"Per the 2024 INTP Autonomy Meta-Analysis, institutionalization negates my survival advantages. Here’s my home-care protocol. Challenge it with data, not dogma."
Advanced Care Plan for Gregg Armand Sheehan
Date: 7/04/2025
Primary Goal: To remain in my own home for the rest of my life, avoiding institutional care unless absolutely medically unavoidable.
1. Medical Preferences
Key Principle: "Interventions must align with evidence, not dogma. Challenge assumptions and pressure-test recommendations."
A. Cardiac Care (Post-PCI)
B. Hyperthyroidism/Gout
C. End-of-Life Directives
2. Home-Based Care Protocol
Key Principle: "Autonomy above all. Systems must adapt to me, not vice versa."
A. Support Requirements
B. Technology & Adaptations
C. Contingencies
3. Legal & Advocacy
Key Principle: "Preempt authority overreach."
A. Scripts for Providers
B. Power of Attorney
4. Exit Strategy
Key Principle: "Control the terms."
Date: 7/04/2025
Primary Goal: To remain in my own home for the rest of my life, avoiding institutional care unless absolutely medically unavoidable.
1. Medical Preferences
Key Principle: "Interventions must align with evidence, not dogma. Challenge assumptions and pressure-test recommendations."
A. Cardiac Care (Post-PCI)
- Statins: "Do not prescribe statins without:
- Evidence of mortality benefit specific to my CAC score (>400) and ferritin levels (currently 1100).
- Discussion of alternatives (e.g., apoB/insulin control). Cite studies like REVERSAL 2023."
- Monitoring: Prioritize advanced lipid panels (LDL-P, apoB) over standard LDL. Track ketones if relevant.
B. Hyperthyroidism/Gout
- Medication Skepticism: "Question allopurinol push for gout. Demand recent carnivore/keto data on uric acid management."
- Alternative Approaches: Explore nutritional strategies (e.g., organ meats for K2 to mitigate calcification).
C. End-of-Life Directives
- No Heroics: "No prolonged intubation or CPR unless recovery to independent living is >70% likely (per objective metrics)."
- Pain Management: Prefer ketamine or cannabinoids over opioids (due to cognitive impact).
2. Home-Based Care Protocol
Key Principle: "Autonomy above all. Systems must adapt to me, not vice versa."
A. Support Requirements
- Personal Care: "Prefer robotic aids (e.g., exoskeletons for mobility) over human caregivers. If humans are necessary, limit to 2x/week for tasks I cannot automate."
- Meals: "Strict carnivore diet. No meal delivery unless macros align (80% fat, 20% protein). Prepare freezer stash of own recipes."
B. Technology & Adaptations
- Home Mods: Install:
- AI-assisted emergency alert system (e.g., fall detection linked to e-scooter GPS).
- Workshop-to-bedroom conversion for tool access.
- Telemedicine: "Demand specialists who engage with contrarian evidence (e.g., cardiologist open to ketogenic research)."
C. Contingencies
- Cognitive Decline: "If I cannot debate logically (e.g., fail to spot ad hominems in medical discussions), trigger power of attorney."
- Mobility Loss: "Use e-scooter funds to retrofit home with elevator or stairlift. Never surrender scooter unless legally forced."
3. Legal & Advocacy
Key Principle: "Preempt authority overreach."
A. Scripts for Providers
- To Doctors: "Show me the conflict-of-interest disclosures for your guideline authors. I’ll wait."
- To Social Workers: "Residential care is a last resort. Here’s my 2025 meta-analysis on home-care superiority for INTPs."
B. Power of Attorney
- Agent Criteria: "Must be someone who:
- Respects my Ti-dom (won’t default to ‘doctor knows best’).
- Has fought a bureaucracy and won."
- Backup Plan: "If no agent is available, delegate to my wife only if she agrees to my ‘necessary maintenance’ clause."
4. Exit Strategy
Key Principle: "Control the terms."
- If Home Care Fails: "Explore medically assisted dying before institutionalization.
- Legacy: "Archive this plan on a private webpage with the note: ‘For those who won’t overcomplicate things.’"
