📚Still reading Inventing the Renaissance, and Lorenzo de Medici’s brother Giuliano of course had a mention. Still, I wasn’t prepared for his bust being quite so metal.

This is at the (not Smithsonian!) National Art Gallery in DC, which has a rich collection of renaissance works.

📚 Some 18th century childhood doodles in a 17th century William Shakespeare first folio, as seen in the Folger collection. Kids will be kids!

In the preamble to his Morose thoughts at the Semiquincentennial, @ReaderJohn notes:

I’m on a social medium (I refuse to abuse the plural “media”) with an astonishing number of people, many of them decades younger than me, who manage, without coming across as idiots (au contraire: I’m struck by how many there make me feel unobservant and thick-skulled about what I do observe), to focus on positive, and personal, and local things. Kudos to its designer, who consciously designed it that way (I’m not sure how, except that one never knows how many people follow him or her, and there are no buttons to simply “like” a post).

That last parenthetical is, I believe, exactly the reason why micro.blog turned out the way it did. My first thought was that it filtered out people who liked to see numbers go up — many of them not of the clearest mind — right at the outset. But that is not all there is to it, probably not even the most important part. The intentional lack of statistics cuts the feedback loops which tend to make some people into complete assholes, and every person into an occasional asshole. [Note: Or at the very least an asshole-appearing online presence, but to the exposed person — meaning you, dear reader — there is no difference. ]

Every popularity contest will reward the extremes. This is why I gave up following the Bear Blog Discovery feed. Random posts from to-me unknown authors just popping into my RSS reader [Note: These days a combination of the [Inkwell][4] Android app on my Daylight tablet and my own homebrewed [Inkling for Emacs][5], which is where I’m writing this! ] reminded me too much of Twitter’s algorithms, and even Bubbles — posts from 5,000+ independent blogs, including this one, ranked by timeliness and popularity — favors criticism of AI and tech in general combined with outrage/despondence/resignation towards news of the day/breakage of everyday life/civilizational decline. The only ever Infinite Regress post that ended up on the Bubbles front page fits right in. ⊕ [Note: A kind reader even uploaded it to Hacker News, where it — thankfully! — received just 4 upvotes and no comments. Small mercies. ] It is, in that sense, no different from Reddit: the medium (of voting) is the message.

Incidentally, these Bubbles and Hacker News and Kagi Small Web and indieblog.page and ooh.directory visitors all leave footprints on this here web site’s Tinylytics dashboard, which has become delightfully uninterpretable owing to the influx in the past few months of what I can only assume are digital ghosts from Hong Kong, Singapore, China and Mexico, in that order. An unexpected benefit of LLM crawlers.

There is something about numbers that makes people’s brains stop working. This is common in medicine, where reflexively treating a lab abnormality without thinking an iota about the patient or even about the ground truth — is this number here “real” or is it a blood collection/lab analysis/data entry error? — is a phase most doctors go through and some never leave. Call it video game brain: confusing the hardcoded information of an RPG stat or a FPS health bar with more malleable values we get from physical measurements.

Well, I know enough about myself not to expect an effortless change in behavior. The effort tank being depleted daily by issues more pressing, I avoid having to interpret these numerical tricksters in any way I can. You see, for feedback to be of any use there has to be effort somewhere and by making leaving it effortless (thumbs up or down? how good was our service from 1 to 10? the text field is optional!) we have made interpreting it seemingly straightforward but in fact harder. Did someone “like” a blog post because reading it was a life-changing experience? Slightly more amusing than the cat photo just below? A toilet seat mistap? Or was it herding?

Now think about all those feedback surveys you started filling because the first page was a deceptive 1–10 scale only to abandon it because page 2 had five large fields for free text, all with a mandatory character count. This puts majority of the cognitive effort on the feedback provider; reading it does take more time than glancing at a number, but the receiver can quickly and effortlessly tell whether it is a) from someone whose opinion they care about and b) what the said opinion is.

So yes this is a long-winded way to nudge you towards writing more emails. Or leaving more comments. Or even starting your own blog. More words, fewer numbers, please. And yes, yes, I am aware how silly asking for more words sounds in these, our Days of Slop. But to go back to the blog post that started all this, and then two links deep to a most brilliant text from Sam Kriss: when everyone from your middle manager bosses to Guardian journalists to prize-winning authors and random tech folk debase themselves with AI, the value of the human-written word does in fact go up.

• Kyla Scanlon: Is AI Going to Destroy our Lives or Not? It has been two months since Scanlon last posted so this is a long update that doesn’t cover much more than Ed Zitron recently did, albeit in a — to me, at least — more readable style. The last section, titled “What Do You Do About It”, may be useful to many.
• Reese Richardson: How much of Thermo Fisher’s antibody data has been manipulated? A lot of it, it looks like. I wonder how many poor PhD students and postdocs wasted weeks and months of effort because the antibodies Thermo Fisher Scientific sold weren’t as specific or sensitive as they claimed. Surely as a publicly traded company TFS should have known better. Must have been a rogue employee, or a hundred. Caveat emptor!
• John Siracusa: EV Stupidity Checklist. Twelve physical items that have gotten worse since more cars became electric, with recommendations on how to go back to saner designs. You know, ones that include a rear window
• Brian Philips for The Ringer: The 40 Most Rage-Inducing Problems in Tech. ⊕ [Note: ᔥAlan Jacobs ] A broader list and more tongue-in-cheek, but items 37 through 39 cut deep.

Have a great weekend!

Doc in a Box from Alex Tabarrok links to an official state government document, from the Utah Department of Commerce. The document is titled “Key Statistics on the Doctronic Pilot Program” but reads more like a bulleted press release, full of percentages without a denominator, begging for a flow chart. Press releases are like that because you typically won’t add images — although this one randomly selected from today does indeed include it along with the full abstract submitted to the ASCO annual meeting, and good for them — but more importantly because you want to pick the best possible picture-perfect view of your shiny spotless data elephant without also acknowledging that it has a rear end, a bunch of flies buzzing around, smells a bit rank. Does your elephant not have an ass, Utah? Or did you just copy/paste what Doctronic — a startup whose wonky web page doesn’t even work — sent you?

⊕ Doctronic. We have hit a technical snag. Go to Homepage to hit it again.

So how many patients could they have evaluated? This article in JAMA Forum says that “[p]hysicians hired by Doctronic will review the AI’s output for the first 250 patients before the system takes any action and will review the next 1000 patients retrospectively after the AI agent begins acting autonomously.” Are the key statistics from the first 250? The very first bullet point in the press release summary document says that the program is still in Phase One and that “the number of patients so far is limited”, so I guess not. Is it 100 at least? Surely they wouldn’t use a percentage as high as 97 if there were fewer than that involved. Except that as low as 30 will give you a percent roundable to 97. So, 30 to 249?

Why am I being so pedantic? Well, these techniques are par for the course in biotech world but coming from a state agency make me think there is a bit too much enthusiasm for it, coming from a government source. Compare and contrast to the shellacking LLMs got in this report from the Office of the Auditor General of Ontario, which reviewed AI Scribe functionality from 20 vendors. Their report even has absolute numbers in it! These state government officials should realize that they are prime targets for flim flam merchants and should behave accordingly.

Note that I am not against the idea in general. The project’s goal is in fact quite noble: there is no reason why plain ol’ machine learning shouldn’t be able to suss out majority of refill requests for chronic medications and flag patients who haven’t had their bloodwork or diabetic foot assessments done, or who’ve had abnormal office blood pressure readings at prior visits. Having that easy refill option available would mean a patient coming in for an in-person visit for what should be “only” prescription refills is even more of a signal that something else may be amiss, even if the patient can’t or won’t verbalize it. So yes, LLM refills, bring ’em on. Doctronic’s end-goal of actual autonomous Shoggoths putting on white coats and replacing MDs, PAs, NPs and other credentialed humans… not so much.

• Dynomight: Is “colorectal cancer” rising in “young people”? It is, and not just colorectal cancer, and not all of it is from overscreening. The anonymous author lists many potential causes; I would group all likely suspects under “new substances”, whether in the air we breathe, the food we eat, or in every friggin’ thing we touch. The price we pay for a modern life, eh?
• Vinay Prasad: Are “healthy people” an endangered species? Speaking of overscreening, Prasad makes a good point about how accessible all these different kinds of blood tests are that will tell you that something is wrong even though you may be feeling just fine. Sometimes this is warranted — a yearly blood count picks up a small decrease in hemoglobin that is the result of intestinal blood loss from an ulcer or (see above) colon cancer — but more often this is a form of medical divination. To repeat myself from 3 years ago, I am not a fan of the “wellness” visit.
• Niko McCarty and Noah Olsman: What’s the Point of Theory in Biology? An interesting exchange between McCarty, who has a degree in bioengineering but has been more focused on the journalism and policy side of science, and Olsman, who as a practicing postdoc with an interest in theoretical biology does well to explain its limits.
• Christos Lynteris for Nautilus: Poop Cruises Are No Laughing Matter. Oh but they are, even without the poop — has Lynteris never heard of a supposedly fun thing DFW will never do again? More seriously, the observation that people pay more attention when things happen to famous people is apt: remember Tom Hanks getting covid? More tangentially, Greg Wilson recently wrote about the upper/lower deck divide as it pertains to the general overhead of living.
• Brett & Kate McKay: The Cheapest, Easiest, Most Ridiculously Effective Way to Eradicate Mosquitoes From Your Property. I wish I knew about mosquito dunks and was able to test them while we still had a back yard which, as any back yard in DC, was nigh unusable in the summer owing to constant bloodsucking.

• Kevin Kelly: Your Most Improbable Life.

Your life’s goal should be to become the most improbable person you can be. Your path, your character, your life, should be the most unlikely, the most unexpected, the least predictable version you can make. Improbable lives have fewer competitors, more unique rewards, and are harder to replace with AIs, since AIs run on the predictable. This is true whether you favor traditional humanist directions or work on a frontier.

This is a nice preamble to a bit of personal news I can finally share: I will soon be going back [Note: It is a qualified “back”, as I have never actually practiced medicine full time, being either in training, doing clinical research as my main job, or being out of clinic altogether save for a few hours a week doing charity work. ] to the practice of clinical medicine. This week is in fact the last in my current position, which had been a magnificent experience but was going, as the careful reader of this blog would have already noted, in a direction not entirely suited to my preferred lifestyle and more importantly — let’s not sugarcoat it — values and beliefs. Onwards and upwards!

• Derek Robertson: 5 questions for Meredith Whittaker. ⊕ [Note: ᔥVoline on Mastodon ]

Whittaker, who is the president of the Signal Foundation (as in the app), had this to say about venture capital back in 2023:

Venture capital looks at valuations and growth, not necessarily at profit or revenue. So you don’t actually have to invest in technology that works, or that even makes a profit, you simply have to have a narrative that is compelling enough to float those valuations. So you see this repetitive and exhausting hype cycle as a feature in this industry. A couple of years ago, you would have been asking me about the metaverse, then last year, you would have asked me about Web3 and crypto, and for each of these inflection points there’s an Andreessen Horowitz manifesto.

It’s not simply that one piece of technology is overhyped, it’s that hype is a necessary ingredient of the current business ecosystem of the tech industry. We should examine how often the financial incentive for hype is rewarded without any real social returns, without any meaningful progress in technology, without these tools and services and worlds ever actually manifesting. That’s key to understanding the growing chasm between the narrative of techno-optimists and the reality of our tech-encumbered world.

Emphasis is mine, as it could be transposed word-for-word into the current world of drug development. Consider it a more polite rewording of prof. Taleb’s take.

• Venkatesh Rao: Commodity Intelligence.

Commodified knowledge is “general knowledge” in the sense tested by trivia/quiz contests. In grade school, we actually had a subject on the curriculum called “GK” and kids good at it (I was one of them) got put on quiz teams to represent their class or school. General intelligence of the sort we actually have today is simply AIs trained on general (ie commodified) knowledge.

But the theological motte-and-bailey move that conflates it with some totalizing-universal divine-omniscience idea of “Artificial General Intelligence” traps a great many of even the smartest people. A category error motivated by theological yearnings, validated by second-order Labatutian psychoses, sustained by epistemic bubbles, and encouraged by sketchy business roadmaps that need a story to justify trillion-dollar investments.

This is a charitable way of justifying the AI billionaire panhandlers’ selling of large language models as AGI, even putting the term in official titles. Less charitably, they all know what Yann LeCun has been saying for years: LLMs will never reach human level of intelligence (“ChatGPT, make me a sandwich”). Whether LeCun’s own pursuits are wise is a different matter.

Separately, Rao gives some good book tips and Benjamin Labatut’s When We Cease to Understand the World is now on the Pile.

• Andrew Gelman: Don’t cite sources you haven’t read, and don’t trust when people claim to be reporting something from the literature.

No quotes because, true to form, everything salient is already in the title. Natural continuation of the debate started last week (see the last link), although apparently written before the new arXiv policy for a 1-year ban for hallucinated references.

• Kieran Healy: Zero Sum Problems.

Healy wrote a book about data visualization so I feel somewhat foolish in writing this, but I do not find Apple Sports’ presentation least bit confusing: the numbers are absolute, the bars show percentage of the total. If the goal is to have more of each (assists, rebounds, steals, etc.) the bigger bar shows the opposing team’s dominance. It’s fine. Healy’s proposed solutions are all notably uglier and demote low-occurrence events like blocks and steals even though they may be crucial in a game. Shows how little both Healy and Gruber — on whose post Healy riffs — know about the game of basketball.

• Sarah Kliff, Margot Sanger-Katz, Erin Schaff and Asmaa Elkeurti for The NYT: Short Naps, Long Hours: How Autism Clinics Squeeze Medicaid Dollars Out of Preschoolers.

At Compleat Kidz, a fast-growing chain of autism clinics based in North Carolina, the policy is firm: Naps cannot be longer than seven minutes before children are awakened to resume therapy. The company says this is necessary to prevent fraud since clinics can be paid only when children are awake and getting services. But it also allows the clinic to bill insurers or Medicaid for more hours.

Yes, you have read that correctly. Waking up a child after a 7-minute nap to perform “therapy” — as if anything meaningful can be accomplished in that hypnagogic state — is both cruel and unusual. But not a punishment! It is merely a way to avoid fraud while optimizing revenue under the watchful eye of private equity:

Private equity firms have acquired at least 500 clinics over the past decade. “There’s just huge opportunities to grow these businesses and help increase access to care,” said Jon Krieger, a managing partner at Calex, a financial firm that assists with autism clinic mergers and acquisitions. He estimates the market could grow to $90 billion.

Mr. Market is a bad doctor, an even worse vet and, it seems, a most diabolical nanny.

Both the ghost and the mermaid museums we visited this weekend were in Berlin, MD, est. 1868. Was it per chance founded by German immigrants, I hear you ask, or a Teutonic-leaning group huddling after the Civil War? Why no: it is a contraction of Burley Inn, so the town is in fact “Burl’in”. TIL.