As a long-time subscriber to the FT and a fan of Janan Ganesh I was glad to see that they both got head-nods from kottke.org (and before that, Robin Sloan). Yes, it is well worth the price.

Always great to see a treatment mature from the lab to clinical trials to a write-up in The Atlantic. This is about post-transplant cyclophosphamide, initially developed at Hopkins for haploidentical (“half-matched”) stem cell transplants, now used even for full matches as it works so well in preventing graft versus host disease. Cheap as chips too, if you can get it (but of course low price and short supply are closely related).

The previously mentioned Axios Local newsletters continues to be a delight to read every morning. To take a quote from today’s edition, discussing the absolute horror of someone cheating at bar trivia:

In a town filled with people trying to relive their Model UN glory days, trivia isn’t just some silly bar game — it’s the D.C. equivalent of flexing shirtless on Muscle Beach.

While this isn’t what most of DC is actually like, there are many people living here who would like it to be this way and that also tells you something.

I forgot to mark the 25th anniversary of NATO’s bombing of Yugoslavia, a childhood-defining event if there ever was one (I was 15 at the time and a high school freshman). Well, today marks 25 years since the modest Yugoslav Army missile defense shot down the F-117 stealth bomber. The story is as good as a wartime story can get: there were no fatalities, the two main characters became friends, and the wreckage is now in a Belgrade museum, ignored by schoolchildren for whom these events are ancient history.

Janan Ganesh’s FT column today ends with an excellent quote which can also serve as the motto of American politics:

“We all know what to do. But we don’t know how to get re-elected once we have done it.”

He doesn’t cite the source because the FT readership would of course know who it was (I didn’t): Jean-Claude Juncker, the former Prime Minister of Luxembourg and President of the European Commission. I thought re-election wouldn’t be a problem in Luxembourg since there were so few politicians around you were bound to circle back to the top spot, but there you go.

One of the problems I have with journalism is that too often style takes precedence over precision. This is obviously fine for fiction books, less so with non-fiction although who can tell the difference these days, and should be less and less acceptable as you go from monthly magazines, to the weeklies, to the dailies, until you get to real-time 24/7 news that should be all facts, all the time.

Har har.

As an example, here is a Washington Post article about the Dutch food industry described the Netherlands as “a bit bigger than Maryland”. The article’s whole point is how much food can be produced in a tight space, so having the readers understand how big or small the country of Nethelrands actually was is important. I have ties to both of these places and some sense of their relative sizes, and I always thought the Netherlands to be more than a bit bigger than Maryland. My adopted home state may take a while to drive across, but since it’s being eaten by the Commonwealth of Virginia from one corner and the Chesapeake Bay from the other, there isn’t much land there.

To confirm my suspicion I went to Wikipedia, which said that the land area of Maryland was 25,314 km² while the Netherlands had 41,865 km² total area, 18.41% of which was water, yielding 31,457 km² of land — a full 25% more than Maryland. ⊕ If if you wanted to be more conservative you could say that Maryland was 20% smaller than the Netherlands, but that is not the comparison WaPo made. See also how percentages change with different framing — caveat lector. If I thought a meal cost $35 with tax but then the bill showed $43.75 I’d be asking for an explanation, and so would WaPo writers.

Or is 25% margin of error good enough, if you are to preserve the tired journalistic trope of comparing one thing to another? Because this is a clear case of precision being sacrificed to the gods of style: at 25,314 km² Maryland truly is the closest to the Netherlands of all the states of the Union and also has the benefit of being in WaPo’s local domain. The next closest, West Virgina, is at 62,259 km² twice the size of the Netherlands. Or rather — let’s not make the same sacrifice here — almost twice the size.

On the other hand, this is a 2-year-old article and who cares anyway? While I did stop paying attention to the newspaper noise a while ago, I still leave space for it to change my perception — which this article would have done were the relative sizes within a single-digit percentage of each other. But then I check, and nope, another disappointment.

(↬Marginal Revolution)

Yesterday I came upon an article about the increasing disconnect between US wealth and GDP growth and this morning I read this personal account of the egg freezing process, and all I can think about now is that both could be the same thing: taking from the future. For better or worse.

Hah: U.S. Sues Apple, Accusing It of Maintaining an iPhone Monopoly.

I can only hope this is a case of an unfortunate headline, not the actual substance of the lawsuit. What would be next, suing BMW for maintaining a BMW monopoly?

I thought we got rid of this nonsense last year, but apparently not. Remember, it’s never too late to resurect Swatch Internet Time.

The Medical Journal of Record The New York Times. The link is to a gift article. has an excellent story on Kawasaki disease out today which reminded me of Balkan endemic nephropathy, another rare disease with an unusual and infectious disease-like distribution. ⊕ Note that prevalence and distribution are where the similarities end. Kawasaki disease is a vasculitis (inflammation of the blood vessels) that affects children and young adults. Balkan endemic nephropathy caused your kidneys to shrivel up and stop working, and affected the middle-aged and the elderly. It had no known cause back when I was in medical school (which was — gasp — 20 years ago), but it has since been tied to accidental consumption of a certain plant. Well, accidental in the Balkans but intentional in China, where it was used in some traditional medicines and could cause “Chinese herbs nephropathy”, which was like the Balkan version on speed. Note that I am referring to both BEN and CHN in the past tense, but should probably temper my enthusiasm: even though we know what’s causing them and how to prevent them, their prevalence has decreased but is not zero.

The genetic revolution has been great for many aspects of medicine, but it has also made us a bit lazy. The promise of the late 1990s and the early 2000s has been that we would fine the genetic cause of most diseases, and would be only a step away from solving them. While we certainly found many genetic disorders, most of the are in the ultra-rare category and tied to newly-established diseases that were previously only described as syndromes. The “big” diseases — hypertension, type 2 diabetes mellitus, major depression and the like — are as unknown as ever, their cause described as “multifactorial” which is code for “we don’t know”. Stomach ulcers were also thought to be multifactorial until we found out they were mostly caused by a bacterium. A similar thing seem to be happening with multiple sclerosis, which seems to be caused by a virus, one that was mostly thought to be an unavoidable nuisance but is now a vaccine target.

But haven’t we already discovered all the big bad bugs? I sincerely doubt it. We have trouble identifying even larger organisms Also a gift link, this time to The Washington Post. I’m on a roll today. — there could be hundreds of disease-causing creatures and substances that we don’t yet know about because we can’t see them, can’t grow them, and/or don’t know where to look. And we terrifyingly bad at looking for anything but the obvious — there are parts of our own anatomy that we’ve discovered just recently.

So, I know that we will find the cause of Kawasaki disease and can only hope that it will be soon. I also hope that we will find the one main cause of the obesity epidemic. Add in essential hypertension and psychiatric disorders in there. Much money has been spent on discovering the genetic factors of these diseases. Now that we know that genes play but a small part in most of them, maybe it’s time to reallocate the funds.