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I'm the Director and Co-Founder of ClusterFree, an advocacy and research initiative focused on cluster headaches. ClusterFree is a project of the Qualia Research Institute. 

I previously worked as Chief of Staff at the Institute for Law & AI (formerly "Legal Priorities Project") and as COO at the Center on Long-Term Risk (formerly "Effective Altruism Foundation"). I also co-founded EA Munich in 2015. I have a master's and a PhD in Computational Science from TU Munich and a bachelor's in Engineering Physics from Tec de Monterrey.

I also have a blog called Globally Bound where I write about consciousness and extreme suffering.

🔶 10% pledger since 2015

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Thanks so much for your comment and your support! :) And yes, we definitely want to engage with representatives at all levels, both ourselves as well as in a decentralized manner (e.g., by empowering patients and other volunteers to take action locally). Any efforts are welcome. Get in touch if you'd like to coordinate somehow or if you need any advice. :)

Thanks for the shoutout and for the vote! :)

I'm not convinced that the number of sufferers isas high as claimed. In 13 years as a doctor in Uganda and treating a few thousand patients, I've never seen a convincing case of cluster headache here.

This is indeed quite surprising! The relatively low prevalence and the lack of recognition of the disease / misdiagnosis may explain it to some extent, but zero patients in 13 years is still very surprising.

(Consider that even an average neurologist only ever sees a few dozen CH patients during their entire career. I asked Opus 4.5 and Gemini 3.0 to estimate how many CH patients an average neurologist in the US sees per year, assuming an annual prevalence of 1/2000 adults, and their responses were 1–2/year and 1/year, respectively. They also think that the average neurologist sees 3–5x (5–10x resp.) more CH patients than the average primary care doctor, but the odds of not encountering a single patient in 13 years should still be very, very low. Will look into this!)

Also, there's almost no epidemiological data on the prevalence of CH in African countries, so the prevalence error bars are large. (In our paper, we included a sensitivity analysis of the most uncertain variables to add some nuance.)

Thanks for your answer! :)

 If so, why not generalise, and conclude you would avert 2^N h of pain of intensity 0.999^N instead of 1 h of pain of intensity 1?

I think the procedure might not be generalizable, for the following reason. I currently think that a moment of conscious experience corresponds to a specific configuration of the electromagnetic field. As such, it can undergo phase transitions, analogous to how water goes abruptly from liquid to gas at 100°C. Using the 1-dimensional quantity "temperature" can be useful in some contexts but is insufficient in others. Steam is not simply "liquid water but a bit warmer"; steam has very different properties altogether.

To extend this (very imperfect) analogy, imagine we lived in a world where steam killed people but (liquid) water didn't (because of properties specific to steam, like being inhalable or something). In this case, the claim "reducing sufficiently many units of lukewarm water would still be better than reducing a unit of steam" would miss the point by the lights of someone who cares about death.

(Here are some thoughts on phase transitions in certain altered states of consciousness.)

Do you know how much funding is spent globally per year on preventing human torture?

I don't! That's the sort of question I'd like to see more research on (or discussed more on the Forum if such research already exists), as well as which torture-prevention orgs/programs are most cost-effective, etc.

As a panpsychist and suffering abolitionist, I'm one of the most sympathetic people in the world to the cause of reducing suffering even in the smallest beings. And yet, I do not want to see more research on how to increase the welfare of microorganisms on the margin (or at least not with EA resources).

I probably won't change your mind about meta ethics, but I strongly disagree with the aggregationist QALY approach to comparing the welfare of humans vs e.g. soil animals (e.g. here). I hope to write more about this at some point, but as an intuition pump, I think there's a good chance that the problem of reducing soil animal or microorganism suffering is somewhat analogous to the problem of reducing, say, pin pricks in humans. I would not support EA efforts to reduce the number of pin pricks in humans, no matter how vast, given that we also have humans who are actually being tortured right now.

As much as I care about insects and other small organisms, I'm really sad that the EA community invests far more resources into their well-being than to reducing torture in humans (e.g. there are 120 EA Forum posts on Invertebrate Welfare and only 7 on cluster headache; and there isn't even an EA Forum tag for "Torture" despite it still being a huge problem globally (Claude estimated 1–2m people tortured per year, ChatGPT estimated 500k–2m)).

I really appreciate your work, and I think we should absolutely think about these problems. But, on the margin, I'd rather see other work being done.

Thanks so much for sharing these resources!!

Like many experts and institutions in global health, we use “disability-adjusted life years” (DALYs) as a way to measure the burden of a health condition. An intervention that improves health will thereby reduce DALYs.

It'd be awesome for OP to explore in parallel other cause areas and interventions that the DALY misses, such as less prevalent conditions inflicting very severe suffering. Otherwise, we risk neglecting those who are worst off.

I make this case in my paper "The Heavy Tail of Extreme Pain Exacerbates Health Inequality: Evidence from Cluster Headache Underinvestment" (forthcoming in "Nature: Humanities & Social Sciences Communications"). My post "How much should we value averting a Day Lived in Extreme Suffering (DLES)?" also touches on some of these themes.

I found it insightful to read your criticisms of the old website! And I really like the new website. Congrats on the launch! 🎉

This is helpful, thanks! (It would have come in handy for our kidney stone project, where we did something very similar!)

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