Brownian initial data, that says you take a Brownian motion on one side and zero on the other side for some bizarre reason you can do the integration. So that case we can do now. So there's some magic formulas still to come, that's for sure. Okay, another thing which is definitely not in this picture. Yeah, in fact, it's sort of the same thing, which makes you, it's just the old trick happens to work here. In fact, it works this, it's the same thing, yeah. It's because the way that that trick worked, use other solvable models, which we can also do. The Brownian initial data, two-time formulas. Well, you're gonna hear, this is an advertisement for Gepeng's talk this afternoon. Two-time formulas, well, as you can imagine, to get a two-time formula out of this, you have to take the Chapman-Komogorov equation and integrate over almost all internal variables, over this enormous space of internal variables.  And yet, they get simple closed-form two-time formulas. So it's not really something in this picture, okay. But I'll tell you something else, which, oops, which is in the picture, can you hear? Here's another important process, which is that you just take the KBZ fixed point and you differentiate the an-axe. Okay, now, okay, maybe you don't like that because it's not differentiable, but you can take a distributional derivative, there's no problem, it's linear operation. So you get a UTX, which is a distribution-valued Markov process. It's not completely obvious it's Markov because you may have lost some information by differentiating, but it is. So this is a distribution-valued Markov process, which is the stochastic burger fixed point. And just like H is dying to be the solution of DTH equals, well, it's actually a quarter of DXH squared. This is sort of the equation for H, you can't prove it. U is supposed to be the solution of DTU equals DXH squared. They are some sort of weak solution of that, though nobody can prove it. But on the other hand, one amazing thing is that we can compute U, we meaning the community, not particularly our group. This is actually known in equilibrium. So U, H has almost invariant Brownian motions. They're not, you could take a two-sided Brownian motion and then later you see a two-sided Brownian motion, but with some shift, which is supposed to be this by-grains distribution, but U should have invariant white noise. Okay, so let's take this and calculate the spacetime covariance in the equilibrium process. So you start this U with white noise and that's supposed to be the invariant process for this stochastic burgers fixed point. It exists, it's a thing. Now of course, it is far from obvious that this formula makes any sense whatsoever because these are distributions, but in fact it does and it's equal to TN minus 2 thirds. This thing called the KPZ scaling function, T to the minus 2 thirds, X. And this just comes from an old calculation of a Ferrari and Spahn. So this FKPZ scaling function, I won't write it down. It's a function which is a lot like the formulas for the polymer endpoint distributions, which Daniel was writing yesterday.  So this was computed by a Ferrari and Spahn, maybe also a little bit in a paper of Praha from Spahn. But, and this just comes out because they had computed this for the space-time covariance of TASAP and it just scales. So that's their scaling limit of space-time covariance. So the thing existed in the literature before and it was just waiting for the process to exist to have that covariance. So the last thing I wanna do is talk about the time, how it changes in time. Okay, so we talked about the space regularity. So the space regularity, it basically looks like a Brownian motion in space, at least locally. So if you start from some initial data, it's gonna produce a Brownian motion version of that initial data. But now we're interested in the time regularity. Yeah, that's coming. You keep anticipating, just wait five minutes. Okay, so time regularity. Oh, I erased the, so it's invariant under this KPZ one, two, three scaling. And from that, it's not too hard to guess what the time regularity is. So the time regularity is you should see that HT plus SX minus H. I'm probably gonna change my notation later. SX should be about T to the one third. That's about how big it should be. So you expect it to be, you expect it to be a little bit less than how they're one third in time, okay? So let's try to prove that. But to prove that, you need some variational formulas. And so this goes back to what Pierre was talking about in his lecture a few days ago. So variational formulas, I have 15 minutes and I know you guys are hungry for lunch and I keep stopping you. So I'm gonna skip a lot of the, I'm gonna give you a simple derivation. At the level of TSAF, one has the following property. Suppose you start TSAF with two different initial datas. So now I'm writing the initial data here. So F1 and now I just take the max of F1 and F2. So I have two functions when I start TSAF, well they have to be fair functions for TSAF, okay? Of course, we know what functions you can have for the TSAF, high function. Suppose I take two functions and I start TSAF with the max of two functions. Turns out that that's equal to, and I'm gonna have to qualify this statement a lot. So don't start asking me questions too fast. That's equal to the max to the initial data. So TSAF has this wonderful property. It preserves max. Now, now I have to qualify this. Okay, so what does it mean to start TSAF with two different initial data? We never really talked about that. So the problem is the right-hand side of this thing actually in principle doesn't make any sense at all. Because you start from some initial data and you start flipping guys down. And the two things are flipping fights. The flips have nothing to do with each other, right? Okay. But of course, you could start TSAF. So TSAF at every site, there's a Poisson process, PX. And the thing flips down at rate. The indicator function that you see that there, okay? And makes a flip of size two. And so it's a minus. That's actually the rate of TSAF flipping down, right? You start with a Poisson process at your site and that Poisson process rings. And whenever you see one of these guys, that's what the one, this guy, you flip it down. Okay, that's the rate of TSAF. So DH and TSAF is just that. Okay? But what it means is that you can take the same Poisson process for TSAF starting from two initial data and run the two on the same Poisson process. Does that make sense? Okay, so just take the same P's. Start with two initial data and run the thing. And now it should be completely clear if you think about it for 10 seconds that if you start with one profile above another, that's preserved for all time. Because there's no way one can flip down below the other one. It just can't happen. That never happens, okay? So if one's above, it stays above. Okay? So that's called the basic coupling of TSAF. You need a coupling. You need a coupling in order to be able to even say the right-hand side. So the basic coupling of TSAF is just use the same Poisson processes. And then this is just the property I just described, actually, okay? Just the fact that if you start above, you stay above is just that property, okay? That's true in ASAP. Yeah, yeah, yeah, that's true. Yeah, it's true even in finite range exclusion. It's a general fact about exclusion processes. It's true in KPZ, yes. Well, proof it's true in ASAP, so it's true in KPZ. Because KPZ is just ASAP, right? Okay. Now, is it true in the KPZ fixed point? Well, yeah, because it's the limit of TSAF. But the problem is I had to use the coupling, right? Now once you couple the two guys, so now we take two initial data for TSAF and now try to take the limit, okay? You can take the limit of the coupled process because you know that they're both tight. Because we have enough information here to show tightness. We even showed that everything's, you know, I didn't say it, but we know everything's uniformly held as you take the limit. So there's no problem. So there's tightness. So you get two copies of the KPZ fixed point with this property, okay? The problem is you don't have uniqueness because of tightness. All you could use is tightness, so you don't know uniqueness. So I'm gonna keep talking, but just keep in mind we don't know uniqueness at the level of trying a couple things. So this is because Markov processes, when you talk about them in terms of their transition probabilities, are missing something for when you write things like stochastic equations for them. Stochastic equations basically couple all initial data. And so it's a stronger thing than just the Markov process using the transition probabilities, okay? So we have the Markov process using the transition probabilities for the KPZ fixed point, but the coupled things come to us in a soft way where we don't know uniqueness anymore, okay? All right, so the fixed point has this property too. So, and the fixed point. But with the caveat that I just talked about, modulo uniqueness problem, okay? So that tells you, let's get a formula from this. So of course, if you can couple two points, you can couple three points, you can couple four points, so I can couple a billion points and I can put a fine mesh of little narrow wedges everywhere and then you get the following formula. This is for the fixed point now. HTXH0, is equal to the soup over Y of HTX starting from a narrow wedge at Y. Okay, is the notation clear? There's a narrow wedge at Y there, plus H. This thing here, for every Y, it's a perfectly processed in X, but in X it's a rather inga-puchket process in Y because what you had to do, if you had 1,000 Ys, you had to do that coupling 1,000 times. I'll call this thing T to the 1 third A of T to the minus 2 thirds, because of the scaling, AXT to the minus 2 thirds Y minus a parabola. If you put these scalings of Xs in that, you would get the same thing, so you can just think of it as A hat, if you like. So this AXY is a two-parameter process. In the first variable, it's a nice stochastic process. In the second, it's a little bit mysterious. It's not unique, we don't know it's unique. This is called the area sheet and this variational formula tells you in a sense how to solve for any initial data as a variational problem using this sheet. Now, the variational, it looks bad because in Y it's so horrible, but on the other hand, because of time reversibility, AXY and AYX are the same thing in distribution. So it's actually just as good in Y as it is in X. And so the only problem isn't the fact that it's badly constructed in Y, the problem is you just don't know it's unique. So modular uniqueness is a perfect formula. And the statement says something bizarre, which is that even if you don't have uniqueness, any area sheet gives you this variational formula, which gives you the KBZ fixed point. So the only thing is I shouldn't use the word the. It's not the area sheet, it's an area sheet. So the problem with this, you might say, ah, well, why don't you just compute the distribution of the area sheet from the KBZ fixed point formula. But what does the KBZ fixed point formula tell you? It's going to tell you exactly the following thing. Suppose I wanted to know, suppose I had two X's and two Y's. So I had the area sheet at XI, YJ, IJ equals one to two. So I have four points of the area sheet. And I wanted to know the joint distribution. So this should be a four-dimensional distribution. The KBZ fixed point formula tells you exactly the following thing. And if you think about it, it's just precisely this. It says that area XI, YJ. Actually, let me put hats on them. So the hat just means that you subtracted the parabola. That's a common notation here. Okay. So it tells you exactly that that thing is less than... Oh, okay. In general, it tells you exactly this. You can compute that. For any F and G, you can compute this. This is exactly what the fixed point formula tells you about the area sheet for any F and G. So if I put... Get that. So you get that information. But here's something a little bit surprising. If you check the span of that in four dimensions, it's only a three-dimensional space. It's not obvious. So it's a three-dimensional linear subspace of four dimensions. And so you actually do not get the information of the area sheet. Okay. So you don't know uniqueness of area sheets. Okay. So how is all of this useful? Okay. All this sheet stuff. I said I wanted to prove this. Let me show you that the proof of this is very easy using this area sheet technology. So one thing you do know, and it's easy, is that the area sheet is an area process in each coordinate. Okay. So in x, it's the area two process, and in y, it's the area two process. That's not enough to characterize it. So it's the area sheet in analogy to the Brownian sheet being Brownian in both coordinates. But you could write this formula. Equals suit. Oh, sorry, with T's. Okay. There's a variational formula. That's a variational formula, which Pierre wrote down. So I want to actually discuss it for just a second. That's the variational formula, but I'm missing the second coordinate. Okay. So that variational formula is true for each x, but it's not true as a function of x. So this formula gives you one point distributions of the resulting object. But if you want this thing as a process in x, you need the whole sheet. Okay. That's the missing information. But I'll just use this formula to prove the time regularity. Okay. So we want h of T plus s minus h of s. Okay. T is positive, and let's suppose that s is positive. Okay. I can't prove the time regularity for any uc function for s equals 0 because initially it's actually false. Okay. Especially if you start with a narrow wedge, you can see immediately that's going to be false. The time regularity is the difference that can be infinite. So because of the Markov property, I could assume that I'm starting with hs. So I might as well just take hT minus h0, but h0 is the kind of function which I get at time s. But at time s I already know that I have a function which is held there beta less than a half. Sorry, there's an x here, of course. And so h0 is held there. But my shift invariance of the whole process, of course the whole process is shift invariance, so we might as well just take out x equals 0. So now let me just write down the formula. We've got hT0, hT0, yep, is equal to sup over y. T to the 1 third of an area process, t to the minus 2 thirds x, minus x squared over t, plus h0 of x of y. This is sup over x, sorry. So x minus h0, 0. That's the variational formula. Now this guy here is locally a Brownian motion, particularly it's held there beta, beta something less than a half. So this thing here is less or equal to c, t to the 1 third, t to the minus 2 thirds x to the beta, because it was held there. And this thing here is held there 1 beta, so this is x to the beta. And you can center the a. Sorry, I can write minus a0. I should just, yeah, thanks. I sort of realized that myself as I was writing it. It doesn't matter in the calculation because you can take that out of both. Okay, anyway, so there's that, right? And now you just do the variational problem. And you immediately see that the sup appears that, the sup is that x is about t to the minus 1 over 2 minus beta, sorry, 2 minus beta. And the sup and gives t to the beta over 2 minus beta. And as beta goes up to a half, that thing just goes to t to the 1 third, right? So beta equals 1 half minus delta just gives, but that proves the time regularity and hits questions for Jeremy. So the problem is, as far as I can tell, and I would love to be told otherwise, if someone has any idea, there's no way to prove uniqueness for such objects except to compute their distributions because we don't have an equation for them, okay? So the only reason we know uniqueness of the KPZ fixed point is because I can give you a formula for it. Since I can't give you a formula for two coupled KPZ fixed points, I can't prove they're unique. That's just that. Any other questions? Okay, one more. Devar, could you talk a little louder? No. No, there's no dual variational formula. I wish. Okay, last question. Yeah. Well, you know, for the stochastic heat equation, it's a quarter in time and a half in space because it has this one, two, four scaling invariance. It's the same thing, and this has this one, two, three scaling invariance, so it's a half in space and a third in time. It's kind of clear from the scaling that it should be like that, okay? Okay, so let's all thank Jeremy again.


Good morning. Good morning. I'm just absolutely delighted to welcome you to the 29th annual Dorothy J. McLean Fellows Conference on clinical medical ethics. The McLean Center has been in operation since 1984. It's one of the oldest and largest programs in clinical ethics in the country. Clinical ethics is a field that examines the practical, everyday ethical issues that that arise when doctors and patients work together. These are issues that arise among patients and doctors and nurses, health care workers and health care institutions. The goal of clinical medical ethics has always been from the outset to improve patient outcomes while respecting patient values and wishes and while at the same time to assist physicians and nurses, health care people who are delivering care, to deal with a set of issues that they might not be entirely familiar with. Over the last 36 years the McLean Center has trained more than 425 fellows in clinical ethics and this year we're proud to be training 26 fellows who have clinical backgrounds in medicine, nursing, surgery, PEDS, obstetrics and gynecology and psychiatry. This annual McLean conference is very much the McLean Center's signature event. The conference remembers Dorothy Jean McLean who helped create the McLean Center and who was always deeply committed to its work. Over the next two days the conference will feature more than 30 talks on important topics in clinical ethics. Almost all of the conference speakers are either former McLean Center fellows or current McLean Center fellows or current McLean Center faculty. After each lecture we've made the lectures five minutes longer than they have in the past by popular demand so the talks will be 20 minutes instead of 15 minutes and I am hoping that there will be five minutes left by the speakers for questions and I believe we have microphones set up in the back on either side. When you go to the microphone I just ask that you give your name and identify where you're from. I want you to know that after the second session this morning there will be a first session and then we'll have a coffee break and then there will be a second session moderated by Marshall Chin on health disparities but after that second session there will be a group photo up here on the stage at about 11.30 a.m. and the photo will include I hope current and former McLean fellows, current and former McLean faculty and members of the McLean Center advisory board. While the photo is going on lunch will be started in what's known as the Green Lounge of the law school. It's within the building to the south and everybody I hope will join us for lunch over there in the Green Lounge. The dean of the law school has asked us to remain in the south part of the Green Lounge. There's sort of a glassed-in section because today is a school day and there are law students in class and they will use the open north side of the Green Lounge and will be within the glass enclosure. I'd also like to call your attention to the McLean Center Prize for clinical ethics. The McLean Center Prize is a $50,000 reward that recognizes outstanding work in the field of clinical medical ethics and this year as your programs will show you the award will be made to Dr. Paul Farmer, to Dr. Farmer for his contributions to ethical medicine, social medicine, infectious disease treatment and to strengthening global health systems. Dr. Farmer will present a lecture after the dean gives him the prize and the lecture will be entitled the Ebola Suspects Dilemma. That lecture and the global health panel that precedes it will not be here at the law school. This is an important point to make that after lunch, after lunch in the Green Lounge there will be about a half an hour time available to walk across the midway to Mandel Hall. Mandel Hall is on 57th Street and a lot of people will be going and those of you who don't know the neighborhood will simply follow along. It's about two or three blocks from here and at Mandel Hall there will be a global health panel headed by Horn Saucy from the university with talks on global health disparities and that panel will then be followed by Dean Polanski awarding the prize and Dr. Farmer's talk. As always I'd like to express my deepest thanks to Barry McClain who recently retired after 25 years as chair of the McClain Center's advisory board and to the whole McClain family for their continued commitment and support of the center. I also wish to thank Rachel Kohler. Excuse me. Rachel, I don't know if Rachel has gotten here yet, but Rachel is our current chair of the McClain Center advisory board and finally I want to acknowledge the McClain Center directors, extraordinary McClain Center faculty, many of whom you'll meet in the course of this two day conference and the McClain Fellows past and present for all their great work and for their involvement and participation in this conference. The opening panel today will be on general clinical ethics and the first speaker in the panel is Farr Curlin. Farr who had been at the University of Chicago for 10 years, 15 years, recently moved to Duke where he is the Josiah C. Trent professor of medical humanities at Duke. Farr is a hospice and palliative care physician, researcher, a medical ethicist. He completed the McClain Fellowship back in 2003-2004. He also completed his internal medicine residency training as well as the health services research fellowship here at the university and remained on the faculty as I say until he moved to Duke in 2014. Farr was a green wall faculty scholar from 2006-2009. While here at the university, Farr co-founded and co-directed the program on medicine and religion. Today Dr. Curlin will give a talk entitled Gender Transition Services Progress or Medical Hubris. Please join me in giving a warm welcome to Dr. Farr Curlin. So it would not be the McClain conference if we were not off schedule already. That will grow as you all know if you've been here. I'm delighted to be here. I have mentors and friends in the room including Dr. Siegler to whom I owe a great deal and yet I will not load them with any of the responsibility for what I'm going to say this morning. As I realize I'm taking up a topic that's quite controversial, particularly controversial in the current moment. I think the University of Chicago is one of its virtues as it's the sort of university where we can talk about difficult controversial topics. I had not thought much about gender transition services. I'm not a pediatrician. I'm not a surgeon. I'm not an endocrinologist. I had not thought much about gender transition services conducted by physicians until last year when in May 2016 the Department of Health and Human Services issued a final rule under the Affordable Care Act that many people didn't even notice because it came the day after a rule that did get a lot of attention in which they instructed schools to interpret Title IX, not Title IX's forbidding of discrimination on the basis of sex as including discrimination on the basis of gender identity and gender preference. The rule that I'm speaking of was issued to in its own terms virtually every physician and every healthcare institution in the country and interpreted federal statutes in the same way. You might think that a rule that prohibits such discrimination should be celebrated by physicians and in a certain respect it should. After all, for centuries physicians have made solemn professions to care for those who are sick without respect to the patient's other characteristics. To tend to the health of our patients without respect to their other characteristics including the characteristics that HHS called the patient's internal sense of gender. Yet interestingly HHS did not claim or give evidence that physicians and healthcare institutions were turning away transgender patients with pneumonia, with heart attacks, with cancer or other illnesses. Rather what the writers of the rule found problematic was that many physicians and healthcare institutions were unwilling to use medical technologies, principally hormonal therapies and surgery, to assist patients in transitioning from one gender to expression to another. HHS acknowledged in their rule in the narrative of it that numerous members of the public had asked that this final rule distinguish between a refusal to provide gender transition services so described from a refusal to provide care that is needed to preserve or restore the health of a patient under this older commitment without respect to their gender expression, gender identity, gender preference. HHS explicitly rejected this distinction however and stated that in this rule that categorical refusals of physicians or institutions to provide gender transition services were unlawful. They violated federal law. Now that got my attention for reasons that those of you who know me can imagine. But with that background consider this case. The case of Jules, an otherwise healthy 13 year old boy who experiences gender dysphoria.  So the question is what should we make of this situation? And I want to ask what should we make of the situation as physicians, as practitioners of medicine? Stanley Howard once wrote the following. Morally speaking the first issue is never what we are to do but what we should see. Here's the way it works. You can only act in the world that you can see and you must be taught to see by learning to say. You must be taught to see by learning to say. Howard's insight inherited I learned from Iris Murdoch. I think can help us ask questions we should ask about medicine and medical ethics. How was it for example that in the early 20th century when people saw those with lower than average intelligence, what they saw were imbeciles whose existence and particularly whose reproduction threatened the future health of this body politic. Having learned to speak in this then very fashionable language of eugenics, early 20th century Americans could see that the only sensible and indeed scientific and progressive thing to do was to sterilize these people even if forcibly if necessary. Physicians were recruited to conduct these sterilizations including many of these occurred in North Carolina. If you could see that if prevalent ideas about eugenics however fashionable endorsed forcibly sterilizing women then the problem might be with the ideas rather than with the women. Instead the practice went on a pace for decades until the logical really started to break down when the logical consequences of the ideas behind eugenics were so terribly exposed in the Second World War. The practice of forced sterilization of the unfit was uncontroversially defended by the Supreme Court in the Buck v. Bell case where Justice Holmes infamously wrote for the majority three generations of imbeciles is enough. That's one example. We could choose many more. We could think of how is it that physicians involved in Tuskegee and Willowbrook could not see that the people in front of them deserved a kind of respect that we now can see so clearly. Many of the studies described in Beecher's famous article about morally problematic research. How could people not see what they were doing? Less controversially how was it that during the 1960s and early 1970s physicians encouraged women to forego breastfeeding in favor of the superior benefits offered by scientifically designed formula? Many of you guys bottle fed in that era because of this? Yeah a few hands going up. So as intelligent as you are you would have been more intelligent on average. Had physicians not discouraged mothers including my own mother from breastfeeding. So what kept physicians from seeing that if the fashionable modes of thinking about the superiority of advanced scientific therapies led them to conclude without evidence that a formula made in a factory is to be preferred to a mother's breast milk then that is evidence against the fashionable modes of thinking not against breastfeeding. So my question which I know is a controversial question but I think it's an essential one to pose and we ought to pose it is that is it possible that we are seeing or failing to see a similar moment with respect to gender transition? So what is it that we have been taught to say that leads us to see Jules this 13 year old as a person needing exogenous hormones to block the pubertal development that he would normally undergo? And to do so in full recognition that this therapy will almost certainly render Jules sterile for the rest of his life incapable of one of the characteristic activities of healthy human beings. How have we come to see his sexual organs as deficient relative to the simulacra of female sexual organs with which we might be willing to replace them surgically? Current cultural fashions lead otherwise reasonable people to say that for a physician to be affirming of Jules the physician must change Jules body to at least have the appearance of being the body of a girl. And to do so by destroying the organs and capacities that distinguish Jules as a male human being. So what is it underlies are seeing this as progress rather than seeing it as evidence that the current cultural fashions must have something must be mistaken in them? How will I suggest that what we see is shaped by what we have learned to say? And it seems clear to me that whether gender transition services for Jules are medical progress or medical hubris depends on two different ways of saying what medicine is for. Two ways that John Lantos anticipated a few minutes ago. In 1979, 20 years after the United States FDA approved the first oral contraceptive Dr. Siegler and Ann Dudley Golbat wrote, The oral contraceptive medication was the first prescription drug that was and is in effect a self-prescribed treatment. Patients, i.e. medical consumers, desiring elective medication demanded that physicians prescribe the contraceptive pill. Other popularly self-prescribed medications soon followed and came to be seen as appropriate solutions or treatments for problems previously considered individual or social concerns. But in any case, not biological abnormalities or specific diseases. Now, to my knowledge, neither Dr. Siegler nor Mrs. Golbat had moral concerns with contraceptives as such. Rather, they worried that the widespread prescription of contraceptives by physicians was setting in place a problematic pattern in which patients and physicians alike come to speak of the physician and to treat the physician as a mere provider of healthcare resources. 38 years later, we can say that what Dr. Siegler and Ann Dudley Golbat anticipated has come about. So in what I will call the new medicine, we have learned to say, we have practiced saying for more than a generation, that medicine is an evidence-based healthcare industry in which the physician acts as a highly skilled provider of services. Making those services available to be used by patients, not so much in pursuit of the patient's health, which would seem rather closed-minded and paternalistic, but rather in pursuit of well-being, overall well-being, holistic well-being, as the patient perceives their well-being requires.  This way of thinking led, as Siegler and Golbat observed a generation ago, led to physicians thinking it obvious that a good doctor makes her patient sterile if the patient requests it. It's led physicians, too, on one hand, do intra-fetal surgeries on 20-week-old fetuses in hopes of preserving the fetus's health, or on the other hand, kill the same fetus by dismembering it alive, and deciding whether one or the other is obligated by the physician strictly on the basis of the patient's perception of what their well-being requires. In the area of end-of-life care, which is my area of practice, this thinking has led doctors to decide that for one patient you might intubate them and put them on pressers and move them to the ICU, to the other you might give them a lethal injection if you're in Canada anyway, all based on what the patient says he or she wants. Changing the secondary sex characteristics of people like Jules seems to me takes the new medicine's rationale one step further. Treating the patient's sexual organs and underlying sexual physiology as either a good to be preserved, which is the case in 99% of our patients, or as a harm to be remedied, strictly on the basis of the patient's perception of himself or herself. In the framework of the new medicine for Jules, who does not want male secondary sex characteristics, those characteristics are to be understood as harms to him, as at odds with his well-being, and therefore which the physician has an obligation to remedy insofar as possible. So my proposal is, or my question is, might this not be an opportunity to see not the problems with Jules secondary sex characteristics, but the problems with the new medicine, with this framework, this way of understanding our work. If we think that, if our language and framework lead us to think that we should make a 13-year-old boy sterile in order to block his sexual maturation, then perhaps we need a new language and a new framework. Now there's another way of speaking about medicine that's a rival to the new medicine, it's lost ground against the new medicine, but that does lead to this second conclusion. You might call it the traditional approach to medicine, according to which medicine is a moral practice that aims at the patient's health, and where health, human health is an objective, that is to say a genuine, a real human good, and it's the good that gives us a singular purpose as physicians. The new medicine obviously does concern itself with health, but in the new medicine, health is taken to be only a subjective and strictly socially constructed concept. As such, in the new medicine, an appeal to health cannot tell us whether health as well-being cannot tell us whether to sterilize a young woman or give her in vitro fertilization, cannot tell us whether we should treat Jules secondary sex characteristics as goods to be preserved, or as anomalies to be corrected. In contrast, in the traditional approach, health is an objective norm of the living body, a norm characteristic of the kinds of animals we are. On the traditional approach, physicians have a reason to avoid and even refuse interventions that would undermine or directly harm the health of their patients. And here's the thing. Our existence, it seems to me, our existence and our health as human animals is sexed. We are male and female organisms, and this makes possible human reproduction, a feature of healthy working of human organisms that physicians attend to. We know this from our observation. Unlike the digestive function, no individual human being suffices for the performance of reproduction, and our sexual characteristics and features constitute this reproductive capacity. They are, again, these are, again, characteristics and features of healthy human organisms, male and female. So the one who speaks out of the traditional approach to medicine will say, will see that Jules, will say and see, that Jules male secondary sex characteristics are expressions of and essential to that dimension of health that makes possible reproduction. Insofar as these features are suppressed or destroyed, Jules health is thereby diminished, seems to me. So the physician has a good reason as a physician to decline to participate in gender transition services, so described. When physicians set aside their constitutive profession to the patient's health, their practices come to be characterized by contradictions and come to be health damaging rather than health preserving. And I'll close with this. That's what we saw with forced sterilization. That's what happens, I think, with assisted suicide in euthanasia. It's even what happened when we set aside healthy breastfeeding. And it seems to me to be happening with respect to physicians changing secondary sex characteristics to adhere to a gender preference or a gender identity. Here's a couple of the contradictions. Sex in this way of thinking is fluid and gender is socially constructed. It's not dependent on biology and anatomy. So if we're to be reasonable, we will set aside the binary of male and female sex. And yet, strangely, this intervention proposed for Jules focuses precisely on biology and anatomy, changing with substantial side effects for the rest of the organism, the very characteristics that are not supposed to matter for gender. Another contradiction. In order to affirm Jules in this way of thinking, physicians should conduct gender affirming interventions that in their objective character, the objective character of these interventions, instead reject what Jules is in favor of bringing about some kind of envisioned new Jules, one that does not exist at present but which the pretense of which at least can be fashioned through hormonal and surgical interventions. So why not, if we want to affirm, affirm to Jules that you are good as you are. Your body is good. And in that you have gender dispositions that are not typical, is not something that you should see as making you not good or your body not good. Third contradiction, in changing sex, we actually don't change sex. Our male and female sexual organs can only be identified by reference to the role these organs typically play in the overall biological economy of a sexed human being. No transplant, much less any reconstructive plastic surgery can integrate a female sex organ into the biological life of an organism whose root capacities are male, nor vice versa. So it's impossible medically because impossible biologically to change Jules sex. I'll stop. Except just to say that it seems to me we are in this case putting so much weight into the positions of a child leading us to do something that in any other context we would judge would be an egregious harm. And that carries the logic of the new medicine to its conclusions but I think it shows also the logic of the new medicine has got to be problematic. Sure.


met up with a couple of my friends and we decided to go for a drive a good old drive and actually come to think of it here is the street right here okay so I was coming from the other side but if you can imagine it came around this street that is the phone my god the fucking fence post still has the the indentation oh my god all right I'm gonna park up right here all right you guys what is going on welcome back welcome back to another video welcome back to Christchurch we're here we're still here it's it's Monday the 14th of October and this is my final day here in Christchurch so I've woken up this morning it's about 11 o'clock it's not a good day unfortunately so you probably won't be able to see the beauty of Christchurch but I do have a few stories I've got a few things I want to talk through myself I want to work through I want to get a bit of closure on a couple things and I also want to create content for my YouTube channel this is personal content this is content that really affects me you know it's it's my childhood Christchurch and Littleton is my childhood up until the age of 19 and any of you guys out there thinking about your own childhoods you'll know what I mean some of you may not even be 19 yet but I spent the first 19 years of my life here I've then spent the next 10 years of my life in Australia so today today today I want to make probably five or six different videos and we're gonna get into those once I go through these lights I've got to put the camera down hold on okay so oh there's an anytime fitness and ferry made I didn't know that so five or six different videos today the first one is gonna be how I crashed my car and what I learned from it the second one is gonna be how I crashed my second car and what I learned from it fundamental lessons I got from the first one was don't try and drift when you can't even drive the second one the main rip the main lesson I received was don't drink and drive and I'm gonna run you through both of those stories as we as we come across the area and the the area that I crashed both cars in because I do want a bit of closure both of those crashes affected me in a massive way shocked to the shit out of me and taught me some lessons so those are the two places two first places we're gonna go after that we're gonna visit my primary school in Littleton which looks a whole lot different than I used to than it used to because of the earthquakes it's actually it's not there anymore the second place we're gonna go to is my intermediate school which is Christchurch South I have not stepped foot in there for like 15 or 16 years so that's gonna be insane and the third place is gonna be sorry the fifth place for the day is gonna be my my high school catch me high school I want to take a stroll through there it's school holidays at the moment so hopefully no one will be there and I'll be able to walk around and reminisce so that's five videos my first car crash what I learned my second car crash what I learned having a look through my primary school my intermediate and high school and that's pretty much it guys that is pretty much it so with that being said I'm gonna shut the camera off and I'll see you at our first location which is where I crashed my dad's car at age 15 having just got my learner's license trying to drift around a corner in a rear-wheel drive that was automatic and that's all I need to say so I'll see you soon all right so as we're as we're nearing closer to the site the crash site yeah there's no other way to say it really the crash site the road is major eight can drive I'll never forget it in fact my best mate at the time his last name was Aitken Liam Aitken what a great guy in fact thinking back on it guys this is how this is how fucked up this was both myself and Liam similar birthdays we just got our license at the same time very similar stories that same night the same night that I crashed my mate Liam crashed his mom's car same insurance companies we both went into it to come to think of it like two weeks later we went in to make our statement about what happened in either our crashes both my dad and his mom had insurance policies with the same person with the same company and we both went in and both sat down they thought that we were like connected in some way so not only were we trying to you know explain how we crashed and basically make up some bullshit they thought that we were connected and that we crashed together and that we were trying to fabricate some story so that's just come to my head actually that was part of it that was part of it but look I want to set the scene I want to set the scene a bit so it was the final day of high school in fifth form I was 15 I just got my license and we had our final end of year prize giving I had never been able to use this car before dad let me I must have begged him the whole entire night so I can't imagine him letting me use it I definitely can't imagine him letting me use it after this because it really fucked things up but setting a scene it was our prize giving end of year prize giving and I take in the car after the prize giving I met up with a couple of my friends and we decided to go for a drive a good old drive and actually come to think of it here is the street right here okay so I was coming from the other side but if you can imagine it came round this street that is the phone my god the fucking fence post still has the the the indentation oh my god all right I'm gonna park up right here let's let's check this shit out I shouldn't be laughing because it was it was an absolutely terrible scary shocking moment in my life but now I can look back at it and talk about the lessons I've learned and that's what this video is about so let's do that let's go check it out all right so 15 years old 15 years old nearly 16 but not quite end of year prize giving thought I was the man rolled in in this Nissan Sefero and back back in like 2007 2008 sorry this is 2005 fast and the furious had come out need for speed underground was out everyone loved the Japanese cars everyone loved the rear-wheel drive cars and the Nissan Nissan Sefero was one of those man and if I hadn't have crashed this car it would have been my car throughout my childhood throughout my teenage years throughout school I probably would have still had it now it was an absolute classic but it wasn't to be it wasn't to be so look I don't know if you can imagine this but this fence this car is gonna go past this fence right here I vividly remember sitting on that after the crash going into shock basically or they told me I was in shock they gave me a blanket this is after the prize giving probably 8 o'clock at night it's it's dark this is one of the first times I've ever driven by myself and I crashed the car I didn't know what to do it was a terrible moment terrible moment but the lesson learned guys the lesson learned there is a lesson learned is that I brought it on myself I didn't drive properly I drove as if I was a fucking professional drift racer and I hadn't even started driving yet so let me let me paint the picture here let me set the scene and let's run through this on a bit a bit of closure that's what I'm doing this for I'm doing this to to get some closure for myself and also to share a lesson a life's lesson so here we are there is the street okay now I don't care that people look at me funny I've got no shoes on but who gives a shit so we're coming along from cashmere high school coming along this way just like this coming along coming along okay here's the street now what I saw happen in front of me I was driving along with this with this guy his name's Simon Bergen Simon if you ever watch this actually Simon Bergen just played for Scotland in the Rugby World Cup as a replacement prop so well done mate but he was in front me and him met up with another guy Alex after the prize giving thank God I didn't have anyone in my car with me but those two were up ahead I saw them come along in front of me they came up to this corner he did a little skid a little skid around the corner and that's it it was nothing crazy it was a front-wheel drive I mean what can you expect then I come along I see that I've never tried to skid before never tried to drift before I see Simon go and do that in front of me and what do I do well I try and do the same thing and it was an automatic car a rear-wheel drive quite powerful and I think it was wet at the time so what do I do I get to about this point here I put my foot down turn the wheel to the right and hope for the best and it didn't work out very well so the first lesson learnt guys is to learn how to drive and don't try and drift when you don't know what you're doing look that's all I could say I could try and I could try and make it funny for you guys I could try and put some some sort of comedic spin to it but really that's all I got to say is don't be a fucking idiot when you're 15 years old and you got no idea how to drive so came around this corner and flying around here come to think of it I don't actually know how I got how I got this far around the corner but I did and so well actually I didn't get that far around the corner because as you can see this is the corner and flying around would have probably had to counter stare at about this point and went straight smash into the retaining wall and that my friends is the mark that I left on this corner look at it now looking at that you probably wouldn't expect too much damage to have happened to the car and neither did I but I can safely say that the car was written off so there's no cars coming now I can tell you I came along from there came around the corner tried to try to imitate what my friend had done earlier and completely fucked it so that's it I guess this is my closure and this is me just just running through my first ever car crash what happened after that I actually hit my head on the steering wheel and got a cut on my head so I couldn't forget about it for probably the next six months because there was a cut and then there was a scar and I honestly guys it was it was a real shock it was a fucking shock it all happened really really quickly you know here I am thinking thinking I'm gonna do a perfect skid around the corner and next minute I'm ringing dad saying I've crashed the car sitting on that fucking lamppost sitting on that fence post with a blanket around me with everyone telling me I'm gonna be alright oh you're in shock you're in shock no fucking shit I was in shock one thing has actually come to me probably in the last couple of years and it was it was a general attitude that I have with things especially negative things or you know so-called negative things I try and get something positive out of it I try and get a hidden meaning out of it I try and think everything happens for a reason now the reason why I crashed on that corner there before coming up this massive hill and possibly crashing summer up there because I can guarantee you guys I can guarantee you if I didn't crash on that corner I would have crashed up here somewhere I was in the mood to try and spin those fucking wheels and try and get some drifting going when I had no idea what I was doing so that was so that was that was the positive that I got out of it that was the the reasoning why it happened there and why God was watching over me and made it happen down there and not up there is because if it had it happened up there I could have most likely killed myself very similar could have been a very similar situation to what nearly happened in my second car crash which is what I'm gonna talk about in the next video okay so the lessons here are well the major lesson is we should not be allowed to drive at age 15 15 is too fucking early I think it should be at least 16 if not 18 because at age 15 I had no idea and it was always gonna happen it was always gonna happen I was gonna push my luck and fuck it up somehow and it happened very very very early in my driving career and it gave me a shock a big shock but it still didn't stop me crashing one more time unfortunately so touch wood I've had my last crash to this date which is to this was my first and you know what I will say is thank God it was on the last day of school thank God I didn't have to turn up at school that next week because you know you know the way that rumors happen because you know you know the way that news travels in high schools and it didn't take long for me to basically sadly be the laughing stock the two guys who were driving in front of me Simon and Alex they knew the seriousness of it but they were the kind of guys that loved a story terrible terrible times terrible times had a massive cut over my head like I said not a cut it was like a graze but it scabbed up and I ran through that that moment I had that the feeling and the sound of it running through my head like over and over again for probably a good two or three years before I actually completely forgot about it and never thought about it again but you know every time I drive past major I can drive every time I come back to Christchurch every time I fucking have to ask dad to use the car just like today it goes through my head you know and it's one of those lessons it's one of those times and and moments that I'll never forget and now it's now definitely never forget it because it's on my YouTube channel so in the next video we're gonna we're gonna check out the summit road which is a road that goes from Sumner to Littleton it's a beautiful drive beautiful drive but unfortunately I didn't make it one time in particular and we're gonna get to that so anyways guys hope you enjoyed there's no time like the present I'm gonna get over to the summit road turn the camera on again and run through another situation that I need closure on so I hope you enjoyed peace out so I hope you enjoyed peace out and I'll see you in the next one


What's up? My name is Broogly and in this video we're going to be doing something slightly different than my normal back room's levels explanations. Yes, because in this video I'm going to be ranking a tier list of a ton of back room's levels. There's like 30 levels here and I'm going to be ranking them from S to F, you know, best or source to best. I have pretty high hopes. I have some controversial opinions as well and I want to see your thoughts on that in the comments. So without any more blabbering on for me, let's get into video, shall we? Alright, so this is the tier list. You know, up here it's got guide, up here's trash and we have regular levels, enigmatic levels, popular levels. Pretty much you've heard of all these and I think I've done explanations on every one of them. So yeah, let's just jump right into this. Level nine. I think level nine embodies something basic about the back rooms. I think it's like the core liminal values. It's just a liminal looking neighborhood. It's pretty empty. I'm going to put it in very cool because I love the aesthetic of an empty neighborhood. I don't know, might be good. Okay, I'll leave it at good. Now, level 10, the wheat field. If you've seen this before, you know that it's just like an expanding field of foggy wheat with some random structures. I really like this level as well. I don't think it's quite on the level of level nine though. I'll put it at okay for now. Why is okay misspelled? Do you see that? That's weird. I'll see you guys like the J-Slat look I got going on here. So level 11, I think level 11 is a very cool one and I think that because it was the first level that had like colonies on it. So it was like a front runner, if you will. And I've always thought that was one of the best ones and it recently got a cool rewrite on the fandom, which I might check out in a video. Let me know if you want that. I think this is a proper, proper ratings for nine, 10 and 11. Level fun. Now, I actually am going to consider level fun very cool, but not above level 11. And that is because it is the embodiment of liminal nostalgia from childhood. Now, level fun looks like, you know, a party room that you'd have a birthday party in, which is obviously awesome. And I've had, you know, many birthday parties in my day and a lot of them look like level fun. And it reminds me of a grand time, which was, you know, my childhood. I mean, now it's pretty good too. Alright, so now we have the wide out in the blackout, which I covered in one single video. Again, they're all on my channel if you want to look them up. I think the wide out is meh, to be honest. I feel like there's multiple levels that are wide out that are just fully white. It's a good concept, but I think that the one level I did where the bugs were behind the wall is a better concept. The blackout though, I think is a very cool level and I think it's very yin and yangy to the white, to the wide out level. But I think it just does a better job of executing and doing a specific world building as well. I don't know why I'm sounding so specific right now. This is literally just a fake ARG, but I don't care. It's immersive. Now, I think the hive has lots of potential and I think it's actually getting a rewrite as I'm recording this. The hive could be very cool. It could be the birthplace of either all entities in the back rooms or it could be like a mega organism. It's just an entire level and I don't think there's any level like that except this one. So that's pretty cool. That video I did is one of my favorite videos. Too bad it tanked because it was like three years ago. Level 12. I like level 12. I think it's going to be okay though because there's other glitchy levels that are better. But level 12 is literally just an error, you know, glitch. I like it. It's cool. Level 13. We're putting that in very cool. I actually put it above the blackout. I love the apartments. I love it because that is such a core memory, you know, my childhood. It kind of looks like some hotel hallways and stuff. I just love that kind of vibe. So now we have a level 14 or paradise as it's been nicknamed. Um, this one is cool. It's outputted good because of its story. I feel like there's a pretty cool storyline there. It's very secretive. Not many people know what's there. There's like some weird cult stuff going on and I kind of like it. So I'll put it, I'll put it a good below the hive. Level zero. Obviously I put it at God tier, similarly because it's the first one and I think it is the most noticeable and it is the most profound level in the back rooms. When you think of the back rooms, you think of this one and I genuinely think that it is such a cool thing that kicks out of this entire creepypasta in my career. Level explanation mark or as it's now known as the long forgotten exclamation mark or as it used to be known level run for your life. I will put that in the middle of very cool above level 13 but below level fun. Another classic level. Y'all know what it is. Very cool concept, very scary concept. Many games have recreated it pretty well. The shady gray. First video on my channel to blow up was the shady gray explanation. So I'm kind of partial but I think I want to put it right below the exclamation mark. I don't know. I really like the concept of the different sub layers and I think it was one of the first levels to actually do like a bunch of sub levels. So that's pretty cool. And like I said, it was the first video on my channel to get like over 100K views, which is cool. Level 15. I'm gonna put met again. Actually, I'll put it okay because it's in space or it's like a spacey thing. I think it's pretty cool. It could have been done better. I might have gotten a rewrite since I checked it out last but the video that I did on it is pretty good. I need to stop self promoing. This is kind of sad. Level 188. God tier. Love this picture. It is single handedly the picture that got me into the back rooms and it's a real life place which I'll be going to at a million subscribers if you didn't know. It's so cool. Very, very elemental picture. I love the found footages and the pictures of it. It's so cool. Now, this is an OG one right here. The Crimson Forest which I'm gonna put at the very top of very cool. This was an original safe level. It got destroyed and has never been heard from or seen since. There are some theories around that, you know, in the canon and canonically but I absolutely love the idea of it. Crimson Forest, Crimson Field. It was amazing and I would love to see it come back in the future. Maybe cross my fingers. Who knows? Level 666 also is in the very cool category. Simply the fact that it plays on your fears and who doesn't love being scared out of their mind? So now we're getting into some theorized exits. So that's gonna be interesting. 3999 was another one of my first videos to really blow up. I think it's got over 1.2 million views now which is insane. Above the blackout here I love the like the liminal arcade. I love they have to complete these tasks to escape and I still don't know if it's an exit. It's still up in the air. I really like it and it's very nostalgic looking because of the arcade type stuff which is always pretty nice. Now the end. I love this level. I think it's also getting rewritten right now and expanded upon but simply this picture is just so it's so nostalgic for some reason it's just a liminal space kind of vibe that's been in the community for a long time. Level 16 I actually, let me check level 16 because I don't really remember call me fake Oh, it's this one. Okay. Yeah, I remember this one. So this is the one that can change. That is a cool concept. I remember when I went over this one it was kind of hard to convey in a video format but I actually really like the level like how it can change and I was a glitchy. We'll put it at the bottom of good for now. Level 33 which I believe what I thought I love this level this one is amazing it also blow up on YouTube but I put this in very cool probably above departments I love abandoned mall aesthetics it is one of the best aesthetics I love levels around it who doesn't level one my first controversial opinion I think it's meh I don't like the concept I don't like the parking garage I don't like the supply crate type stuff it kind of gets a little too video gamey there for me which I know I'm a hypocrite for saying that like level fun is better but I don't know for some reason I don't like it I never really have I don't know it's always been my opinion level negative zero I actually really like this level and one of the reason I like it is because of how much controversy it stirred up I got about 500 comments on my video and they were all like you can't have negative zero that's physically important bro it's the back rooms dog you can't numbers or nothing it doesn't mean anything I really love the concept it's very cool it's very mind mind bending if you will now level negative one I'm gonna just do the deed here and go look at this on the wiki dot yeah I I don't think I like this one I'm gonna put it in meh it's just a little bland for me not not a fan now level two negative two I do remember liking this one yes so I actually really like this level it is very weird and it's very enigmatic and most of the time if it's an enigmatic level I'm all over it and I'll put it at the very end very cool the hub one of my favorite concepts of a level level you can get to other levels from it's kind of like a train station type deal I really like it it's gonna go very cool probably above level 11 it's also a cool design very weird looking there's some really cool found footages that I've reacted to on my tucley channel level unnamed I love this level I really want to put it in god tier but I don't I don't I don't think I can I'm gonna put it above the apartments I love the concept of the oil paint that it's just a painting and then if you stay there long enough you become a part of the painting that's pretty cool level point two this was the first sub level that I ever went over and I think it's just it's either good or okay I'll put it in okay it's very it's a cool concept it's like the first sub level I ever found it was in the my first video that was what was it what are sub layers you know it's cool I like that it's a it looks like it's a recreation of level zero that the backroom's builders made if I remember the lore correctly so this is level 1.5 I believe let me look this up now I remember this level used to be on the wiki not a long time ago if I remember correctly it's cool it's like a little bit of it's like in the middle of these right here I like how it's grayscale in some areas now it's kind of like fuzzy but it got taken off the wiki dot so level 404 of course god tier you know it's got to be one of the most og levels one of the coolest it's all corrupted and stuff it's I think it is the og corrupted level besides level 12 level 256 if I remember correctly is yes so it's it's demo scene which it's funny because in my video about this I actually call it demon scene so it's demo demo scene it's a cool level concept I like how it's just a it's very empty and abandoned kind of feeling I love all this kind of levels to do that I'll put it above one point I'll put it right there that's pretty okay level 6.1 another sub level that I first went over we'll put that in very cool above unnamed I love the concept I love I love levels where wanderers and explorers can come together and kind of chill without being eaten alive you love to see it and I think it's a very cool level I know I keep saying that for everything but it's that nostalgic vending machine type of vibe level 2 another controversial opinion I don't like it it's going to the mech category I'm not a fan of the hallways or the pipes I feel like that's bland I don't know like all this stuff up here is like so cool to me but then you get down here to 1 and 2 and it's just like a parking garage and pipes I just I can't deal with it level 20 we'll put it okay just right above me I like warehouses I think it's cool I think abandoned warehouses and empty warehouses are very liminal level 777 I'm going to put it at the very top of good that is a cool level it's got some cool lore to it some cool anomalous properties I really enjoyed the video on it that I made check it out I'm going to stop self-promoting thank god to you the first level that got 500,000 views on my channel and that was the first video that I premiered live so I was interacting with you all while I was premiering I had like 10k views in like 10 minutes that's absurd and I only had like 30k subs I love that level that is a very special place in my heart just the sheer amazingness of it it's pretty cool level 999 is also there but I think I'm going to put it right under the crimson forest I love it's got a really good rewrite that I just went over I think you all are going to see that video before this level 999 is such a cool concept I love it I love it if man is still alive I really I think I have not made a video about this yeah it's negative 15 I have not made a video about this I don't know how to feel about it if I'm being honest I think we'll leave it at meh it's not bad level 907 see I don't know what this level is so I'm just going to put it at meh I don't know I don't know what it was if it was deleted or something let me know in the comments if you remember what it is this level is on the enigmatic list for the wiki dot if I recall I think this level is pretty cool it's a little bit too similar to level negative 1 for my liking so we'll put it right below it the grave I love the grave idea I love it being a mass grave for wanderers that have explored the back rooms and somehow have met their fate it's a very cool concept and there's I think there should be more levels like this with more mythos and stuff I'll put it right below the snack rooms the end of the freaking world I love this level and I really enjoy the concept of it it is so cool and it's got some really dark energy to it it's right up there with a shady gray for me I really enjoy my explanation on it it's really good it's in the top 10 most disturbing back room levels video on my channel I have not gone over this level before bro this is cool well looks like you're going to be seeing a video on this one coming soon just now cool it looks it's going to get a very cool I don't know how I have missed that what? level 3 finally a good level in the first top 5 that I actually like really enjoy I'll put it at the top of good the good category I love the idea of the electrical stations and how it's all like this huge cog in a machine and how there's these bars that are electrified that's a cool concept I like that level negative 998 I love this level 2 I love the like the post apocalyptic nuclear type vibe how it's like a recreation of the USA and then the world very cool very cool lore my videos are banger on it I've got to stop saying that dude I'm so used to sell problem I'm sorry guys level 4 very cool level level 4 is just a banger it's literally up here with like the hub and the level 11 it's so cool so vibey I love the abandon itself and I love the idea that you can get the almond water from here I love just everything about it level 5 is also right up there huge hotel with these weird creatures in it it's such a cool idea hotels are very liminal very personal very cool level level 6 I have mixed feelings in a way it's kind of lame cause it's just dark and there's really no other world building but there is world building it's like this maze of darkness that there might be something behind you but there might not be it's definitely going to be the good I'll put it above level 3 level 7 gets a god tier it's always been one of my favorite levels it's such a cool level I love water I love the lore behind it I love the creatures in it it's such a good level level 8 is the final one on this tier list honestly I'm going to put it at the bottom of good it has a better sub level than its actual level level 8.1 I think is better but level 8 is also a classic cave you know what not so this is my tier list of all these levels put together what do you think? let me know if you would change anything in the comments below let me know what your favorite are if they weren't on here so yeah that was my tier list hope you enjoyed it if you want more facecam content like this more background stuff that's not necessarily level explanations like found footage reactions like found footage rating rankings rants all that kind of stuff leave a like I would love to do more I feel like this is just more personal but if you want more stuff like this I upload on Tugli my second channel videos like this all the time thank you for everything I appreciate you all we're on the road to 1 million and I'm so happy I cannot wait to get that golden play button I cannot wait to stream it and I cannot wait to go to England to the level 1 8 hotel it's gonna be fun thanks for everything I'll see you later peace