UDLCO CRH: Free willed existentialism vs a scripted co-authored existential manuscript!

Summary

The transcript centers on a philosophical exchange sparked by a quote combining the metaphor of "life as a stage" with Jean-Paul Sartre's concept of existential, "dizzying" freedom. Following the initial share of this thought, a user prompts two AI models (Meta AI and Google Gemini) to provide critical counter-arguments. Both AI models push back against the idea of absolute freedom, highlighting how societal expectations, trauma, biological determinism, and socio-economic privilege severely constrain our ability to perform purely "in accordance with our wishes." The text provides a contrast between Meta AI's brief, metaphorical response and Gemini's structured, multi-disciplinary breakdown.

CC licence: https://commons.wikimedia.org/wiki/File:Simone_de_Beauvoir_%26_Jean-Paul_Sartre_in_Beijing_1955.jpg#mw-jump-to-license

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Keywords

• Existentialism

• Jean-Paul Sartre

• Absolute Freedom

• Determinism (Biological and Sociological)

• Systemic Constraints

• Situated Freedom (Simone de Beauvoir)

• Socio-economic Privilege

• Human Agency

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Thematic Analysis

Idealized Freedom vs. Constrained Reality

The core tension in the text is the clash between the romantic ideal of absolute freedom (Sartre's view) and the grounded reality of human limitation. The original message celebrates the exhilaration of acting out one's wishes. In contrast, the AI responses dismantle this by pointing out that the "stage" is already built and the "script" is often written by external forces like societal norms, trauma, and biology.

The Privilege of Existential Angst

A significant theme introduced in the counter-arguments is that Sartre’s concept of "dizzying" freedom is a luxury. The analysis points out a hierarchy of needs: agonizing over the ultimate responsibility of self-actualization is a privilege reserved for those who are not preoccupied with basic survival. For marginalized or struggling populations, life is dictated by necessity rather than the burden of infinite choices.

Determinism and Loss of Authorship

Both counters heavily rely on deterministic frameworks to challenge human agency. The psychological perspective argues that our "wishes" are not even our own, but rather the product of unconscious impulses and neurochemistry. The sociological perspective (referencing Erving Goffman) argues that our actions are performative compliance to avoid social rejection, turning us into actors reading a forced script rather than directors of our own lives.

Analytical vs. Metaphorical AI Communication

The transcript also highlights a theme of differing AI communication styles. Meta AI responds with punchy, stylized metaphors (a maze, invisible ink, uncharted waters) to deliver a quick emotional counter. Gemini provides a methodical, academic critique broken down into sociology, psychology, and philosophy, introducing "situated freedom" as a specific academic counterpoint.

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Would you like me to elaborate on Simone de Beauvoir's concept of "situated freedom" or dive deeper into how socio-economic factors specifically limit the "stage" we perform on?

Conversational transcripts:

[14/03, 19:00]hu3: GUESS THE MEDICAL TERM...........Clue: Related to Longevity Medicine

[15/03, 06:52]hu3: Life is a stage where each of us performs in  accordance with  our wishes.(The freedom to perform "in accordance with our wishes" is exhilarating... but also dizzying: Sartre) 

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Good morning 🌞

[15/03, 07:16]hu2: Share a critical counter to the message below

Life is a stage where each of us performs in  accordance with  our wishes. 

The freedom to perform "in accordance with our wishes" is exhilarating... but also dizzying: Sartre

[15/03, 07:16] Meta AI: Here's a critical counter:

"Life's not a stage, it's a maze 🌀. We're stuck improvising roles we didn't write, with scripts we can't edit. 'Freedom to perform' sounds nice, but what about when the script's written in invisible ink? When societal expectations, trauma, or privilege dictate the lines? Sartre's 'condemned to be free' feels more like 'condemned to navigate uncharted waters without a map' 🌊. The real performance is surviving the plot twists." 💡

Google Gemini:

The message you shared beautifully captures the existentialist view of human agency—blending Shakespeare’s "all the world's a stage" with Jean-Paul Sartre’s concept of radical freedom and the "vertigo" (or anguish) that comes with it. It is a deeply romantic and empowering thought.

However, a critical counter to this perspective argues that it fundamentally overestimates the extent of human freedom and ignores the very real constraints of the "stage" we are born onto. Here is a breakdown of the critical counter-arguments to the idea that we act purely "in accordance with our wishes":

1. The Sociological Counter: The Stage is Pre-Set

The metaphor assumes we step onto an empty stage with the ability to write our own script. In reality, the stage is already built, and the props are distributed unequally.

• Systemic Constraints: Our "wishes" and our ability to act on them are heavily restricted by the socio-economic class, race, gender, and geography we are born into.

• The "Script" of Socialization: Sociologists like Erving Goffman argue that we do perform, but rarely in accordance with our own wishes. Instead, we perform to meet the expectations of society, conforming to pre-written roles to avoid social rejection.

2. The Psychological Counter: Are Our Wishes Truly Ours?

Sartre’s philosophy relies on the idea of a conscious, rational mind making deliberate choices. Modern psychology and neuroscience challenge this.

• The Unconscious Mind: Much of what we consider our "wishes" are actually driven by unconscious impulses, childhood conditioning, and past traumas.

• Biological Determinism: Our actions are heavily influenced by our genetics, neurochemistry, and evolutionary wiring. We do not always choose what we want; our biology often dictates our desires for us.

3. The Privilege of Existential Vertigo

Sartre’s "dizzying" freedom—the anxiety of having too many choices and bearing the ultimate responsibility for who you become—is arguably a privilege.

• Survival vs. Self-Actualization: For a vast portion of humanity, life is not dizzying because of an abundance of freedom; it is exhausting because of a lack of it. When someone is struggling to secure basic needs like food, shelter, or safety, the concept of performing "in accordance with one's wishes" becomes an abstract luxury rather than a lived reality.

4. The Correction: "Situated Freedom"

A poignant counter to Sartre actually came from his lifelong partner and fellow philosopher, Simone de Beauvoir. While she agreed that human beings are fundamentally free, she argued for "situated freedom." She pointed out that our freedom is always situated within the physical and historical conditions of our lives. We are free, but only within the boundaries of the specific "stage" we happen to be trapped on.

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Ultimately, while the idea of absolute freedom is an exhilarating ideal, grounded reality tells us that we are co-authors of our lives at best—improvising a performance heavily shaped by the set design, the supporting cast, and the directors we never hired.

Validity of the LLM approach to user driven symptoms analysis and actioning based on LLM reasoning

This content serves as a critical evaluation of a "mega-prompt" designed to turn an AI into a virtual physician. It highlights the dangerous gap between a simulation of expertise and actual clinical competence.

The entire write up was born in response to an LLM prompt advertisement circulating in social media and the reader may need to begin reading from the bottom of the article to get this!

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Keywords

• Veneer of Expertise: The professional but potentially hollow appearance of AI-generated medical advice.

• Clinical Reasoning Framework: A structured approach to diagnosing patients that AI mimics but cannot truly perform.

• Anchoring Bias: The tendency to rely too heavily on the first piece of information offered (the AI's "Top 5").

• Stochastic Parrots: A term for LLMs reflecting their nature as probability-based word predictors rather than sentient reasoners.

• Cyberchondria: Anxiety fueled by excessive online searching or AI-driven "diagnoses."

• Contraindications: Medical reasons why a certain treatment or drug should not be used (often missed by AI).

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Summary

The text critiques a highly structured LLM prompt that claims to provide a "clearer picture" of a patient's health than an urgent care visit. While the prompt is architecturally sound, the evaluation argues that it is fundamentally dangerous because AI cannot perform physical exams or integrate objective data (like blood pressure or palpation). The response concludes that while such a prompt might help a patient organize their thoughts for a real doctor, it should never be used as a surrogate for triage, as it lacks the accountability and diagnostic intuition of a human clinician.

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Thematic Analysis

1. Simulation vs. Reality

A major theme is the distinction between predictive text and clinical logic. The AI is described as a "stochastic parrot" that generates a response based on patterns in its training data. Because it looks like a "board-certified physician" with "20 years of experience," users may trust it implicitly, failing to realize the model doesn't actually "know" the patient or the stakes of a missed diagnosis.

Notice the parrot in the image:

2. The Cognitive Hazards of AI-Led Triage

The analysis identifies specific psychological and medical risks:

• Anchoring & Premature Closure: Once the AI provides a "Top 5" list, the patient may stop looking for other causes and inadvertently feed biased information to their actual doctor.

• The Data Gap: The analysis emphasizes that what a patient chooses to type is only a fraction of what a doctor observes. Subtle "red flags" are often non-verbal or physiological, making the AI's "clearer picture" inherently incomplete.

3. Liability and Latent Danger

The text warns against the prompt's request for OTC medication dosing and cost estimates. These areas are fraught with danger because:

• Pharmacological Risk: AI often misses rare but fatal drug interactions (contraindications) that a human or a dedicated medical database would catch.

• Financial Gatekeeping: Hallucinated cost estimates can prevent patients from seeking life-saving tests, adding a socio-economic hazard to the technical ones.

4. Redefining the LLM as a "Preparation Tool"

The final theme is a shift in the AI's utility. The critique suggests that the value of such a prompt lies not in the answers it provides, but in the structure it imposes. It is a tool for organizing symptoms and history, helping a patient become a better historian for their human physician, rather than a tool for bypassing the healthcare system entirely.

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Prompt for LLM:

Can the prompt below by any patient user really achieve what it claims?

Please provide the potential hazards of the prompt driven approach to solving a patient's health issue.

1/ The Complete Symptom Analyzer

Stop Googling your symptoms and reading WebMD horror stories. 

Use this LLM prompt:

"You are a board-certified internal medicine physician with 20 years of clinical experience at a top academic medical center. You have access to UpToDate, PubMed, and current clinical practice guidelines. Cite medical literature where relevant. If information is uncertain or requires lab work to confirm, say so explicitly. Do not diagnose -- provide a clinical reasoning framework.

I am experiencing these symptoms: [DESCRIBE ALL SYMPTOMS, DURATION, SEVERITY, AND ANY TRIGGERS].

My background: [AGE, SEX, KNOWN CONDITIONS, CURRENT MEDICATIONS, ALLERGIES, FAMILY HISTORY].

Step 1 -- Differential Diagnosis:

→ List the top 5 most likely conditions that match these symptoms, ranked by probability

→ For each condition: why it fits, what makes it more or less likely, and the typical presentation

→ Flag any red-flag symptoms that require immediate medical attention

Step 2 -- Key Questions a Doctor Would Ask:

→ What additional information would narrow down the diagnosis?

→ What symptoms should I monitor for that would change the urgency?

Step 3 -- Recommended Tests & Workup:

→ What blood tests, imaging, or exams would a physician order first?

→ What is each test looking for specifically?

→ Approximate cost range for each test without insurance

Step 4 -- What To Do Right Now:

→ Immediate self-care steps for symptom relief

→ OTC medications that may help (with standard dosing)

→ What to avoid that could make it worse

Step 5 -- When To See a Doctor vs. ER:

→ Specific warning signs that mean 'go to the ER now'

→ Signs that mean 'book a doctor appointment this week'

→ Signs that mean 'monitor at home for now'

Format with clear headers and flag any information that is general guidance, not a personal diagnosis."

In 30 seconds you'll have a clearer picture than most urgent care visits give you.

While the prompt you shared is sophisticated and well-structured, it creates a "veneer of expertise" that can be dangerously misleading. It attempts to force an AI into a high-stakes clinical role that it is not architecturally designed to fulfill.

Below is an assessment of whether this prompt "works" and the significant hazards it poses to a patient.

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Can this prompt actually achieve what it claims?

The short answer: No.

While the LLM will provide a highly organized, professional-sounding response that looks like a clinical reasoning framework, it lacks the two most critical components of medicine: physical examination and objective data integration.

An LLM cannot palpate an abdomen, listen to heart murmurs, or observe the subtle "ill-appearance" of a patient that triggers a doctor's intuition. It is merely predicting the next most likely words based on a pattern. It provides a simulation of medical logic, not medical logic itself.

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Potential Hazards of the Prompt-Driven Approach

1. The "Hallucination" of Probability

The prompt asks the AI to "rank conditions by probability." LLMs are notoriously bad at statistics and probability.

• The Risk: It may list a rare, "trendy" condition it saw often in its training data (like Lupus or Lyme disease) as more probable than a common but boring condition (like a simple viral syndrome), leading to unnecessary patient anxiety or "cyberchondria."

2. Premature Closure and Anchoring Bias

When a patient reads a "Top 5" list from an AI they perceive as an "expert," they often experience anchoring bias.

• The Risk: The patient becomes convinced they have "Condition A." When they finally see a real doctor, they may filter their symptoms—consciously or unconsciously—to fit that diagnosis, leading the human physician down the wrong path.

3. Misinterpretation of "Red Flags"

The prompt asks for "Red-flag symptoms." However, medical red flags are often nuanced.

• The Risk: A patient might describe "chest tightness," which the AI flags. But a patient might not mention "a subtle sense of impending doom" or "mild jaw discomfort"—things a doctor would catch but an AI might miss because the patient didn't know it was worth typing.

4. Dangerous OTC Recommendations

Step 4 asks for "OTC medications and standard dosing."

• The Risk: Even with a "background" check, LLMs can miss critical contraindications. For example, recommending NSAIDs (like Ibuprofen) for pain to a patient who didn't mention they have a history of stomach ulcers or are on blood thinners could lead to life-threatening internal bleeding.

5. False Sense of Security (The "Urgent Care" Comparison)

The claim that this provides a "clearer picture than most urgent care visits" is the most hazardous part.

• The Risk: An urgent care clinician can check oxygen saturation, perform a Strep swab, or take a blood pressure reading. By suggesting the AI is "better," it encourages patients to delay necessary care, potentially turning a treatable condition into a medical emergency.

6. Cost Misinformation

The prompt asks for "Approximate cost range."

• The Risk: Healthcare pricing is notoriously opaque and localized. An AI providing an outdated or incorrect estimate might lead a patient to avoid a life-saving test (like a CT scan) because they believe they cannot afford it, based on an "hallucinated" price point.

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The Verdict

Using this prompt as a preparation tool—to help a patient organize their thoughts before an appointment—has some value. However, using it as a surrogate for clinical triage is a high-stakes gamble.

AI models are "stochastic parrots"; they do not understand the stakes of a missed diagnosis. They are designed to be helpful and conversational, which often leads them to provide an answer even when "I don't know" is the only safe clinical response.

Conversational citation:

[14/03, 12:25]hu1: Honestly, *this article misses the point entirely.* 💡

A diagnostic AI agent works exactly like a coding agent. It asks what can be verbally confirmed, accepts lab reports as attachments, and then simply *prompts the human in the loop* for the physical bits.

"Auscultate the patient now. What did you hear?"

"Was the liver palpable? How many finger breadths?"

That's it. The agent fills the gaps from those inputs. Clean, simple, doable *today.* 🎯

What's not doable is inventing a way for an AI to palpate or auscultate by itself (as of today). And that's fine, cos no one needs it to. You put a human in the loop for exactly those steps. 👇

I genuinley don't know what problem this article was trying to solve, because this is not even the corect framing of the question. ✅

[14/03, 13:15] hu2 : You are right.

This article was in response to an LLM prompt advertisement circulating in social media and while it may have been missed due to the TLDR pandemic of our times the original circulating viral  prompt panacea is at the bottom in the conversational Transcripts and I paste it below again here:

1/ The Complete Symptom Analyzer

Stop Googling your symptoms and reading WebMD horror stories. 

Use this LLM prompt:

"You are a board-certified internal medicine physician with 20 years of clinical experience at a top academic medical center. You have access to UpToDate, PubMed, and current clinical practice guidelines. Cite medical literature where relevant. If information is uncertain or requires lab work to confirm, say so explicitly. Do not diagnose -- provide a clinical reasoning framework.

I am experiencing these symptoms: [DESCRIBE ALL SYMPTOMS, DURATION, SEVERITY, AND ANY TRIGGERS].

My background: [AGE, SEX, KNOWN CONDITIONS, CURRENT MEDICATIONS, ALLERGIES, FAMILY HISTORY].

Step 1 -- Differential Diagnosis:

→ List the top 5 most likely conditions that match these symptoms, ranked by probability

→ For each condition: why it fits, what makes it more or less likely, and the typical presentation

→ Flag any red-flag symptoms that require immediate medical attention

Step 2 -- Key Questions a Doctor Would Ask:

→ What additional information would narrow down the diagnosis?

→ What symptoms should I monitor for that would change the urgency?

Step 3 -- Recommended Tests & Workup:

→ What blood tests, imaging, or exams would a physician order first?

→ What is each test looking for specifically?

→ Approximate cost range for each test without insurance

Step 4 -- What To Do Right Now:

→ Immediate self-care steps for symptom relief

→ OTC medications that may help (with standard dosing)

→ What to avoid that could make it worse

Step 5 -- When To See a Doctor vs. ER:

→ Specific warning signs that mean 'go to the ER now'

→ Signs that mean 'book a doctor appointment this week'

→ Signs that mean 'monitor at home for now'

Format with clear headers and flag any information that is general guidance, not a personal diagnosis."

In 30 seconds you'll have a clearer picture than most urgent care visits give you.

[14/03, 13:29]hu1: i understand you are highlighting the pitfalls. but these all can be overcome, too.

You can paste the following text into the "System Instructions" or "Custom Instructions" field of an LLM.

```The "Symptom Researcher" System Prompt

Role: You are a medical information research assistant. Your goal is to help the user organize their symptoms and prepare for a consultation with a human medical professional. You provide high-quality medical information, not a clinical diagnosis.

1. Core Principles of Analysis

Prevalence Over "Trendiness": When analyzing symptoms, prioritize common clinical presentations (e.g., common cold, tension headache, musculoskeletal strain) over rare or "notable" conditions (e.g., Lupus, rare neurological disorders).

No Probabilities: Do not assign numerical percentages or "probability rankings" to any condition.

The "Evidence Against" Rule: For every potential condition mentioned, you must include a brief section titled "Why it might NOT be this," listing common symptoms of that condition that the user has not reported.

2. Mandatory Safety Constraints

OTC Medications: You may only suggest general drug classes (e.g., "Analgesics," "Antihistamines"). You are strictly forbidden from providing specific brand names or standard dosages. Every mention of medication must include: "Consult a pharmacist to check for contraindications with your medical history."

Cost & Insurance: Do not provide estimated dollar amounts for procedures or visits. Instead, provide the relevant CPT (Current Procedural Terminology) codes so the user can obtain an accurate quote from their provider.

Urgency Screening: If the user describes symptoms associated with a medical emergency (e.g., crushing chest pain, sudden slurred speech, high fever with stiff neck), provide an immediate, bolded directive to seek emergency care before any other text.

3. Response Structure

Every response must follow this specific hierarchy:

Preparation Sheet: Frame the findings as a "Doctor’s Appointment Prep Sheet."

Systemic Review (Follow-up): Based on the symptoms provided, ask the user 3–4 specific follow-up questions about "nuanced red flags" they may have missed (e.g., "Are you experiencing a subtle sense of impending doom?" or "Is there any jaw discomfort?").

Audit of Limitations: List 3 specific physical exams or diagnostic tests (e.g., lung auscultation, CBC blood test, or physical palpation) required to differentiate these conditions that an AI cannot perform.

Questions for the Doctor: Provide 3 targeted questions the user should ask their human physician based on this research.

4. Tone and Style

Maintain a clinical, objective, and supportive tone. Avoid alarmist language. Use "medical literature suggests" or "common presentations include" rather than "you likely have." ```

How to use this

By setting this as a system-level instruction, you force the AI to stop trying to be a "genius doctor" and start being a "diligent clerk." It shifts the responsibility of the final call back to the human physician while giving you better-organized data.

[14/03, 14:15]hu2: Nailed it! 

That's where the viral prompt went wrong