A few unpopular (in certain circles) opinions from a person who has no rights having them
For better or worse, the American system of government is strong. Those who say otherwise have a financial interest in people thinking the opposite.
Culturally, US has more similarities with Iran than with Saudi Arabia, even if you count religion and religiosity as part of culture. The Christian right is working hard to make them even more similar.
Though still quite hard, it’s easier for a high-skilled immigrant to come to America than to any other country in the world. Comparison is even more favorable for low-skilled and unskilled immigrants. For all of them, quality of life, acceptance, and protection they get are better than anywhere else.
The randomness of the Green Card lottery process is a feature not a bug.
Reading the non-fiction sections of The New Yorker, The Atlantic, and whatever their conservative equivalents are, is good for generating fake insight but ultimately pointless. The Economist is useful for a tiny segment of the population but lets be real: if you’re reading this you are not it.
The only useful section in the daily newspapers is Local. Maybe Sports, if you are into that sort of thing, but professional and college sports are a scam so stick with the amateur leagues.
TSA agents and airline personnel are nice people but some passengers check out their brains at the curb and make everyone’s lives less pleasant.
Apple hardware products are underpriced for what you get but do you actually need what they offer? This doesn’t include the AirPods, which are the best thing Apple has made in the last 20 years and still underpriced; though they unfortunately resemble in both name and appearance a mind control method from Doctor Who S2 and paired with a smart phone are not far from it.
The world doesn’t need another IPA. America needs more tripels.
This is all coming from a non-immigrant resident alien with no expertise in politics, international law, transportation, or technology. I do know beer though.
Voices in my head, 2018 edition
- Conversations with Tyler: I much prefer this over his mostly spartan, often cryptic, and always clueless about things medical blog Marginal revolution. Cowen‘s interview style brings out the best from people; it is also a good and rare example of clear thinking. Compare and contrast his chat with Malcolm Gladwell and Patrick Collison’s chat with Cowen: when answering, Gladwell uhms and ahhs and changes direction mid-sentence; Cowen pauses for a half-second, then produces paragraphs of prose that could have been lifted right out of an encyclopedia. Not to belittle Gladwell — for one, I’d be even worse (as anyone who had to finish my sentences for me can confirm); and two, he is responsible for
- Revisionist history: He had me at Food Fight. Gladwell embraces and owns his Well, actually kind of story-telling — even the show’s name is a big Well, actually to the Gladwell-haters. And good for him, because the stories are marvelous in both topic and style, and make me want to read his books again.
- Sources and methods: Two ex-spies talk about learning and cognition. They are still in intelligence-gathering mode, interviewing guests you‘re unlikely to hear anywhere else. It’s how I learned about Tinderbox (and you can too).
- America the bilingual: One part pep-talk to encourage the pre-1990s waves of immigrants to America to take up a second language, one part advice to parents raising multilingual children. The latter validated my plan to
save moneystrengthen the offspring’s Serbian by shipping them across the Atlantic to spend some quality time with the grandparents. - Novel targets: Finishing of the list of men talking to each other is the best oncology podcast I’ve come across. It may be heavily slanted towards immunotherapy, and not zealous enough in dampening the hype, but it tries.
Level up
The next time someone asks me about books to read before residency, I will direct them here. You don’t have to be a medical trainee to benefit from these, but that period of anxious anticipation between match day and orientation is perfect for buffing your attributes.
How to read a book, by Mortimer J. Adler
What better way to start learning about learning than by reading a book about reading books?
The Farnam Street blog has a nice outline of the book’s main ideas. The same establishment is now hocking a $200 course on the same topic. It’s probably good, but at $10 the source material is slightly more affordable.
Getting things done, by David Allen
The first few months you will be neck-deep in scut work no matter what you do. After that, though, you will have to juggle patient care, research, didactics, fellowship/career planning, and piles of administrative drek—and that’s just inside the hospital. At the very least, this book will help you make time for laundry (and maybe some reading).
Thinking, fast and slow, by Daniel Kahneman
Superficially, similar knowledge to what is in these 400+ pages can be found in a few Wikipedia entries. But you would miss out on the how and why cognitive biases and heuristics are so important. Medicine and research are bias-driven endeavors, and not understanding them is not knowing real-world medicine.
Only three? Yes. If anything, the two and a half months between mid-March and July 1st won’t be enough to read them all with the attention they deserve. But you should try.
Podcast time
Another year, another round of podcast recommendations:
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No, it’s not your browser. The list is empty.
After 10 years of attaching electric appendages to my head using flimsy earhooks some call ear-phones, I have decided that one voice in my head at a time is quite enough, thank you, and that there are better ways to muffle the sounds of everyday existence than the nasal overtones of middle-aged white men.
Who will be crushed to lose me as a listener, I am sure.
I haven’t suddenly decided that they are all bad, mind you—I have spent cumulative months listening to them, so they must be good. The problem is, I like them too much.
Behold my modified CAGE questionnaire for podcasts:
- Have you ever felt you needed to Cut down on your time spent listening to podcasts? Doing it right now.
- Have people Annoyed you by criticizing your listening to podcasts at inappropriate times? Does my wife count as people*? If so, then yes.*
- Have you ever felt Guilty about listening to a podcast instead of doing something else? You mean like sitting in the car 10 extra minutes after coming back home from work, waiting for an episode of Radiolab to finish? Umm…
- Have you ever felt you needed to put on your headphones first thing in the morning (Eye-opener) to finish listening to last night’s podcast, or to get a head start on completing the unplayed list. “Felt like?” I do it all the time.
Aced it.
Granted, being mostly free, not too hard on your body, sometimes educational, and often entertaining, podcasts are not the worst thing in the world to be addicted to. But to be alone with your thoughts is exceedingly rare when there is a toddler in the house—rare enough that you do not want to spoil it by introducing external stimuli which make it impossible to string a chain of thought longer than the 30-second commercial break for Squarespace.
Farewell, voices. It was good while it lasted.
June 2014, final tally
- 4 books read: Ocean at the End of the Lane, Tenth of December, The Golem and the Jinn, Ubiq
- 2 books re-read: Getting Things Done, Mindfulness in Plain English
- 1 book half-way through: Embassytown
- 2 computer games completed: To the Moon, Bastion
- 3 tabletop games played: Dixit (3 sessions), Pandemic (2), Eldritch Horror (4)
- 1 used minivan purchased
- 1 article, 1 abstract submitted
- 61 km ran
- 1000+ toddler photos taken
- 0 tedious field trips made
NIH orientation started today. My commute is 90-plus minutes each way, and the first four months are mostly inpatient. I will have to wait until retirement for another run like this.
Ten common residency idioms and phrases
- I don’t feel comfortable doing that.—I don’t know what you’re asking me to do (nurse to intern); I’m too lazy to do it (intern to resident); I think it’s a stupid idea and there’s no way you can make me do it (resident to attending); You’re not paying me enough to do this crap (attending to administration).
- It’s a light elective—You don’t need to show up.
- Needs to read more. (on a written evaluation)—I have no idea how much medicine this person knows. I barely know any myself.
- The family is reasonable.—Family members don’t ask too many questions and will agree with anything you say.
- The patient has xyz.—I’ve read in an old discharge summary that the patient has xyz, but have no idea how they established the diagnosis, what stage it is in, or what the hell xyz even is.
- The head is normocephalic, atraumatic. Pupils are equal, round and reactive to light and accommodation. Sclearae are nonicteric.—If I were to report the physical exam I actually did it would take five nanoseconds, so take these fillers to make it seem like I’ve put in some effort.
- Thank you for the thorough presentation.—Why did you waste my time with all that useless information?
- That’s an outpatient work-up.—Administration is already breathing down my neck because of this patient’s length of stay and you’re worried about a mild anemia and a positive hemoccult!?
- That’s her new baseline.—Her disease is worse and we don’t know why, so I guess she’s stuck with it.
- Please let me know if you have any more questions.—This is the end of our conversation, so please stop talking. I shall now leave.
30 iPad apps I use almost every day
After 18 months of intensive use, here are some of the apps left standing on my iPad 3, sorted by category. I like to think I’m a semi-advanced user, so for some of them I have also listed simpler alternatives. It goes without saying that you should download all the free iWork and iLife apps.
Medicine
MKSAP 16
- For: all medicine residents
- Recommendation: strong
- Price: free (if you bought online MKSAP access)
MKSAP question bank. No-brainer if you are studying for your internal medicine board or MOC exam. Less page-flipping and instant gratification. Unfortunately, it doesn’t allow you to highlighting or annotate the explanations. Also, it can’t make custom quizzes, can’t review unanswered/wrong questions, and doesn’t allow you to copy any of the text to your notes. Lot’s of cants, but it’s the only MKSAP app available. Free if you purchase the electronic version of MKSAP 16.
Download MKSAP 16 from the app store here.
ACP Guidelines
- For: all interns
- Recommendation: ok, sort of
- Price: free
It seems like a good idea, and the content is great, but it is more of a branded PDF reader than anything else. Doesn’t have search or favorites, and you have to download each recommendation one by one. The download is fast, but good luck getting what you need without internet access. So, good for night-time reading, particularly if you’re an intern, but not a good POC tool.
Download ACP Guidelines from the app store here.
Stanford 25
- For: everyone
- Recommendation: just OK
- Price: free
If you haven’t heard of Stanford 25 before, see this TED talk and see the blog. It’s another good, if ugly, night table app.
Download Stanford 25 from the app store here.
Productivity
Things for iPad (or Omnifocus)
- For: everyone
- Recommendation: strong
- Price: $19.99 for Things, $39.99 for OmniFocus
Whether you’re a GTD fan or not, this or it’s more powerful and more expensive sibling OmniFocus are a must-have for anyone shuffling between more than two areas of responsibility. It still hasn’t been updated for iOS 7, but is very functional. Only two missing features for me, really: there are no nested tasks/dependencies, and you can’t filter by more than one tag.
I’ve been thinking about switching to OmniFocus, but this works well enough for me that the hassle of complete overhauling my system wouldn’t be worth it. Not to mention the >100$ price tag.
Download Things for iPad from the app store here. You can find OmniFocus for iPad here.
Boxer
- For: everyone who gets more than 5 emails/day
- Recommendation: strong
- Price: $0.99
The best mail client on the iPad. Apple’s Mail.app was OK until I realized I spent way too much time scrolling through my list of 20 IMAP folders whenever I wanted to move an email. Boxer works with Gmail, IMAP and Exchange accounts, has smart email sorting, and integrates with Sanebox.
Dropbox
- For: everyone
- Recommendation: strong
- Price: free
If you use Dropbox on your PC—and you must—then this is a no-brainer.
Download Dropbox for iOS from the app store here
iThoughts HD
- For: nerds
- Recommendation: OK
- Price: $9.99 for either
I found Tony Buzan’s book on mind mapping as a first-year medical student and used the hell out of it for my biophysics, chemistry and genetics coursers. As the material got more complicated, shuffling huge stacks of A3 paper became unwieldy, so I went back to plain old Cornell notes for biochemistry et al. This app is what got me back to making maps, this time when writing review articles and planning out other research. Also good when contemplating the GTD 50,000 ft view.
Download iThoughts HD for iPad from the app store here. It’s prettier new cousin Mindnode 3 is available here
Calendars 5
- For: all busy overachievers
- Recommendation: ok
- Price: $6.99
The default calendar used to be ugly and impractical. With iOS 7 it’s just the latter. This is a good replacement. Fantastical for iPad would be nice, though.
Download Calendars 5 from the app store here.
Drafts
- For: advanced users
- Recommendation: strong
- Price: $3.99
Quick note-taking and automation rolled into one. I use it as the default inbox for anything and everything, mainly by appending a dump.txt file in my Dropbox. There is a separate iPhone version that is just as useful.
Download Drafts for iPad from the app store here.
Pinner
- For: pack-rats
- Recommendation: ok
- Price: $1.99
Pinboard is an excellent almost-free bookmarking and discovery service. There are plenty of iPad clients available, but Pinner seemed to be the most cost-effective. I haven’t regretted the purchase.
Download Pinner from the app store here.
GW Mail
- For: anyone who is forced to use GroupWise
- Recommendation: meh
- Price: $9.99
I have to use GroupWise email for work. This is the only decent client I found for iOS. Stopped looking for a replacement since my last day of residency is less than six months away.
Reading
Reeder 2###
- For: serious feed readers
- Recommendation: strong
- Price: $4.99
I’ve been using RSS feeds since the days of Bloglines (circa 2001) and switched to Google reader after the first big redesign. It’s sad that Google decided to murder it instead developing its potential as a social service. Feed wrangler is a good replacement, Feedly is a free one. Reeder 2 is the best iPad feed reader there is, and works well with both.
Download Reeder for iPad from the app store here.
Instapaper
- For: everyone who reads
- Recommendation: strong
- Price: $3.99
If you read any text that’s longer than 500 words with any regularity, you need a service that will keep track of the articles and remove all the annoying cruft surrounding the text. Instapaper is the first one of its kind, and the best way to read articles on it is on an iPad.
Download Instapaper for iOS from the app store here.
NextDraft
- For: everyone
- Recommendation: strong
- Price: free
Ten good articles hand-picked by an expert hand-picker and delivered (almost) every weekday. My only source of news for the past six months.
Download NextDraft from the app store here
ReadQuick
- For: dabblers
- Recommendation: ok
- Price: $4.99
The second book from Tony Buzan that I read was on speed reading. This app will flash words from any article you find online or in your Instapaper/Pocket queue one-by-one at a set rate. Good for those who are too lazy to swipe.
Download ReadQuick from the app store here
Writing
Day One
- For: everyone
- Recommendation: strong
- Price: $4.99
A journaling app. I don’t use it for the Dear-Diary types of texts—though I have no doubt it would be perfect for that. Instead, I use it to keep an archive of meeting and lecture notes (usually started in Drafts and sent to Day One), with an occasional milestone in between. Feature request: multiple journals.
Download Day One for iOS from the app store here
Byword
- For: beginner iPad writers
- Recommendation: ok
- Price: $4.99
If you want to write a long text on an iPad and don’t need automation, text expansion et al. then this is the app for you.
Download Byword for iOS from the app store here
Editorial
- For: advanced users
- Recommendation: strong
- Price: $4.99
If you want to write a long text on an iPad and like mucking about with workflows, text snippets and Python scripts—which I most certainly do—this is your only choice on any platform. This will become essential next July when I start my long commute.
Download Editorial from the app store here
Social
Twitterific 5 or Tweetbot
- For: everyone
- Recommendation: meh… you might want to wait for the newest version of Tweetbot to come out
- Price: $2.99 for Twitterrific, $2.99 for Tweetbot
If you are on Twitter—and if you are a physician you really should be—please get a decent iOS client. The official one is definitely not it. Tweetbot used to be until iOS 7 came and made it look and feel ancient. Twitterrific is a good—if slightly annoying—substitute, with the added benefit of being universal (i.e. iPhone and iPad with the same purchase). I’m using the old version of Tweetbot and waiting for the new one, since Twitterific tended to make a mess of my position in the stream.
Download Twitterrific 5 here and Tweetbot for iPad here
- For: everyone who uses Facebook (why?)
- Recommendation: my wife likes it
- Price: free
OK, I guess, if you’re into that sort of thing.
Download Facebook for iOS here
Skype
- For: everyone away from family
- Recommendation: OK
- Price: free
This is the international default for long-distance communication, I guess. It gets choppy and drains the battery, but it’s the only thing my mom knows how to use so I’m stuck with it.
Games
Letterpress
- For: everyone who can spell
- Recommendation: strong
- Price: free (with in-app purchase)
An excellent turn-based word game. The only multiplayer game I play with any regularity. You need an in-app purchase if you want to play more than two games at the same time, but it’s well worth it. I have five going on right now.
10000000
- For: nerds
- Recommendation: strong
- Price: $1.99
Bejeweled meets a 2D RPG. Hours of fun, even when you get to 100000000000 or however many points.
Aquaria
- For: adventure gamers
- Recommendation: strong
- Price: $4.99
A 2D side-scrolling action-adventure game set under the sea. At my pace I will finish it in about two years, but it’s great even in 15-minute increments.
Shopping
Deliveries
- For: serious shoppers
- Recommendation: strong
- Price: $4.99
Forward an email containing a tracking number to a special email address. Boom, you can now track your package through this app, with push notifications if you’re into being interrupted whenever a case of -diapers- Wild Turkey is delivered to your front door.
Download Deliveries for iOS here
Eat24
- For: serious eaters
- Recommendation: OK
- Price: free
Good app for ordering food in the Baltimore area. Don’t know about rest of the country.
Hipmunk
- For: world travelers
- Recommendation: strong
- Price: free (you pay for the plane ticket, though)
The best flight comparison engine there is. Find the most affordable and least annoying plane route. Also does hotel rooms, which I haven’t tried.
Entertainment
Netflix
- For: everyone with a Netflix subscription
- Recommendation: OK
- Price: free
I have used this app exactly once, to watch a couple of episodes of Buffy the Vampire Slayer while waiting for an Amtrak train. Well worth it, though.
AppleTV Remote
- For: everyone with an Apple TV
- Recommendation: strong
- Price: free
I don’t have my original remote any more. We assume Dora ate it. This app is even better, since you don’t have to muck around with the tiny remote buttons when entering your wifi password or searching Netflix.
comiXology
- For: everyone who reads comics
- Recommendation: strong
- Price: free (the app, not the comics)
The only way to read comics on an iPad.