• Adam Cifu: Goodharts Law and Medical School Admissions. A significant contributor to scientific slop is “research output” as requirement for fellowship, residency, and even medical school admissions. And yes, I am also a fan of the law.
• Paul Teirstein for WSJ: The Gatekeeper Driving Doctors From Medicine. On board certification, which now seems to have some powerful enemies so consider me conflicted.
• Jonathan D. Cohen and Isaac Rose-Berman for NYT: Gambling. Investing. Gaming. There’s No Difference Anymore. “There should be a line of separation,” Alexander Hamilton [wrote] in 1792, “between respectable stockholders … and mere unprincipled Gamblers.” As a side note, it is incredible how much sports betting has exploded in the 15 years I’ve been in the US. One of many ways America is looking more and more like Serbia, where seedy gambling outposts are now more common than grocery stores.
• Brian Potter: More on US Pedestrian Deaths. An update of a previously linked-to post, which raises more questions than answers. Allow me to be somewhat conspiratorial: could worse hospital care combined with increasing organ donation contribute to this increase? There have been 3,200 more pedestrian deaths in 2023 compared to 2009 and 8,393 more deceased donor donations according to OPTN. And then there is this.

• Raghuveer Parthasarathy: Reading Like It’s 1937. The experiment was to choose only books published in a single year and read these in a short period of time. As expected, there were more duds than classics, and with not that many books coming out in 1937 it amount to very few good books indeed. This kind of experimentation does support the claim that we live in a literary golden age, and I’d say it’s because of a combination of high absolute numbers and us being better at detecting edge cases, not necessarily that the relative percentage of classics per year has increased. If anything, it is probably much lower because of all the AI-generated slop.
• Mike Taylor: If you’d built a “tool” that stupid, why would you advertise the fact? The AI tools described are indeed stupid, but remember that the marginal cost for advertising them is 0, and if you find them stupid you were never the intended audience. In that way they very much resemble phone scams and emails from a Nigerian prince.
• David Shaywitz: The Startling History Behind Merck’s New Cancer Blockbuster. A story from 8 years ago, but it was news to me that pembrolizumab had a very roundabout way of reaching patients. GLP-1 inhibitors had a slightly less circuitous route, but still took too long to get to where they are. Is this truly the best way to develop drugs? (↬Derek Lowe)
• Cal Newport: Is Sora the Beginning of the End for OpenAI? Probably not, and this is not really an edge case, but as someone who has trouble concluding blog posts (which is why you’re reading a list) I just wanted to pause and admire that last sentence.

📺 Broadchurch, Season 1 got my full attention the moment David Tenant screamed Bloody Twitter. The show deserves an A+ for drama, a B- for the mystery, and an F for its medical chops. Fortunately, medicine didn’t come into play until very late, when drama and mystery were already at full steam.

🍿 Chef (2014) brought me back to my residency days in a Baltimore ICU, when the attending mentioned during rounds that he saw the movie with his grandson and enjoyed the scenes of food being cooked, if not the humor. A movie made for Netflix before Netflix made movies.

The British crime drama Broadchurch came out in 2013. John Favreau’s food porn vanity project Chef was released in 2014. Despite both now being more than a decade old, in my mind they are still filed under “new things that came out that we missed because we had an infant in the house while also being medical residents”. It was therefore jarring to see how dated they both were, and for similar reasons.

Broadchurch deals with the murder of an 11-year-old boy in a small coastal community. Twitter is mentioned a handful of times, only in the context of breaking news. There is no Instagram or messaging apps: pre-teens email each other. The boy’s family is at a loss for how to attract national attention to the killing and finds the answer in a tabloid journalist. It all feels quaint, though admittedly I don’t know if that was intentional even in 2013 (from the edgy music and the oh-so serious tone of the show, I suspect not). I won’t mention a recent British show by name for fear of spoiling other, but if you’ve seen both you will now what is the clear parallel and how much things have changed.

Chef, on the other hand, is completely Twitter-dependent, and is arguably one of the first movies to use Twitter #MainCharacter dynamics as a plot point (Justine Sacco had landed a few months before the movie was released, and probably wasn’t even on Favreau’s radar). Twitter is shown in a completely positive light, and I can’t think of any other movie that has done that. It is also a good time capsule of the food trucks on Twitter craze. The early 2010s were the peak time for both, before culture wars killed one and covid the other.

So now I am inclined to see what else came out in that 2010–2015 period. Is it too early to be nostalgic for those times?

• Rusty Guinn: Anatomy of a Narrative Virus. A case study of our collective disregard for truth.
• Branko Milanović: Defeated by reality. A post-mortem to neoliberalism.
• Doug Muir: Five technological achievements! (That we won’t see any time soon.) A healthy dose of techno-pessimism.
• Helen Andrews: The Great Feminization. A just-so story of our current condition. Note that “only a woman could have written this” does not necessarily make it true.
• NYT: Nick Offerman Woodworked His Way to Playing the President. A portrait.

A prediction, based on nothing but this short post from John Gruber and a hunch: within 5 years, Apple will have a deal to stream all college football. NFL may be out of reach, but for many people — Tim Cook included — NCAA is what matters.

As a not-so-recent graduate of a medical fellowship program, I often get spammy job offers via email, text, LinkedIn messages, etc, some of them with promises of eye-popping income. A memorable add mentioned over $800,000 annual compensation for a position in Caribou, Maine. It was telling that I was getting it for at least a year before it stopped, and if you were the brave soul who took up the job then please get in touch, I would like to hear how it’s been!

Often, the number is not mentioned at all. Those jobs have a clear advantage in terms of the institution, geographic location and time commitment. All others fall into two categories: “up to” and “guaranteed”. A decade-plus of reading Nassim Taleb’s writing has taught me to avoid the up-to and value the guaranteed.

Many people focus on “benefiting from disorder”, but this is in fact the basic asymmetry behind Antifragile, which Taleb touched on even earlier in his books. Cap the losses and yes, stay open for high — ideally unlimited — upside, but avoiding ruin takes precedence.

The up-to/at-least dichotomy is broader than job postings. “Up-to” precedes many numbers and sometimes, fair enough, it is important to mention and valid in the conversation. But sometimes — often? — it is uttered under the breath and while clearing throat to yell out a large number that is meant to impress, change minds, open up hearts… and wallets.

“You could earn up to $900,000 per year”, if you see 40 patients per day five days a week with 10 days off for the entire year. Extrapolate to other areas of life as need.