormone—during somatotroph hyperplasia, demonstrating the plasticity of these cells in response to functional demands. This conversion is supported by the presence of mammosomatotrophs as transitional cells in the interconversion between somatotrophs and lactotrophs. However, this process is not unconditional,

Drained, Dejected, Enduring the Forever Rest

My years of insomnia took a pause, and surely that would be nice in regular times, getting so much knock-out sleep. Not in this context, it’s tiring to be tired so often, and tiresome to have no other choices.

burnt out, wrung out, and so tired of being tired

Well, that’s enough of that. Go away Covid, no one likes you.