Surprised that some airlines still ask us to stow away “large electronic devices” but keep using iPhones and tablets in airplane mode. So it’s OK to use the 13 — sorry, 12.9” — iPad Pro, but not the 11” MacBook Air? Or even smaller Chromebooks? Someone hasn’t thought this through.

My friend and fellow oncologist Timothée Olivier has just started a YouTube channel called Primum Non Nocere — yay for Latin — and the first video, about reading clinical papers, is well worth 40 minutes of your time.

When the “Nobel Prize for Economics” gets announced, and people cry out that well-actually it’s the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel and it’s not part of Alfred Nobel’s original endowment, it is because this joker has won it, so how valuable could it possibly be? On the other hand, the most recent award went to the genuinely brilliant Claudia Goldin — here is a good pre-award interview — and the other Nobel prizes also went to some real ding-dongs. Things are never so clear-cut.

When I last wrote about crime in D.C a man was murdered while watching a soccer game right next to my kids' elementary school. This was back in July. Since then, the murders increased even more in August and decreased to (still high!) 2022 levels in September. Then a congressman got carjacked in front of his apartment building and the news media were all over it.

I mentioned in passing how you can trace a direct line from bad decisions to even worse consequences. While there has been movement to correct some of the more egregious mistakes, I haven’t seen even a suggestion of a mea — or sua — culpa from a council member. Until now!

When the stakes are lower, such as lets say public transit fare evasion, there is more space for assigning responsibility. The press release announcing the new legislation and the history behind the reversal is as good of an example of unintended (but not unforeseen) consequences and externalities as I’ve seen. You could, of course, trace the same well-intentioned path from calls for justice to murders on the soccer field, but that would of course not be so politically palatable.

All of this has reminded me of medical reversals and the unfortunately-titled (but good!) book about ending it. ⊕ This is why it is unfortunate: medical reversal is when something that is standard medical practice despite lacking evidence of benefit goes out of fashion once data, usually from a randomized controlled trial, show it doesn’t work. Now, ending reversal could mean two things: that you keep doing the thing despite the new evidence, or that you never start doing the thing to begin with. The authors meant the latter, where my common-sense interpretation is the former. People do dumb stuff. We should promote their reversal. Now, “legislative reversal” and “legal reversal” are terms already reserved for when an appeals court overturns a lower court’s decision, so what should we call “medical reversal” for written law? There are plenty of examples: from customs enshrined in old legislation than is then abolished (like traditional medicine disappearing with evidence showing it doesn’t work) to seemingly progressive legislation which is in reality a fountain of unintended consequences becoming quickly reversed.

Whatever the name, the consequences are at least more definitive than with medical reversals, which are rarely full — people still insert intra-aortic balloon pumps and perform kypholasties, I hear — and outside of a full FDA withdrawal of approval never have as clear of a demarcation line as written law. And we shoud strive to promote it, not end it.

The recent conversation between Peter Attia and Russ Roberts on cancer screening and longevity has left a good impression, so in case you rushed out to buy his new book, Outlive, here is some thoughtful criticism. Biennial colonoscopies and whole-body MRIs at any frequency are indeed unreasonable.

Flâneur:

A French noun referring to a person, literally meaning “stroller”, “lounger”, “saunterer”, or “loafer”, but with some nuanced additional meanings (including as a loanword into English). Flânerie is the act of strolling, with all of its accompanying associations… Traditionally depicted as male, a flâneur is an ambivalent figure of urban affluence and modernity, representing the ability to wander detached from society with no other purpose than to be an acute observer of industrialized, contemporary life.

Flânerie has been anglicized into flaneuring, a term I first saw when Nassim Taleb described his strolls through Belgrade but which is popular enough to have had its segment on the Today Show, plugging a book that looks like something that I would never in my life touch, but hey, the concept is sound! Take a leisurely walk through the city without a destination or a particular plan. Don’t wear headphones. Do have a partner or two to share your observations.

It is exactly what we have been doing in Honolulu for the last few days and I mentioned off-handedly to my wife the Taleb post and the term. It clicked instantly, like “premium mediocre” did back in the day. What was once premium mediocre has become an unbridled luxury ⊕ To keep the Talebian theme going, this is as clear of an example of the Lindy effect as any. — thank you, inflation — so we don’t mention the phrase much, but as long as there are cities there will be flaneuring.

The non-touristy parts of DC — which is most of them, actually — would probably be in the US Top 5, which is damning with faint praise because the competition is so bad. It is a shame that it wouldn’t be the clear number 2 — with New York being the obvious number 1 — but DC is fairly small, and Chicago is even better for flaneuring than NYC for 3 months of the year. Of course, if we started taking weather into account Honolulu would soon rise to the top and overtake all; but as we are not effective altruists, let’s not.

Accompanying the spouse to a conference is always good, but doubly so when the conference is in Honolulu! There will be a more detailed report after we are back; in the mean time, here are a few murals, from delightful to bizarre.

The last time I attended a large annual meeting of a professional society was in 2019, and either things have taken a strange turn in the last 4 years, or hematology and oncology are so different that attending any other society’s opening session feels uncanny.

I say this because I attended one yesterday — see the other post from today — and if my eyes could have rolled all the way back into my skull, they would have. This is what I am used to: speakers standing behind the podium — usually elevated, sometimes not — looking straight ahead, reading off the teleprompter more or less skillfully — since after all they are doctors and PhDs, not professional salespeople — occasionally averting their gaze in an attempt to connect with the crowd, which is of course impossible because of the glaring stage lights, but all is forgiven because, after all, we are there to learn, not to be entertained.

Well, someone must have come in and told the medicine men they were doing it all wrong, because this session looked like an Apple keynote — the boring parts, where Tim Cook talks about how many stores they opened — crossed with a TED Talk from a dubious but super-enthusiastic liberal arts professor. There is no podium to anchor yourself, so you and your hands are all over the place gesticulating wildly — power-posing, perhaps? — while you gaze into the teleprompter positioned at 45° above the horizon to give you that contemplative look.

This style of presentation is cringy even when most tech companies do it: Apple is Apple; the other big ones don’t even try to compete, and it’s not until you come to the mid to lower-tier This is a link to the Procreate Dreams reveal video. It is an excellent product which I will definitely get for my kidds to play with, and the creators seem rightfully proud of what they accomplished, but copying Apple did it a disservice. that the “person emoting in front of a large professionally-made slide” style re-emerges.

I wish that was all there was to it. Alas, there was a keynote speaker for this openning session of a professional medical society, and the keynote speaker was — it was at this point that I realized the universe was making me pay for coming to Hawaii — a YouTuber! Which is fine, only they decided to set their talk to background music and flashy videos, and pepper it with excerpts from their own content, letting a good personal story of their family and education get drowned in dumb glitz.

Therefore, to be possess’d with double pompe,
To guard a Title, that was rich before;
To gilde refined Gold, to paint the Lilly;
To throw a perfume on the Violet,
To smooth the yce, or adde another hew
Vnto the Raine-bow; or with Taper-light
To seeke the beauteous eye of heauen to garnish,
Is wastefull, and ridiculous excesse.

Four centuries later, we are in full-on gild mode.