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Buffet: The making of an American capitalist

I’m glad the author, Roger Lowenstein, didn’t even attempt to appear impartial in this, Amazon’s most highly rated of Warren Buffett biographies. It’s the reverse of a Power Broker hit job: in the reprint afterword, Lowenstein is wistful about not getting more praise from Buffet while the aforementioned is signing the author’s personal copy at a conference. How wonderful it would be if our heroes loved us as much as we love them.

Granted, Buffet is an easy person to love, what with being an aw-shucks Midwestern pro-government regulation democrat who is modest, smart, and also one of the richest people in world. That he first earned his money off of America’s addiction to sugar and shopping, followed by tobacco and war, followed by decidedly inegalitarian buddy deals, all while neglecting his wife to the point of her leaving, and his children to the point of their becoming New Age musicians, just supports his claim to being the most American of all American heroes. Kudos.

Written by Roger Lowenstein, 2008


A Wrinkle in Time 👎

So much wasted potential in this one. It could have been a great movie for both children and adults, a Labyrinth for the age of CGI and social justice. Instead, it’s a confused, hurried mess in which lots of Stuff happens for no good reason; a Michael Bay extravaganza for your middle-schooler. My daughter (6) liked it, but even she questioned a major plot point. “But, why did X become evil, daddy?” I’ve no idea, Honey, and I’m not sure the screenwriters gave it much thought either.

Such is the faith of many book adaptations; this one even more so, having had to pass through the Disney committee wringer. I haven’t read the book(s? That’s how much I know about the potential franchise) but I’ve read and watched enough fantasy to know that 1) your made-up world needs to have rules, and 2) if you break them, it better be for a good reason. The few week rules set in the Wrinkle’s first half are promptly broken at the half-time, with no explanation and nothing to replace them. Instead you get a holodeck of a planet, where anything can happen: hurricane in a haunted forest turns into a Stepford wives cul-de-sac turns into a crowded beach, and no there is nothing connecting those dots.

Which is too bad — each one of those scenes would’ve made a good episode for the second season of the unmade Wrinkle TV show, perfect for Disney’s new streaming service. Such a waste.

Directed by Ava DuVernay, 2018


Ending medical reversal

The first thing I picked up after taking the hematology boards was this gem from Chicago’s medical royalty (Adam Cifu) and everyone’s favorite oncologist (this is of course a joke — you know that people hate your guts, Vinay).

I didn’t, and still don’t, care much for the title. It is ambiguous: if medical reversal means overturning an established practice that was based on weak to no evidence once stronger evidence comes along — usually in the form of a (multi-center, blinded) randomized controlled trial — why on earth would you want to end reversals? Well, the book is about how to stop those kinds of practices from becoming established in the first place, which would indeed end medical reversal, but an easier way to stop them and one that would be endorsed by most of industry and many researches would be to just not look. “Ending Medical Reversal the Hard Way” is therefore a more appropriate name.

Title aside, I agreed with pretty much everything they wrote, from reforming medical education, through stopping direct-to-consumer marketing and direct-to-academic (not their words) payments, to having more people participate in (simpler, cheaper, and fairer) randomized trials. I enjoyed their honesty and clear style, and wished my medical school had at least a passing resemblance to the one they proposed (if you thought US medical education leaned too much on basic science-oriented and was heavy in professorial mechanistic proclamations, try the average European med school). Granted, I work in a federal research hospital and focus on some of the rarest of the rare diseases; but that only makes me shake my head in disbelief more when my colleagues who specialize in breast or lung cancer, not to mention coronary artery disease and diabetes, randomize enormous numbers of patients to search for minute differences in surrogate outcomes.

Written by Vinayak Prasad and Adam Cifu, 2015


Stubborn Attachments

This is as close to a “Rules for Life” book as we’ll get from Tyler Cowen, and if you’ve listened to his podcast or followed his blog what’s inside won’t surprise you — but it will make you think. Which is good: surprise is overrated anyway, and things that depend on it don’t do well on re-reading/watching/listening. I’ll be coming back to this one.

Cowen argues that growth is good even when it doesn’t benefit everyone all the time. There are things that can grow that you can’t measure (like happiness, life satisfaction, health, culture, feeling of superiority [I may be misremembering some of these]), so don’t focus on wealth only but instead on Wealth Plus. Also, distant future is just as important as the near future, so don’t sacrifice long-term prospects for short-term gains. Speaking of future, we can’t predict it, so even though tiny decisions can influence it in an oversized manner we should stop fretting over those and focus on the big picture: which is to chose policies that provide the greater sustained benefit sooner. Finally, common sense morality can usually steer you in the right direction, but if it feels like it’s not, remember everything else in the book and you should be all set.

That’s all well and good, except that I kept imagining someone from Serbia — currently a second-world European kakistocracy — living by the standards of this book. Hilarity ensued: for things would be included in Wealth Plus that Cowen hadn’t foreseen (the ability to redraw borders, to name one), and common sense morality would include good doses of nepotism, chauvinism, and the desire to cheat the state (yes, yes, I know, #notallserbs).

So the first thing that’s keeping this book from being great is that it can’t be universally applied — it was written by an American for his fellow Americans who have lost their way — and doesn’t explore, or even mention, the implications of his vague concepts of Wealth Plus and common sense morality being different around the world.

The second is that shortly after admitting that economists don’t have crystal balls (the twelve-year-old me would have loved to put parentheses around “crystal”), he goes on to compare hypothetical policies based on their projected rates of growth well into the future. It may be my lack of an economic background speaking, but how can those two go together?

But do read the book. After my first pass I can say it’s good, if not great. For me as a doctor the idea of delaying gratification for long-term gains felt familiar. The oncologist in me would add that inflicting harm for a known long-term benefit is also reasonable and depending on the alternatives even preferred. Of course, it took centuries of wading in the dark before medicine got to the point where it could with any certainty predict the outcome of its interventions. Are social sciences there yet?

Written by Tyler Cowen, 2018


Applied minds: how engineers think

I wanted to like this book more than I actually did. The title is seductive for those of us who work with people’s very unengineered fleshy bits: would it help if we added some engineering tools to our mental toolbox? Well, maybe it would, but this book couldn’t help me find them, being more of an essay on why I should think like an engineer rather than an instruction manual on how.

Apparently, you need a lot anecdotes anecdotes to explain the Why; stories zip by so fast they gave me whiplash. There are too many narratives and not enough thoughts: instead of just buttressing the main point or two, the anecdotes take center stage, sprinkled with outlines of different ideas that never become central.

For a book about engineering, I expected better construction.

Written by Guru Madhavan, 2016


If on a winter’s night a traveler

The book is almost forty years old but it could have been written yesterday. It is short, smart, punchy, and very, very meta. It also makes me want to learn Italian, though I understand William Weaver is a good translator.

Written by Italo Calvino, 1981


The death and life of great American cities

Jane Jacobs loved Greenwich Village so much that she wrote a book about why that was and why more neighborhoods weren’t like it. She looked at other similar areas in Boston, Chicago, Philadelphia, etc. as well some failed ones, and gave a few guidelines on what was needed for safe, lively, and desirable city streets.

It has enough whimsical observations of city life to keep things interesting for its too-many—over 400—pages. E.g. on a city park’s homeless population:

Almost imperceptibly, like the hand of a clock, the raggle-taggle reception creeps around the circular pool at the center of the square. And indeed, it is the hand of a clock, for it is following the sun, staying in the warmth.

Or, comparing a safe-but-dirty city street to a desired but decidedly unsafe park:

The sidewalks were dirty, they were too narrow for the demands put upon them, and they needed shade from the sun. But here was no scene of arson, mayhem or the flourishing of dangerous weapons. In the playground where the night-time murder had occurred, things were apparently back to normal too. Three small boys were setting fire under a wooden bench. Another was having his head beaten against the concrete. The custodian was absorbed in solemnly and slowly hauling down the American flag).

It’s all quite lovely. But ultimately, it is an exercise in confirmation bias that misses as many essential points as it reveals. What was arguably the most devastating influence on American cities — Robert Moses — is but a misguided elderly official who, and kudos to him, knows his way around public funds. City planners like big, disruptive projects because of their bad (deductive!) reasoning, not because they give politicians photogenic ribbon-cutting ceremonies.

If you want to know why American cities are the way they are, better read The Power Broker.

Written by Jane Jacobs, 1961


The Last Jedi 👊

Extraordinary set pieces strung together by the thinnest of plots, based on an absurd, sitcom-worthy failure to communicate. A particular subplot should have been spun off as a buddy cop movie.

The Ray-Luke-Kylo triangle should have been a bigger part of the movie, but then many of the new characters, the ones that aren’t white and/or men, would have nothing to do. Such are the problems of building on an old and popular franchise: you can’t both stay true to the roots and change with the times.

It has cute animals and looks good in 3D though, so Dora (5.4) approves.

Directed by Rian Johnson, 2017


What I believe that most people probably don’t (no data behind this, just the armchair)

The world in general, and the US in particular, is spending too much on goal-directed, targeted biomedical research while undervaluing both applied and theoretical physics. Picture Leonardo da Vinci drawing helicopters: that’s the modern-day cancer researcher. The universal cure for cancer — and there should be one, if humanity survives long enough to create it — will not come from an NIH grant. If grants are involved at all, it will be something initially funded by the National Science Foundation. The current system of funding (government, non-profit, biotech, you name it) is broken, and if you account for the opportunity cost it is a complete disaster. Each of these statements deserves at least a paragraph, but I am saving my carpal tunnels for a manuscript, an LOI, and a couple of protocols (oh, the irony).

In the meantime, a few things physician-scientists should do for the overall good: * find causes and create better prevention strategies, because a look at the SEER database will tell you that it’s not just bad luck; * eliminate barriers for administration of known curative therapies world-wide (do we really want to leave this to politicians and economists?); * ensure rapid and honest evaluation of the many new treatments, procedures, and diagnostic/prognostic methods coming out of the biomedical behemoth.

How beneficial any of this would be for one’s career is a different question altogether, but let’s not get into incentives because RSI. I am also very open to opposing opinions, since my being wrong would make my life easier.


Brush up on your Serbian

Serbia’s public broadcaster, RTS (that’s PTC in cyrillic) has a good chunk of its archive spread across multiple YouTube channels, and it is magnificent (this one in particular).

Observe the 1960s-1990s televised plays and TV dramas. I still have vivid memories of watching one particular product the first time it aired, about a Serbian family keeping in touch with their ex-pat relatives in Germany via VHS tapes. Replace camcorders with smart phones and speed up the timeline to account for the internet, and it could have been shot today. Technology changes, people don’t.

My favorite childhood TV show hasn’t aged well at all; then again has anything from the ‘90s? If you consider most of it was made during a civil war and in a time of hyperinflation it is actually quite good. What was 90210’s excuse? Better kids’ shows have been made in Serbia both before and after.

Best for last: the celebration of hard core nerddom that is Serbia’s longest-running quiz show, important enough to have its own channel. It starts with anagrams and math problems, makes a detour to Mastermind, then finishes off with three different ways to test for trivia. Jokes about the autism spectrum would be writing themselves if this were an American show, but it’s not, and (before I left, at least) Serbian viewers still had some admiration for the participants. It is all very serious and competitive, and has been on the air every weekday for the last 24 years. (A political side-note: this does not mean Serbia is free from anti-intellectualism, quite the opposite in fact. Some combination of militant anti-intellectuals, gas-lighters, and proponents of economic/financial scientism has been in positions of power since the early 90s. There are no lessons here, just observations).

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