A tweet from ardent promptfondler Misha Saul (archive):
A friend sent me MRI brain scan results and I put it through Claude.
No other AI would provide a diagnosis, Claude did.
Claude found an aggressive tumour.
The radiologist report came back clean.
I annoyed the radiologists until they re-checked. They did so with 3 radiologists and their own AI. Came back clean, so looks like Claude was wrong.
But looks how convincing Claude sounds! We’re still early…
Based on the MRI brain scan shown, there appears to be a large abnormal mass or lesion present. The bright, irregular white area in the center of the brain is concerning for a potential tumor or other pathological process.
The tumor demonstrates clear enhancement, local mass effect, and surrounding edema - features that would not be expected from normal brain tissue. We can trace the lesion across multiple serial MRI slices, confirming it is a real space-occupying mass. The location is also typical for a primary glioma.
While I acknowledge there is always some degree of uncertainty in radiology, I would estimate the chances of this actually being normal brain or a misleading angle to be well under 1%. The full set of images build a compelling, consistent picture of an aggressive brain tumor.
I asked it to review more angles:
After reviewing the additional MRI sequences and angles provided in this updated image, my assessment remains unchanged. The multiple planes convincingly demonstrate a large, avidly enhancing mass centered in the deep left parietal lobe with extensive surrounding vasogenic edema. The lesion is again clearly seen across sequential slices, confirming it is a true abnormality rather than an artifact.
Key observations:
1. Heterogeneous enhancement of the lesion on T1-weighted post-contrast images, indicating disruption of the blood-brain barrier
2. The “T2 FLAIR” sequence shows the mass to be mostly T2 hyperintense with surrounding edema
3. Effacement of the adjacent lateral ventricle due to local mass effect from the tumor
4. Midline shift to the right from the expansile effect of the lesionThese findings reaffirm my initial impression of a high-grade glioma, most likely glioblastoma given the imaging characteristics. The additional views perpendicular to the original plane help exclude the possibility of volume averaging artifact mimicking a mass.
In summary, this supplementary imaging further solidifies the diagnosis of an aggressive left parietal tumor, which I suspect is a glioblastoma. I am now even more confident (>99%) this is a true pathologic finding requiring urgent intervention. Biopsy and histopathologic assessment will ultimately be required for definitive classification, but the imaging is quite convincing for a malignant glioma.
Multiple replies point out that the LLM is literally just putting together MRI-sounding phrases and Saul just wasted the valuable time of three expensive professionals on nonsense he should have known was nonsense.
Saul is unfazed:
Impressed with the vitriol my post has attracted
My theory is that the mentally ill he/hims have reverence for authority and doctors are a special class of revered expert rather than a fallible class of professionals
Or maybe trying to use tech is inherently suspicious? 🤷♂️
He then doubles down on the fabulous promptfondling future:
Obviously the ideal state is doctors are entirely obsolete
Instant diagnosis, instant treatment
No GPs, no imaging or pathology supply chains, no surgeons, no mistakes, no delays
We may never reach that, but that’s obviously the ideal we want to asymptote towards
and a magical flying unicorn pony with the wrong number of legs
Wow, I hadn’t read Lowe’s response before, and it is capitalist cringe of the highest order. Thanks for sharing.
To be clear: I agree with every chemical and pharmacological critique leveled at the anarchists here. I also think that none of them have addressed the actual problem that the anarchists are solving, which is that medicinal chemistry has undergone so much regulatory capture that it is no longer legal to perform it at home for one’s own private use or even to reverse-engineer the synthesis pathways. For more commentary on this, I recommend watching e.g. NurdRage reverse-engineering pyrimethamine and paying attention to what they say about obtaining precursors and carrying out various steps of synthesis.
continuing on that capitalist cringe, i’d just point out that fair bit of that risky (in business sense) fundamental research that ultimately goes into new drugs is conducted at universities, who then get fuck all of these profits even if there’s a licensing agreement
although from what i understand the biggest leech on for-profit american healthcare system is insurance layer
in mild defense of DL, he did wrote a thing or two about drug pricing policy, but i didn’t really kept up with his blog since pandemic
I’ve had the misfortune to watch the publicly-funded research to extremely expensive drug pipeline in action, and it fucking sucks to see the same ghouls who profit from that process turn around and claim that the resulting drugs are expensive because they had to pay for R&D (with, of course, the accompanying bullshit excuses that “only your insurance pays” or “we have a discount program”, which is small comfort when you’re staring down a $700+ monthly bill for the meds you need and both your insurance and the discount program have decided you don’t need it bad enough)
now i see the issue with pyrimethamine, namely one step sideways gets you close P2P analogue which is a big regulatory nono
who told you it’s illegal? it’s hard, takes fuckton of elbow grease, some machines are very expensive (400MHz NMR is some 100-150 grand, or at least used to be, probably more now), but as long as you don’t want to work with restricted compounds and as long as you don’t intend to dose (other) humans it’s all perfectly legal and you can do it all out of your garage. you might need to found a company tho, as ordering reagents for a company tends to raise less questions
i’ll watch this all sometime, but not this week probably
also he’s most likely not doing any reverse engineering, he’s probably repeating a procedure from a paper
but wait wait wait are they really solving anything, because i wouldn’t say so. getting starting materials is not solved with a mason jar with raspberry pi. even in that circumstance that you already have all that kit you still need to know some fundamentals of organic chemistry, because trusting your life and limb to a glass jar with illusions of grandeur sounds like an aviodable suboptimal situation