Old (1999), but still good.

When I was a house officer and installing one of the first right-heart catheters, the machine that showed intrapulmonic arterial pressures was enormous and was equipped with strain gauges rather than computer chips. Making it work was difficult. After the line was in, the attending, the nurse, and I tried desperately to adjust the machine to show the pulmonary arterial pressure waves. We could not get them. The line on the screen remained flat. We manipulated toggle switches and strain gauges for about 15 minutes. Nothing. Finally, I glanced at the patient: He was dead.

The story that follows is even better.

→ NYT: Cancer and Climate Change

→ Esquire: When the End of Human Civilization Is Your Day Job

→ Guardian: Sea levels rising at fastest rate in 2,800 years due to global warming, studies show 

OK, one comment: do not buy any coastal properties.

The next time someone asks me about books to read before residency, I will direct them here. You don’t have to be a medical trainee to benefit from these, but that period of anxious anticipation between match day and orientation is perfect for buffing your attributes.

How to read a book, by Mortimer J. Adler

What better way to start learning about learning than by reading a book about reading books?

The Farnam Street blog has a nice outline of the book’s main ideas. The same establishment is now hocking a $200 course on the same topic. It’s probably good, but at $10 the source material is slightly more affordable.

Getting things done, by David Allen

The first few months you will be neck-deep in scut work no matter what you do. After that, though, you will have to juggle patient care, research, didactics, fellowship/career planning, and piles of administrative drek—and that’s just inside the hospital. At the very least, this book will help you make time for laundry (and maybe some reading).

Thinking, fast and slow, by Daniel Kahneman

Superficially, similar knowledge to what is in these 400+ pages can be found in a few Wikipedia entries. But you would miss out on the how and why cognitive biases and heuristics are so important. Medicine and research are bias-driven endeavors, and not understanding them is not knowing real-world medicine.

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Only three? Yes. If anything, the two and a half months between mid-March and July 1st won’t be enough to read them all with the attention they deserve. But you should try.

Another year, another round of podcast recommendations:

• …
• …
• …

No, it’s not your browser. The list is empty.

After 10 years of attaching electric appendages to my head using flimsy earhooks some call ear-phones, I have decided that one voice in my head at a time is quite enough, thank you, and that there are better ways to muffle the sounds of everyday existence than the nasal overtones of middle-aged white men.

Who will be crushed to lose me as a listener, I am sure.

I haven’t suddenly decided that they are all bad, mind you—I have spent cumulative months listening to them, so they must be good. The problem is, I like them too much.

Behold my modified CAGE questionnaire for podcasts:

1. Have you ever felt you needed to Cut down on your time spent listening to podcasts? Doing it right now.
2. Have people Annoyed you by criticizing your listening to podcasts at inappropriate times? Does my wife count as people? If so, then yes.
3. Have you ever felt Guilty about listening to a podcast instead of doing something else? You mean like sitting in the car 10 extra minutes after coming back home from work, waiting for an episode of Radiolab to finish? Umm…
4. Have you ever felt you needed to put on your headphones first thing in the morning (Eye-opener) to finish listening to last night’s podcast, or to get a head start on completing the unplayed list. “Felt like?” I do it all the time.

Aced it.

Granted, being mostly free, not too hard on your body, sometimes educational, and often entertaining, podcasts are not the worst thing in the world to be addicted to. But to be alone with your thoughts is exceedingly rare when there is a toddler in the house—rare enough that you do not want to spoil it by introducing external stimuli which make it impossible to string a chain of thought longer than the 30-second commercial break for Squarespace.

Farewell, voices. It was good while it lasted.

Last week I shared a brief reflection on a tiny aspect of my commute. Please check it out it if you haven’t already, it is a quick read.

Wasn’t that nice? It started by introducing some old concepts in a new light—you knew about trains before, and maybe even knew there was a MARC Penn that line goes from Baltimore to DC, but probably didn’t know the specific trains and their timetables. Then it gave you a coherent explanation of a phenomenon you hadn’t known about before. This first caused slight, but not unpleasant, cognitive strain while you were figuring out what I writing about, followed by the small pleasure of an ah-hah moment once the pieces clicked.

It was a brain massage, if you will. It was also complete bull.

Not that anything I wrote was wrong, as far as I know, but I didn’t give many arguments for it being right, either. There were no ridership statistics or arrival times to back up my claims. And even if there were—I didn’t give any alternative hypotheses to explain the situation, nor reasons why those would be less likely than my own explanation. When you think about it, it was more of a brain Twinkie than a massage—all empty calories, with a fleeting feeling of fullness.

Welcome to 99.99999% of the written word, and to anything ever spoken out loud.

We like stories. They need to make a threshold amount of sense (this is why societies universally ostracize schizophrenics). They should contain an element of surprise (it is not that the 7:07 train would come later than the 7:23—twists like that do not surprise anyone any more—it is that it comes in much earlier because people think it wouldn’t). And they get bonus points if—as my last parenthetical implied—they paint the others as stupid or incompetent. There are many more checkboxes; more of them checked, the better the story.

Most professions are based on storytelling. Doctors tell different stories to their patients, each other, and themselves—as do most other scientists, to a different degree. Lawyers tell stories to their clients to make them believe they will craft good ones for the judge, jury, and the opposing side. Ask a marketer what makes a good commercial (spoiler: story).

Being a coal miner doesn’t involve telling stories. No one wants to be a coal miner.

Our minds prefer a good story over a true one, and will have us believe it more, too. However, the more boxes you see checked, the more suspicious you should be that someone manipulated the tale to make it more pleasurable, ergo memorable, ergo believable.

(So, if what you’ve just read made sense…)

If you are looking for an objective truth—or getting as close to it as possible—any medium that involves audio/visual queues will be an impediment. Sights and sounds stir up emotions, and emotions prime us to believe or not to believe. Pay attention to the background music in a documentary, or how the desk of that shifty lawyer they’re interviewing is a complete mess.

TV news is, of course, a joke—this is why comedy shows are becoming the most popular delivery form.

Written word has its own way of deceiving—anecdotes, incomplete data, misquotes, lazy references—all to make a better narrative. Just read anything by Malcolm Gladwell. And look at the time it takes to get to the bottom of just one tiny factoid in that story of the iron content in spinach. Finding truth is exhausting and exasperating, and people whose job it is to find it (hello, accountants) are way less fun than those who make stuff up. Mark Twain said it best:

A lie can travel half way around the world while the truth is putting on its shoes.

Misquoted? Most likely. Or is Huff Post wrong? It wouldn’t be the first time.

There is nothing in this post that bigger and better minds than my own haven’t written about already. But that’s a boatload of pages! Not many people have the time, discipline, and interest to read all that—and even if they did, they would keep making the same mistakes over again, as shown in several studies described in those same books (yes, yes, all studies are flawed; one windmill at a time, please). These things are hard-wired, and for a good reason—evolution doesn’t care for objective truths.

Or maybe it does. I don’t know, I’ve just made it up.

Or it may happen, eventually, when I get to it. Probably close to the trial expiration date, if ever.

Sigh.

Here is a screen grab of the the Marc Penn line southbound schedule.

Note train 415, departing Baltimore Penn at 7:00 (I get on at West Baltimore, so in my mind it’s the 7:07 train). Also note train 517—my 7:23, and the times they both arrive at Washington Union Station.

Is it ever worth taking the 7:07?

Well, actually, yes. Because:

• Most commuters look at the schedule and make the same conclusion that you probably did: waking up at least 16 minutes earlier in the morning is not worth the 7 minute lead time you get in DC.
• With that in mind, even if they leave early they don’t really rush to the 7:07; therefore significantly fewer people need to get in at each stop compared to the 7:23 and it usually gets to Union slightly ahead of time.
• Because of more people waiting on the 7:23 it tends to limp along in the last few stops and doesn’t get to Union until 8:15 in the best of days.
• The 15-20 minute difference does mean a lot if you have to use DC’s abysmal metro which gets crowded by the minute between 8 and 9.

These are the sorts of things you think about when your commute is almost two hours each way. If you would like to read more about extreme commuting (and who wouldn’t?), this old New Yorker article is a good place to start.

This website is:

• a public repository of articles, lectures, and other original works I authored or co-authored;
• a place to repost comments, reviews, and recommendations I wrote on other sites (like Quora, Amazon, etc);
• a place where my half-baked ideas and philosophizings go if I think them interesting enough for general consumption.

This last one is what gives me trouble. Ideally, if I think a topic is worth writing about, I should make the extra 3-day effort to gather references, edit it nicely, and have it published. But like the character in “The bridge on the Drina” who means to be the town chronicler but can never find an event worthy enough to write about, most subjects have me less excited the more I think about them. By the time I finish a blog post, then, I have no intention to revisit the matter.

This is an excellent filter against appearing foolish in print, but horrible for productivity.

Two solutions come to mind readily, with equal chances of failing—either stop posting the third category of articles altogether and start writing everything with an intention of publishing; or start writing even more with the hope that at least a small percentage of that will turn into something a journal would accept for publication.

The former is a set-up for procrastination, the latter—doing extra work in a hope to create material for even more work—oxymoronic . I will try both and see where I end up.

Two years ago, I haplessly expressed excitement about my task list manager of choice being updated soon.

Speaking of @culturedcode, looks like Things 3 is progressing nicely. Hope “more structure” is code for dependencies. pic.twitter.com/ctwycDyL1e

— Miloš Miljković (@Miljko) February 2, 2014

It hasn’t yet. Two iterations of iOS and an Apple Watch later, Things 3 is still not available, and I am becoming increasingly annoyed. Inside my mind, two kinds of costs—Ms. Sunken and Mr. Opportunity—are battling it out.

Mr. O has me thinking about time wasted on not being able to turn a next action into a project; or having to make too many taps to edit anything in the iOS app. And then I stress out even more contemplating all the features I don’t even know I’m missing out on—not wanting to find out about those is why I not dare read reviews of the competition.

Ms. S, meanwhile, is raising dread whenever I thinking about moving to Omnifocus, Taskpaper, or whatever the GTD app du jour is—knowing that I would be trading a set of known deficiencies for a potentially grater set of unfamiliar ones.

The mister and missus are irrational beings—even though Things 3 remains vaporware, there have been a few 2.x updates that iOS7-fied the experience—from going flat to adding extensions and notification center widgets. All that considered, I should not spend so much time thinking about an app.

And yet, it is 6pm on January 2, 2016, and instead of writing about getting back to the lab, finally finishing the PhD thesis, or being a haughty gastro-tourist in unseasonably warm New Orleans, I am being much too first-worldly for my Balkano-Serbian comfort.

Which I will add to the pile of absurd reasons for why I dislike Cultured Code.

Work will happen 24 hours a day, 365 days of the year, if you let it. We are all in that place where we are all letting it for some reason, and I don’t know why.

Via Cal Newport’s blog