December 28, 2021

Goodbye, Drummer (for now)

Drummer is an online outliner that enables quick, easy, and near real-time posting of text both long form and short — what we used to call blogs back in the good old days of two years ago. Dave Winer created it for his own purposes, but it works beautifuly with just your Twitter account as a login. Here is my page.

As things are still very much in progress, Dave recommended doing daily backups. Sadly, I didn’t, and as of today’s updates a few weeks' worth of half-baked notes are wiped out from the Drummer server (but thankfully not from the website they helped create). That’ll teach me.

Since posting to that page is on hold until everything is back in order, expect more — dare I say daily — updates here. Managing markdown files is not nearly as intutitive or pleasant to use as Dave’s outliner, but he seemes to be working on an OPML to markdown converter. That will be well worth the wait.

December 25, 2021

Voices in my head, 2022

Listen to podcasts long enough and you are bound to develop tastes. After 15-some years, mine are these: conversations over stories, with minimal to no editing, and lasting no longer than a couple of hours per episode. Even within these constraints, the list of podcasts I could listen to is near-infinite. Yet these are the few to which I keep returning:

  1. Omnibus, which survived John Roderick’s attempted cancelation to continue providing two poorly-researched topics per week. Highlights of 2021: Mobile Jubilees, The Bottle Conjuror, Officials General, Merkins (yes, those), and The Phantom of New Guinea in which the curious popularity of an obscure Canadian detective show in Serbia makes an appearance.
  2. EconTalk, which continues to be the best general-interest interview show for people who’d rather avoid snake oil salesmen. Highlights of 2021: Dana Giola on poetry (which is in fact the best episode of 2021), Julia Galef on her book Scout Mindset (which I am yet to read, but oh well), Anja Shortland on lost art, Bret Devereaux on ancient Greece and Rome, and Johann Hari on lost connections (which reminded me of a particularly sad episode from my tenure as a heme/onc attending).
  3. Healthcare Unfiltered is the first new healthcare-related podcast I’ve started listening in years. Chadi Nabhan is a good interviewer with an even better access to relevant guests, particularly when he attempts to bring together both sides of a twitter-heated medical debate. Highlights of 2021: Bishal Gyawali on clinical trial design, Aaron Goodman and Matt Wilson on CNS prophylaxis for DLBCL, Barbara Pro and Mehdi Hamadani on PTCL, Mikkael Sekeres and David Steensma on mid-career transition, and Aaron Goodman versus the world, supposedly about randomized clinical trials.
  4. Plenary Session was back on my playlist this year, and mostly Covid-free. Highlights of 2021: Chris Booth, Adam Cifu, Manni Mohyuddin, Bapu Jena, and again Aaron Goodman (who should really start his own podcast instead of squatting in other people’s).
  5. The VPZD Show is the one about Covid. Prasad and Damania have their hearts in the right place and fairly sharp minds; they can evaluate evidence on merits and are willing to admit past mistakes. Without mourning days past when these characteristics were more common — because in fact they weren’t — I’ll just note that in times like these, they are essential. Highlights of 2021 include the entirety of the show, which has only just started.

Previous editions: 2021202020192018The one where I took a break from podcastsThe very first one

Zero to One

Peter Thiel’s thoughts about startups, which I presume every founder past, present, and future has read and internalized.

But I jest. Browse Twitter and you’ll see his seven fairly simple principles of running a successful startup abused, ignored, and misinterpreted, particularly in biotech.

Instead of building a technology that will be useful 20 years from now — the durability factor — technologies are made to solve problems of 20 years ago. Layering optical character recognition, artificial intelligence and machine learning over the cruft of hand-written notes faxed back and forth between doctors' offices comes to mind. Compare and contrast to mRNA vaccines, a technology created more than a decade ago to treat today’s pandemic.

Instead of developing drugs and other treatments with at least 10 times the effect size of current standards of care — principle of technology — the regulatory agencies and markets are overwhelmed by me-too drugs whose marginal benefit requires mammoth trials for any chance of detection.

Instead of vertical integration and ownership of drug discovery, manufacturing, clinical operations and biomarker development within the same organization, with positive feedback loops between all the factors leading to a faster pace — the team prinicple — we get ghost companies made of slide decks and good wishes whose only tangible impact on the world is achieved via Contract Research Organizations.

I could go on: the principles of timing, monopoly, and distribution are also violated early and often in a biotech startup’s lifetime. But then I’d be breaking a principle myself, that of the secret.

October 28, 2021

Godwin’s Law and the Rise of Hyperbole on MedTwitter

Saurabh Jha:

“Today’s Galileos fight over one or two vaccine doses in teenagers, whether the risk of vaccine-induced myocarditis is 1/1000 or 1/10, 000. Nothing encapsulates our pettiness more completely than our probability wars.”

Echoes of Chris Hitchens here.

October 23, 2021

Dune (2021)

The 1984 version showed that making a good movie out of a 700-page tome is a complex problem that can’t be solved in 2 hours 17 minutes on a $40M budget. It took 20 minutes and $50M more than that for Denis Villeneuve to cover just half of what Lynch attempted, but the end result is so much better. The story is what it is — between the book, the movie, the TV show, and the game I now know it by heart — but the casting, the pace, cinematography, score, the movieness of it, are all pitch perfect. A cross between Mad Max: Fury Road and Star Wars, noted our perceptive nine-year-old somewhere around the 30-minute mark. Yes, and more like this, please!


Viewing notes: we saw it on a 120" screen with a 5.1 surround system. If you have anything less at home I’d strongly recommend going to a movie theater. Yes, it’s nice that it is available for streaming on day 1, but you would be doing a disservice both to the movie and to yourself seeing it on a postage stamp. </privilege>

October 19, 2021

The Mysterious Benedict Society, Season 1

A Disney+ TV show that WoG followers would like. Villains are IYI vegans who live in modernist buildings and make children live by absurd and contradictory rules that only give an appearance of freedom (“You are free to go wherever you like, as long as you stay on the path”, to paraphrase one). Our heroes, both children and adults, are messy but resourceful, at home in both a Georgian mansion and the wilderness of (I assume, though it’s never specified) the Pacific Northwest.

It starts in a picturesque costal town right off of Townscaper. By the third episodes the children are stuck in a nightmareish brutalist school that is all acute angles and ’70s orange-white plastic furniture — not nearly as pretty to look at, but the puzzle-of-the-day aspect makes every episode worthwhile. It ends with most of the loose ends tied up but with promises of more to come. And Tony Hale is in almost evey scene. What’s not to love?

October 18, 2021

A brief chronology of my employment


  1. Someone else’s, to be clear. ↩︎

October 11, 2021

CODA

A few notches below Little Miss Sunshine, a movie of a similar sensibilities. Some changes might have improved it — e.g. why does Ruby end up at high-school choir practice because of a boy, and not because of her love of singing? — but none of it can correct the one huge flaw, which is that conflict between Ruby’s supporting her family by providing free ASL interpreter services and Ruby’s becoming a strong independent young woman is a zero-sum game which will end up in either financial hardship or broken dreams.

But, you know, the music was nice.

September 8, 2021

Mare of Easttown

Mare of Easttown is the best dead-girl-in-a-sad-town TV show to come out of the US since Twin Peaks. To be clear, the 30-some years that separate them still have many good shows of the genre, but none were American. When they weren’t busy churning out the millionth iteration of CSI, Americans could only muster pale copies of what came out of Britain and Scandinavia, with characters and plots lifted wholesale and Northern European sentiments crammed oddly into New England toponyms.

The Mare takes its setting more seriously, and not just with flannel shirts, odd accents, and dozens of bottles of Yuengling and Rolling Rock drunk per episode. You quickly learn that the town is not all that bad: it has decent homes, an upscale college and high school, and a pretty good sense of community. It’s the people who are sad, each in their own way and for their own reasons, with the titular Marianne the saddest of them all, and the show mostly dedicated to exploring how and why this happened.

There is also a murder or two, some kidnappings, and an action scene that brought back some of the best moments of The Silence of the Lambs. A few of the cliffhangers were the murder mystery equivalent of a jump scare, but that can be forgotten because the show manages to pull off a successful double-twist ending that is both reasonable and unexpected.

Ultimately, if a show is good enough for Kate Winslet to be in, it’s more than good enough for me to watch.

August 26, 2021

The White Lotus, Season 1

Two parts lifestyle porn one part sociologic study of intergenerational struggle, with a smidgen of mystery to whet your appetite and make you think there is more there there than it actually is, though what is there is still pretty good if not exactly a Knives Out caliber of crime comedy. And it is here that I realize I never wrote about Knives Out, which would have been the movie of the year had it not come out in 2019, a good year for movies in an otherwise mediocre decade. So here is my review: it is outstanding, go see it (👍).

But oh my that soundtrack.