> When I re-read Flowers for Algernon recently I was just sad. The second half of the story, where his mind is going away, is just brutal, especially when he can remember how smart he was but knows it's gone for good.

https://news.ycombinator.com/item?id=21544149

"Von Neumann would carry on a conversation with my 3-year-old son, and the two of them would talk as equals, and I sometimes wondered if he used the same principle when he talked to the rest of us." - Edward Teller

I watched a documentary from the 80ies a long time ago. A mathematician (can't remember his name) who worked with von Neumann in Los Alamanos was interviewed. He described von Neumann's last weeks in the hospital - the cancer had already metastasized into his brain. The mathematician said something along this lines (I am citing from memory): "von Neumann was constantly visited by colleagues, who wanted to discuss their latest work with him. He tried to keep up, struggling, like in old times. But he couldn't. Try to imagine having one of the greatest minds maybe in the history of mankind. And then try to imagine losing this gift. I was terrible. I have never seen a man experience greater suffering."

Marina von Neumann (his daughter) later wrote this about his final weeks:

"After only a few minutes, my father made what seemed to be a very peculiar and frightening request from a man who was widely regarded as one of the greatest - if not the greatest - mathematician of the 20th century. He wanted me to give him two numbers, like 7 and 6 or 10 and 3, and ask him to tell me their sum. For as long as I can remember, I had always known that my father's major source of self-regard, what he felt to be the very essence of his being, was his incredible mental capacity. In this late stage of his illness, he must have been aware that this capacity was deteriorating rapidly, and the panic that caused was worse than any physical pain. In demanding that I test him on these elementary sums, he was seeking reassurance that at least a small fragment of this intellectual powers remained."

Watching my grandmother slide helplessly into the dark mental abyss of dementia and then be lost inside it for years made me realize that it is downright inhumane to not offer end of life assistance to people.

I have conflicting feelings on it

On one hand, I had a similar experience with my grandfather. He eventually couldn't even remember to speak English, he reverted to his childhood language. When we translated, he thought I was a childhood friend of his, not his grandson. It was awful

But sometimes he would be so lucid and remember everything. It was so awful thinking that "he is still in there" the idea of him choosing to end it and not have those last few times to talk.. I dunno

During one of those lucid times was the most deep and important conversation I ever had with him. He understood what was happening and it gave him the freedom (courage?) to talk about things he'd never talked to me about before. It was so important to me as a young man, I cannot imagine if he had signed an end of life form and I never got to see that side of him before he passed

Selfish of me I know. But still. Maybe this really just highlights how important it is for people to really talk to one another when they are alive

> I have conflicting feelings on it

As ardent a supporter of assisted death as I am, I really don't think there's any other way to feel about it. You illustrate exactly why these types of choices will never be easy.

Yeah, to clarify I do support it. I think reducing suffering is a noble goal and allowing people to choose not to suffer needlessly is overall a good thing

But it definitely is not cut and dry and I can see why some people are extremely resistant to the idea

Where I currently live, terminally ill nearing their end often fall in a pattern of eating and drinking less and less, to the point of having nothing (not even water). This process of dying takes 1-2 weeks(!). Longer if some liquid is still imbibed.

This is a common ending of a terminally ill process and apparently seen as humane. Though I think if anyone treated their dog like that, we'd report them for animal abuse.

I don't have good answers to most questions surrounding this topic. But I'd like to get to a point where people are treated as humanely as their pets in their final period. And I can't even tell you the current practice isn't, just that it does not at all feel that way to me.

> Where I currently live, terminally ill nearing their end often fall in a pattern of eating and drinking less and less, to the point of having nothing (not even water). This process of dying takes 1-2 weeks(!). Longer if some liquid is still imbibed.

Even just getting to this point is usually a brutal period of pain. Then you have to die like that? It's frankly barbaric.

bit ironic, all this effort to extend life but it turns out that living that long isn't always so great so we start euthanizing folks.

I'm not saying it's wrong or right (I don't have a full opinion on the matter yet) but it seems very indicative of human endeavors more generally. Like a big a cosmic joke.

There's a really big gap between 'living so long' and 'living with a lovecraftian deteriorating and debilitating disease'

> In this late stage of his illness, he must have been aware that this capacity was deteriorating rapidly, and the panic that caused was worse than any physical pain.

I watched my father go through this (due to Alzheimer’s) before he passed away. He would say “I don’t understand why I just can’t think like I used to”. It was heartbreaking. He was a brilliant mathematician before the disease put him in a mental prison. It was pure torture for him.

Now keep in mind that that frustration - the absolute torture of losing who and what you are - applies to everyone going through something like this, not just the greatest minds of their time.

Makes me glad that we're starting to look at assisted dying more seriously...

why not try to cure alzheimer or other mental diseases that show up on the elderly instead?

Do you genuinely believe that this is a binary decision, or is this just anti-euthanasia rhetoric disguised as concern trolling?

Offering humane end-of-life options to people suffering today does not prohibit ongoing disease research towards potentially helping people in the future.

It's not entirely binary, but there is an obvious unpleasant tendency in e.g. Canada, to soft-push MAID onto potentially treatable patients who don't even seek medically assisted death.

I wouldn't want my government to have an option of dealing with the problem this way, and if I needed MAID, I'd just self-administer.

Yes, it's a slippery slope once a state providing assistant to suicide is law imho.

It just doesnt seem something a state should be charged with.

I doubt you can cure these diseases, you can perhaps prevent them, but to cure would mean removing their effects, and if you could remove their effects and say, bring a seriously deteriorated Von Neumann back to his previous mental heights it seems like you should be able to make anyone the equal of Von Neumann - which I agree would be a great thing to be able to do but seems to be a much further along than the words cure or prevent would indicate.

Yeah tbh english isn't my first language, and I meant more into -finding the causes- and eradicating alzheimer, aka preventing it, much like we have done with polio, or whatever.

Not really curing people already in advanced state of the maladie...

anyways, they're not mutually exclusive, but enhanching life should preceed ending it in the order of priorities imho

There is a world of difference between removing an inhibitor and adding an enhancement.

since these diseases destroy parts of the brain not just inhibit the functioning of the brain you would need to add an enhancement and not remove an inhibitor to bring back lost functionality.

1. As other commenters point, many cases have intact memory and circuits for what would be considered "lost", which activate from time to time. So it's likely a question of SNR and tissue vitality (e.g. basic capillary function) for these cases.

2. You wouldn't believe what feats of neuroplasticity lie behind a few receptors properly pushed by molecular keys. We just don't have experience to describe it. Adult neuroplasticity and (disproven btw) neurogenesis is a rigid sad joke compared to what's possible.

Depends very much on the disease, for my specific type of brain fog from dysautonomia (via ME/CFS and hEDS) it may feel like a gradual and permanent degradation but it is largely completely reversible and when you know what you're doing it's actually pretty easy to do so. This is only known by a very small minority of doctors so the chance a specific patient meets such a doctor is incredibly low which is why most people still think it's some great big mystery. I was able to remove the inhibitor and bounce back better than ever. I think the brain fog in my case was caused by excess IL-1B pro-inflammatory cytokines and directly targeting that with medication did result in the brain fog near permanently lifting.

It’s also likely that even if the degradation is permanent it is also likely multifaceted and one of those facets is likely to be treatable such that the impact of the degradation could be greatly reduced. I think it’s incumbent on us to try as much as possible even in the seemingly lost causes because learnings from such attempts could yield insights for those who are not lost causes.

It’s a ridiculous conflation to suggest that the inability to take a regular person and give them Von Neumann intelligence means that we can’t help Von Neumann stuffing an ailment even if a component of that ailment is clearly permanent.

> I agree would be a great thing to be able to do but seems to be a much further along than the words cure or prevent would indicate.

If the words "cure" or "prevent" don't indicate that, why did you bring it up? :)

I think this is being needlessly pedantic. Keeping in mind that one of HN's guidelines is to respond to the strongest plausible interpretation of a comment, I think we can assume that GP meant, essentially, "learn enough about these diseases so as to detect and prevent them from causing irreparable damage"

sorry but the strongest plausible interpretation of the word cure is obviously not "prevent", it is to undo the damage.

>If the words "cure" or "prevent" don't indicate that, why did you bring it up? :)

the strongest plausible interpretation of my comment would be I brought it up for the reason I said - that if you could cure the disease you would have to be able to give anyone the capabilities the disease destroyed (because these diseases seem to destroy parts of the brain so even if you "brought back" the brain it would be a different brain with different data in it)- and that, although I did not state it, I felt that the original poster had not considered this when they expressed a wish to cure.

on edit: obviously if you have experienced minor damage you can get back to what you were before because the brain has a lot of redundancies and it can recover if decline is halted, but if you have experienced major damage you're probably not getting back and asking for a cure there seems unlikely to work.

The "disease" we're talking about here is death. Von Neumann was losing his mental capacity because he was dying. I know some in the silicon valley set think that "curing" death is both feasible and desirable but I disagree on both points.

A voice from outside SV (mine): We can extend life and prevent disease in animals and should do the same in human beings. As much as the West has exclusive access to biomedical R&D, it's an ethical imperative for the West to pursue this goal on behalf of humanity as a whole.

You invented noblesse oblige and should measure up to it.

no death is just part of life, there's no life without death.

the disease would be alzheimer, and curing it would mean probably preventing it / being able to edit the genome to nullify whatever gen is making it come up in the first place (if its genetic)

Are these mutually exclusive ideas? Can we not pursue research in this area while not forcing families to watch their loved ones slowly lose their mind and wither away?

It will be mutually exclusive along some class line if we try to pursue both. Additionally, without the desire to preserve life and value of the advantages of aged minds, we will not make as much progress on the disease.

Well, we are not "trying to" pursue both - we actively are. Anyway, there certainly is much discussion to be had about class discrimination in medical care, but that seems out of scope for this thread - not least because of very simple things like some country's healthcare systems being radically different than others.

> Additionally, without the desire to preserve life and value of the advantages of aged minds, we will not make as much progress on the disease.

I'm not sure why you think that easing end-of-life suffering would lead us to stop preserving life?

We're also not talking about "aged minds," we're talking about damaged minds - and even if we were, we're not talking about de-aging or anything like that.

I guess we can explore both, but I'd ask you to research how these laws are already affecting families too in new ways on places where eutanasia is already legal.

It's easy on older -about to die-, people, but what about not such clear cut cases, some families are actually against their beloved ones taking their lifes, and the state allowing it, (Parents suing their offspring, to try and not have them do it, for example)

and yes, a judge rules out on such cases, but to me, well, i dont see why the state should -sanction- taking your own life, when is something that shouldn't be natural, there's medical cases for sure, but laws sadly aren't perfect, i'd rather have no one wrongly off themselves

> I guess we can explore both, but I'd ask you to research how these laws are already affecting families too in new ways on places where eutanasia is already legal.

Can you provide some reading? Because this doesn't really mean much by itself.

> It's easy on older -about to die-, people, but what about not such clear cut cases, some families are actually against their beloved ones taking their lifes, and the state allowing it, (Parents suing their offspring, to try and not have them do it, for example)

Then those families can talk about it and the person dying can make their choice. The families who don't like it can do what they want, just like those who do want it.

> when is something that shouldn't be natural,

Almost nothing about our modern life is "natural", including most of medicine. That said, how is death unnatural?

> Almost nothing about our modern life is "natural", including most of medicine. That said, how is death unnatural?

only meant having to bear the death of your child before you, usually a parent dies first, although i guess infant mortality rates where much higher until recent times...

this recent case what i was thinking specifically https://www.elconfidencial.com/espana/2025-03-17/justicia-av...

> The young woman has been in a wheelchair for years after falling from the top of a building .

> He added that his daughter suffers from mental problems with suicidal tendencies and constant changes of heart, and therefore needed psychological treatment, not assisted death.

> "The patient's capacity to make decisions has also been verified," the ruling states, "by the attending physician and the psychologist at the Hospital Residencia . The plaintiff has not presented any evidence that could refute the conclusions of these reports. They show that Noelia retains her capacity to make all types of decisions, including, therefore, the decision to undergo euthanasia."

This is a terribly sad situation all around, but I don't see this as evidence for why euthanasia laws are bad. The best I can see is that this highlights that we shouldn't push euthanasia as a solution to every lifelong disability, but that s a social/cultural issue, not a legal one - and one that we will certainly have to adapt to as assisted dying becomes more socially accepted. There will likely be more stories where, arguably, it goes too far, but I don't think there will be an epidemic of people offing themselves for relatively minor things.

> only meant having to bear the death of your child before you

Of course this is sad, but given the context of the conversation, the other choice being watching a child lose their mind or suffer in a world that is extraordinarily hostile to disabled people, I don't think saving the parents one type of pain (while subjecting them to another) is a really great idea either.

Also, isn't it better to have a way for people to kill themselves "cleanly", rather than kill themselves at home (or worse, in public)? Presumably finding one's child like that would be far worse?

(Of course, none of this is to say that we shouldn't e.g., make the world more accessible to disabled people, or help people learn to live with their disabilities, or try to cure Alzheimer's and the like - but as said, we can do all of these things at once. In the meantime, before we cure Alzheimer's and make everyone perfectly mentally healthy, we should also deal with the harsh realities that not having done those things entails.)

I didnt link them but several similar cases around mental illness.

IMHO a state shouldn't give individuals the right to off themselves.

Nature and physics already do, providing laws and a framework around it perverses it to push that people that feels out of society to bad decisions some times

Maybe its better to have them be able to do it -cleanly- and legally, but that also means more of them do?

I don't see mental health, or disabilities, as granting ending your own life, my worry is this discourse around euthansia is actively against that view and detremines the experience of humans that are considered not optimal to society as they where a throw away toy

> IMHO a state shouldn't give individuals the right to off themselves.

This is a really terrible way of putting it (another way of putting it might be "the right to end their suffering"), not to mention that a state needs a good reason to deny its citizens of rights, not the other way around. I don't see any good reason why we should deny people the right to end their suffering when they choose.

> Maybe its better to have them be able to do it -cleanly- and legally, but that also means more of them do?

I don't think assisted dying being accessible is going to cause more people to become suicidal, no.

> I don't see mental health, or disabilities, as granting ending your own life

The thing is, you don't get to decide that for me either, on a legal basis. You're welcome to feel this way yourself, of course, and encourage your friends and family not do so, but you don't have the right to decide that for others.

> my worry is this discourse around euthansia is actively against that view and detremines the experience of humans that are considered not optimal to society as they where a throw away toy

The thing is... we already do. Disabled, elderly, neurodivergent... There are large groups of people that society has been failing for a long time. Giving some of those groups (like the elderly) the option to not have to endure that seems to me a good thing.

because assisted suicide is a bit more damn easy than “curing alzheimer”

why not cure cancer while you’re at it

well I didn't ask which one was easier but more worthy to pursue

We haven’t yet and likely won’t for a lot of people who, to be blunt about it, would quite literally rather die than lose their mental faculties. Ultimately it’s their choice. Honestly it doesn’t strike me as all too different than a DNR.

> I’ve always identified with my thinking—I have value because I’m smart. Turns out, as with all attachment, this is a mistake.

I experienced a period of severe cognitive deficit while recovering from a medical episode. We didn't know whether it would be permanent or not. I also discovered - as a fellow my-IQ-is-my-identity person - that it didn't matter anywhere near as much as I'd have expected it would. I was still able to experience love, and joy, and humour. Some things sucked, and were frustrating, like not being able to retain enough information to read a moderately-complex piece of prose, but the point is that I still felt like myself, even at a very low cognitive level. I'm immensely comforted. I expect I'll experience that again, as I (hopefully!) age, but it holds no particular terror anymore.

I've had cognitive decline over the past 6 years. I turn 41 this year. It's strongly (maybe solely) due to stress, anxiety, depression, migraines, and insomnia. This entire clusterfuck started 6 years ago because, while I had the skills to excel in school and career, I was sorely lacking in the skills to be a father, husband, and homeowner. When I got married and we began having children, my decline began. But it was slow enough and normal enough at first (new parents often don't get enough sleep, they often have extra stress and anxiety, etc) that I did nothing to combat it. It wasn't until 2021 with all the added awfulness of 18 months of a global pandemic that it become obvious things were unsustainable. I was barely able to function at work, I was being put on a PIP, and I was almost completely absent from my family. When I was with my family I was irritable, angry, constantly complaining.

I got on antidepressants and that helped, though it came with it's own set of problems. I started seeing counselors, reading self-help books, I went through 6 months of cognitive behavioral therapy for insomnia (CBTi), working with a neurologist to get migraines under control, seeking help wherever I could. It has been a slow process but I'm doing a lot better. I'm still nowhere near where I was cognitively. In fact I don't know that has improved much at all. And it's only been in the past year that I've began to understand my decline as a result of jumping into marriage, fatherhood, and home ownership without the necessary skills to handle them. I'm hopeful things will continue to improve, I've learned an enormous amount about life, fatherhood, marriage, love, forgiveness, hope, and priorities.

If you are a young parent, or considering being a parent soon, work on yourself. Ensure you have the skills you need or your life (and the lives of those near to you) will become a bag of utter despair filled with shit.

Hey I think you might be me, this is basically me in most respects. I have nothing helpful to say except to say yeah, this is a real thing that I think many people are silently suffering through right now, 5-ish years post-pandemic.

I used to get this pretty regularly, I thought I just keep burning out. I have an unusually high IQ and noticed that my symptoms were very similar to the string of condensed matter physicists that committed suicide. Their descriptions of their health issues before they killed themselves mirrored my own and I too used the Flowers from Algernon to describe my difficulties to others. I shared other weird stuff like extreme sleep difficulty and extreme noise intolerance. I found out only relatively recently it was due to ME/CFS which was from undiagnosed hEDS, a condition nowhere near as rare as it’s thought to be. I had been to see a huge amount of doctors and none of them diagnosed me with this despite being a walking bag of symptoms and having extreme hyper-mobility. Anyway, I think tech, like physics, has a fairly strong IQ selection criteria bias so I’ve noticed a concentration of the same health issues here on HN.

The characteristic brain fog seems to be tied to dysautonomia and excess IL-1B pro-inflammatory cytokines. I treat the latter with a strict no sugar diet, and high doses of D3, TUDCA, and DIM. I treat the dysautonomia with LDN, modafinil, amitryptiline, and a low dose of semaglutide (ozempic).

Interesting - your story of ME/CFS mirrors mine. Mine was triggered by a really mild cold a couple of years back, likely COVID. Thankfully a lot more research is going on into this, and im mostly back to full health now but the brain fog made me doubt myself at work a lot more than usual.

> The characteristic brain fog seems to be tied to dysautonomia and excess IL-1B pro-inflammatory cytokines. I treat the latter with a strict no sugar diet, and high doses of D3, TUDCA, and DIM. I treat the dysautonomia with LDN, modafinil, amitryptiline, and a low dose of semaglutide (ozempic).

Does it work?

Very much so, night and day. I’ve been pretty much issue free for 2 years, except for PEM which means I have to avoid cardio. I don’t know how to fix that. Instead of cardio I eat healthy and lift weights. I was one of those gifted kids which was a hell of an advantage but things slipped away from me as I got older, now I’m back and as good as ever.

I was in a car crash and spent a month in the hospital where they gave me heavy-duty pain killers. I could tell I was having cognitive issues because I couldn't remember words that I knew I used before, but I wasn't curious about it.

After a while they halved the prescription and after a few hours I could feel my words returning. It was terrifying to feel my IQ rise substantially. Before I left eh hospital they gave me various cognitive and mental tests and it was reassuring to be told that I was in the 96 percentile of my peer group (college educated, engineers)

We deal with a parent with dementia and another with a stroke. The difficult part with all of these are not really seeing the decline from the inside, sometimes there are the acknowledgment of hints of decline but mostly you don't want to think about it and compensate as best as you can.

Heavy duty pain killers tend to do that but it's temporary.

I remember having a particularly nasty dentist visit after which I kept myself stuffed with a painkiller i hadn't head of, on her instructions. Then going to the corner store and forgetting why I went there.

Permanent cognitive decline is another, much sadder, topic.

What is “the genie” that is referred to a few times? An AI coding copilot?

Yes. LLMs

If you experience temporary cognitive decline like this definitely pay attention to it, it can indicate serious stressors in your life that need to be dealt with immediately. It can get worse steadily if you ignore it!

I am actually just starting to go on medical leave from work due to this

My performance has been going down, my anxiety and stress are through the roof. Honestly you wouldn't know it from talking to me, other than the fact my memory is shot

I'm completely forgetting stuff minutes after it happens

I'm very unhappy with the feeling, and I hate going on leave for this, but I have to. I'm not even 40 and this is the second time in my life I've burned out hard like this

This happened to me during the pandemic. High (insupportable) stress, plus a year or two of significantly too little sleep, plus social isolation.

It was terrifying. I had just seen my mom taken by Alzheimer’s (or something similar) way too young, and thought my life was over.

All the tests coming back negative, making a point of hanging out with friends, returning to the office, and getting enough sleep seemed to help, and it slowly started getting better.

I am somewhat the opposite. The pandemic was great for me. Being able to work remotely is wonderful. Much less stressful than commuting daily, more free time, less scrutiny during work hours and I don't live alone so staying home isn't isolating

I definitely do need to spend more time out of the house with friends and such though

Most of my current stress is due to AI fears, layoffs looming, uncertain about the future job market for my skills, and such. Definitely too little sleep

I think I'm too young for Alzheimer's to be a serious concern but it does run in the family so it might be worth asking my doctor about it. I hadn't thought of that

I really do think that it's mostly a combination of my company having like 6 rounds of layoffs in the last couple of years, plus them turning up the pressure to use AI as a daily driver now.

I've been trying but I just cannot get the productivity out of it that other people are claiming. Makes me feel obsolete

Edit: I also can't really wrap my head around my coworkers who are gleefully embracing AI tools after watching the company cut literally half of our development team over the past couple of years.

It makes me feel like I'm watching chickens sharpen the farmer's axe

I think sleep is possibly the most important part. I also did a sleep study and started using a CPAP machine: might want to look into that if it’s a possibility…

I do have one already and it helps a great deal for getting good sleep when I can

But it does not help me get to sleep in the first place unfortunately. Too much anxiety

I appreciate the suggestion though and if anyone else struggles to sleep, wakes up randomly out of breath, I do strongly recommend a cpap. It is great for me when I actually can sleep

Good luck friend

Thank you, very kind of you

I mostly wanted to share my current state so if other people reading also recognize themselves in it, hopefully they realize it isn't normal and they also go seek help

As for me I will be okay. I've been through this before on my own and managed. This time I have a partner to help me through too

I have a fairly unusual genetic disorder, and quite rare to boot in this particular variant. The gold standard cocktail contains a medication which, while effective in dealing with one facet of the pain, absolutely turns down the dimmer switch on my mind in fairly particular ways. Gait is affected the next day, along with a mild aphasia. During the peak, however, I am dumb as a box of rocks. Math and spatial business seem fine. I can still program, however. Just do not talk to me, as communication is ... troublesome.

I usually skip this portion of the cocktail unless things are particularly bad. The disorder is progressive, so when it comes for my brain, well, that's when things are over. I do not have much going on for me in terms of personal value except for, well, solving problems.

A very close friend of mine has had two hospitalizations for gangrene, and the second one absolutely devastated his cognitive abilities. He has leveled off at about eighty-five percent of where he was before. If he is tired or feeling unwell, verbal perseveration begins.

My mother is fairly well-on in her years. She used to have a tremendous vocabulary, despite her very limited education. Now, she has begun to lose words and I end up "translating" for her because I know what she is getting at. She could do crosswords but refuses to, even the Monday selections, which are typically the easiest. Very recently, she has begun misplacing things. I had my suspicions, and during a routine head, neck, and brain imaging for something else, I checked out the results and, sure enough, some loss of volume in the right hippocampus.