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Writing Makes It “True”

08.30.21 // Miscellany

From “How to Leverage Language to Cultivate Your Creative Process” by Nicole He in Killscreen.

I had a concept in my mind—maybe I felt it emotionally, I had a feeling about what this thing is supposed to represent. Now what I’m saying makes it real. After that, I started responding to journalists the next morning. What blew my mind was this: the thing I wrote about my project became true about the project. Many of the things I would say, the lazier journalists would just copy and paste. Weirdly, seeing my own ideas in the media suddenly made them even more true—things about a project being about intimacy, about computers knowing more than we know about ourselves. All of this became true, because someone else was saying things about my project, but based on what I had said about my project.

There’s a lot to be said for putting in the effort of distilling a vague idea into a clear concept and writing it down (and, yes, maybe even sharing it). Not just for a specific project, but for you and your whole career.

There is power in storytelling, both internally and externally.

And, perhaps weirdest of all is that—on the whole—you get to define your own narrative.

Semiannual Social Media is Terrible PSA

07.08.21 // Miscellany

Here’s a little exercise adapted from “You Really Need to Quit Twitter” in The Atlantic:

Step 1: Take the Simone Weil essay  “On the Abolition of All Political Parties” and replace the word “parties” with something that maybe shouldn’t exist, like social media:

The mere fact that social media exists today is not in itself sufficient a reason for us to preserve it. The only legitimate reason for preserving anything is its goodness. The evils of social media are all too evident; therefore, the problem that should be examined is this: Does it contain enough good to compensate for its evils and make its preservation desirable?

Step 2: (Oh well I still have my Twitter account).

The Limitations of Copy and Paste

06.17.21 // Medicine, Miscellany

From “To Kickstart a New Behavior, Copy and Paste” by Kathy Milkman, author of the new book, How to Change, which suggests the best way to master a new skill is to emulate the methods of someone successful.

Happily, it’s easy to turn yourself into a deliberate copy-and-paster. The next time you’re falling short of a goal, look to high-achieving peers for answers. If you’d like to get more sleep, a well-rested friend with a similar lifestyle may be able to help. If you’d like to commute on public transit, don’t just look up the train schedules—talk to a neighbor who’s already abandoned her car. You’re likely to go further faster if you find the person who’s already achieving what you want to achieve and copy and paste their tactics than if you simply let social forces influence you through osmosis.

Kinda maybe sorta.

There is a big, big difference between emulating psychosocial habits (like vegetarianism or fashion) or noncomplex skills (like a workable commute route or some forms of regular exercise) and achieving success in a skill-based habit like practicing medicine or playing an instrument.

For low-stakes or low-commitment behaviors, sure. It’s reasonable to try to save time and give yourself the boost of something that has worked for someone. Copy-paste saves you from analysis paralysis.

But copy and paste is also a guaranteed way to fully embrace survivorship bias. You don’t know if the people you are emulating succeeded because of their methods or despite them. You don’t know if those methods are optimal for you or if the most important aspects of said methods are even those which are externally visible or consciously retrievable from the expert.

A lot of people don’t know why they’re successful, and their attempts to craft a narrative about their successes are fiction.

And when it comes to experts instead of peers, one of the common difficulties for many is that it’s been so long since they’ve been a novice that they literally don’t know what it’s like anymore. Their memories of their early growth are fuzzy and often out-of-date to boot.

As we are back in the middle of USMLE Step season for the medical students among you, I am reminded of this post I wrote in 2014 about the Methods to Success Fallacy.

Underwriting is Noisy

05.18.21 // Miscellany

An example a brief essay “Bias Is a Big Problem. But So Is ‘Noise.” about noise and decision-making in the NYT by Daniel Kahneman and his co-authors in support of their new book Noise: A Flaw in Human Judgement:

Consider another noisy system, this time in the private sector. In 2015, we conducted a study of underwriters in a large insurance company. Forty-eight underwriters were shown realistic summaries of risks to which they assigned premiums, just as they did in their jobs.

How much of a difference would you expect to find between the premium values that two competent underwriters assigned to the same risk? Executives in the insurance company said they expected about a 10 percent difference. But the typical difference we found between two underwriters was an astonishing 55 percent of their average premium—more than five times as large as the executives had expected.

This is why you don’t buy an insurance policy from a captive agent; you purchase through an independent agent who can get quotes from multiple companies. Every decision is subject to bias and noise, and they are separate and independent problems (i.e. both inaccurate and imprecise).

The easiest way to push both in your favor is through multiple independent attempts.

Student loan debt predicts burnout

05.14.21 // Miscellany, Radiology

From “Predictors Between the Subcomponents of Burnout Among Radiology Trainees” by Le et al. in JACR.

 

 

In summary:

Debt level < $200,000 was associated with lower [emotional exhaustion] scores among upper-level trainees and was the only predictor of burnout that significantly affected multiple years of training.

I suspect there is a dose-response above that debt level as well.

Uncertainty breeds despair. Make sure you develop a student loan action plan.

Regulatory controls and not-so-free markets

04.26.21 // Miscellany

Not just doctors but all sorts of students and professionals scrambled to figure out how to deal with their high-stakes exam during the pandemic. Lawyers were no exception. Some states had new lawyers take the bar remotely. But a few states just got rid of it altogether and allowed diplomas from accredited schools to stand on their own.

NPR’s Planet Money, “Most People Can’t Afford Legal Help. 1 Reformer Wants To Change That” is an interesting quick discussion of slowly changing legal regulations that has plenty of parallels with medicine:

The National Conference of Bar Examiners, which helps states administer the bar, argues that the bar remains important in protecting the public. “Every high-stakes profession, including engineering, medicine, aviation, and others, relies on licensure to ensure that practitioners meet minimum standards of fundamental competency, and the practice of law is no exception,” the organization said in a statement.

But Gillian Hadfield, a law professor and economist at the University of Toronto, argues there’s no evidence that the bar actually protects the public. She thinks not only it is time we reevaluate use of the bar exam — it’s time to completely revamp how we regulate the practice of law in the United States.

The bar exam, she says, is one part of a broader system that raises the cost of legal services and contributes to an “access to justice crisis” in the United States. “My estimate is well over 80% of Americans who need legal help can’t get it because it’s too expensive,” Hadfield says. “And the main reason for that is a crazy regulatory system. The bar exam is part of that.”

…

It’s kinda like cafe baristas getting control of the coffee market by using the regulatory system to prevent restaurants, Keurig machines, and gas stations from providing you coffee. They’re like, “It’s for your safety! You could get burned or poisoned! The coffee will be worse!” Meanwhile, a cup of coffee costs $20.

The Support Page

01.24.21 // Miscellany

It’s one of those things I probably should have done around a decade ago, but last week I put up a “support” page. As I don’t run any ads and the vast majority of my writing is unmonetized, this site is largely a labor of love (and I’m happy with that).

But…

I also talk to enough folks who want to support my efforts that it’s silly for me to make that challenging.

So while the page does include a way to directly send me money, it’s mostly a collection of the active affiliate arrangements I have, which are easy ways to get someone else (Amazon, educational products, physician survey companies, etc) to provide me with financial support at no cost to you if/when such things meet your needs (and usually with a reader discount).

Also, please feel free to ignore it entirely.

Regardless, I will continue to accept virtual high fives, which remain my primary currency.

Productive Procrastination

01.04.21 // Miscellany, Reading

From Indistractable: How to Control Your Attention and Choose Your Life:

I discovered that living the life we want requires not only doing the right things; it also requires we stop doing the wrong things that take us off track.

If distraction costs us time, then time management is pain management.

That’s a catchy line.

Being okay in your skin, being okay within your own mind is part of it. We reach for the phone because it’s easier.

There’s a lot of navel-gazing writing about how you should just stand in the grocery line and be mindful: to find space in that brief time to just be.

And that sounds so nice.

But…I also start a lot of drafts in those in-between moments. I haven’t conquered being alone with my thoughts, and maybe I never will. But at least I’ve practiced sublimating them into something I consider meaningful.

If you’ve ever chewed over something in your mind that you did, or that someone did to you, or over something that you don’t have but wanted, over and over again, seemingly unable to stop thinking about it, you’ve experienced what psychologists call rumination. This “passive comparison of one’s current situation with some unachieved standard” can manifest in self-critical thoughts such as, “Why can’t I handle things better?”

But there’s the rub.

I’m not sure it’s really possible to avoid the rumination and bad habit loops without dealing with that pain management directly. I see a lot of workaholics that are good at doing things but not so good at just being alive, and perhaps our work-focused, over-scheduled, and outcome/comparison-focused society is at least partially to blame.

Certainly, the resume-fluffing requirements we place on students for competitive colleges, graduate schools, and jobs like medical residencies are teaching those lessons early enough at young enough ages that we’re likely still susceptible to making them part of our personalities.

The Basis for No

12.21.20 // Miscellany

In Essentialism, Greg McKeown writes:

Many capable people are kept from getting to the next level of contribution because they can’t let go of the belief that everything is important.

We’re in the middle of residency interview season, but for many students, the CV-padding season started in high school and never ended. We have a “meritocratic” system where people are rewarded for doing things and accumulating line-items.

I’ve had a lot of meaningful hobbies in my life, but most of the things I’ve done for other people were useless for my development and for the world. While you have to do enough to figure out what you like and what you could become good at, we could all move the needle more by saying no to more “opportunities” (if only getting to the next stage of the process didn’t require so much box-checking).

Time is finite, so every “yes” for something you don’t care about is a “no” to the things you do.

And that applies to the types of productive procrastination we often employ (like me writing this brief post instead of doing the harder work of finishing the draft of my next book). The discipline to focus on the impactful and meaningful 20% from the 80/20 rule is hard.

1980 or 2020?

12.14.20 // Miscellany

There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that “my ignorance is just as good as your knowledge.”

—Isaac Asimov, in his 1980 essay, “A Cult of Ignorance.”

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