Note: don't take medical advice from a half-baked blog.#
Drug of the day: fluvoxamine, which is sort like an ivermectin that may actually work for preventing severe Covid-19. It is cheap as dirt and already prescribed like candy, so both financial and physical toxicities are minimal. Bonus points for none of the (culture) warring sides co-opting it, yet. #
Medicine is both a science and an art, but most doctors are neither scientists nor artists. Instead, we are bureaucrats, negotiators, communicators, guides, to use the full spectrum of sentiments. If you need a reminder of why most medical doctors are empathically not scientists, listen to a recent episode of the Healthcare Unfilteredpodcast about real-world evidence versus clinical trials, where there is much confusion about biases #
Tool of the day: DEVONthink, which has, with my new job, shifted slowly from a note-taking and thought-organizing tool to a lab notebook. But that is the beauty of versatile tools, once you get to know them. #
Tool of the day: Daytona. A perfect companion to Drummer that, unlike most tools, does not lock you in to any particular app but rather to OPML, which is not much of a lockin, being completely open.#
Tool of the day: scite_, which is the next best thing to an army of medical students for doing literature reviews, especially if you are new to a field. Helpful with my new job, which goes way beyond hematology and oncology. They do charge for their service, though there are student discounts.#
I am, by the way, not a fan of Atlanta for ASH. Good food, but not good enough to offset the bad December weather. #
2021 Annual Meeting of the American Society for Hematology is starting in Atlanta, and my favorite thing to do on Twitter right now is reading the #ASHaiku tweets. Wrote a couple too.#
Every other week November-March a child comes home from school with a nose full of snot and every other week I wonder: when will we have home tests for every common respiratory virus? It's 2021, where is my at-home BioFire?#
George Saunders has a newsletter, and it is fantastic. The name is Story Club, the topic is writing (and reading!) short stories, the opportunities to learn about writing in general are many. #
Two short movies that you should see, courtesy of Craig Mod and his (free!) newsletter Roden: the first, Bud, will make you cry, and the second, David, will make you cringe. They are both quite good.#
The Dawn of Everything is an extraordinary book that I will reread at least once in the years to come. Who knew prehistory could be so much fun? #
Four Thousand Weeks was not nearly as enjoyable. It had excellent reviews, mostly written by middle-aged men — a group I'm settling into — but there wasn't much there there. The badness of Productivity for its own sake and the benefits of rests are well-known to my own and younger generations, but do those born before the 1980s not know this already? #
Influence, Revised Edition came at an opportune moment: my wife and I were being invited to one of those time-share pitches. Had I not read the book I would've found the general oddness of the whole situation mystifying; knowing the techniques they were using made slightly more sense, but it was still awkward.#
Tools for Thought is a book before its time — it would've fit right into the modern complex systems cosmology cannon, but languishes in obscurity instead. Here's a small Twitter thread about it.#
Scott Alexander had some things to say about "Balkan people", mostly about their height. It started with a photo of the Montenegrin president Milo Đukanović towering over the 5'9" Boris Johnson at the COP26 meeting. Both Đukanović and his Serbian counterpart Aleksandar Vučić are 6'6", which is not the only thing they have in common.#
Setting aside the ridiculousness of the paper he then goes on to describe, this paragraph really rubbed me the wrong way: #
"Some sources note that they manage to beat the Dutch despite the latter country’s much higher human development index. The Dutch are probably tall through a combination of nature and nurture; Balkan people are tall through nature alone."#
The paper he discusses is about men from Herzegovina. Alexander extrapolates it to everyone on the Balkans, only of course, "The Balkans" likely refers to Western Balkans alone, and only to the Slavic/ex-YU populations, Greeks, Albanians, and Romanians not being that known for their great height. #
Alexander is a prolific writer who can turn a good phrase or five in what seems like minutes. But for a high-profile member of the Rationalist community his takes are less precise than I would expect, particularly about things close to me by the nature of my job or my origins. I will continue following his writing with even more grains of salt than usual, lest I fall pray to Gell-Mann Amnesia.#
This is the first time traveling east (back home, in this particular case) did not cause major jet lag. Significant backlog of work tasks did cause no updates, though. #
You may have heard that LA traffic was bad. That is entirely true, and it is probably worse than you an imagine. A trip that takes one hour at noon stretches out to two and a half by 3:30pm, then back to a reasonable 35-40 minutes by 10pm. It's the unpredictability that kills me.#
It is unfathomable that a vast area with climate perfect for walking year-round is now covered by perfectly unwalkable slabs of concrete. Someone should go to prison for this crime against urban architecture. #
On the other hand, the food in LA is both better and cheaper than in DC. But not so much better to offset traffic.#
LAX is a good example of America's crumbling infrastructure: bad signage, overcrowded even with the pandemic, centrally located inside the city yet still difficult to get to because of the constant bumper to bumper traffic. It's not only past its prime, it's past its expiration date.#
Cincinnati airport, on the other hand, was clean, spacious, with great service and interesting museum pieces spread throughout the terminal. It may have helped that I was there at 5am, but still, pleasantly surprised.#
Apropos: 5am layovers are a bad idea. Avoid at all cost.#
A tip for those over 35: do not discuss cryptocurrencies with the younger crowd, lest you want to expose yourself to quite a few incoherent thoughts about the gold standard, fiat currency, the greatness of Elon Musk, hoDLing, and the dictionary definition of gambling.#
A funny thing happened on my way to LA: I forgot to pack my iPad, and I didn't even notice it was gone. The M1 MacBook Air survived the 6+ hours of almost constant in-flight use with 66% charge. It is also noticeably lighter (or lighter-feeling) than the 12" iPad Pro with a keyboard case.#
There is only one use case for the iPad now, but it's a big one: taking notes in GoodNotes with a PDF open side-by-side. Even if MacBooks got touch screens — which will never happen — I doubt that Surface-like folding over to take notes is in their future.#
So the one thing Steve Jobs was against being on a tablet ("If you see a stylus … they blew it") is now its main differentiating factor. How times change. #
This morning I wrote a mini Twitter thread about "Tools for Thought", an out-of-print book about complex systems, the scientific method, and the limits of science from the perspective of a curmudgeonly British biologist at the end of his career (author C.H. Waddington died in 1975 shortly after finishing the book). It was a decent way to summarize what I've read and show some highlights, but mostly it reminded me how much I dislike Twitter threads. To each their own.#
Today has so far been — completely unintentionally — a No Social Media Day, but it turned out so well that I'll switch off every Friday. I get enough of Social at home and at work, and the Media I can do without.#
I will pause playing around with custom domains, https, etc, until Drummer completes its hookup with GitHub. Both are excellent services and I expect the combination to be more than just additive. #
"A media form which does this better than blogs is academic journals. Although it is possible to subscribe to a journal, it’s very uncommon to expect to read a journal entire. And the reason is that the form is designed so that each article finds its own audience. For instance: the title and abstract are designed to make it super-easy to not read a paper. They say “Oh, unless you have these interests and this background, you should ignore this”. They��re sometimes described as “marketing” for papers, but really they’re better thought of as anti-marketing. In particular: they set the right expectations, and help drive away the wrong kind of reader. That’s invaluable not just for the reader, but perhaps even more for the author." #
This is from an essay by Michael Nielsen on personal websites. Do read the whole thing, but the paragraph above stands well on its own. Abstracts as anti-marketing is a good concept that more authors should follow when writing their own articles.#
Alas, in much of life science abstracts are more of a tool for passing editorial pre-review. My favorite example is how deep you need to go to figure out whether the proclamation of the title refers to cell lines, animal models, ex vivo human cells, or humans themselves (or a combination thereof). More often than not the abstract doesn't reveal that one important nugget.#
A good Note to Self though: think of the next abstract you write as anti-marketing.#
I have been following Ben Thompson's thoughts on the Metaverse(s) on Stratechery for a while now (you should subscribe), and through that I have realized that all the big companies behind electronic medical records — EPIC and Cerner for sure, but others as well — are all trying to build a healthcare metaverse out of their products.#
EPIC is the most egregious example: it wants to capture not only scheduling, billing, ordering, resulting, and documentation, but also communication all healthcare-related communication — between patients and providers, between different providers in the same institution, and between institutions. How is this different from what Satya Nadella showed is now possible in Microsoft Teams? (the whole presentation is here but Thompson linked to the relevant clip in his article on Microsoft and the Metaverse).#
The future has first sneaked up on us and then engulfed us. With tele-visits being reimbursable c/o Covid-19, many physicians spend close to 50% of their patient interactions online. Even before the pandemic, physically interacting with patients and other providers was a minority of time spent on work for the non-procedural specialists. Would be nice to have data on how much time a rheumatologist spends physically interacting with the world nowadays, compared to time spent in the Healthcare Metaverse.#
(I pulled the 50% out of thin air, in case you are wondering — data I have no time to look up now, but it should be in the right ballpark)#
Sure, some if it is shifting goalposts for what the metaverse means — our VR future is not there yet — but our EMR overlords sure are looking more and more like Microsoft's definition of the metaverse, at least.#
There was a slim chance that all of the components (billing, scheduling, etc…) could have been modular and interacted via standardized APIs. But it didn't work for the internet as a whole and it didn't work for electronic medical records.#
With some luck, we'll get to reinvent the wheel and rebuild an open Metaverse once the closed ones start showing even more of their warts. It's RSS all the way down.#
Note: don't take medical advice from a half-baked blog.#
Drug of the day: fluvoxamine, which is sort like an ivermectin that may actually work for preventing severe Covid-19. It is cheap as dirt and already prescribed like candy, so both financial and physical toxicities are minimal. Bonus points for none of the (culture) warring sides co-opting it, yet. #
Medicine is both a science and an art, but most doctors are neither scientists nor artists. Instead, we are bureaucrats, negotiators, communicators, guides, to use the full spectrum of sentiments. If you need a reminder of why most medical doctors are empathically not scientists, listen to a recent episode of the Healthcare Unfilteredpodcast about real-world evidence versus clinical trials, where there is much confusion about biases #
Tool of the day: DEVONthink, which has, with my new job, shifted slowly from a note-taking and thought-organizing tool to a lab notebook. But that is the beauty of versatile tools, once you get to know them. #
Tool of the day: Daytona. A perfect companion to Drummer that, unlike most tools, does not lock you in to any particular app but rather to OPML, which is not much of a lockin, being completely open.#
Tool of the day: scite_, which is the next best thing to an army of medical students for doing literature reviews, especially if you are new to a field. Helpful with my new job, which goes way beyond hematology and oncology. They do charge for their service, though there are student discounts.#
I am, by the way, not a fan of Atlanta for ASH. Good food, but not good enough to offset the bad December weather. #
2021 Annual Meeting of the American Society for Hematology is starting in Atlanta, and my favorite thing to do on Twitter right now is reading the #ASHaiku tweets. Wrote a couple too.#
Every other week November-March a child comes home from school with a nose full of snot and every other week I wonder: when will we have home tests for every common respiratory virus? It's 2021, where is my at-home BioFire?#
George Saunders has a newsletter, and it is fantastic. The name is Story Club, the topic is writing (and reading!) short stories, the opportunities to learn about writing in general are many. #
Two short movies that you should see, courtesy of Craig Mod and his (free!) newsletter Roden: the first, Bud, will make you cry, and the second, David, will make you cringe. They are both quite good.#
The Dawn of Everything is an extraordinary book that I will reread at least once in the years to come. Who knew prehistory could be so much fun? #
Four Thousand Weeks was not nearly as enjoyable. It had excellent reviews, mostly written by middle-aged men — a group I'm settling into — but there wasn't much there there. The badness of Productivity for its own sake and the benefits of rests are well-known to my own and younger generations, but do those born before the 1980s not know this already? #
Influence, Revised Edition came at an opportune moment: my wife and I were being invited to one of those time-share pitches. Had I not read the book I would've found the general oddness of the whole situation mystifying; knowing the techniques they were using made slightly more sense, but it was still awkward.#
Tools for Thought is a book before its time — it would've fit right into the modern complex systems cosmology cannon, but languishes in obscurity instead. Here's a small Twitter thread about it.#
Scott Alexander had some things to say about "Balkan people", mostly about their height. It started with a photo of the Montenegrin president Milo Đukanović towering over the 5'9" Boris Johnson at the COP26 meeting. Both Đukanović and his Serbian counterpart Aleksandar Vučić are 6'6", which is not the only thing they have in common.#
Setting aside the ridiculousness of the paper he then goes on to describe, this paragraph really rubbed me the wrong way: #
"Some sources note that they manage to beat the Dutch despite the latter country’s much higher human development index. The Dutch are probably tall through a combination of nature and nurture; Balkan people are tall through nature alone."#
The paper he discusses is about men from Herzegovina. Alexander extrapolates it to everyone on the Balkans, only of course, "The Balkans" likely refers to Western Balkans alone, and only to the Slavic/ex-YU populations, Greeks, Albanians, and Romanians not being that known for their great height. #
Alexander is a prolific writer who can turn a good phrase or five in what seems like minutes. But for a high-profile member of the Rationalist community his takes are less precise than I would expect, particularly about things close to me by the nature of my job or my origins. I will continue following his writing with even more grains of salt than usual, lest I fall pray to Gell-Mann Amnesia.#
This is the first time traveling east (back home, in this particular case) did not cause major jet lag. Significant backlog of work tasks did cause no updates, though. #
You may have heard that LA traffic was bad. That is entirely true, and it is probably worse than you an imagine. A trip that takes one hour at noon stretches out to two and a half by 3:30pm, then back to a reasonable 35-40 minutes by 10pm. It's the unpredictability that kills me.#
It is unfathomable that a vast area with climate perfect for walking year-round is now covered by perfectly unwalkable slabs of concrete. Someone should go to prison for this crime against urban architecture. #
On the other hand, the food in LA is both better and cheaper than in DC. But not so much better to offset traffic.#
LAX is a good example of America's crumbling infrastructure: bad signage, overcrowded even with the pandemic, centrally located inside the city yet still difficult to get to because of the constant bumper to bumper traffic. It's not only past its prime, it's past its expiration date.#
Cincinnati airport, on the other hand, was clean, spacious, with great service and interesting museum pieces spread throughout the terminal. It may have helped that I was there at 5am, but still, pleasantly surprised.#
Apropos: 5am layovers are a bad idea. Avoid at all cost.#
A tip for those over 35: do not discuss cryptocurrencies with the younger crowd, lest you want to expose yourself to quite a few incoherent thoughts about the gold standard, fiat currency, the greatness of Elon Musk, hoDLing, and the dictionary definition of gambling.#
A funny thing happened on my way to LA: I forgot to pack my iPad, and I didn't even notice it was gone. The M1 MacBook Air survived the 6+ hours of almost constant in-flight use with 66% charge. It is also noticeably lighter (or lighter-feeling) than the 12" iPad Pro with a keyboard case.#
There is only one use case for the iPad now, but it's a big one: taking notes in GoodNotes with a PDF open side-by-side. Even if MacBooks got touch screens — which will never happen — I doubt that Surface-like folding over to take notes is in their future.#
So the one thing Steve Jobs was against being on a tablet ("If you see a stylus … they blew it") is now its main differentiating factor. How times change. #
This morning I wrote a mini Twitter thread about "Tools for Thought", an out-of-print book about complex systems, the scientific method, and the limits of science from the perspective of a curmudgeonly British biologist at the end of his career (author C.H. Waddington died in 1975 shortly after finishing the book). It was a decent way to summarize what I've read and show some highlights, but mostly it reminded me how much I dislike Twitter threads. To each their own.#
Today has so far been — completely unintentionally — a No Social Media Day, but it turned out so well that I'll switch off every Friday. I get enough of Social at home and at work, and the Media I can do without.#
I will pause playing around with custom domains, https, etc, until Drummer completes its hookup with GitHub. Both are excellent services and I expect the combination to be more than just additive. #
"A media form which does this better than blogs is academic journals. Although it is possible to subscribe to a journal, it’s very uncommon to expect to read a journal entire. And the reason is that the form is designed so that each article finds its own audience. For instance: the title and abstract are designed to make it super-easy to not read a paper. They say “Oh, unless you have these interests and this background, you should ignore this”. They��re sometimes described as “marketing” for papers, but really they’re better thought of as anti-marketing. In particular: they set the right expectations, and help drive away the wrong kind of reader. That’s invaluable not just for the reader, but perhaps even more for the author." #
This is from an essay by Michael Nielsen on personal websites. Do read the whole thing, but the paragraph above stands well on its own. Abstracts as anti-marketing is a good concept that more authors should follow when writing their own articles.#
Alas, in much of life science abstracts are more of a tool for passing editorial pre-review. My favorite example is how deep you need to go to figure out whether the proclamation of the title refers to cell lines, animal models, ex vivo human cells, or humans themselves (or a combination thereof). More often than not the abstract doesn't reveal that one important nugget.#
A good Note to Self though: think of the next abstract you write as anti-marketing.#
I have been following Ben Thompson's thoughts on the Metaverse(s) on Stratechery for a while now (you should subscribe), and through that I have realized that all the big companies behind electronic medical records — EPIC and Cerner for sure, but others as well — are all trying to build a healthcare metaverse out of their products.#
EPIC is the most egregious example: it wants to capture not only scheduling, billing, ordering, resulting, and documentation, but also communication all healthcare-related communication — between patients and providers, between different providers in the same institution, and between institutions. How is this different from what Satya Nadella showed is now possible in Microsoft Teams? (the whole presentation is here but Thompson linked to the relevant clip in his article on Microsoft and the Metaverse).#
The future has first sneaked up on us and then engulfed us. With tele-visits being reimbursable c/o Covid-19, many physicians spend close to 50% of their patient interactions online. Even before the pandemic, physically interacting with patients and other providers was a minority of time spent on work for the non-procedural specialists. Would be nice to have data on how much time a rheumatologist spends physically interacting with the world nowadays, compared to time spent in the Healthcare Metaverse.#
(I pulled the 50% out of thin air, in case you are wondering — data I have no time to look up now, but it should be in the right ballpark)#
Sure, some if it is shifting goalposts for what the metaverse means — our VR future is not there yet — but our EMR overlords sure are looking more and more like Microsoft's definition of the metaverse, at least.#
There was a slim chance that all of the components (billing, scheduling, etc…) could have been modular and interacted via standardized APIs. But it didn't work for the internet as a whole and it didn't work for electronic medical records.#
With some luck, we'll get to reinvent the wheel and rebuild an open Metaverse once the closed ones start showing even more of their warts. It's RSS all the way down.#