Calling it now: “quietly” is Word of the Year 2026.
What AI sired, mindless zeitgeist reverberators now rear.
Frequent Infinite Regress linkee Ruxandra Tesslo wrote an op-ed for The New York Times about why we can’t get new cancer cures. Unsurprising for those who have read her past work, she places the bulk of the blame on the glacial speed by which clinical trials are designed, set up and run, at least in the US. Biotechs are looking at other countries — yes, including China — for their next first-in-human trial. All the cures we need are right there in the lab, you see, it is these darn trials that are too slow, keeping patients away from life-saving medicines. There is a nice n-of-one story about a patient with KRAS-mutated lung cancer who received a RAS inhibitor in a phase 1 trial to set the tone.
Vinay Prasad calls out a few big omissions in Tesslo’s article, and the number one point he brings out is the number one point I have issue with as well: the science is, in fact, lacking. There are no miracle cures locked in a drawer somewhere, not reaching patients because of government bureaucracy or a big pharma conspiracy.
But how can that be, with all the money thrown into cancer research ever since Dick Nixon’s War on Cancer? Well. Though I don’t know this for a fact, I have a strong suspicion that the answer to the curious lack of cancer cures is the same as the answer to that other question no one dares ask: if trials being so slow and expensive is a huge bottleneck, why are they so slow and expensive in the first place? It’s also the reason why a discerning reader of this blog may have noticed that my writing has taken a slight but unexpected anti-market turn.
Financialization, once the great enabler of garage-based startups, has turned every field of American endeavor into a casino and given one too many a bullshitter enough money to choke the competition. Biomedicine is particularly susceptible to bullshit large and small. Even if decently financed, the honest players — of which there are quite a few — have to fight for other limited resources in the ecosystem, from PhDs to do the actual research and clinical trial sites to attention. The result is hyperinflation of trial costs and a veritable bullshit bonanza in the biomedical literature, and this is not even taking into account the more personal motives of academics to fill the field with dreck.
My big fear is that no one is talking about the negative impact of financialization because it is water. Kudos to Tesslo for not talking about billion dollar drugs, but that seems to be the default, even among science journalists. Mr. Market will give you cheaper 4K TVs — surveillance comes for free — what it won’t give you is cancer cures.
A note on the title: I have come to detest The NYT’s two-sentence titles that go out of their way to dumb down the subject matter while piquing people’s interest, but thought it would be fun to write one for a quick post that’s a comment on a NYT article. Promise it won’t happen again.
The human body is not a car. We don’t know how most of it works. There are a handful of labs you should start getting once you hit 40 (or earlier depending on family history), and a few cancer screenings we know work. Anything else is a needless waste of money at best, and a recipe for an iatrogenic disaster if an incidental finding from a whole-body MRI leads to a wild goose chase, biopsies, surgeries, etc. Not to mention the false sense of security these things can give.
My quarterly Now page update is up. Nothing’s new and everything is, depending on your point of view.
Alex Tabarrok writes that it doesn’t matter if the workers’ share of GDP shrinks because of AI. As long as the pie is bigger — and our AI oligarchs say it can be as much as 10% bigger each year! — the average worker will have a bigger share in absolute terms if not in relative.
Hogwash. The one who has the bigger slice has the power to lord over the ones with smaller slices so the relative size does in fact matter. Never mind that our sense of wellbeing is itself ties to how we perceive ourselves in the overall community. What Tabarrok proposes is voluntary serfdom. I think not.
I did it. I used overmorrow in a progress note today.
Doing my part to bring it back.
Haven’t mentioned it in a while, but my move away from Apple continues.
Pixel 10a purchased, GrapheneOS installed.
Alea iacta est.
Calling it now: “quietly” is Word of the Year 2026.
What AI sired, mindless zeitgeist reverberators now rear.
AI has become increasingly important to drug research at big pharmaceutical companies. Eli Lilly, maker of popular weight-loss drugs, has partnered with AI chipmaker Nvidia chips and earlier this year invested in Insilico Medicine, a company focused on AI for drug discovery.
Please. I would wait until any of the money poured into drug discovery AI produces a tangible result before calling it “increasingly important”. Never mind that it’s not the discovery that is the real bottleneck.
The more I think about Dan Wang’s book Breakneck the less I think of it. Wang presents America as a country of lawyers — orderly, slow, nothing gets done — and China as a country of engineers, moving fast and breaking things, some of the breakages being described in detail. If only America was ruled more by engineers, or China had more lawyers involved, and we’d have two great countries instead of two deeply flawed ones.
I would suggest that the true dichotomy Wang described is not one between lawyers and engineers, but one between rule of law and rule by law. If it ever appears that projects are being bogged down in legalese, I would posit that it is not because too many lawyers are involved but rather than an appropriate number of lawyers is trying to, and I am choosing my words carefully here, stop stupid shit being done. They are not always successful but at least they try.
So if it ever appears that infrastructure in America doesn’t get built any more and that nothing ever gets done, it is because the doers of this country have, for the most part, become obsessed with doing stupid shit.
Which is to say, I would be ecstatic if any of my children wanted to pursue a career in law; and I would strongly consider disowning them if they went into finance.