At a hundred pages, a fifth of which is the preface, this is a slender book that compares the 1950s state of the art computer and neuroscience, but more importantly gives the answer to the burning question in oncology: how much are a few months of overall survival benefit worth? Well, if you are John von Neumann and you have boney metastasis from a cancer of unknown origin eating away first your energy and then your mental capacities while your are writing a series of lectures on how similar and different brains are from “modern-day”1 computers, and you are way ahead of your time in thinking about both, well, the answer to that question is quite a lot. It is in fact an unthinkable loss that he died before he could even finish his writing, let alone hold the lectures.
It was also somewhat eerie to read about the comparison between humans and machines shortly after Apple announced its quite literally game-changing M1 processor. There is fierce competition among the big tech companies to build the Skynet of our universe, and as of last week Apple is winning.
i.e. 1950s, though apparently the architecture hasn’t changed at all, save for the size and number of the components. ↩︎
Netflix has a knack for producing empty calories, and Enola Holmes is not an exception. Pretty visuals, female empowerment, and decent to above-average acting can’t hide the blandness of its storyline nor the absence of any reasoning, deductive or otherwise.
It is, by the way, hard to think of Enola’s character as particularly empowered when the next three women in screen time order are her mother the polymath rebel, her friend the black martial arts teacher, and an aristocratic evil mastermind. Not to mention the brief appearance of a coitery of female anarchist geniuses. In Victorian London!1 A bit too on the nose, maybe? To paraphrase the Incredibles, when everyone’s special, no one is.
What’s worse, there is a story where this particular cast of characters makes perfect sense in this particular setting, one where a downtrodden young woman — think female Oliver Twist — meets them in order to learn what’s possible. But Enola is built up to already be the self-reliant Victorian anti-lady. Running into even more of the same archetype on her way to saving the prince makes for boring and lazy storytelling. ↩︎
It’s full of style, has excellent casting, and pretty good chess1, which is enough to make it into an enjoyable but forgettable miniseries. If only they had put in as much effort and thought into character development as they did in Beth Harmon’s dresses…
I hear, never being much into chess, except that now thanks to the show I’m a paying member at chess.com and am very much looking forward to playing a few games with my own children once they’re old enough not to chew on the figures constantly. But I still think Twilight Struggle is the superior game. ↩︎
As long as I can remember, [Note: Which is to say, mid to late 1980s. ] any protagonist of a movie or a TV show who wasn’t world-weary and cynical was either naïve, stupid, or both. In American popular culture, “good” people are the way they are only because they don’t understand how the world truly works. As side characters they are mostly comic relief. As protagonists they can only succeed through piercing the veil of ignorance — becoming worse people in the process — or by pure dumb luck. Ned Flanders, Forest Gump, Kimmy Schmidt all come to mind.
Not so with Ted Lasso, the only character in recent memory who is well aware that the world is harsh and that there are people out to get him, [Note: The show doesn’t hide who this is: all of England, save for two close friends. ] yet defaults to thinking the best of everyone he meets. He is still capable of mild deception in the service of punishing the wicked, but he can’t even punish someone without an endearing monologue on what he’s all about: being curious and not judgmental.
Being more curious and less judgemental would serve everyone well at any time, but never more so than this year, when everyone suspects the worst of everyone else. The default behavior is mistrust, the default sentiment cynicism. This show starts with plenty of both, yet they melt away under Lasso’s high-power beam of un-ironic and very self-aware goodness. If the 2000s were the decade of The Wire and the 2010s were the decade of the Game of Thrones, I wish, hope, pray that the 2020s turn out to be the decade of Ted Lasso.
These 250 pages on the many ways that cancer care in America is broken should be read by everyone with even a passing interest in oncology, and must be read by every heme/onc fellow or fellow-to-be. Malignant reminded me of the best days of my own fellowship, when the then-program director Tito Fojo would eviscerate an article — these tended to be poorly thought out phase 3 trials of one TKI or another that somehow made it to the New England Journal — with a few slides made at the last minute.1 But this is not just a rehash of those lectures, nor is it the best of Prasad’s prolific Twitter feed, nor an overview of his billion meta-science articles and editorials. It is instead a series of lectures — enough to fill a semester — that takes bits and pieces of the above and adds quite a bit of new to make something better.
It is not the easiest of narratives to follow. This is understandable: cancer research, policy, and outcomes are as intertwined as the molecular pathways Prasad valiantly tried to avoid, and mapping their connections will inevitably result in a crazy wall. There are nominally four parts to the book with four chapters each, because you had to put it together somehow, and the parts make sense. Even so, more than once I was wondering what exactly a particular vignette had to do with where it was in the book, and wanted to put it somewhere else. But the feeling goes away quickly — Prasad’s style is entertaining, the puns are clever2, and there isn’t a superfluous paragraph in site.
To that last point — if anything, the book is too short. My pet cancer peeve, the disconnect between bioplausability and reality, and the many misuses of animal models to inform clinical trials, was barely mentioned when it could’ve easily made a whole chapter. Same for grant mechanisms, which did get a page and a half — that one half is a figure — but left too many things unexplained and uncovered, particularly for the lay audience. And as to Prasad’s big advice that the federal government should take over running clinical trials from private companies, well, it’s nice to put some pie-in-the-sky proposals out there, but something that is so against the grain should be more fleshed out.3 Or maybe mention some more feasible proposals, in the line of Vincent Rajkumar’s plea to cut down the number of people with veto power over a randomized controlled trial. I could go on, but I’d rather not spend too much time on what can be refuted by a single sentence: “Write your own damn book”.
Written by Vinay Prasad, 2020
And I mean this quite literally: you could see him cropping screenshots two minutes before journal club. ↩︎
My favorite involves a marinating chicken and curry. ↩︎
There is, of course, the argument that someone who’s never run a clinical trial has no right to comment on the quality of those that are out there, nor to propose how they should be done. Rather than resorting to modern arguments against gatekeeping, I will echo my grandmother: I don’t have to lay eggs to know when there’s a rotten. ↩︎
The decade in which one’s three children are born will have to rank among the best ones ever, no matter what else happened. But then add marriage, a move to America,
[Note:
[Note: ]
So yes, it has been a good ten years. Certainly better than any other ten-year span I’ve had. A good test would be imagining the ten-year-ago me learning the outcome of the single decision he’s made back in 2008 to go for residency training in the US of A instead of a PhD in Germany, and I’m not one to pee their pants from excitement but I do imagine myself coming close, even without knowing the counterfactual.
Is America the greatest country in the world? It was for me, at the time, even as a visitor [Note: Or rather a nonimmigrant alien of extraordinary ability, for now. ] . And it may continue being so for decades to come; I don’t see any competitors coming close. [Note: And I’m looking. ]
Directed by Various, 2019
EconTalk with Russ Roberts is the best interview podcast I’ve listened to, period. Unlike Tyler Cowen Roberts focuses on an issue or two, not the personality being interviewed. He gives fewer if any passes. The effect is that I feel like I’m actually learning about the thing in question, not just getting acquainted with Cowen’s personality du jour. Whether any learning actually takes place at my advanced age is another matter.
My top 5 episodes:
Honorable mentions: Cowen, Holiday, Hossenfelder, Bertaud
Conversations with Tyler are as good as ever. This year’s favorites:
(Note that the majority are episodes with women - Cowen has Roberts easily beaten here)
Breaking Smart with Venkatesh Rao I would recommend to anyone who’s enjoyed the above-linked interview Russ Roberts did with Rao on one of the better Breaking Smart essays. It’s 15-20 minutes of Rao performing mental stretching excercises, solo.
Plenary Session with Vinay Prasad is another podcast that shines with the solo performances, but the interviews aren’t half-bad either. That isn’t a surprise, since this year Prasad has talked to David Steensma, Frank Harrell, Adam Cifu, H. Gilbert Welch, and Clifford Hudis, among others. Sadly, the podcast still doesn’t have a proper website, so I can’t link to any of these episodes directly.
Written by Branko Milanović, 2019
Written by George Packer, 2019