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Member since Jun-04-08 · Last seen Feb-18-15
Good Day to All! Ma-ayong adlaw sa tanan. And my thanks to for this excellent website. Salamat Opinions:

1. World Chess Championship

The true Chess World Champions are the holders of the Traditional Title that originated with Steinitz & passed on in faithful succession to Lasker, Capablanca, Alekhine, Euwe, Botvinnik, Smyslov, Tal, Petrosian, Spassky, Fischer, Karpov, Kasparov, Kramnik, Anand, and Carlsen. The sacredness of this Title is what makes it so valuable.

And how does one become the true Chess World Champion? In general, by beating the previous Titleholder one on one in a Match! Matches are preferred over Tournaments because of the Tradition of the WC Succession & because the chance for pre-arranging a Tournament result is more likely. The only exceptions to this rule:

A. In case where the Candidates and World Champion participate in an event that all the participants agree to be a World Championship event because of extraordinary circumstances.

Thus, the 1948 World Championship Tournament was justifiable because of the death of the Title holder Alekhine.

Likewise, the 2007 WC Tournament was justifiable under the extraordinary circumstances of the Chessworld trying to heal its internal rift over the 1993 Kasparov Schism. Anand himself became the World Champion in this 2007 Tournament & not in 2000 when he won a knock-out FIDE Tournament. Caveat: Some chess fans deem the 2007 WC Tournament as illegitimate, considering that Anand became the World Champion only in 2008, when he beat the previous Titleholder Kramnik in a WC match. From this perspective Anand only became the Undisputed World Champion in 2008.

Karpov lost his Title to Kasparov in 1985, & never regained it in the 1990s events that FIDE labeled as 'world championships'. All solely FIDE Champions that emerged outside WC Traditional Succession elaborated on above, strong as they were, were not true World Champions (eg., Bogolyubov 1928, Khalifman 1999, Ponomariov 2002, Kasimdzhanov 2004, Topalov 2005).//

B. In case the previous Titleholder defaults an event that the Chessworld largely deems as a World Championship event in the Tradition of the World Championship Succession. Thus, Karpov was the true successor to Fischer who defaulted their WC Match in 1975.

2. The strongest chess events in different eras of chess history?

Because of the brain's limitations explained below, the best professional (amateurs don't matter much in top level chess) chess players of each generation beginning in the Lasker era have always played at a similar level - near the maximum allowed by human standards. Now there are larger cohorts of chess professionals post WW2 than preWW2 thanks to government state funding in the Soviet era and presently corporate funding. The result is that large preWW2 tournaments had numerous 'bunnies', relatively weak players. By the Kasparov era, super-tournaments that featured most of the top ten, and no bunnies, had became more common. However, the top 4 or 5 since Lasker's time have always been very strong.

Consequently the smaller the top-player-only tournament, the stronger it gets. For any era. If there was a double round robin tournament in 1914 featuring Lasker, Capablanca, Alekhine, and Rubinstein, and no other, it would be as strong as any present day super-tournament.

Now weed out everyone except the two strongest players in the world. What we (usually) get is the chess World Championship match.

There has been talk of elite tournaments, composed only of the strongest top masters and no weaker bunnies replacing the World Championship match in prestige, probably because of the assumption that they would be the strongest chess events possible. False assumption. The strongest chess events in chess history generally have been World Championship matches. Even the strongest masters in each generation usually do not match the world champion and challenger in chess strength. In a World Championship match, the contestant has to meet the monster champion or challenger over and over again, with no weaker master in between. Capablanca vs Lasker 1921 was just as strong a chess event as the recent Carlsen vs Anand 2013, and far stronger than Zurich 2014. (Imagine having to play 14 straight games with a computer-like errorless Capablanca at his peak.)

3. The strongest chess players in chess history?

IMO the 1919 version of Capablanca & the 1971 version of Fischer, both of whom played practically error-free chess, are it; updated in opening theory, they should beat anyone in a match.

If computers were self-aware, I have no doubt that they would unanimously choose the 1916 to 1924 Capablanca as the strongest chess player in history. And please no red herring remark that Capa played only 'simple' chess. This young Capablanca played some of the most complicated, sharp, double edged, and bizarre positions possible; and played them without making a single losing error (and by all accounts with unsurpassed quickness), something that has always befuddled my mind when I got to peruse through his games.

We have to take this question in the context of the limits of the human Anatomy and Physiology. A concrete example would be the one hundred meter dash. The human body is designed such that the limit it can run is about 9 seconds. In order for a human being to run faster, we would have to redesign the human anatomy into that of say a cheetah. One can rev up the human Anatomy and Physiology, say with steroids, but this regimen would hit an eventual Stonewall too; the same way that we could rev up human proficiency to learn openings with computer assistance.

Since the Nervous System has physiological limits (example of a limit- neuronal action potential speed don't go up much more than 100 m/s) and so limits the human chess playing ability, increasing the number human chess players, thus expanding the normal curve of players, simply creates more possibilities of players playing like a Fischer in his prime, but will not create a mental superman who plays chess at computer levels. This explains why human and computer analysis indicate that Lasker was playing on a qualitatively similar level as more recent WCs.

'Worse' in chess, any computer assistance ends once the opening is over. After a computer-assisted opening prep, every GM today has to play the game the way Lasker did a hundred years ago, relying on himself alone, with the same fundamental chess rules and chess clock. An Encyclopedic opening repertoire is not a necessity to be a top player. In fact, there are World Champions who did not do deep opening prep; they just played quiet but sound openings that got them into playable middlegames and then beat their opponents in the midlegame or endgame. Just look at Capablanca, Spassky, Karpov, and now Carlsen.

Because of subconscious adherence to the narcissistic generation syndrome, the belief that everything that is the best can only exist in the here and now, many kibitzers would not agree to the above theses. While it is true that there have been more active chess professionals and consequently larger cohorts of top chess masters on a yearly basis since WW2 thanks to Soviet state funding and present corporate funding, the very top chess masters since Lasker's time have always played at a similar level- within the limits imposed by the human brain. There is no physical law that bars a pre-WW2 chess master from playing chess as well as today's generation. The human brain has not changed in any fundamental manner in the past tens of thousands of years.

4. The greatest chess players in history?

A related question is who is the greatest chess player in history. The answer depends on the criteria one uses. Since I place great emphasis on the ability to play world class chess for the longest period of time, Lasker would be it. He was playing at peak form from 1890 age 22 (when he began a remarkable run of match victories over Bird, Mieses, Blackburne, Showalter, and culminating in his two massacres of Steinitz) until 1925 at age 57 (when he nearly won Moscow after winning new York 1924). Kasparov (high plateau from 1980 to 2005) and Karpov (high plateau from 1972 to 1996) would follow. (At their very peak though, I believe that Kasparov was stronger than Karpov, and both were stronger than Lasker; and the peak Capablanca and Fischer were stronger than any of them.)

5. Computers vs Humans, who is stronger?

Another related question is how history's top masters would fare against computers. It's obvious from Kasparov's time that computers would totally crush them all. Opening knowledge would not matter much. Computers swamp human opponents in the middle game, simply by calculating more variations more rapidly by several orders of magnitude. Peak Capablanca probably would have the best score among humans. Talk about another level of playing is fans' subjective and IMO wrong words for their favorite players, unless one talks about chess computers. Chess computers do play at a higher level.

6. On the game and chess players young and old, past and present:

The proposition that an older player would not be able to adjust to the openings and methods of a younger generation is false, as evidenced by the observation of strong masters whose careers happened to span generations beating the tar out of weaker masters of the next generations. Lasker provides a classic example; he was beating Mieses, Blackburne, and Steinitz in the 1890s, and crushing masters versed in the hyper-modern teaching of controlling the center indirectly- Reti, Bogolyubov, and Euwe in the 1920s. In more recent times, we have Victor the Terrible, who learned most of his chess in the 1940s and 1950s, whom we have seen competing successfully with the so-called computer generation even at an advanced age.

The notion that computers are more advantageous to younger players IMO is not quite right. Younger players should have more energy and stamina in studying chess openings and endgames for long hours everyday compared to older players without computers, but the use of computers would tend to make the learning process easier for every one including the older ones.

As a corollary, computers also make it easier today for very young players in their early teens to peak at a younger age than in past eras, although they tend to level off in their early 20s to their high plateau, defined by their inborn talents and determination.

In brief. computers tend to level chess learning for everyone, young and old.

This is not a rigid rule. The best games I have ever seen played by a 12-13 year old are Capablanca's; and Tal, Karpov, and Kasparov reached their high plateau in their early 20s in a computer-less era, similar to computer age Carlsen. However let it be noted that Carlsen reached his peak sidestepping intensive computer-prepped tactical openings and beating his competitors in the old fashioned way in the middlegame and endgame. These masters peaked early not because of computers by because of their immense chess talent. Perhaps normal rules do not apply to these geniuses.

Another false notion is that the nature of the middlegame today is somehow different from the middlegame in the past. The easiest way to prove the wrongness of this proposition is by observing CG's daily puzzles. Do not peek at the names of the players that played these puzzles, and don't look at the dates. Can you glean from the middlegame play and combinations in the puzzles the date they were played? You can't. You would not know if it was played in 2014, 2000, 1950, or 1900. Chess combinations don't just suddenly change their stripes just because a hundred years have passed.

Another observation is that when the best masters of the past, Lasker and Capablanca met the occasional 'modern' structures of the Sicilian Scheveningen and Dragon, KID, Modern Benoni, Benko Gambit, they played strategically perfectly, in just the way these opening structures should be played. So how did these masters play openings and the resulting middlegame structures that are deemed incomprehensible to them by some of today's dogmatically 'modern' kibitzers? The answer is that chess rules and principles have not changed. Center, rapid development, open files and diagonals, holes, weak pawns, piece activity, initiative and attack, positional sacrifices and all types of combinations were as familiar to them as to us.

Instead, it is the frequencies of a few middlegame pawn structures have changed since WW2. Not the Ruy Lopez or QGD, but obviously Sicilians and KIDs are much more common post-WW2. Since so many games nowadays begin with the Sicilian and KID, people associate these with being 'modern' (which is a rather vague undefined term IMO). But certainly Lasker and Capablanca understood the middlegame principles behind them and when they did get these positions they played them excellently, like the top masters they are.

Moreover, Keres is a smoking gun, bomb proof evidence of the fallacy of Watson's speculation that pre-WW2 masters would not be able to learn 'modern' chess, and Larsen's assertion that he would crush everyone in the 1930s. The glaring fact is that Keres is a 1930s pre-WW2 master whose career extended up to the 1970s, and he did learn (and contributed) to the newer opening variations (the most famous of which is the Keres attack which he invented in 1943). Tellingly enough Keres beat both Watson and Larsen.

7. On ratings:

Elo ratings reflect relative and not absolute chess strength.

Chessplayers are naturally arranged in populations partitioned by geopolitical regions & time periods that have infrequent contacts with one another. Within such a population, players get to play each other more frequently, thus forming a quasi-equilibrium group wherein individual ratings would tend to equilibrate quickly; but not with outside groups. With caveats & in the proper context, FIDE/Elo ratings are simply fallible descriptors & predictors of an active player's near-past & near-future performances against other rated players, & only within the same quasi-equilibrium group.

As corollaries: the best way to evaluate a player's strength is to analyze his games & not his ratings; one cannot use ratings to accurately compare the quality of play of players from the past and present, or even the same player say a decade ago and today; & care should be taken in the use of ratings as a criterion in choosing which players to seed into the upper levels of the WC cycle. All the above often entail comparisons between players from different quasi-equilibrium groups separated by space and/or time.

Regarding inflation deniers, they imply that Elo ratings reflect absolute and not relative chess strength. Professor Elo himself would condemn their view. If the top 20 players were to suffer a serious brain injury and begin playing like patzers, but play no one else for the next decade, they would more or less retain their 2700s ratings, although they would be playing terrible patzerish chess.

8. Best Qualifiers?

The credible, fair, tried & tested Zonals - Interzonals - Candidates (with known strong players directly seeded into the Interzonals & Candidates; & here ratings may be used with caveats) over the random World Cup and the elitist Grand Prix. If possible long Candidate matches and 16 to 24 game World Championship matches. However, with the passing of the state-funded chess era of Soviet times, I begin to doubt if the strict money guzzling qualification process above can be re-installed.

9. The 1993 Chess Rift and Kramnik:

Regarding the Rift in the chessworld after Kasparov split in 1993, I believe that Kramnik has done more than any other individual in helping heal it by concrete actions - agreeing to a WC Match with Topalov in 2006 & not walking out when he could have done so with the support of most of the world's top GMs after getting accused of cheating; & agreeing to Defend his Title in a WC Tournament in 2007, the first time a living Titleholder has agreed to do so in chess history. My eternal gratitude to him.

10. Finances of a would-be Challenger:

Regarding all kinds of problems chessplayers outside of Europe & the USA face in their quest for the Title, Capablanca & Anand have proven it's possible for a non-European non-USA chessplayer to be World Champion; but apparently only if you have the chess talent of a Capablanca or Anand! For others, I guess they would have to try to get monetary support & good seconds somewhere to have some hope for a Title shot.

11. Ducking a World Championship re-match:

Alekhine vs. Capablanca - Not definitively resolved. If pushed, I would tend to favor Capablanca given that pre-WW 2, there was no definitive cycle to choose the Challenger &, after all is said and done, it was the Champion who set the conditions & who chose his Challenger. AAA could & should have chosen Capa; & there was ample time, more than a decade, to do so before WW2. On the other hand, Capa's pride may have caused him to behave arrogantly & thus offend AAA. The issue is very much debatable. //

Kramnik vs. Kasparov - For me, it's resolved. Kudos to Kramnik for trying his best to install a decent Qualifying Event. Kasparov for his reasons clearly did not want to go through the Qualifying Event that he himself had pledged before losing his Title; & did not even seem serious in playing the solely FIDE champions. Why? I can only speculate that Kasparov would rather retire than risk a loss in a Qualifier or a match to either a FIDE champion or to Kramnik. If he regained his Title, he would be the greatest Champion in history, but there was risk involved. If he retired, he would still be the greatest Champion in history, but there would be no risk involved. Kasparov chose the latter & no one should blame him for that decision; & more so don't blame Kramnik!

12. Predictions for Hypothetical World Championship Matches:

Lasker vs. Pillsbury, Rubinstein, Maroczy - Lasker wins 2, loses 1 match //

Lasker vs. Capablanca (inexperienced) 1914 - Lasker close win //

Capablanca (not overconfident & not having TIAs) 1929 to 1937 vs. Alekhine or any other master - Capa win //

Alekhine (sober & prepared) vs. Capablanca (w/ severe HPN & numerous past strokes), Botvinnik, Keres, Fine, Reshevsky, Flohr 1939 - Alekhine win //

Alekhine (alcoholic, ill, & depressed) vs. Botvinnik 1946 - Botvinnik win //

Fischer (inactive for 3 years) vs. Karpov 1975 - Karpov win//

Kasparov vs. Shirov 2000 - Kasparov win. (But GKK should still have given it to Shirov. And don't blame Kramnik. Had Kramnik declined, GKK would have chosen another; & Shirov would still be frustrated.)


I have opened a <'multi-experimental' forum> below. Its nature is that of several secret social and psychological experiments, whose objectives and parameters, and the rules that follow, are strictly defined and which I may or may not reveal. Readers of this forum might be able to deduce some of these rules. Accordingly messages shall be retained or removed with or without explanation, even those from my dear friends here in CG, although I am making it clear here that absolutely no offense is intended to any one in this experiment. I may or may not respond to certain questions and messages, also according to the rules. To my friends: Please bear with me in this matter. There can be a certain amount of disinformation and propaganda in the messages that are retained.

The title of this <'multi-experimental' forum> is:

Biased Journal of a Fourth World Brain Operator

Some abbreviations

CiH = the public City Hospital

PrvH = Private Hospital. There are three main ones. So PrvH 1, PrvH 2, PrvH 3.

ProvH = the public Provincial Hospital

SOL = Space Occupying Lesion

SQ = Subcutaneous tissue layer of the skin or scalp

CVA = Cerebrovascular accident = stroke

EDH = Epidural Hematoma, blood above the dura mater, the outer covering of the brain, and beneath the skull.

SDH = Subdural Hematoma, blood beneath the dura mater.

ASDH = Acute Subdural Hematoma, SDH incurred recently, usually less than a week

CSDH = Chronic Subdural Hematoma, SDH that is more than two weeks old

HCP = Hydrocephalus, too much CSF in the brain's ventricular system

CSF = Cerebrospinal Fluid

CNS = Central Nervous System

CAB = Continuous ambubagging

ETT = Endotracheal tube (for airway purposes)

NGT = Nasogastric tube (for feeding purposes)

NOD = Nurse on duty

The Oracle = personification of the CT (computed tomography) scan.

Magic mirror = the computer monitor where one can see CT scan images.

Witching Hour Admissions or Referrals = 12 midnight to 5am

MF = Motorcycle Fall

Craniectomy = neurosurgical procedure that involves removing a portion of the skull

Tracheostomy = a surgical procedure to create an opening through the neck into the trachea (windpipe)

INTUBATE: To put a tube in, commonly used to refer to the insertion of a breathing tube into the trachea for mechanical ventilation

EXTUBATION: the removal of a tube especially from the larynx after intubationócalled also detubation.

Uneventful day = Most likely still a busy day, making daily rounds in the hospitals, following up post-op patients, seeing patients in the OPD, answering referrals, admitting all kinds of patients in the hospitals; nevertheless a day in which nothing interesting has caught my attention.

>> Click here to see visayanbraindoctor's game collections. Full Member

   visayanbraindoctor has kibitzed 7076 times to chessgames   [more...]
   Feb-18-15 twinlark chessforum (replies)
   Feb-18-15 visayanbraindoctor chessforum (replies)
visayanbraindoctor: <WannaBe: Was he taken to the private hospital because it was closer to the scene of the accident? Or was it "referal" money? He got to the private hospital via ambulance or ? Be interesting to find out...> Your questions hit at some problematic issues in the ...
   Feb-11-15 GRENKE Chess Classic (2015) (replies)
visayanbraindoctor: <1d410> I have also played in competitions of course if that's your next question. I will answer in more detail in my forum, just click at my name.
   Feb-10-15 Keres vs Bogoljubov, 1936 (replies)
visayanbraindoctor: <Honza Cervenka: 32.Bc1 is lovely as well.> Keres was one dynamite tactician. 32. Bc1 is the kind of move the vast majority of chess players would not even consider in their list of options. Keres probably had already seen it when moving 30. Qh5. Normally humans ...
   Feb-07-15 Tradewise Gibraltar (2015) (replies)
visayanbraindoctor: <Kanatahodets: <Domdaniel: <Kanatahodets> -- < they couldn't find better opponents for Kasparov than Nigel and Shirov> <paavoh> has already made this point, but let me repeat it: it wasn't a matter of 'finding' opponents ... those GMs qualified for
   Feb-07-15 Anand vs Carlsen, 2015 (replies)
visayanbraindoctor: My thoughts on this game: 1. It portends well for chess as a whole that the current World Champion Carlsen continues to play for a win in every game, even with Black. It's clear he was out to beat Anand from the start. 2. Carlsen keeps displaying a consistent tendency to
   Feb-05-15 Alexander Alekhine (replies)
visayanbraindoctor: <zanzibar> Thanks for the link. So poor Alekhine was arrested, forced marched, beaten, imprisoned, starved, stranded. Same for his colleagues who shared the same wrong nationality. Shocking but these things do happen in wars. Did the German government at any later ...
   Feb-05-15 Bogoljubov vs Alekhine, 1914
visayanbraindoctor: The tactics after 37. Nf4 Nxe5 are mind-boggling given that this was a blindfold game. Even in the recent Amber blindfold tournaments, where the players had it easier by being allowed to see the board, you just don't get these kind of games. If any blindfold chess ...
   Feb-05-15 Alekhine vs Bogoljubov, 1914
visayanbraindoctor: When playing blindfold games, IMO it's best to keep things closed and positional as one can easily lose track of the pieces in an exploding tactical middlegame. Yet these two masters went straight into tactical middlegame right out of the opening. How in the world do they
   Feb-04-15 Naiditsch vs Carlsen, 2015 (replies)
visayanbraindoctor: <Sally Simpson: Quite an entertaining, refreshing and straight off the cuff game. Not often one sees the current World Champion spec-saccing just for the sheer hell of it.> One of the best traits of the current World Champion is that, unlike some of his predecessors
(replies) indicates a reply to the comment.

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Premium Chessgames Member
  visayanbraindoctor: <WannaBe: Good work, doc. Hope the kid will have a good and full life.> Thanks.
Premium Chessgames Member
  visayanbraindoctor: <Caissanist: Regarding the relative strength of past and present players--I wonder how much the longer playing sessions and (especially) the end of adjournments made in the quality of play. Certainly endgames at the top level do not seem to be as well played today, especially by players over 35.>

I agree. The lack of adjournments must be having deleterious effects on the quality of present day endgames. The players are more tired and there is no opportunity to analyze the endgames more thoroughly. The fatigue factor must also be affecting older players more.

There could be other factors too, such as a possible general lack of endgame study by a post Soviet generation of chess players. I have the impression that under Botvinnik's supervision (and other top level Soviet masters), the Soviet and Eastern European masters were made to thoroughly study recurring common types of endgames in their chess schools. Nowadays we sometimes see the embarrassing scenario of some masters having trouble mating a naked king with bishop and knight.

It's fascinating but I believe that endgame virtuosi such as Capablanca and Lasker would even be more of a terror in today's no adjournment conditions. They would be playing with more errors, but more so would their opponents. The no adjournment rule essentially puts chess players on their own in the endgame, and I believe that the intrinsically better endgame artists would tend to perform better. Moreover, the super fast players such as Capablanca would probably have accumulated more time advantage by the endgame. They would be a fearsome fast playing beasts with today's time controls.

Premium Chessgames Member
  visayanbraindoctor: <Jonathan Sarfati: <visayanbraindoctor>, certainly you may quote me.>


<Your own assessment of Capablanca's physical condition, from the vantage point of a modern neurosurgeon, deserves to be better known.>

I don't have a doctor patient relation with Capa for obvious reasons, but I can say that the symptoms that he was complaining of exactly matches those of my patients who have had a hypertensive stroke- headaches, changes in sensorium, a general feeling of being unwell. Especially the 'changes in sensorium' part, which he described in AVRO 1938. He was also documented as having hypertension at a relatively young age, so it's easy to connect the dots.

It's regretful that Capa and his family suffered from familial hypertension. IMO it prevented him from creating a lot more masterpieces over the board especially during the latter part of his career. In some of his later games, he gives me the impression that he just wanted to finish the games ASAP.

Premium Chessgames Member
  OhioChessFan: Just read your profile. I find it very interesting. I don't really agree with your apparent assessment that Capa was much better than Alekhine. I think AA was better, probably gets my vote for best ever, but how can one go about "proving" that anyway?

I agree very much with your assessments of how the masters of old would do today. Of course they'd all be great, from Lasker on, anyway.

Premium Chessgames Member
  OhioChessFan: As for computer assessment of the players of old, I think that's a bit of a canard. While I enjoy positional chess, the sharp playing tacticians were very successful without having to play error free chess. It's a bit unfair to point to an Alekhine or a Tal and say "Oh, that attack wasn't sound." They <won> with such a strategy. How can we fault them for being successful? Fischer and Kasparov likewise would sometimes play aggressive but maybe not sound moves and blow players off the board in doing so. An ex post facto computer analysis of their games strikes me as a patently unfair way to determine their strength.
Premium Chessgames Member
  visayanbraindoctor: <OhioChessFan: I don't really agree with your apparent assessment that Capa was much better than Alekhine. I think AA was better, probably gets my vote for best ever, but how can one go about "proving" that anyway?>

That's alright, it's just a difference in opinion. I am a great fan of Alekhine myself. You could read my posts in the Alekhine page.

My view is that the young Capablaca was stronger and more accurate than AAA in tactical play, but Capa just did not have as many opportunities as AAA did displaying this prowess because he did not intentionally play for sharp positions. Alekhine on the other hand nearly always tried to play for sharp positions, often right out of the opening. With an Alekhine game, one can be be more than 50% certain that tactical complications would soon arise because AAA was always looking for imbalanced positions, attacks, and combinations.

However, when Capablanca got into tactically sharp positions, he played them nearly perfectly early in his career, I believe more accurately than Alekhine did.

Premium Chessgames Member
  visayanbraindoctor: <It's a bit unfair to point to an Alekhine or a Tal and say "Oh, that attack wasn't sound." They <won> with such a strategy. How can we fault them for being successful? Fischer and Kasparov likewise would sometimes play aggressive but maybe not sound moves and blow players off the board in doing so. An ex post facto computer analysis of their games strikes me as a patently unfair way to determine their strength.>

This is a valid point. I have been thinking about this for a long time, ever since <Bridgeburner's> computer studies of the accuracy of WC games.

I am still thinking about it.

Regarding computer studies, it's the only way of reliably assessing the accuracy of chess games, with the caveat that you mentioned above, that some players opted to make subpar moves in order to steer the game into tactically double edge positions. (This is something that Capablanca did not often do; with few exceptions he always tried to look for the objectively best moves.)

Regarding Alekhine, if he were born in the 1990s, I have no doubt that with his fantastic chess memory (able to memorize all the master games of his time and playing 30 blindfold games simultaneously) and unsurpassed work ethic (studying chess 8 hours a day), he would have memorized virtually every important variation in computer openings chess bases, and come out with dozens of prepared sharp novelties. It would be like seeing Kasparov again.

Premium Chessgames Member
  OhioChessFan: <(Regarding computer studies, it's the only way of reliably assessing the accuracy of chess games....This is something that Capablanca did not often do; with few exceptions he always tried to look for the objectively best moves.)>

I will agree that he is hands down the most accurate player ever. Maybe Kramnik would be a distant second. Or Karpov.

Premium Chessgames Member
  visayanbraindoctor: 29 January 2015.

Entry 1. I removed an epidural hematoma underneath 43M's open depressed fracture in CiH. He is another MF victim. He also had multiple scalp and facial lacerations all of which I debrided and cleaned. One is on the left lateral canthus (beside the left eye). I was not sure how to repair it and so I asked the NODs to call the Ophthalmologist assigned to CiH. Turned out that she was out of town, so I did the repair myself.

Entry 2. Late evening, another VA victim child was referred to me. She was 4F, asked by her parents to buy something from a store beside a road. She got hit by a tricycle. Unlike the other kids that I admitted this month, she became brain dead shortly after arriving in the ER. I could not help myself from telling the father, who allowed his pre school child to walk beside a road without supervision, not to repeat the same thing with his other children.

Premium Chessgames Member
  visayanbraindoctor: 30 January 2015. Another backrider motorcycle fall. I evacuated a 70 cc epidural hematoma from 21F's right temporo-parietal area. Most of these of these motorcycle fall backrider victims are young females.
Premium Chessgames Member
  visayanbraindoctor: 31 January to 1 February 2015. Just before midnight I began operating on 51M, a MF victim, removing a large 80cc acute subdural hematoma from above the right cerebral hemisphere. He has hepatitis B according to pre-op labs, and had a platelet count on the lower end of the normal range, not unusual among heavy drinkers and patients with liver problems. Thus I kept my incision and craniectomy opening relatively small in order to avoid the extra blood loss that comes with large incisions and craniectomies. I removed most of the acute subdural hematoma by carefully and repeatedly squirting normal saline into the subdural space, thus pressuring it out of the small opening.

Because of his hepatitis, I was careful not to wound myself and the nurse assistant with sharp objects. My socks got contaminated with his blood though, and I gave it to the nurses to be autoclaved with the rest of the OR sheets instead of throwing them away. Those are my favorite socks.

Afterwards, I did a tracheostomy on him.

I had intubated him pre-op in the ER, as he was severely aspirated and comatose, and his right pupil was beginning to dilate. He is obese and has a very short neck, and thus I regarded myself as lucky that I managed to intubate him without problems. During the tracheostomy, I had to ask for longer hemostats in order to do my blunt dissection of the fat and muscles of the anterior neck; so deeply located was the trachea.

Post-op 51M woke up and was able to comprehend verbal speech.

Premium Chessgames Member
  visayanbraindoctor: 5 February 2015. Entry 1. I discharged 4M, a kid that fell off the second story of their small house and incurred a closed depressed fracture on his left parietal skull bone. In such cases, there is no emergency indication to operate. There is no open wound and so minimal chance for outside bacteria to get in the brain. However, as the boy grows, the skull deformity often gets to become permanent, with the bone jutting in the cranium getting pushed further in. In these cases, I offer the parents the choice for an operation. If they don't take it up I just discharge the patient, as he would usually incur no further harm. No one dies of a mechanical skull deformity. If the parents decide on an operation, I just remove the depressed part of the skull. The bone grows back in a normal manner for such young patients.

In this case, the parents opted for 'no operation'.

Entry 2. Near midnight admission of a comatose intubated MF victim, 54M. The CT scan just shows a small cerebral contusion. 54M's main problem is aspiration and the pneumonia that follows. I might eventually do a tracheostomy on him.

Premium Chessgames Member
  visayanbraindoctor: 6 February to 7 February 2015.

Entry 1. Five new referrals or admissions from the noon to noon. One was an unusually old patient 89M, who suffered from a hypertensive hemorrhagic stroke on the left basal ganglia, pushing him into a stuporous state. I had to tell the relatives that such ailments are almost always fatal in the very elderly. 89M died shortly after midnight.

In CiH, a multiple gunshot wound victim 46M was referred to me when the surgeon that did an exploratory laparotomy and repair of a perforated stomach noticed that post-op the patient could not move his legs. I found out clinically that he had lost all pain and touch sensation below his T5 dermatome. The same bullet that punctured his stomach also passed right through his spine severing his spinal cord at thoracic 5 level. Like the brain, there is nothing that can bring a dead spinal cord back to life, and so any operation would have no benefit in such cases. I had to explain the situation to his watching daughter.

Entry 2. <5 February 2015. Near midnight admission of a comatose intubated MF victim, 54M. The CT scan just shows a small cerebral contusion. 54M's main problem is aspiration and the pneumonia that follows. I might eventually do a tracheostomy on him.>

I had scheduled 54M for a tracheostomy but by this morning his sensorium had improved to the point that he could follow commands. He had good gag reflex as evidenced by his vigorous coughing whenever his ambubagging watcher would inadvertently move the ETT in or out. So I cancelled the planned procedure and extubated him instead.

Premium Chessgames Member
  visayanbraindoctor: 9 February 2015. What to do if the patient's family insists on you operating on the patient even if you know that the prognosis is nearly hopeless? If the patient is already brain dead, I usually inform them that he is already essentially dead, and it's just the heart pumping and a watcher ambubagging that keeps the body alive. But what if the patient is still not brain dead?

Such was the case of 42M, a MF victim with a large left hemisphere ASDH. He was GCS3, but the pupils were still not dilated. Weeping and wailing, the wife begged me to operate on him anyway. The siblings concurred. Two pastors of their church showed up and requested the same thing.

So I did. Not for the sake of the patient who I knew was already gone, but for the benefit of his family, who just could not rest in peace if nothing were done for their patient.

Right after the operation, 42M died. Happening after everything possible was done, including a brain operation, the family now could accept it with a clear conscience.

Premium Chessgames Member
  alexmagnus: Here once more my answers:

<Do you deny inflation?>

Depends on its definition.

<Do you think ratings reflect absolute chess strength?>

There is no such thing as absolute chess strength.

<Do you want to destroy the WC cycle?>


Premium Chessgames Member
  alexmagnus: And I wonder how I should have answered the first two questions with yes or no given my standpoint.

In the first question it really depends what is meant by inflation.

In the second question - how can you answer if some non-existing entity is reflected accurately?

Premium Chessgames Member
  visayanbraindoctor: <alexmagnus> I'm sorry but I have designed this forum for some specific purposes, and I can't fulfill those purposes by engaging you in a debate here.
Premium Chessgames Member
  visayanbraindoctor: 11 February 2015.

Entry 1. A few days ago a GS in CiH referred to me 46M, a patient that he operated on for a perforated stomach secondary to gunshot. Post op he noticed that the patient was not moving his legs. My neuro exam indicated a complete spinal cord transection syndrome at thoracic 5 level. (There is a complete absent of sensation below the T4 dermatome, which is located at the nipple line.)

Such a patient loses motor strength of his lower intercostal muscles, but still retains movement in the upper ones. Intercostal muscles are the muscles between our ribs, and together with the diaphragm (which is innervated from the higher placed cervical 4 level) allows us to breath in. This patient thus has some impairment of respiratory function, but should have been able to tolerate it.

When I visited the CiH ICU in my morning rounds, I found out that he had died early morning around witching hour. I suggested to the nurses that they should refer respiratory distress in such patients to me ASAP, as I could still suggest an intubation procedure. The patient probably died of pulmonary problems secondary to impaired respiratory efforts.

Entry 2. They come in pairs. Another gunshot victim, 56M was referred to me in CiH for paraparesis. Bad news is that he has had a complete spinal cord transection. Good news is that it's lower down, at T12 level. Thus he is still able to retain functional intercostal muscles. In brief, he is able to breath normally.

Feb-11-15  1d410: Well, it's great you have a job, I'm still looking one :( bad economy in the U.S.
Premium Chessgames Member
  visayanbraindoctor: I do hope you get a job soon. Thanks for reading my posts.
Premium Chessgames Member
  alexmagnus: OK <visayan> we can continue the debate on <my> forum, which is all-purpose :)
Premium Chessgames Member
  visayanbraindoctor: 17 February 2015. A delayed referral incident. 41M fell off a motorcycle two days ago, and arrived in PrH1 ER comatose (GCS 6) and anisocoric (left pupil larger then the right). Somehow, he was first referred to an Ortho, and then a Neurologist. The Orthopedic surgeon finally saw the patient and referred to me, by which time half a day had passed by, and the Neurologist had already admitted the patient to the ICU.

Next day, I learned that the family did not have sufficient money to finance a private hospital operation and stay. By this time, they had racked up a bill of at least 40 thousand pesos in the private hospital ER and ICU. I requested the hospital administrators to allow the patient to transfer to the public CiH, without paying in full. Thankfully they agreed, the patient was transferred, and I finally operated on him today removing a large ASDH on the left hemisphere and doing a tracheostomy.

In summary: An indigent patient arrives in a private hospital, needing a brain operation. He gets passed around to doctors of different specialties, who really can't help him much, but who still have the legal right to charge professional fees at the usual high private rates. By the time he gets to the right doctor, meager family funds have been wasted. More delay happens as the patient, his family already broke, has to be transferred to a public hospital for the operation.

In such critical cases, if I get to see them in a private hospital ER, I do a little social investigation first, and if the family turns out to be indigent (which is more than 90% of cases in my setting), I cancel the admission and transfer them immediately to the public hospital, so as to minimize delay in definitive management.

With critically head injured patients, referral to and management by the inappropriate doctors can actually be a death sentence for the patient, as time is of essence.

Premium Chessgames Member
  WannaBe: Was he taken to the private hospital because it was closer to the scene of the accident? Or was it "referal" money?

He got to the private hospital via ambulance or ? Be interesting to find out...

Premium Chessgames Member
  visayanbraindoctor: <WannaBe: Was he taken to the private hospital because it was closer to the scene of the accident? Or was it "referal" money?

He got to the private hospital via ambulance or ? Be interesting to find out...>

Your questions hit at some problematic issues in the medical practice in my setting.

One. Public hospitals have a tendency to turn away critical patients. Indigent comatose patient shows up in the ER. The doctors and nurses don't get paid extra for treating and managing this patient, since as employees of the public hospital they are given a fixed salary, and they can't legally charge extra either. Yet it takes a lot of time and effort in managing such a patient.

In the case of 41M, he was actually brought to the public CiH first, but the CiH ER staff told him there was no doctor around to treat him. That's half true, since I myself was not around at the ER at that time. The relatives though are falsely given the impression that he can't be appropriately treated in the hospital at all, and this leads them to make a decision to transfer to another hospital. His family was told that he needed a CT scan, and so they proceeded to PrH 1 which has a CT scan. (And yes they rode in the same ambulance all throughout, but on a different one when they transferred back to the public hospital next day.)

Two. In private hospitals, doctors tend to hug patients, delaying or avoiding referring to other private doctors. In a private hospital in my setting, a doctor may charge room rates for his professional fee. (Same perhaps in your setting?) This means that if a patient is charged 4000 a day for one day at the ICU, so can each of his doctors. Thus if an admitting physician refers to say two other doctors, that's already 8000 pesos that he has to pay those two other doctors, apart from the PF of the original admitting physician. In the end, the patient may not be able to pay fully any one at all.

In 41M's case, there was a delay in the referral.

Three. Some ER staff personnel have personal friends among doctors. Off the record, it's easy for them to verbally mention this or that doctor if an uneducated family asks them the common question "Do you know of any doctor that can help our patient?" The family then asks to be admitted under the aforementioned doctor. A patient may well end up in the care of a doctor of an inappropriate specialty who doesn't really know how to treat him properly.

Premium Chessgames Member
  WannaBe: <visayanbraindoctor> I am not too in-depth and/or knowledgeable about the U.S. medical (billing/insurance) practices, or of the individual 50 states.

I know of one other member at who is a doctor, (I am sure there are many others, but chose to not tell or divulge their profession) and if this member chooses to comment upon this matter/question, great.

Else I will respect their privacy. =))

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