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Blogroll

I, for one, am glad that blogs are making a comeback. Here are a few I’ve been reading for at least a few months, many of them for years, some for decades.

Applied philosophers

The only true philosophers of our time.

The new scientists

People without major academic credentials who have interesting ideas about science.

The old scientists

People with major academic credentials and interesting ideas, something to teach, or both.

The ludites

People against modernity of one sort or another.

People doing their own thing

Unclassifiable but exhilarating.

Apple enthusiasts

Some tips, a few tricks, many opinions.

Finance-adjacent

Economists and investors, for the most part.

Journalist-cum-substackers

Former or current journalists who now earn some or all of their living by writing newsletters via Substack, which is slowly reinventing blogs (in the sense of reinventing the wheel, not actually making them better and in fact in many was making them much worse).

Company blogs

For when I really want to know when the next update is coming.


Notes from West Virginia

It was the middle of another heat dome week, but the morning was cool enough to require long sleeves. The grass — freshly cut, of course — was covered in dew. In less than 20 minutes one could see sitting on the front porch: several hummingbirds battling around a feeder, two deer grazing just off the gravel driveway, a wild turkey, a rabbit, several blue jays and cardinals; I half-expected Snow White to skip down the forest path and burst into song.

The Broadband internet in West Virginia is not great, but it’s not terrible either. Why are there only 2 million people in this state?


Clearing the PDF log jam

There is a crisis in medicine, but not the one you think:1

Reading primary literature is superior to press releases and tweets — it sounds so obvious, but not many physicians act on it. There no prizes to be won for not just following the KOLs2, nor do you save any time. Quite the opposite: instead of a promoted tweet about the me-too drug de jour falling into your lap, you need to find a way to identify what’s worth your time reading, and also find time to actually read it — not a small achievement, as highlighted by the above tweets.

But then what? Sure, there is profit at the end of the rainbow in the form of useful knowledge, but merely reading a PDF may not result in any knowledge at all, let alone knowledge you can use. Or, as the underpants gnomes would put it:

Step 1. Read PDFs; Step 2. ???; Step 3. PROFIT!

I too had a backlog of unread PDFs once, spent so much time organizing files and folders, using this and that program to store the metadata3, trying out plain paper, a Kindle, an iPad or two, thinking it is how I was reading them that mattered and oh if only I could find the perfect setting, under the shade of an old oak tree perhaps, with some peace and quiet, a pen in one hand and a cup of coffe in the other, well, then the unread pile would melt away and all would be good in the world.

But reading is easy, if what you read is useful, entertaining, or both. For most people without visual impairments or dyslexia, the log jam is at Step 2. We don’t want to read our pile of PDFs because, in most post-GME circumstances, there isn’t a clear goal to reading them (lest you have superhuman memory).5 This is particularly true early on in your carreer, when you have nothing to hang your hat on mentally, and few connections to make between what you are reading and what you already know. Sure, you don’t need to keep track of the articles you’ve read if the only reason for reading is to pan them on Twitter. You do, however, want to summarize what you’ve read and save it for future use, be it in a lecture, article, grant proposal or a blog post. So if and when you find a fairly obscure but potentially important fact about this or that cellular pathway in a supplemental figure from a CNS-adjacent journal, and you memorize the fact for later use, and then a year or so later you do use it to make a figure for the background section of a clinical trial protocol, well, what you do not want happening in that case is to spend hours of your life trying to retrace your steps and figure out the original source when a fellow asks where you got the data.4

I wouldn’t be admitting to all that if I didn’t think I’ve found a solution. A few years ago, I replaced the unsustainable routine of just-in-time literature reviews for whatever I needed done with a robust knowledge management system — a GTD®6 for ideas, if you will. It got to a point where I can read at least one article every day and skim a few more, get the useful information out and into my app of choice7, and have all the information I need to write an editorial like this in a morning or two.

As with most of the things I do it is too personal and Rube Goldberg-y to be of use to anyone else, but it started with a forum post and a book, and if you’d like to turn your plate full of PDFs into something more usable may I recommend that you start with one or both of those and see how it goes. Could it be any worse than what you’re doing now?


  1. And not only in medicine, of course. 

  2. Key Opinion Leaders, the influencers of medicine before influencer became a real noun. Note that unlike the influencers of social media KOLs don’t use the #sponsored hashtag, though there is a hashtag equivalent

  3. NB: if you write any sort of scholarly texts you will still need a reference manager, no matter what system of organizing PDFs themselves you choose. I recommend Zotero, lest your institution has a requirement for Endnote (which must have quite a salesforce, to so thoroughly insert their buggy, laggy, slob of a program into every academic crevice). 

  4. Yes, this has happened to me. We do have good fellows. 

  5. The clear exception here being board exam and MOC prep, where the goal is obvious and the sources of information are all spelled out. 

  6. © David Allen Co. 2001. It is a good system though 

  7. The app of choice before DEVONthink was Roam, which is a web service and a marvelous one at that, but unfortunately not much into encryption, privacy, and other things people dealing with confidential information like to have in the tools they use. 


Notes from the beach

  • Southwest Florida is better for a short family vacation than Maui, conditional on the family not owning a private jet.
  • Florida sand is superior to Maryland and Delaware sand. For one, it doesn’t collapse as easily; second, it is much easier to clean; third, on Sanibel and Captiva islands it is mostly made of quartz and broken down shells and is there anything cooler than that?1
  • More bird diversity makes for happier humans and while D.C. has a respectable population of birds, it doesn’t come close to Florida with the ospreys and the fish hawks, brown pelicans and roseate spoonbills, white ibises and snowy egrets, sanderlings and sandpipers, woodpeckers both pileated and downy, and not a robin in sight.2
  • Is it just me or is sunscreen really so much better now than it was 30 years ago? With UPF swimwear you need less of it anyway, and the little that you do need is easier to apply, lasts longer, and just works better than whatever smelly Coppertone slurry we used in the 90s.
  • Beach towels are useless.
  • Spending a week in a zip code with no Instacart, no DoorDash, no Uber or Lyft or ad hoc taxis of any kind was refreshing, but I wouldn’t recommend it long-term. Although there was still Amazon next-day delivery and plenty of UPS trucks, so not all was lost.
  • Physical books continue being better than e-books; the calculation will change for me as soon as e-book readers solve quick note entry — emphasis on quick.
  • Where are all the Nightingales is a great way to start the day, on or off the beach.

  1. Sure, volcanic sand sounds cool, but have you tried washing off the glossy black detritus? Not to mention it is much sharper. 

  2. Although maybe a few too many common grackles. 


Against sarcasm

Everyone loves Ted Lasso, both the character and the show, in great part because he manages to be funny without being sarcastic. It reminds me of what made Frasier so good: that the writers never took the easy jokes. Smart humor is hard, smart humor without sarcasm is even harder.1

The past few years have made me sarcarsm-intolerant. I can still appreciate professionally done satire — Stephen Colbert of the Colbert Report years comes to mind — but you, my Twitter friend, are no Stephen Colbert. Good satire takes some effort to create, but is easily understood. Casual sarcasm is the opposite: it is easy to say or write what you don’t mean, but recognizing sarcasm requires knowledge of the context, the author’s prior writings, the subject in question, and even then, often, it is missed. Queue the author’s indignation and musings on how the Twitter sheeple can’t recognize a joke, though sometimes the indignation itself can be self-consciously funny.

The exchange above was notable for erecting a barrier between people who some time ago would have considered themselves part of the same ingroup.2 If there is one thing sarcasm does well, it is to erect barriers between smaller and smaller groups until everyone is at a war of wits with everyone else. It turns a tool of communication capable of spreading great knowledge quickly into a French court-style spectacle for the masses, fueled by the algorithm.

Dropping sarcasm would not make the internet excruciatingly boring. Note @10kdiver of the Markov chain thread from the paragraph above, or @wrathofgnon, @Gwern, @craigmod, @BCiechaowski… all brilliant, not an ounce of sarcasm between them (half an ounce from Gwern, perhaps). There is in fact an infinite number of ways to be interesting online without being sarcastic, and sarcasm itself permeates the online life so much that it is, well, boring.

Offline, the distinction blurs between being sarcastic and having plausible deniability. Sarcasm may be the highest form of intellect in teenage years, where plausible deniability helps save face, but before the end of adolescence saving face quickly turns into gaslighting. Small wonder that the most sarcastic character on Friends was also the one to catfish a woman.3 So if there ever was a quick and easy litmus test, it is this: after the horrible year we’ve had, and a decade that was not much better, whom would you rather hang out with and who would you rather be: Ted Lasso or Chandler Bing.


  1. This is also why in the great Seinfeld versus Frasier debate I will always choose Frasier. Don’t @ me. 

  2. Yes, ingroups of days past still had factions and civil wars, but what used to be confined to the university cafeteria or the sparsely attended conference session is now right there for the world to see, and pile onto. Somewhat paradoxically, meatspace barriers are as ephemeral as an academic’s memory; online barriers, while not set in stone, are quite a bit more solid. The algorithm remembers. 

  3. This is also one of many reasons why Friends will never be in contention for the best of anything, except maybe the best show to reveal the 90s to be the backwards decade it truly was. 


What I learned on Twitter, week of 2/15/21


What I learned on Twitter, week of 2/8/21


What I learned on Twitter, week of 2/1/21


What I learned on Twitter, week of 1/25/21


What I learned on Twitter, week of 1/18/21

What a week…

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