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.

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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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A few unpopular (in certain circles) opinions from a person who has no rights having them

For better or worse, the American system of government is strong. Those who say otherwise have a financial interest in people thinking the opposite.

Culturally, US has more similarities with Iran than with Saudi Arabia, even if you count religion and religiosity as part of culture. The Christian right is working hard to make them even more similar.

Though still quite hard, it’s easier for a high-skilled immigrant to come to America than to any other country in the world. Comparison is even more favorable for low-skilled and unskilled immigrants. For all of them, quality of life, acceptance, and protection they get are better than anywhere else.

The randomness of the Green Card lottery process is a feature not a bug.

Reading the non-fiction sections of The New Yorker, The Atlantic, and whatever their conservative equivalents are, is good for generating fake insight but ultimately pointless. The Economist is useful for a tiny segment of the population but lets be real: if you’re reading this you are not it.

The only useful section in the daily newspapers is Local. Maybe Sports, if you are into that sort of thing, but professional and college sports are a scam so stick with the amateur leagues.

TSA agents and airline personnel are nice people but some passengers check out their brains at the curb and make everyone’s lives less pleasant.

Apple hardware products are underpriced for what you get but do you actually need what they offer? This doesn’t include the AirPods, which are the best thing Apple has made in the last 20 years and still underpriced; though they unfortunately resemble in both name and appearance a mind control method from Doctor Who S2 and paired with a smart phone are not far from it.

The world doesn’t need another IPA. America needs more tripels.

This is all coming from a non-immigrant resident alien with no expertise in politics, international law, transportation, or technology. I do know beer though.

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Voices in my head, 2018 edition

(voices as in podcasts, not a psychotic episodes)

  • Conversations with Tyler: I much prefer this over his mostly spartan, often cryptic, and always clueless about things medical blog Marginal revolution. Cowen‘s interview style brings out the best from people; it is also a good and rare example of clear thinking. Compare and contrast his chat with Malcolm Gladwell and Patrick Collison’s chat with Cowen: when answering, Gladwell uhms and ahhs and changes direction mid-sentence; Cowen pauses for a half-second, then produces paragraphs of prose that could have been lifted right out of an encyclopedia. Not to belittle Gladwell — for one, I’d be even worse (as anyone who had to finish my sentences for me can confirm); and two, he is responsible for
  • Revisionist history: He had me at Food Fight. Gladwell embraces and owns his Well, actually kind of story-telling — even the show’s name is a big Well, actually to the Gladwell-haters. And good for him, because the stories are marvelous in both topic and style, and make me want to read his books again.
  • Sources and methods: Two ex-spies talk about learning and cognition. They are still in intelligence-gathering mode, interviewing guests you‘re unlikely to hear anywhere else. It’s how I learned about Tinderbox (and you can too).
  • America the bilingual: One part pep-talk to encourage the pre-1990s waves of immigrants to America to take up a second language, one part advice to parents raising multilingual children. The latter validated my plan to ~~save money~~ strengthen the offspring’s Serbian by shipping them across the Atlantic to spend some quality time with the grandparents.
  • Novel targets: Finishing of the list of men talking to each other is the best oncology podcast I’ve come across. It may be heavily slanted towards immunotherapy, and not zealous enough in dampening the hype, but it tries.
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The culture that is Nortwest Washington DC

I have cut my commute down to 40 minutes door-door (from ~2 hours), 25 of which are walking, and we only have to pay 1.69 times the rent. Yay?

Some observations about our new neighborhood from a Serbian/European/Baltimorean transplant.

Dogs are everywhere.

Runners and cyclists too.

And a couple of homeless people. One seems to have staked out a bench I pass by every day.

Very few children. Assuming all the little Audreys and Maddisons are attending their ballet lessons, or whatnot.

Restaurants with street seating. It’s like I’m back in Belgrade. Alas, most of them serve nothing but greasy American classics, only they call it Southern-style and put even more grease.

Are people who eat at these places the same ones doing all the running?

Why do two different streets in the same neighborhood have the exact same name? If you put a super-block that cuts a road in half, does it not make sense to rename one of them?

Safeway is a dump.

The title may remind you of Marginal revolution. That’s on purpose. Go read it.

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→ Annals of internal medicine: Curiosity

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.

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Level up

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.


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.

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Podcast time

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.

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