I’m running low on my stash of Cometeer coffee. If you’re interested, you can get $30 off your first order ($15 off the first two boxes) + free shipping and help subsidize my terrible caffeine addiction. (Full review here. Not an ad, but I’ve been ordering for the past three years and I really do like cheaper coffee.)
Morgan Housel, “Little Ways the World Works”:
Chamath Palihapitiya once noted that however fast your business grows, that’s the half-life for how quickly it can be destroyed. So many companies, flush with cheap money from previous years, are learning this right now. Every business and every industry has a natural growth rate – push beyond it and short-term growth comes at the cost of long-term quality, and eventually survival.
From Face it: you’re a crazy person, about the importance of “unpacking” a job to understand your relationship to a potential career:
High-status professions are the hardest ones to unpack because the upsides are obvious and appealing, while the downsides are often deliberately hidden and tolerable only to a tiny minority.
[…]
Making matters worse, people are happy to talk about themselves and their jobs, but they do it at this unhelpful, abstract level where they say things like, “oh, I’m the liaison between development and sales”. So when you’re unpacking someone’s job, you really gotta push: what did you do this morning? What will you do after talking to me? Is that what you usually do? If you’re sitting at your computer all day, what’s on your computer? What programs are you using? Wow, that sounds really boring, do you like doing that, or do you endure it?
How important and yet almost impossible does that sound?There are wide chasms between expectation, perception, and reality. I’m not sure most people are truly psychologically willing to confront unpacking themselves, let alone comprehensively do it for others.
Dictation is such a powerful skill.
I strongly believe that writing is incredibly valuable, and in many ways, I feel that writing is how you really learn how you think. But speaking out loud has its own benefits—for figuring out what you want to say and practicing the skill of taking nebulous ideas and turning them into crisp prose.
With experience, it’s also simply faster than typing with your hands and more accurate with spelling than your clumsy fingers.
The Value of Verbalizing in Radiology
The return of the radiology oral boards is, I think, largely a reflection and acknowledgment of the reality that taking cases is a valuable skill—not just because of the performance art component or the ability to assess critical thinking, but because the ability to verbalize and think out loud is intrinsically valuable, even if it’s hard to quantify.
The more you say things, the clearer you can become in how you express yourself. It’s also no secret that we create mental shortcuts and cognitive macros in our ability to rapidly describe things, just like riding a bicycle. If you hear an older attending free-dictate every single word of the report like a well-paid auctioneer as though we’re still living in the 1990s, you would see how powerful that automaticity can be.
I don’t know if it’s the same basal ganglia circuitry, but it’s also undeniably something that you can see every first-year resident develop a library of as they practice. Dictating reports is part of the learning process, even if it doesn’t feel like learning specifically.
The more you verbalize complex cases, the more you reduce the cognitive load of those interpretations. I think the ability for people to gain speed and confidence in reading cases is not just a matter of how many cases you’ve looked at, but likely also a reflection of how many cases you’ve dictated.
Dictation as a Personal Superpower
I also think—taking a step back from radiology—that dictation is a super valuable skill. I’d always been drawn to the idea of dictating but wasn’t really able to put enough reps in to become comfortable with it until I became a radiology resident. I even bought a copy of Dragon back in high school after NY Times columnist David Pogue started dictating all of his columns but had terrible results at the time. This was a symptom of my desire to be a writer but inability to put in the actual work to be less terrible at writing, and the incorrect belief (that I still fall prey to) that if I had just the right tool, I would magically get things done.
Even outside of accuracy problems with earlier software (especially my admittedly not very clear speech), the fact was that I had the same writer’s block with a blank page whether I was trying to type or to speak.
But since starting residency and thanks to the built-in voice transcription of modern cell phones, I’ve been able to capture ideas that would have been lost in the ether or only partially captured through written shorthand (less well-formed and often frustratingly unintelligible to my future self).
As I’ve written before, I even dictated the majority of the first draft of my book about student loans while walking on a bridge between the reading room and our noon conference.
Dictating while walking is an especially incredible gift, because the act of pacing around is distracting enough to help you silence your internal editor and allow the free flow of ideas without being demanding enough that the actual thinking itself is impaired.
While the dictation is never the final draft, it provides incredible, unfiltered raw material for revision. Editing and expansion are where, for me, the real craft of writing takes place, but there’s so much less friction when you’ve built some momentum through dictation.
If you think you might want to start writing but can’t seem to build the habit, try speaking first.
After 40 years, Spaceballs is set to return. Mel Brooks, a national treasure, will, incredibly, be over 100 if it comes out in 2027 as planned. My son is overdue to see the original.
From Obsolescence Rents: Teamsters, Truckers, and Impending Innovations, published by the National Bureau of Economic Research:
We consider large, permanent shocks to individual occupations whose arrival date is uncertain. We are motivated by the advent of self-driving trucks, which will dramatically reduce demand for truck drivers. Using a bare-bones overlapping generations model, we examine an occupation facing obsolescence. We show that workers must be compensated to enter the occupation – receiving what we dub obsolescence rents – with fewer and older workers remaining in the occupation. We investigate the market for teamsters at the dawn of the automotive truck as an á propos parallel to truckers themselves, as self-driving trucks crest the horizon. As widespread adoption of trucks drew nearer, the number of teamsters fell, the occupation became ‘grayer’, and teamster wages rose, as predicted by the model.
“Obsolence rents” is a neat phrase. I remember a friend growing up whose aging father made a great living maintaining legacy systems in the nearly defunct computer language COBOL.
We discussed “Choosing Rocks” earlier this year, and I wanted to return to Four Thousand Weeks again to discuss distraction and control.
On the true nature of saying “no”:
Elizabeth Gilbert points out, it’s all too easy to assume that this merely entails finding the courage to decline various tedious things you never wanted to do in the first place. In fact, she explains, “it’s much harder than that. You need to learn how to start saying no to things you do want to do, with the recognition that you have only one life.”
This is the principle of the popular “One Thing” argument: with finite time and energy, we are always saying no to things inadvertently by omission. Saying yes to reasonable or even awesome things can be a mistake if it distracts from your true priorities. If you really want to coach your kid’s sports team, even the most engaging opportunities may be a no to your priority as a parent.
French philosopher Henri Bergson tunneled to the heart of Kafka’s problem in his book Time and Free Will. We invariably prefer indecision over-committing ourselves to a single path, Bergson wrote, because “the future, which we dispose of to our liking, appears to us at the same time under a multitude of forms, equally attractive and equally possible.” In other words, it’s easy for me to fantasize about, say, a life spent achieving stellar professional success, while also excelling as a parent and partner, while also dedicating myself to training for marathons or lengthy meditation retreats or volunteering in my community—because so long as I’m only fantasizing, I get to imagine all of them unfolding simultaneously and flawlessly. As soon as I start trying to live any of those lives, though, I’ll be forced to make trade-offs—to put less time than I’d like into one of those domains, so as to make space for another—and to accept that nothing I do will go perfectly anyway, with the result that my actual life will inevitably prove disappointing by comparison with the fantasy. “The idea of the future, pregnant with an infinity of possibilities, is thus more fruitful than the future itself,” Bergson wrote, “and this is why we find more charm in hope than in possession, in dreams than in reality.” Once again, the seemingly dispiriting message here is actually a liberating one. Since every real-world choice about how to live entails the loss of countless alternative ways of living, there’s no reason to procrastinate, or to resist making commitments, in the anxious hope that you might somehow be able to avoid those losses. Loss is a given. That ship has sailed—and what a relief.
The liberation is perhaps a bit more bittersweet than Burkeman suggests, but this is a fantastic paragraph.
Distraction from Without and Within
So it’s not simply that our devices distract us from more important matters. It’s that they change how we’re defining “important matters” in the first place. In the words of the philosopher Harry Frankfurt, they sabotage our capacity to “want what we want to want.”
Frankfurt also wrote the delightfully-titled short book On Bullshit.
In T. S. Eliot’s words, we are “distracted from distraction by distraction.”
It’s not usually that you’re sitting there, concentrating rapturously, when your attention is dragged away against your will. In truth, you’re eager for the slightest excuse to turn away from what you’re doing, in order to escape how disagreeable it feels to be doing it; you slide away to the Twitter pile-on or the celebrity gossip site with a feeling not of reluctance but of relief.
Ugh. How many times have people harped on the advice to change the notification settings on your phone? Yes, of course that helps to an extent. But I am perfectly capable of distracting myself thank you very much.
Mary Oliver calls this inner urge toward distraction “the intimate interrupter”—that “self within the self, that whistles and pounds upon the door panels,” promising an easier life if only you’d redirect your attention away from the meaningful but challenging task at hand, to whatever’s unfolding one browser tab away. “One of the puzzling lessons I have learned,” observes the author Gregg Krech, describing his own experience of the same urge, “is that, more often than not, I do not feel like doing most of the things that need doing. I’m not just speaking about cleaning the toilet bowl or doing my tax returns. I’m referring to those things I genuinely desire to accomplish.”
Burkeman suggests an extension of the timeless classic Pascal quote (from—get this—1654!): ‘All of humanity’s problems stem from man’s inability to sit quietly in a room alone.’
No wonder we seek out distractions online, where it feels as though no limits apply—where you can update yourself instantaneously on events taking place a continent away, present yourself however you like, and keep scrolling forever through infinite newsfeeds, drifting through “a realm in which space doesn’t matter and time spreads out into an endless present,” to quote the critic James Duesterberg. It’s true that killing time on the internet often doesn’t feel especially fun, these days. But it doesn’t need to feel fun. In order to dull the pain of finitude, it just needs to make you feel unconstrained.
The overarching point is that what we think of as “distractions” aren’t the ultimate cause of our being distracted. They’re just the places we go to seek relief from the discomfort of confronting limitation. The reason it’s hard to focus on a conversation with your spouse isn’t that you’re surreptitiously checking your phone beneath the dinner table. On the contrary, “surreptitiously checking your phone beneath the dinner table” is what you do because it’s hard to focus on the conversation.
Satisfaction = reality minus expectation:
The most effective way to sap distraction of its power is just to stop expecting things to be otherwise—to accept that this unpleasantness is simply what it feels like for finite humans to commit ourselves to the kinds of demanding and valuable tasks that force us to confront our limited control over how our lives unfold.
Control Is an Illusion
The cognitive scientist Douglas Hofstadter is famous, among other reasons, for coining “Hofstadter’s law,” which states that any task you’re planning to tackle will always take longer than you expect, “even when you take into account Hofstadter’s Law.”
So a surprisingly effective antidote to anxiety can be to simply realize that this demand for reassurance from the future is one that will definitely never be satisfied—no matter how much you plan or fret, or how much extra time you leave to get to the airport.
I remember struggling to get through Hofstadter’s Pulitzer Prize-winning Gödel, Escher, Bach: An Eternal Golden Braid in high school (my father kept telling me to read it, I wasn’t quite that big of a dork). Some of the references and predictions have aged out, but it’s still something else (really been meaning to re-read it sometime).
What we forget, or can’t bear to confront, is that, in the words of the American meditation teacher Joseph Goldstein, “a plan is just a thought.” We treat our plans as though they are a lasso, thrown from the present around the future, in order to bring it under our command. But all a plan is—all it could ever possibly be—is a present-moment statement of intent. It’s an expression of your current thoughts about how you’d ideally like to deploy your modest influence over the future. The future, of course, is under no obligation to comply.
Yet it turns out to be perilously easy to overinvest in this instrumental relationship to time—to focus exclusively on where you’re headed, at the expense of focusing on where you are—with the result that you find yourself living mentally in the future, locating the “real” value of your life at some time that you haven’t yet reached, and never will.
Always beware the arrival fallacy.
Last year, we also discussed Inescapable Finitude and the Productivity Trap.
From the excellent Alchemy: The Dark Art and Curious Science of Creating Magic in Brands, Business, and Life by Rory Sutherland:
In theory, you can’t be too logical, but in practice, you can. Yet we never seem to believe that it is possible for logical solutions to fail. After all, if it makes sense, how can it possibly be wrong?
[…]
If you are a technocrat, you’ll generally have achieved your status by explaining things in reverse; the plausible post-rationalisation is the stock-in-trade of the commentariat. Unfortunately, it is difficult for such people to avoid the trap of assuming that the same skills that can explain the past can be used to predict the future.
The world trades in stories, but compelling stories aren’t necessarily true. See also: hindsight bias. The post hoc seeming inevitability of where we are now is a mirage.
Adam Smith, the father of economics – but also, in a way, the father of behavioural economics – clearly spotted this fallacy over two centuries ago. He warned against the ‘man of system’, who: ‘is apt to be very wise in his own conceit; and is often so enamoured with the supposed beauty of his own ideal plan of government, that he cannot suffer the smallest deviation from any part of it. He goes on to establish it completely and in all its parts, without any regard either to the great interests, or to the strong prejudices which may oppose it . . . He seems to imagine that he can arrange the different members of a great society with as much ease as the hand arranges the different pieces upon a chess-board. He does not consider that the pieces upon the chess-board have no other principle of motion besides that which the hand impresses upon them; but that, in the great chess-board of human society, every single piece has a principle of motion of its own, altogether different from that which the legislature might chuse [sic] to impress upon it. If those two principles coincide and act in the same direction, the game of human society will go on easily and harmoniously, and is very likely to be happy and successful. If they are opposite or different, the game will go on miserably, and the society must be at all times in the highest degree of disorder.’
This chess piece argument is also a metaphor favored by conservative economist Thomas Sowell as the key failing conceit of central planning.
The problem that bedevils organisations once they reach a certain size is that narrow, conventional logic is the natural mode of thinking for the risk-averse bureaucrat or executive. There is a simple reason for this: you can never be fired for being logical. If your reasoning is sound and unimaginative, even if you fail, it is unlikely you will attract much blame. It is much easier to be fired for being illogical than it is for being unimaginative.
[…]
The fatal issue is that logic always gets you to exactly the same place as your competitors.
The primary function of managers is to preserve their position within management. The second function is to be promoted. The distant third is to actually manage people well or improve their organizations. (Further Reading: Academic Medicine and the Peter Principle)
The late David Ogilvy, one of the greats of the American advertising industry and the founder of the company I work for, apparently once said, ‘The trouble with market research is that people don’t think what they feel, they don’t say what they think, and they don’t do what they say.’*
[…]
It is fine to provide up-to-date magazines in reception to show that you care, but when the urge to show commitment to patients involves performing unnecessary tests and invasive surgery, it probably needs to be reined back.
Yes. I am reminded of Patient Satisfaction: A Danger to be Avoided.
If you want to change people’s behaviour, listening to their rational explanation for their behaviour may be misleading, because it isn’t ‘the real why’. This means that attempting to change behaviour through rational argument may be ineffective, and even counterproductive. There are many spheres of human action in which reason plays a very small part. Understanding the unconscious obstacle to a new behaviour and then removing it, or else creating a new context for a decision, will generally work much more effectively.
Behavior change is hard. I can barely control a whole host of my own impulses, let alone guide others.
The self-regarding delusions of people in high-status professions lie behind much of this denial of unconscious motivation. Would you prefer to think of yourself as a medical scientist pushing the frontiers of human knowledge, or as a kind of modern-day fortune teller, doling out soothing remedies to worried patients? A modern doctor is both of these things, though is probably employed more for the latter than the former. Even if no one – patient or doctor – wants to believe this, it will be hard to understand and improve the provision of medical care unless we sometimes acknowledge it.
[…]
To put it crudely, when you multiply bullshit with bullshit, you don’t get a bit more bullshit – you get bullshit squared.
[…]
Nassim Nicholas Taleb applies this rule to choosing a doctor: you don’t want the smooth, silver-haired patrician who looks straight out of central casting – you want his slightly overweight, less patrician but equally senior colleague in the ill-fitting suit. The former has become successful partly as a result of his appearance, the latter despite it.
The Taleb reference is commonly referenced even if it may not always work in real life. It’s one of those lightbulb-generating remarks that strikes that magic of being surprisingly intuitive after seeming counterintuitive.
There is an important corollary: proxy metrics (patrician manner, various training factors) don’t actually mean what we want them to mean. You want to see a Harvard-trained doctor because you assume they are better through the implied meritocratic scarcity of an elite institution and the presumption that therefore, surrounded by other geniuses and some presumably fancy digs, their training was uniquely better—but there is no actual basis for this belief.
In making decisions, we should at times be wary of paying too much attention to numerical metrics. When buying a house, numbers (such as number of rooms, floor space or journey time to work) are easy to compare, and tend to monopolise our attention. Architectural quality does not have a numerical score, and tends to sink lower in our priorities as a result, but there is no reason to assume that something is more important just because it is numerically expressible.
Measurability does not equal importance. See “Overweighing what can be counted” in Munger’s Incorrect Approaches to Medicine.
The more data you have, the easier it is to find support for some spurious, self-serving narrative. The profusion of data in future will not settle arguments: it will make them worse.
…I naively thought Covid would bring people together. And it did, for maybe a week or two. Then the dueling data wars began.
We are flush with data. Absolutely awash in data. If the past few years of social media have taught us anything, it’s that information isn’t truth. It’s raw material for storytelling. Yoval Noah Harari does a nice if depressing job discussing information networks in his recent book, Nexus.
The toddler puts on a show of having an argument, but they are holding a tantrum in reverse. If they ‘win’ the argument, no tantrum is needed. If they lose, they can tell themselves that they tried but the other person deserved the tantrum because they didn’t listen.
– Seth Godin, “How to win an argument with a toddler” (P.S. You can’t)