iiinova — where your digital self keeps evolving

Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 17/08/2026

Do you know why the updates are consistently being released _after_ the summer wave? It seems to me timing these in June would be better- is it political?

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 19/06/2026

Well we can certainly hope some of them were just being metaphorical and don't really believe it.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 13/06/2026

Learning to use Procreate. This is from a photo I took on a friend's back deck last fall, when a rare NorCal storm came up during our Samhain potluck.

Procreate watercolor with weathered yellow house, tree, part of red house behind it, and mostly sky with pink at bottom deepening into blues and grays.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 13/06/2026

Hmm, I just bought a little wedge today... now I have an irresistible urge to try lighting it on fire in my cast iron skillet 🤣

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 05/01/2026

This is an especially difficult setting bc the word count means most context is absent from many posts. So it's even easier than usual to be wrong but not know why 😅. I have appreciated people in the past who told me I was wrong and why, so I could change my mind. It's kind of exciting even

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 05/01/2026

What a creep. I commented to agree with him on something today and he responded by calling me stupid. Then I saw this and blocked him.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 05/01/2026

This is great reporting. Please support this news org!

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 05/01/2026

Multiple levels of safeguards, including the idea it would be embarrassing to recommend war-- that others would think you weren't fit for a dinner party-- and the more advanced practices of compassion and discernment.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 05/01/2026

A culture without safeguards leaves people vulnerable. So a combination of standards like "adults don't act that way" plus a much better instruction on dark triad signs is very important.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 05/01/2026

Psychopathy is neurological-- it's an evolutionary niche that gets exploited. There are ways to discourage acting the way they do, but they are biologically different. Instead what capitalism does is almost guarantee they will climb over us to the top.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

I agree completely. I was raised atheist, not using words like evil, but it's certainly hard to think of anything more accurate. Oddly one of my beefs with Christianity is the myth that everyone can potentially be "good"-- it's not true.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

Think toddlers. I adore them. They can be very kind, and they will also bite each other pretty hard. They kick and pinch and hit. When they're mad they scream. Because they haven't yet learned other options. They aren't bad, just inexperienced. Adults shouldn't act that way. Legit analogy.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

Ha, I guess I do the same thing. Interesting. Bc I'm planning to bake cookies today and there's a high chance I will burn the bottoms 😂. But I did recently learn a trick-- run them over the fine side of a box grater to get the burn off! Sadly, will not work with pancakes

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

I'm not disagreeing at least for some, though many, say, Pete Hegseth fit OP's description. It's a mix. And what is most effective to dissuade their followers is unclear, but a vision of adulthood as peaceful could matter. Do you disagree?

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

Could be, and even if so, reframing them as not adult, not worthy of emulation, could be a wise move. Even though toddlers are awesome, they will bite and hit trying to get their way. The comparison seems apt. No metaphor is perfect but some have power.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

I am a defender of children, who often have beautiful and kind impulses. I also want to give them a vision of adulthood that's different from what we have now. One where maturity means solving conflicts without murder.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

I think the point was what a culture puts forward as "adult" whether it is or not has included war. And that if we break that myth open by seeing the immaturity involved, and even ridiculing it, the culture of adulthood could change.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

Children are far less likely to prefer bitter tastes. It may be protective against poison. And if only psychopaths participated in wars, we would not be plagued by them. There aren't enough of them to carry on without followers. But I think the point of OP's metaphor is being missed.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

On the geographic size and population, I do sometimes wonder if that's a part of our problem. Maybe we are too big to coordinate well.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

But WHY don't the French cops have qualified immunity? It's not genetic. There has to be something they are actually doing better. They aren't perfect. They have a right wing. But they do some things much better, and willingness to shut stuff down could be part of it.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

Hi, I'm a so-called less lethal rubber bullet shot intentionally at a protest medic for the crime of rinsing tear gas out of eyes-- missed my target's head by a few inches. Landed in the grass.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

This week I asked a parent about travel history for Tb screening, and their preschooler piped up "we live on EARTH!" with such a tone of wonderment that I have thought about it ever since. We live on EARTH, how wild and weird is THAT?!

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 04/01/2026

When mine was a kid I had him write about his anti war beliefs periodically and saved it so he'd have an extended record to be a conscientious objector. In case of a draft.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

Also-- not sure how much the judgment of history is an effective motivator. Maybe it is for some. I don't care about that... when I'm dead I'm nonexistent. It's more an emotional feeling of not wanting to cause suffering. It hurts physically in my bones just to imagine.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

I'm old and have had many chances to find out my automatic habit is refusal to cave despite costs and danger. But I intentionally hold a grain of self doubt. Knowing I could fail one day is a safety measure. I have seen too many overly confident ppl cave.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

At first I said Bray's Antifa book. But this morning I thought: Gilgamesh. Someone who has really been through it. All the questing, all the grief. Then comes home and says well damn, look at this city. It's effing spectacular.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

I read this as "we are going to ruin the country", which would've been a more accurate description

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

By the time they got to Deandra, I just felt compassion for all of us. We try so hard to do the right thing. We get into these awful double or triple binds. We judge ourselves and each other. And at the end there's the possibility of forgiveness.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

I can tend to be judgmental about that stuff. But it's hubris. Those moments when each of them realized they would betray each other were intense. I could feel their nausea and sadness, their changed self perception.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

Rewatched One Battle After Another. This time what jumped out at me was all the "ratting". Perfidia, Billy, Willa's friend, Deandra. It isn't viewed harshly. It says: this is hard. Don't think you're immune. #onebattleafteranother

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 03/01/2026

Even with the racism and the recent pedophile stuff? Grok seems pretty horrifying.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 01/01/2026

I defended a fellow atheist and got put on a list of anti-theists. Ok! 😆 Definitely would be on the rebellion team if some creepy being was to blame for this mess, so that's accurate!

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 01/01/2026

My son, on the Purple Rain scene in Stranger Things: "that's the kind of thing that makes you realize how often it's done better" LMAO 😅

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 01/01/2026

Lol now some of them have batteries you can't remove/built in. And this diabolic tab you're supposed to push to stop them from torturing you at 2 am. I had to hit mine with a hammer while cussing. But did bring whole contraption to recycling. Ugh.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 01/01/2026

I also assume, perhaps wrongly, that driverless cars won't commit sexual assault on passengers.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 01/01/2026

It's possible ride share safety is worse than average driver stats. Would be useful to compare Waymo to Lyft/Uber. I've had enough scary ride share moments that I gave up and rent a car to drive myself when traveling. gitnux.org/rideshare-ac...

gitnux.org

Rideshare Accident Statistics Statistics: Market Data Report 2025

Our in-depth Market Data Report about Rideshare Accident Statistics. Explore the latest data.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 31/12/2025

My then teen daughter, seeing me in new jeans, with an approving tone: "wow, you don't look any better than half bad!"

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 31/12/2025

I wonder what makes a doc go off the rails like that. I knew a peds GI once who called all vomiting "acid reflux", statistically unlikely in peds, even after one of his pts actually had a brain tumor causing vomiting.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 30/12/2025

and then we start asking each other hey, is so and so being kinda fast and loose about x diagnosis? Yep, yep. Happened today. And darn it bc it's a hard to access resource we now can't trust. But we're responsible for quality of referrals.

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 30/12/2025

Every so often there's a specialist who starts diagnosing a condition in numbers out of proportion to reported incidence, and without doing the standard evaluation for it. Out in Pcp Land we start wondering after a few consults

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 30/12/2025

Exactly. I just finished On the Move, highly recommend!

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 30/12/2025

Nice: I'm a quirky gay neurologist- author who rides motorcycles and finds late-life love. Count me in!

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 29/12/2025

It's as if the secret instructions were "gaslight the prescribers until they cry"

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 29/12/2025

We are already seeing AI being used for med PA's. Leads to bizarre stuff where it requires a PA for a med, denies it and says it covers an alternative med-- the exact one I already prescribed-- then when I appeal it says "you didn't need a PA for this- it's preferred."

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 29/12/2025

I know what dry January is but bc I typically forget alcohol exists, just never appealed to me, my brain immediately goes "oh no are they dehydrated?"

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 29/12/2025

No because I have lexical synesthesia and that word tastes like green slimy garbage. If I have to say it at work I will retire 😅

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Pippa Elayne Coulter MD PhD 💛🤍💜🖤 @pippaelayne.bsky.social · 28/12/2025

Not a Christian and don't wanna love everyone 😆. IMO these aren't at all similar. Nobody has a duty to sell or perform for all people. Excluding people on the basis of race, sex, gender and other personal characteristics that harm no one is immoral. So is baking a cake for a Nazi.

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