• Raghuveer Parthasarathy: Space mirrors, solar panels, fools, and their money.

A few months ago I noted that the one of the main reasons biotech was not like tech was its almost unlimited freedom do bullshit. Well, people are able to raise money by BS in other areas as well, as this article shows, but an order of magnitude less because most investors are able to do back of the envelope calculations.

• Bryan Vartabedian: The Measure of Everything.

A take on Goodhart’s Law as applied to medicine, this time through the lens of instrumentalisation. If any of these articles tickle you and you haven’t yet read Zen and the Art of Motorcyle Maintenance, please do so now. Ted Gioia recently wrote about the book and its legacy. As an occasional note-taker I am in the minority club of Lila fans as well, though both of Pirsig’s books are due for a re-read.

• James Olds: The Chronology Problem.

The point is in the subtitle: “how our bias towards recency in scientific discovery hurts our understanding”. It rings true, and even reminded me of the 26 years it took for CRISPR/Cas systems to travel the path from an oddity to a gene editing platform, until I realized that those 26 years were not spent idling as this review in Cell describes in detail. So, the (lack of) developments in theoretical biology would be a much better example.

• Phil Price: Ted Williams and Me.

Ted Williams was, apparently, a base-ball player about whom John Updike had this to say: “For me, Williams is the classic ballplayer of the game on a hot August weekday, before a small crowd, when the only thing at stake is the tissue-thin difference between a thing done well and a thing done ill.” This applies to any profession you can imagine, and indeed things outside of one’s professional life. People who have the inner drive to do things well even in the absence of stakes could unkindly be called “perfectionists”, but let’s remember that they are the ones who keep the wheels of civilization in motion, in opposition to the hordes of blankfaces, lazy asses and morons.

Proactive vs Reactive DDAVP: The Clamp Finally Faces an RCT from Joel Topf is a perfectly good hyponatremia article if you are into that sort of thing, but what got me interested was the preamble:

Note: This was one of my first posts on Roon.com If you are an American physician who likes to chat about medicine, you should sing up.

Roon.com is “a community for physicians to connect, share knowledge, and shape the future of medicine.” A walled garden for physicians? Made and funded mostly by ex-Pinterest people? Sign me up!

• Lily Lynch: A Tale of Two Missiles (and other stories).

Behind a paywall, but well worth subscribing to for the unusual perspective of a West coast American who has spent so much time in the Balkans that her thinking about world affairs is fresh and unique. When bombs fell in Iran and Americans started talking about regime change, all I could remember was the summer of 1999 when Nato bombs extended the Serbian zombie regime’s lifespan by a year. Lynch explains the how and why better than I ever could.

• Daniel Frank: on high context and low context environments.

You could also call this dichotomy thick and thin culture, as Chris Arnade did not so long ago. Although religion features only briefly and superficially, is it not mostly about religion?

• Christopher Butler: Modern wealth is a parlour game played by the well fed.

Summary: “Market crashes aren’t accidents—they’re board-clearing strategies that consolidate power while the rest of us lose everything.” The diagnosis is right though I can’t say that I understood Butler’s solution which was, if my reading was correct, to play dead?

• Sam Wigglesworth: Doctors should admit they don’t know.

The list of indignities Wigglesworth suffered from various dcotrors was horrifying and I wondered for a moment where in America medicine was still practiced in that way (the VA?). Then I saw that she was Dutch and things made even less sense. Say what you want about the Lovecraftian horror that is the American “health” “care” system — second in Cthulhu-ness only to its system of immigration — but doctors are for the most part the least paternalistic one can find anywhere in the world, and to a fault.

Dave Winer asked me a question about APIs. A friend of mine, who is also an oncologist and a big fan of Mad Men, upon seeing the interaction: “This would be like Matt Weiner asking me for advice on a short story I wrote”. Indeed!

I want to do more to support blogrolls and recommendations between the apps. Need to explore this more. For the API, there is a very sparse help page here which I’ll be expanding later this week.

That was Manton Reece in response to my question about Inkwell, an RSS feed reader. And with that sparse help page, Gemini sucesfully completed my request to create “Inkling”, an Emacs client for Inkwell which uses Microbe to compose posts with quoted text, as I’m doing now. It can even bookmark posts using micro.blog bookmarking service.

Dave Winer wondered how he would fit Inkwell into his life. Thanks to Manton’s continued use of open APIs — and with much help from Gemini — I don’t have such dilemmas.

Update: inkling.el is now available on Github, on the Microbe project page. Inkling depends on Microbe for the auth token, so anyone brave enough to try may as well get both!

• Vladimir Campos: The em dash is not an AI thing — have you ever read a book?

As a heavy em dash user myself, I can only concur.

• Kieran Healy: Using Quarto to Write a Book.

Healy will soon have a new book out, or rather a revised edition of his book about data visualization. Quarto is the open-source Rube Goldberg machine he used to create it. Particularly salient was the transformation of Quarto’s output into professional print, which unlike the online version required much human judgement and fiddling. Yay for humans, and yay for physical books .

• Sharon Lohr: AI vs. Undergraduate Statistics Students.

Lohr passess Gemini through the same gauntlet of tests her students went through. The more abstract the task the worse it gets, particularly with regards to critical thinking. Kind of important if we want generative AI to perform peer review! Though again, the state of human peer review is bad enough that I don’t think it would be that much worse.

• Daniel Sell: How To Stop Jumping Ship.

Or rather, how to keep the independent blog community going. He had me at “Screw Discord”.

• Ian Betteridge: Zen fascists will control you… (sic!)

The same thoughts have crossed my mind and even though I keep calling it the naturalistic fallacy, Wikipedia says that the correct term is appeal to nature. However you call it: homo sum; humani nihil a me alienum puto, in its widest interpretation.

• Branko Milanović: To work or not to work. A modern economic take on the Red Queen’s race of capitalism. Pairs well with this question from Alex McCann.
• Alex McCann: The Case for Active Optimism. Speaking of! Yes, let’s extrapolate the transitions from agranian to industrial to information societies into this new transition to the society of slop (SoS). I still worry that those required levels of civic vigilance that we are not currently able to muster (and arguable failed at even as moved from industry to information, hence our current predicament).
• Derek Sivers: Offline 23 hours a day. A palate cleanser before the next course.
• Harry Crane: When Prediction Markets Don’t Predict: The Khamenei Resolution Debacle. Crane is a semi-professional gambler and views these new gambling devices rather favorably (see: name of his blog) but even he bristled at what happened here. There is also a follow-up.
• Sara Talpos and Michael Schulson for Undark: Do America’s Top Health Research Officials Stick Around Too Long? Yes, with interesting caveats. (ᔥJim Olds, who makes an appearance)

In addition to the categories listed on the blogroll my RSS reader has one labeled “New” which acts as a saucer for my feed subscriptions. I end up deleting quite a few of these — the post that got me interested may not be representative of the whole thing Which brings up an interesting question of whether or not blogs are ergodic. Let that be an excercise for the reader. — but some do move on. Below are a few of those.

Stories & Journals

• Weird and Deadly Interesting by Ahmet Alphan Sabancı, “a critical futurist, writer, journalist and activist”.

Economy & Finance

• Citation Needed by Molly White, “a researcher, software engineer, and prominent critic of cryptocurrencies and blockchain-based projects”.

Reading & Writing

• Note to Self by Gina Trapani, “a writer and programmer based in New York City”.

Science & Medicine

• Aaron Cheng, MD by Aaron Cheng, “a classical hematologist and clinical investigator”.

Philosophy & Religion

• Heavy Machinery by Mike Pepi, “a cultural critic”.

Hardware & Software

• Tonsky.me by Nikita Prokopov, “Software Engineer with a vast open-source portfolio and strong UI/UX background.”
• nickschaden by Nick Schaden, “an engineering manager and creative technologist”.
• journal.stuffwithstuff.com by Bob Nystrom, a “programming language developer at Google working on Dart, ex-game developer at EA, UI nerd, author of ‘Game Programming Patterns’ and ‘Crafting Interpreters’”.
• Disconnect by Paris Marx, who " hosts the award-winning Tech Won’t Save Us podcast and is the author of Road to Nowhere: What Silicon Valley Gets Wrong about the Future of Transportation."
• karpathy by Andrej Karpathy, “AI researcher”.

An honorable mention goes to the Bear Blog Discovery feed which will forever remain in the “New” category as new blogs keep bubbling up. That feed is also the reason “Hardware & Software” blogs overrepresented in the above list. My preferred platform, micro.blog, also has a Discovery feed, but since it tends to promote micro posts (duh) it is there more to find new people to follow on micro.blog itself rather than the feed reader.

So, any pointers to non-technical blog chains and other discovery mechanisms would be much appreciated!

• Aaron Cheng: On the emotional weight of a life in medicine. Thoughts of a newly-mintend hematologist which act as a good counterbalance to the popular fictional accounts. Feel free to peruse the few pre-2017 posts from the Infinite Regress archive for my own thoughts from that period.
• Fred Vogelstein: Enveda’s drugs from plants will turn pharma upside down. This is what Ruxandra Teslo warned us about a few months back.
• Joseph Howlett for Quanta Magazine: The Man Who Stole Infinity. On Georg Cantor, plagiarist. It does cause one to become more cynical, as we keep discovering that high-profile scientists built their reputiations on the backs of people with more scrupules and less need for attention. Taleb’s minority rule applied to sociopaths.
• Adam Mastroianni: The one science reform we can all agree on, but we’re too cowardly to do. It is to abolish for-profit scientific publishers, and I am all for it. But, people being people, I do not have high hopes that this prisoners' dilemma will have a positive outcome.

• Derek Lowe: The Best Ideas Are Not Always Enough.

Drugs which look great in those cellular machinery flow charts with boxes and arrows pointing every which way, and which may even cure a few genetically monstrous and wholly artificial lab mice, tend to flop where it matters. Lowe links to 11 such examples and writes in more detail about the twelfth.

• Adam Kroetsch: Why clinical trials are inefficient. And why it matters.

An overly long article ⊕ ᔥNintil with which I don’t completely agree ⊕ For example, Kroetsch describes the role of a site investigator as resembling “that of a glorified data entry clerk - the investigator’s primary responsibility is gathering the data that the drug company needs and sending it to them”. This is incorrect: site investigators usually have clinical research coordinators and data managers to do it for them. But this deserves a post of its own. but which nevertheless provides a good overview of the many things wrong with how clinical trials are being conducted in the US, the biggest one being that they are reinventing the wheel each and every time they are done. The “lean trial” proposal at the end matches my own thinking.

• Ruxandra Teslo: A response to Dario Amodei on AI & clinical trials.

Teslo picks up on the tech bro magical thinking streak in which things you don’t sufficiently understand seem eminantly solveable using the most recent technological developments. Five years ago it was electronic medical records and blockchain, now it’s clinical trials and AI. The article gives the many reasons why things are not that simple. Now, if we all agreed on the set of LLM prompts that would provide an unbiased protocol and informed consent form review thus eliminating as many people from the loop as possible, well, then we may be on to something.

• Alex Tabarrok: If you have the right to die, you should have the right to try!

If someone qualifies for euthanasia, should they also not be eligible for every expanded acces, compassionate use, right-to-try scheme imaginable? Obviously: yes. Maybe not so obviously: there is a branch of my subspecialty aptly named desperation oncology which in the vast majority of cases leads to false hope, financial ruin and, worst of all, time misspent in doctors' offices and infusion clinics instead with your loved ones. As a doctor and a human being I am partial to life, so I see state-assisted dying programs like Canada’s MAID as monstrous, but “you’d rather be dead so here, take this drug” is only a half-step above that qualifier and leads to the bad reputation of experimental therapies.