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: 2021 — 2020 — 2019 — 2018 — The one where I took a break from podcasts — The very first one

• 1994: Fifth grade; I am charged with editing the school newspaper. There is an Intel 386 PC at home that is about to be upgraded to a 486 and do something more than run Lands of Lore.
• 1996: Seventh grade; I typeset a book of poems¹. The school newspaper becomes the school magazine — in layout only; the publishing schedule remains haphazard — as I upgrade from Word 6.0 to QuarkXPress
• 2000: High school starts again after a freshman year interrupted by NATO bombing. I make the town library’s official website. It is a php hack job laid out in tables instead of the newfangled and to me unknown CSS; it still wins an award.
• 2002-2008: Med school; I typeset a book here and there and occasionally help out with the library website.
• 2009: Teaching assistant, Institute for histology and embryology, Belgrade School of Medicine.
• 2010: Resident, Internal medicine, JHU/Sinai, Baltimore MD.
• 2013: Chief resident, Internal medicine, as above; I understand the benefits of not being invited to a meeting.
• 2014: Clinical fellow, hematology/oncology, National Cancer Institute, Bethesda MD.
• 2016: As above, but also Chief fellow ex tempore for the joint NCI/NHLBI fellowship; my hatred of poorly-run meetings intensifies.
• 2017: Staff clinician, later to be renamed Assistant research physician, Clinical Trials Team, Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda MD; the 1994 me marvels at the word salad trailing the title.
• 2021: Chief Medical Officer, Cartesian Therapeutics.

It is easier than ever to organize and attend a meeting, which should scare the living daylights out of anyone who doesn’t organize or attend meetings for a living. It used to be that only middle management had to deal with a series of 90-minute meetings all 15 minutes apart in which they had no specific role, which had no effect on their task list, and which left them no better off than they’d be if they had just read the minutes.

We are all middle management now.

My own experience with middle management was during chief residency and I learned quickly that the more administrative aspects of it just weren’t for me. But I also learned a few coping strategies, modified below for the video conferencing age.

• A short ad-hoc meeting is better than a long email thread. Email is a brilliant technology, but it just wasn’t meant for frequent back and forth between any number of people. It always amazes me when someone sends an email with five direct recipients and ten more addresses cc’ed, and then expects to have a productive conversation. Pre-2020 the excuse would have been that everyone was too far apart to attend a meeting, whether in another time zone or in a different building on campus. No longer.¹
• A short standing meeting is even better than an ad-hoc one. Few things in any line of work need someone’s immediate and undivided attention. Issues can usually wait: if one project is on hold because a decision needs to be made, there will be others to work on. If they can wait a full week, why not batch them and bring them up with your boss/employees/co-workers/contractors at a weekly meeting. If they can’t wait for more than a day, make it into a short daily meeting held at a set time. We have these meetings all the time in medicine — we call them rounds, and they have worked well for more than a century.
• Frequent short meetings are better than infrequent long ones. Setting one up used to be hard logistically: from booking the right sized room on time to making sure the timing works out for everyone — not to mention having to include a buffer for getting to the conference room and setting up AV. With that much overhead for a meeting of any length, of course the default was at least 60 minutes, if not a full hour and a half. Now even a 90-year-old can tap a link on their oversized phone to log onto that Zoom meeting while quarantining at home. The negligible cost of starting a meeting may mean they are more frequent, but it should also make them shorter. Much shorter.
• One day full of meetings is better than all five weekdays broken up with just a few per day. When in meeting mode, it takes me at least 30 minutes to get my bearings back to doing other work. Mode switching is a fixed cost and it’s best done infrequently. I therefore have a day dedicated to meetings, and if I have any say whatsoever in when a meeting will be held I try to do it then.² If you need to have a meeting on a different day, try to have it as a bookend — morning and afternoon rounds are a good example of this.
• Finish off a meeting with a task list and the designated person(s) for each task. You will probably have missed something, but that’s OK since you’re still at the meeting and others can fill in the gaps. Send off that list as an email to all attendees. Congratulations: you are now the meeting’s Most Valuable Attendee. If the meeting ends without anyone being able to come up with a single task, it should not have taken place. This is an important lesson. Take note of whomever called the meeting and try to avoid attending their meetings in the future.³
• Bonus tip: If you are setting up a one-on-one meeting with me, and you are the one sending out a calendar invite, do enter both of our names in the meeting title. I have too many meetings with myself on the calendar and it’s getting hard to keep track.⁴

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If you liked this, you may also enjoy my lukewarm take on handling email.

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.

• Mathflaneur (by Nassim Taleb)
• Ribbonfarm (by Venkatesh Rao, who also has a newsletter of half-baked ideas he calls Ribbonfarm Studio)

The new scientists

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

• Alexey Guzey (also see Guzey’s Best of Twitter, and also see New Science)
• Applied Divinity Studies
• Astral Codex Ten (former Slate Star Codex)
• Fantastic Anachronism
• Gwern
• Nintil

The old scientists

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

• I am Intramural (from the NIH Intramural Research Program)
• Statistical Modeling, Causal Inference, and Social Science by Andew Gelman
• Statistical Thinking by Frank Harrell
• Stephen Wolfram Writings
• The Mathematical Oncology Blog (see also This week in Mathematical Oncology)

The ludites

People against modernity of one sort or another.

• Axiom of Chance (Simon DeDeo, who does not seem to have a Twitter account)
• Patrick Rhone (who does have a Twitter account)
• Study Hacks (by Cal Newport, whose Twitter account, if real, has been abandoned years ago)
• Wrath of Gnon (who is in fact — and sadly — all Twitter)

People doing their own thing

Unclassifiable but exhilarating.

• Craig Mod (and on Twitter) who walks, makes books, and takes photos.
• Garden of Forking Paths (by Abe Callard, who watches movies)
• Rands in Repose (by Michael Lopp, who manages people)
• The Sephist (by Linus, who makes his own software tools)
• Thought Asylum (by Stephen Millard, who makes other people’s software tools more usable)

Apple enthusiasts

Some tips, a few tricks, many opinions.

• And now it’s all this
• Brett Terpstra (if you have a Mac and use it for more than just browsing the internet and answering email — not that there is anything wrong with that — Terpstra’s tools will save you days of work; he could easily have been slotted in the category above, but the Apple tag predates all and he is an Apple lifer)
• Daring Fireball (by John Gruber)
• Hypercritical (a sadly neglected blog by John Siracusa although what you should really check out is the podcast of the same name which has been out of production for years but still fun and relevant)
• Macdrifter
• Marco.org (by Marco Arment)

Finance-adjacent

Economists and investors, for the most part.

• Global Inequality (by Branko Milanović)
• Marginal Revolution (by Tyler Cowen and Alex Tabarrok who also wrote an excellent textbook in economics which I plan on reading some day, likely in retirement)
• Pseudoerasmus (the last post was in 2017 so I’m not holding out any hope, though he is on Twitter)
• The Rational Walk (see also Rational Reflections and the Twitter account)
• 10-K diver (as close to a blog that a Twitter account can get)

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).

• Everything Studies (by John Nerst)
• Galaxy Brain (by Charlie Warzel)
• Insight (by Zeynep Tufekci, who is hands down the best journalist currently writing)
• Slow Boring (by Matthew Yglesias)

Company blogs

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

• Devonian Times, from the makers of my note-collecting tool of choice, DEVONthink
• The Omni Group, makers of OmniFocus (and OmniGraffle, which I don’t use often enough for it to be essential but which is fairly
• Wolfram Blog, from the makers of Mathematica

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?

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

I have a folder called Articles for them on my desktop. Which never gets opened. It is a like a black hole.

— Venkatraman Radhakrishnan (Venky) (@venkymd) November 15, 2020

90% of what I do on Twitter is email myself interesting articles I see Tweeted only to never be read.

— Aaron Goodman - “Papa Heme” (@AaronGoodman33) February 25, 2021

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:

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?

• 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.

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.

Uh oh, I guess I better be able to prove real fast that I was doing work on bats a few years back…. pic.twitter.com/abkBX2z0Xl

— Vinay Prasad MD MPH (@VPrasadMDMPH) May 17, 2020

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.

• Photo of the week: Mars, of course (this one is even better, but there’s something to being first)
• Article of the week: Mars, of course
• Video of the week: May as well be from Mars (this one too)
• Gaming story of the week: There was supposed to be a Monkey Island movie, then Steven Spielberg asked for more monkeys and the thing fell apart. I’m heartbroken.
• Meme of the week: Texas.

• Article of the week: Zeynep Tufekci on critical thinking (and a close second: Matthew Yglesias on controversial topics)
• Thread of the week: Taleb gets Covid-19
• Video of the week: John Mattick’s RNA lecture.
• Internet service of the week: Radio Garden
• Meme of the week: Psychology versus cognitive science