• Michael DePeau-Wilson for Asimov Press: Why the FDA Is Slow to Remove Drugs. And more importantly, why this is bad. You can’t accelerate drug approvals without also doing more culling on the back end. Symmetry, please.
• James L. Olds: Why Transformational Science Can’t Get Funded: The Einstein Problem. I disagree with most of it, but it is in fact the institutional point of view.
• Anonymous for the Good Science Project: A Top Scientist’s Ideas as to NIH. Did AI write this? Not great, but again, an institutional point of view masquerading as call to reform.
• Bryan Vartabedian: Physician authority and influence. An important distinction, and kudos to Dr. Vartabedian for coping that he has more influence than authority. I, on the other hand, have neither.
• Joe Boudreau: On 10 Years of Writing a Blog Nobody Reads. I have been doing it for at least 15 (13 of those in English) and it is in fact wonderful.
• Todd Vaziri: The “Mad Men” in 4K on HBO Max Debacle. The best and most concise review of this royal screwup of one of my favorite shows.

• Jamie Thingelstad: I gave Gemini “Thinking 3 Pro” and Nano Banana Pro a more interesting question tonight. Ready for prime time in biomedical graphics? I would be ever paranoid about a mistake that I missed, so still not for me.
• Tom Loughlin: According to timeanddate.com, sunset is at 4:44PM EST, and will continue to set at this time until Dec. 15th. Look in the comments for the answer why.
• Paul Williams: The Verge on HBO’s poor execution of the “remastering” of Mad Men in 4k for streaming. I had a look today and even the picture quality wasn’t that great, but the errors they are describing are truly bad. Matthew Weiner can’t be happy.
• Niko Kultalahti: I enjoyed this list about 15 rules of blogging, especially rule 2, and they are quite similar to mine. Using micro.blog helps.

And better than any list I can give is the newly-refreshed (by a new curator) Discovery feed, also available as RSS!

“The internet is dying on the outside but growing on the inside”, wrote Yancey Strickler last month in a follow-up to his 2019 essay The Dark Forest Theory of the Internet. To avoid misunderstanding, malicious interpretation, competitive intelligence gathering and cancelation, conversations have been moving from the public-facing “social” “media” to gated, invitation-only services (e.g., your favorite Substack author’s members-only discussion forum) and private group chats (e.g., the Let’s Bomb Yemen Signal texts).

But some parts of this Cozy Web are growing faster than others, and as if often the case doctors and scientists are ruled by inertia. Both groups have the perfect setup, in the form of professional societies, to carve off some gated space in which to have potentially controversial discussions without providing fodder to “the enemy”. ⊕ In these kinds of metaphors I always reach out to Venkatesh Rao’s The Internet of Beefs, which explains quite well why the public Internet has turned into a dark forest in the first place. And yet even the most developed online community program I know of — American Society of Clinical Oncology’s myConnection — is a stuffy, ⊕ ASCO boasts as having more than 50,000 members. The two largest “communities” on MyConnection, “New Member” and “Women in Oncology”, have more than 9,000 members each yet the last post on one was 9 days ago (with zero replies) and 7 days ago (two replies). All of November, the more active WiO group had 9 posts with median 1 reply (range 0–20). formal messaging board that can barely be considered active. Most of ASCO’s online activity is still on X, where the official account has almost 150,000 followers and the hashtag for its annual meeting is heavily promoted. Other large hematology/oncology societies like ASH (hematology) and AACR (general cancer research) don’t even have that. Their “online community” is a member directory and heavy promotion of in-person conferences, which I can only assume are the true money-makers.

So I have to wonder, do they still deserve to call themselves “societies”? It is, after all, 2025 and much of life has moved online. By not providing an avenue for true internal discussion and instead promoting public debate, are they hurting their members' cause more than helping? ⊕ Yes, it was fun to post out in public when there was a slight chance that your favorite celebrity — or the POTUS — would retweet your post, but we have since learned that this is a liability more than a benefit and there are more high-follower accounts on X now that I would rather avoid. I have argued recently that scientists may want to button up their conversations if they are to keep or regain trust. Should these societies not be providing the means to do so, and not only once per year in a stuffy conference room? ASCO’s MyConection is on the right track, but much too formal. Yes, give people the opportunity to create subgroups and even more private chats as you do now. But if you think debating on X with millions of spectators is healthy, why not give all 50,000-plus members a chance to interact by default, and do so in a format that is not an early 2000s web forum?

Concluding the most recent article, Yancey Strickler provided a toolbox for people to create their own communities which he called the Dark Forest OS, of DFOS. While laudable, this effort is to put it bluntly too artsy fartsy for me. Strickler comes from the world of “creators” whose sensibilities are much different from those of doctors and scientists. But then science and medicine already have much of DFOS in place, from a members list to paying dues. The only thing we need now is for the said societies to build their walled gardens — with an app included! — which they would promote instead of X at the annual meetings and other conferences.

Where a SciMeDFOS would come useful is at smaller scale, for collaborative groups and maybe even large individual labs, where members are known but there are no dues, funds, or IT workers ready to build a custom Twitter clone. If I were to make one now I would probably use Hometown, which is a fork of Mastodon that enables local-only posting, though it being a single person’s passion project makes me a bit reluctant. But then what else do we have, Discord, WhatsApp and Signal? Whatever Dave Winer comes up with in collaboration with Wordpress? Maybe Squarspace could make creating private Twitter clones be as easy as creating websites? I will be on the lookout.

• Rachael Bedard: I Went to an Anti-Vaccine Conference. Medicine Is in Trouble. Tragic considering all the good vaccines have brought us, most recently against cervical cancer. And the news from the FDA is, of course, a disaster from any perspective.
• Kurt Streeter: How to Fix a Typewriter and Your Life. A palate-cleanser for the above. And if this piques your interest, Chris Aldrich has a wonderful primer on learning typewriter maintenance and repair.
• Ross Douthat interviews Paul Kingsnorth: ‘This Is the War Against Human Nature’. Not the only interesting interview Dothat made, and they make for better reading than listening.
• Jeff Giles: How I Began to Love Reading Again. I too loved If on a winter’s night…

Enjoy!

• Oliver Burkeman: Interest is everything. The argument for living a life that is interesting to yourself, with which I agree. I have also learned about type 2 burnout in which “you’re not overworked, you’re just working against your own grain.” That too is interesting.
• Casey Handmer: Antimatter Development Program. A ridiculously (to my untrained in physics mind) detailed writeup of what could be the next generation of rocket fuel. To the above point: Handmer’s interest in the topic is contagious.
• Sacha Fast: One (and another) Gear in the Zettelkasten Machine: A Deep Dive into a Key Mechanism. Another person writing about a topic they love, which is slip-boxes. These kinds of posts are dangerous because this interest too is contagious but unlike Handmer’s is also immediately actionable at home. Caveat lector!
• Tanner Greer: The Making of a Techno-Nationalist Elite. Nominally a book review, actually an essay that surpasses the said book in its coverage of the topic.
• Ben Hunt: World War AI and Nick Maggiulli: Is This How the AI Bubble Pops? with two angles converging on the same conclusion, which is that our interesting times are about to become even more interesting.

Happy Thanksgiving, dear reader!

• Tom Forsyth on Mastodon: “Recent discussion about the perils of doors in gamedev reminded me of a bug caused by a door in a game you may have heard of called Half Life 2.” Parallels in biology immediately come to mind.
• David Roberts on Blue Sky: “In an era filled with tech dipshits who never developed emotionally past the age of 13 & use their wealth to become odious monsters … listen to Steve Wozniak.” We are where we are in big part because there weren’t enough Steve Wonziaks in key industries when it mattered. Or rather, because they by definition bowed out and gave the sociopaths free space to roam.
• Ruxandra Teslo on X: “We should do smth abt this.” The “this” is the threat of clinical trial infrastructure being flooded by the biotech equivalent of AI slop. And many misguided people think that this is a good thing!
• Joe Janizek on Substack: The birth of Advanced Radiology. Or: radiology as chess. Radiology and pathology are the few areas of medicine in which AI may be produce immediate benefit.
• Nassim Taleb on Substack: Medical Mistakes with Probability, 2. Why the benefit of statins in people with barely elevated cholesterol and no other risk factors is grossly overestimated. Note that this constitutes most of the market for statins! My cynical take: Now that they are all out of patent I don’t think anyone would complain about cutting back.

It is infrastructure day on the blog today, with two updates:

1. The Blogroll is now a fresh export from my feed reader and an accurate representation of what I am actually reading. I still need to figure out how to make the very detailed “About” field for each entry actually show up, so stay tuned for that one.
2. The Now page had its biannual refresh. I will at some point make it a more frequent ritual but best not to expect real-time reading/watching/listening lists.

You may have noticed more linked lists on this blog, starting this summer and ever-increasing. This is the direct result of moving my RSS reading from (mostly) NetNewsWire on the phone to (mostly) Feedly on the Daylight tablet. Whatever the cons I thought it had in the beginning, they melted away as the proof is in the output. Interestingly, I hardly ever use the pen, but did pair it with an old (pre-Touch ID) Magic keyboard encased in this handy case/tablet stand and this light-weight pair of devices is all I need on most short trips.

Now, it is not a cheap device! There is currently a 48 hour pre-Black Friday flash sale, and it is still $649 pre-tax. It is also much less versatile than an iPad (no camera and therefore no video calls, and certainly not a good media player although being an Android tablet it does have an official YouTube app, unlike some other better-screened devices. But if you already have a large phone and a laptop, does that middle screen truly need to be a full laptop replacement?

I was also pleasantly surprised by the (heavily customized) Android tablet interface. Things have evolved quite a bit since I briefly owned a Fire tablet, which appropriate to the name I wanted to burn in an effigy. I haven’t owned a Remarkable or a similar e-ink device, but from the refresh rate alone I would guess my reaction would be the same. The plain old LCD technology that Daylight uses ⊕ Even though, yes, they’ve rebranded it to “e-paper” and say it’s their invention. I don’t know enough about screen technology to comment on whether this is valid, but to me it smells like mostly marketing. was the perfect compromise for my uses, and one I hope more companies would emulate.

• Niko McCarty: Here are 30 great essays about biology. They are indeed great, and it even includes one where I gave a modest and unattributed contribution (you will be able to guess which one). To this I would add William Kaelin’s Publish houses of brick, not mansions of straw, cited many times on this blog (most recently just last month).
• Jason Locasale: My latest article in The National Review on what 60 Minutes got wrong about Harvard and the biomedical research industrial complex, and why the deeper issues in science can’t be fixed by throwing more money at broken institutions. Here is the article, which I agreed with directionally but had so many “I know this person and let me tell you what they are truly like” moments that I thought there had to be a backstory to this insider-ish scoop. And indeed there was, as noted in responses to Michael Eisen’s tweet. So much drama, and all it does is make it easier for people to shrug their shoulders, say that it’s complicated, and defer to higher authorities (i.e., Harvard).
• Nassim Taleb: I believe this paper addresses, even solves, the most relevant statistical problem of the century, including the replication crisis & the fake results in publication. No false modesty here. Papers like this make me think that frequentist statistics are fine for the lab where you can truly do the same experiment over and over, but when it comes to clinical trials you can never cross the same river twice and we should all be Bayesians.
• Christopher Hooks: I sincerely believe that anyone pushing this should be shot. I agree in spirit. Whoever made this AI abomination should study Hayao Miyazaki and his work.

• Doc Searls: Smart is as Smart Does. On the deficiencies of IQ as a metric, and I wholeheartedly agree.
• Damon Linker: The Most Moving TV Show I’ve Ever Seen. Which is The Leftovers, of course, and I agree. Bonus article: last year’s NYT interview with the showrunners. (ᔥTipsy Teetotaler)
• Andrew Gelman: Conflicting statistical evidence on the long-term effects of children on being whacked by their parents. How one feels about spanking depends greatly in their own experience of it as a child, as the comments to this blog post show.
• Joseph Heath: Populism Fast and Slow. An aside from this article did more to dissuade me from spanking (sorry, “whacking”) as a teaching method than anything Gelman cited. Its main point is also important, and I will quote it here:

People are not rebelling against economic elites, but rather against cognitive elites. Narrowly construed, it is a rebellion against executive function. More generally, it is a rebellion against modern society, which requires the ceaseless exercise of cognitive inhibition and control, in order to evade exploitation, marginalization, addiction, and stigma. Elites have basically rigged all of society so that, increasingly, one must deploy the cognitive skills possessed by elites to successfully navigate the social world.

As a card-carrying member of the cognitive elite, I fully support the rebellion.