My fellow NCI-trained oncologist, friend, and occasional co-author Vinay Prasad had another appearance on my favorite podcast, and I’m happy to say that the result is a contender for the best EconTalk episode of 2023. It is all about cancer screening, but also about decisions, paternalism, and regret. No mention of Covid — thankfully — and Russ Roberts mostly listens but then asks the most poignant questions that result in some spirited conversation.

The word not mentioned — a surprise since Russ likes to pull in Talebisms whenever there is a good opportunity — was ergodicity. Or rather, the non-ergodicity of medical interventions: there may only be a 0.01% chance of death with a procedure, but if it happens to you, you are 100%, not 0.01% dead. People I don’t do well with negative definitions and it would be nice if there were a separate word for non-ergodic processes, like there is for antifragility.

Another missed opportunity is to discuss efficacy — the outcome of a procedure in ideal settings — versus effectivness, which is how procedures behave when you let humans do their human things en masse. Even with that, it is a great episode, do listen, and maybe take some notes along the way.

Reading Adam Mastroianni’s latest article, about the vacuousness of psychology, and it looks like the world is ready for psychohistory. Now if only we had an intelligence greater than ours to develop it…

It’s the first day of school in DC, and we now officially have a middle-schooler in the family. I need to watch Eight Grade (2018), if it’s not already out of date by now. Tempus fugit…

The mantra at the end of this back-to-school themed Washington Post column — please drive safely, please drive safely, please drive safely — should have an addition: and don’t look at your G-d damn phone. We’ve had a couple of near-missed walking through DC; each time it was because the driver was too busy texting to pay attention to the intersection.

Some brutalist wilding in Cape May, New Jersey. Worthy of being the new cover photo, I dare say. Here’s where the current one comes from.

Kudos to @danielpunkass for making MarsEdit idiot-proof. I was writing a long-ish text this morning and while uploading the photo the app crashed, an unsaved post disappeared, and my heart sank. But on restart, everything was still there. Phew! ❤️

⊕ Wildwood Crest beach. The appropriate word is 'expansive'.

⊕ The colors aren't Victorian, but I'm sure the darkness and dampness inside are.

• The Wildwood beaches are ridiculously large. It’s as if someone took a super-sized Costco and made it into a beach. You can have a “beach access” house and still need to walk 15 minutes to get to the ocean, two thirds of that being a walk across the sands.
• At least the sand is packed tight! Great for walking and castle-building, and I hope it’s less prone to a deadly collapse because I’ve never seen so many families spend their beach time just diggin' holes — and not even that close to the water in an attempt to make a pool. What is the purpose of it? What are they expecting to find?
• Too bad that it’s still the ocean… I have been forever spoiled by the mild Mediterranean seas, never mind the exorbitant prices and the overcrowding.
• Morey’s Piers — the Mariner’s Pier in particular — are better run and more fun than anything in Atlantic City. Which, duh, of course it would since one is clearly geared towards adults with “family fun” somewhat of an afterthought, but this was a confirmation.
• I was genuinely surprised by the amount of pro-Trump T-shirts on display in every boardwalk store. There was a mug shot T-shirt on sale less than 24 hours after his arraignment. No one on the boardwalk wore any of them, though I did see quite a few “I ♥︎ hot guys” shirts.
• A different type of an amusement park is the town of Cape May, which is apparently a Victorian bed & breakfast bonanza. I’ve lived in 100-year-old house, and it’s not what it’s cracked up to be, but maybe the feeling is better when you know it’s not your own place and you’re just there for a vacation? Still, they are pretty on the outside.
• And all of this in less than 4 hours of driving from DC! The key is to leave on a Monday morning.
• So, if anyone asks what the default affordable beach holiday should be, my vote is probably for the Shore over OBX if you’re in it for the beach and the attractions, the other way around if you prefer the activities; but as the designated driver I really can’t discount that one is half the driving distance of the other. Jersey Shore wins.

Jason Snell notes that the iMac’s strongest legacy was Apple itself:

The company was close to bankruptcy when Jobs returned, and the iMac gave the company a cash infusion that allowed it to complete work on Mac OS X, rebuild the rest of the Mac product line in the iMac’s image, open Apple Stores, make the iPod, and set the tone for the next twenty five years.

I’m currently reading The Dao of Capital, which is all about the Austrian school of economics and the roundaboutness of true entrepreneurs, and this made what Apple is doing even more salient. Can you name a more roundabout tech company than Apple? ⊕ To be clear, I suspect little of this was premeditated in the long term — i.e. no, Jobs and Ive probably did not have a Vision Pro in mind as the ultimate goal when they thought of the iMac — but the ethos of seeing everything as a potential intermediary and not commoditizing it fully à la Samsung is very much the Apple way. Using the iMac as the intermediate step towards the iPod, which was itself an intermediate step towards the iPhone, which was supposedly to be an intermediate step towards the iPad but turned into something much greater, though it also did end up being an intermediate step towards Apple silicone, all the while peppering these intermediary products with technology — LiDAR, ultra-wide lenses, spatial audio — that would become the key building blogs of Vision Pro, which is itself an intermediary towards who knows what. Very Austrian.

Thinking more closely to home, I can think of a few biotech companies that may be doing something like this — maybe, if you squint — but none come close. The addiction to immediate profits that the distorted American health care market provides is much too great.(↬Daring Fireball)