Ben White

What I Read in 2024

12.27.24 // Reading

This past year was the fifteenth of this site and this is my eleventh reading list. This year, among other things, I also took over as the neuroradiology division chief for our large private practice (in addition to serving as associate program director for our radiology residency) and then started a new hand-crafted high-touch job board exclusively featuring true radiology private practices called Independent Radiology. It’s been busy.

  1. Steal Like an Artist by Austin Kleon
  2. Show Your Work by Austin Kleon (referenced in this April post)
  3. Keep Going by Austin Kleon
  4. Tehanu by Ursula K. Le Guin (I remember being somewhat disappointed by this book when I read it as a boy. Returning to it as a grown man with children, it feels like a completely different book. Le Guin is one of my favorite writers of all time.)
  5. The Drawing of the Three by Stephen King (This book and its personalities had a hard time carrying its length, I remember why I dropped the series in high school.)
  6. Tools of Titans by Tim Ferris (skimmed large sections due to format and the fact that I’m not going to do meaningful dietary content restriction, convoluted workouts, or psychedelics. I have a full-time job and a family I want to eat with.)
  7. The Boy, the Mole, the Fox, and the Horse by Charlie Mackesy (I read this to my son when it was new and selling oodles of copies, I opened it up again because my daughter is almost to that age again.)
  8. Make Something Wonderful: Steve Jobs in his own words (a free and sometimes even a little raw collection of Steve Jobs’ emails, quotes, and speeches)
  9. Bird by Bird by Ann Lamott (this may be the most delightful book about writing I’ve come across)
  10. The Dark Forest by Cixin Liu (The Three-Body Problem #2)
  11. The Other Wind by Ursula K. Le Guin (I remember when this came out when I was in high school, and I remember being happy the series ultimately hadn’t ended with Tehanu. But I’d literally forgotten everything about this story [it’s great].)
  12. Anything You Want by Derek Sivers (very short. Perhaps it’s hard to justify the cover price and sell books when they seem too short, but more nonfiction should be this short and to the point).
  13. The Eyes and the Impossible by Dave Eggers (this book is middle grade—and I bought it for my son—but I read it first, and I’ll freely admit to being surprised by how it came together).
  14. Death’s End by Cixin Liu (lots of info dumping and not always the most elegant prose given the translation but incredibly unique and inventive universe-scale science fiction)
  15. Tales of Earthsea by Ursula K. Le Guin
  16. The Culture Code by Daniel Coyle
  17. Ancillary Sword by Ann Leckie (Imperial Radch Book 2—good!)
  18. Slow Productivity by Cal Newport (1: Do fewer things, 2: Work at a natural pace, and 3: Obsess over quality.)
  19. The Power Law by Sebastian Mallaby
  20. A City on Mars by Kelly and Zach Weinersmith (TLDR: All the popular ideas of settling space probably won’t work for a variety of reasons)
  21. Ancillary Mercy by Ann Leckie (Imperial Radch Book 3)
  22. Artificial Condition by Martha Wells (Murberbot #2, really great series, concise and enjoyable with strong efficient plotting)
  23. Rogue Protocol by Martha Wells (Murberbot #3)
  24. Exit Strategy by Martha Wells (Murberbot #4)
  25. Network Effect by Martha Wells (Murberbot #5)
  26. Fugitive Telemetry by Martha Wells (Murberbot #6)
  27. System Collapse by Martha Wells (Murberbot #7)
  28. The Coward by Stephen Aryan
  29. The Warrior by Stephen Aryan
  30. Loaded by Sarah Newcomb (meh)
  31. Hyperion by Dan Simmons (this is one of those classic sci-fi Hugo winners from the 1980s. It was pretty out there.)
  32. Mr. Penumbra’s 24-Hour Bookstore by Robin Sloan
  33. Yumi and the Nightmare Painter by Brandon Sanderson
  34. The Algebra of Wealth by Scott Galloway
  35. Translation State by Ann Leckie (I normally don’t care very much for spin-off stories set off the main story arc, especially prequels. This takes place after the Radch trilogy, covers new ground, and has some fun cameos. I enjoyed it, and the series in general continues to be an illustration—in a good way—of the fact that Science Fiction says more about the period in which it is written than about the future it envisions).
  36. Spelunky (Boss Fight Books) by Derek Yu (written by the creator of a popular/niche roguelike indy videogame; it’s always neat to open the hood and see how something is made, how someone approaches a novel set of problems.)
  37. Emperor’s End by Kyle Kirrin (Ripple System #5)
  38. The Anxious Generation by Jonathan Haidt (I think this is a very important book)
  39. Children of Memory by Adrian Tchaikovsky (Children of Time #3)
  40. The Sunlit Man by Brandon Sanderson (I would say overall the most enjoyable of the Year of Sanderson)
  41. The Knowledge: How to Rebuild Civilization in the Aftermath of a Cataclysm by Lewis Dartnell (answer: it would honestly be very hard.)
  42. The Happiness Hypothesis by Jonathan Haidt
  43. The Employees by Olga Ravn (Disorienting epistolary sci-fi. I saw this on a list of 100 best sci-fi books of all time. I definitely wouldn’t go that far, but I’ve always had a soft spot for the form. I wrote a very small portion of an abandoned epistolary novel myself when I was a medical student.)
  44. The 4 hour Body by Tim Ferriss
  45. The Infernal Machine by Steven Johnson (Interesting narrative history tying together several bits of history I knew very little about: anarchism, the role of dynamite in the creation of modern terrorism, and the rise of the modern detective).
  46. He Who Fights with Monsters 11 by Travis Deverell
  47. The Great CEO Within: The Tactical Guide to Company Building by Matt Mochary
  48. The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure by Greg Lukianoff and Jonathan Haidt
  49. Outlive by Peter Attia
  50. The Signal and the Noise by Nate Silver
  51. Chrono Trigger (Boss Fight Books) by Michael P. Williams (One of my favorite games of all time, but this didn’t hit anywhere the same notes as Spelunky in terms of diving into the mechanics of the game from the perspective of its designers.)
  52. The Fragile Threads of Power by VE Schwab (a new series continuing the world of the Shades of Magic)
  53. A Man for All Markets by Edward O. Thorpe (fascinating memoir, my brief summary and some choice quotes here)
  54. How to Decide by Annie Duke
  55. Dungeon Crawler Carl by Matt Dinniman (I’ve read a lot LitRPG, but this series somehow brought the subgenre into the mainstream [relatively speaking]. It looked like—and is—an absolutely ludicrous entry, so I’d been ignoring Amazon’s recommendations about it for a while. But it came up in conversation with a normal human so it seemed like it was time. Seth MacFarlane is even going to make it into a TV show).
  56. Carl’s Doomsday Scenario by Matt Dinniman (Dungeon Crawler Carl #2)
  57. The Dungeon Anarchist’s Cookbook by Matt Dinniman (Dungeon Crawler Carl #3)
  58. The Gate of the Feral Gods by Matt Dinniman (Dungeon Crawler Carl #4)
  59. The Butcher’s Masquerade by Matt Dinniman (Dungeon Crawler Carl #5)
  60. The Eye of the Bedlam Bride by Matt Dinniman (Dungeon Crawler Carl #6) (I thought when I started the series that it was complete at 6 books, but book 7 is coming out next year, argh)
  61. The Black Swan by Nassim Nicholas Taleb (his books are well established in the thought-leader zeitgeist and yet often misconstrued for personal gain. He may be a bit of a boor in his internet and intellectual fights, but I think his arguments themselves hold water.)
  62. Insight by Tasha Eurich (I bought this book in 2019 apparently. Ultimately, I’m not sure what got me to pick it up at the end of the year, but it’s a great example of the glorified single article premise padded into a book through the overuse of tedious stories format of business publishing)

Here are the prior years:

A Man for All Markets

11.08.24 // Reading

A Man for All Markets by Edward O. Thorpe is a fascinating memoir from the mathematician/gambler/investor who solved card counting and essentially invented modern quantitative investing strategies.

While reading, I was struck by two things: One, unsurprisingly, Thorpe is/was curious, industrious, and clearly a genius. Two, that his life as a latchkey kid in the early 20th century, which included buying dangerous chemicals and making amateur explosives at home could not seem more distant than the modern American screen-based and scheduled childhood.

A few standout passages:

Regarding the need to have both a desired outcome and an expected outcome in mind when making a new decision:

If you do this, what do you want to happen?

If you do this, what do you think will happen?

The problem of moral hazard in the modern US economy:

Our corporate executives speculate with their shareholders’ assets because they get big personal rewards when they win — and even if they lose, they are often bailed out with public funds by obedient politicians. We privatize profit and socialize risk.

On negotiating to “win”:

It doesn’t pay to push the other party to their absolute limit. A small extra gain is generally not worth the substantial risk the deal will break up.

The information food chain:

Be aware that information flows down a ‘food chain’, with those who get it first ‘eating’ and those who get it late being eaten.

Regulation matters, but only when simple and effective and not crafted by the schmucks making all the bad choices:

Nassim Taleb asked why, after a driver crashes his school bus, killing and injuring his passengers, he should be put in charge of another bus and asked to set up new safety rules.

How much leverage is enough?

The lesson of leverage is this: Assume that the worst imaginable outcome will occur and ask whether you can tolerate it. If the answer is no, then reduce your borrowing.

The gambler’s approach to life:

In the abstract, life is a mixture of chance and choice. Chance can be thought of as the cards you are dealt in life. Choice is how you play them.

And finally, what old people always say but young people can’t seem to internalize:

That acknowledgment, applause, and honor are welcome and add zest to life but they are not ends to be pursued. I felt then as I do now that what matters is what you do and how you do it, the quality of the time you spend, and the people you share it with.

Productivity is a Trap

02.01.24 // Reading

A little over a year ago, I found Oliver Burkeman’s Four Thousand Weeks: Time Management for Mortals to be one of the most excerpt-able books I’d read in a while.

In it, Burkeman describes cosmic insignificance theory, the perhaps counterintuitive argument that I would summarize as, “You really don’t matter very much in the grand scheme of things, so stop getting so worked up.”

You could consider the aspirational approach to be a form of happy nihilism. 

Here are some of my favorite passages:

The world is bursting with wonder, and yet it’s the rare productivity guru who seems to have considered the possibility that the ultimate point of all our frenetic doing might be to experience more of that wonder.

Except the people who want to amass experiences like a collector hoarding trinkets.

I also always love references to Keynes and his prediction for the 15-hour workweek:

None of this is how the future was supposed to feel. In 1930, in a speech titled “Economic Possibilities for Our Grandchildren,” the economist John Maynard Keynes made a famous prediction: Within a century, thanks to the growth of wealth and the advance of technology, no one would have to work more than about fifteen hours a week. The challenge would be how to fill all our newfound leisure time without going crazy. “For the first time since his creation,” Keynes told his audience, “man will be faced with his real, his permanent problem—how to use his freedom from pressing economic cares.”

But Keynes was wrong. It turns out that when people make enough money to meet their needs, they just find new things to need and new lifestyles to aspire to; they never quite manage to keep up with the Joneses, because whenever they’re in danger of getting close, they nominate new and better Joneses with whom to try to keep up. As a result, they work harder and harder, and soon busyness becomes an emblem of prestige. Which is clearly completely absurd: for almost the whole of history, the entire point of being rich was not having to work so much. Moreover, the busyness of the better-off is contagious, because one extremely effective way to make more money, for those at the top of the tree, is to cut costs and make efficiency improvements in their companies and industries. That means greater insecurity for those lower down, who are then obliged to work harder just to get by.

That summarizes a lot of depressing things about the modern human condition.

Not to mention the downsides of being effective. In many industries, that means the more you are able to do, the more you get to do.

Productivity is a trap. Becoming more efficient just makes you more rushed, and trying to clear the decks simply makes them fill up again faster. Nobody in the history of humanity has ever achieved “work-life balance,” whatever that might be, and you certainly won’t get there by copying the “six things successful people do before 7:00 a.m.”

Heh. No matter how much you do, you can’t do it all—so stop being so dramatic.

The day will never arrive when you finally have everything under control—when the flood of emails has been contained; when your to-do lists have stopped getting longer; when you’re meeting all your obligations at work and in your home life; when nobody’s angry with you for missing a deadline or dropping the ball; and when the fully optimized person you’ve become can turn, at long last, to the things life is really supposed to be about. Let’s start by admitting defeat: none of this is ever going to happen.

The lists don’t magically become empty unless you don’t mind them being empty.

The fundamental problem is that this attitude toward time sets up a rigged game in which it’s impossible ever to feel as though you’re doing well enough. Instead of simply living our lives as they unfold in time—instead of just being time, you might say—it becomes difficult not to value each moment primarily according to its usefulness for some future goal, or for some future oasis of relaxation you hope to reach once your tasks are finally “out of the way.”

On the opposite side of binging content in its many forms is the feeling that activities need to be “worth it” by some metric, that you are accountable for your time to any judge but yourself. (Also, I’m a hypocrite.)

I was a “productivity geek.” You know how some people are passionate about bodybuilding, or fashion, or rock climbing, or poetry? Productivity geeks are passionate about crossing items off their to-do lists. So it’s sort of the same, except infinitely sadder.

That’s a good line.

I tried to align my daily actions with my goals, and my goals with my core values. Using these techniques often made me feel as if I were on the verge of ushering in a golden era of calm, undistracted productivity and meaningful activity. But it never arrived. Instead, I just got more stressed and unhappy.

I would never succeed in marshaling enough efficiency, self-discipline, and effort to force my way through to the feeling that I was on top of everything, that I was fulfilling all my obligations and had no need to worry about the future. Ironically, the realization that this had been a useless strategy for attaining peace of mind brought me some immediate peace of mind. (After all, once you become convinced that something you’ve been attempting is impossible, it’s a lot harder to keep on berating yourself for failing.) What I had yet to understand, at that point, was why all these methods were doomed to fail, which was that I was using them to try to obtain a feeling of control over my life that would always remain out of reach.

Inevitably, to Nietzsche:

We labour at our daily work more ardently and thoughtlessly than is necessary to sustain our life,” wrote Nietzsche, “because to us it is even more necessary not to have leisure to stop and think. Haste is universal because everyone is in flight from himself.”

…which is a lot like the classic quote by Pascal: “All of humanity’s problems stem from man’s inability to sit quietly in a room alone.”

In practical terms, a limit-embracing attitude to time means organizing your days with the understanding that you definitely won’t have time for everything you want to do, or that other people want you to do—and so, at the very least, you can stop beating yourself up for failing.

…which then reminds me of the Covid-era essay by happiness professor/guru Arthur C. Brooks: How to Want Less.

Even embracing limitations, it’s easy to want to turn finitude into some sort of productivity paradox like the one thing: the best way to get things done is to do fewer things.

What Burkeman suggests is instead: just be okay with doing fewer things.

 

From the free ebook A Manifesto for Applying Behavioral Science from the UK’s Behavioural Insights Team:

The other concern is that [behavorial science] theories can make specific predictions, but they are disconnected from each other – and from a deeper, general framework that can provide broader explanations (like evolutionary theory, for example). The main way this issue affects behavioral science is through heuristics and biases. Examples of individual biases are accessible, popular, and how many people first encounter behavioral science. These ideas are incredibly useful, but have often been presented as lists of standalone curiosities, in a way that is incoherent, reductive, and deadening. They can create overconfident thinking that targeting a specific bias (in isolation) will achieve a certain outcome.

Cognitive biases and mental models make for great blog posts but are really hard to put into practice as an individual or effectively guide policy as an organization.

For further reading, try Nudge (the new/final edition was just released in 2021).

// 08.28.23

From Tanner Greer’s The Scholar’s Stage:

The professionalization of intellectual pursuit is another problem. Melville would never have written Moby Dick if he had spent years enrolled in an MFA program instead of spending years at sea. Men and women who in past ages would have observed humanity up close (or at least who would have been forced through a broad but rigorous education in classics) instead cloister themselves in ivory towers. Their intellectual energy is channeled into ever more specialized academic fields and cautiously climbing a bureaucratic and over-managed academic ladder. Could that social scene ever produce a great work?

// 08.21.23

The Negativity Tendency

03.20.23 // Medicine, Reading

The late Hans Rosling gave an amazingly popular TED talk back in 2006 (and many other popular talks since). You may have seen it. It’s the one showing recent human progress by following counties over time as a series of bubbles. It’s not all rosy, but it shows us how counterintuitive reality can be compared with our usually grimmer assumptions. One could summarize: things can be bad but still be improving. Trajectories matter.

In his follow-up book, Factfulness, Rosling discusses the fact that almost all “news” by definition is bad news. His helpful grounding suggestion: When you hear bad news, ask yourself if similar good news would be able to reach you.

* * *

In healthcare, M&M is full of bad outcomes. Do you hear about the patients who recover uneventfully in the hospital? Not really. Do people gossip about the patients who go home after surgery with well-healed incisions? No, they do not. As a radiologist, I only hear about my misses. About once a year, someone congratulates me on a good catch, and usually, that’s coming from another radiologist who read the follow-up.

As an attending evaluating my residents’ overnight work, I have to grade every change. We have grades for verbiage changes, incidental additions, small relevant misses, and big emergent misses. There’s nothing forcing me to tell my residents that I recognize the great job they’re doing tackling a large volume of complex cases. Most of what they see is negative feedback, even though that parade of bad news doesn’t really tell them an accurate story about the work they’re doing.

When I was a resident, my program had a separate grade for doing an amazing job. You could receive a coveted “1” on the 1-4 scale for crushing a subtle case, performing at a subspecialty level, etc. 1’s were rare.

One evening as I logged in for another shift, I was reviewing my grades from the night before and I saw I’d received a 1. Exhaustion aside, I was always excited when I earned a 1. The comment said, “Everyone deserves a 1 every now and again, so here’s yours.” I didn’t know how to parse that cryptic statement, so I clicked on the link to see the case.

It was a completely normal head CT in a young patient.

I hadn’t changed a word of the template.

* * *

We learn medicine through the slow accumulation of emotional microtrauma. As an educator, it takes special effort to try to really teach through praise and positive reinforcement; usually the vague “great jobs” show up on end-of-rotation evaluations. I’ll be the first to admit I can be too far on the pedantic curmudgeon spectrum.

Yes, feedback—even negative feedback—is a critical component of the learning process. But, when you’re beating yourself up about your mistakes and questioning your skills/growth, you also need to ask yourself:

What are the odds that I’m receiving the true positive side of the same coin?

The answer is you’re probably not.

Things can be bad and still be improving. Trajectories matter.

You can have a lot to learn and a long way to go and still be doing a great job.

On Building

02.17.23 // Medicine, Reading

Highlights from Build: An Unorthodox Guide to Making Things Worth Making by Tony Fadell (who led the teams for the iPod, iPhone, and Nest Learning Thermostat):

On the need to divide decisions into two main camps, data-driven or opinion-driven:

Data-driven: You can acquire, study, and debate facts and numbers that will allow you to be fairly confident in your choice. These decisions are relatively easy to make and defend and most people on the team can agree on the answer.

Opinion-driven: You have to follow your gut and your vision for what you want to do, without the benefit of sufficient data to guide you or back you up. These decisions are always hard and always questioned-after all, everyone has an opinion.

Every decision has elements of data and opinion, but they are ultimately driven by one or the other. Sometimes you have to double down on the data; other times you have to look at all the data and then trust your gut. And trusting your gut is incredibly scary. Many people don’t have either a good gut instinct to follow or the faith in themselves to follow it. It takes time to develop that trust. So they try to turn an opinion-driven business decision into a data-driven one. But data can’t solve an opinion-based problem. So no matter how much data you get, it will always be inconclusive. This leads to analysis paralysis-death by overthinking.

“Data can’t solve an opinion-based problem” is a core problem of the universe.

And the problems are worse when you can find a way to shirk responsibility for making those decisions:

But we fell into the same trap as everyone else. We were wowed by the consultants, excited by the numbers. And we quickly became far too reliant on them: everyone wanted data so they wouldn’t have to make decisions themselves. Instead of moving forward with a design, you’d hear, “Well, let’s just test it.” Nobody wanted to take responsibility for what they were making.

So you’d run the test. And then run it again. On Monday the customer panel would pick option X. On Friday, the same group would go with option Y. Meanwhile, we were paying millions of dollars to consultants who took a month and a half to put their own slant on everything.

The data wasn’t a guide. At best, it was a crutch. At worst, cement shoes. It was analysis paralysis.

“Design by committee” is an adjunct to the crutch of data, where there is no vision for the product and no responsibility for the outcome. I see this in medical schools, residency programs, and medical centers of all varieties. So many meetings to discuss so many dashboards. The analytic tools have become robust, so we are awash in numbers and react by massaging our processes to push various metrics in the right direction, often with no regard to second-order effects.

We so often seem locked into a rearranging deck chair approach to problem-solving instead of designing from first principles to make better products and achieve better outcomes.

On being a doofus:

I remember we had a huge all-hands meeting at Apple once these meetings would only happen two, maybe three times a year. And a guy stands up during the Q&A and starts asking Steve Jobs why he didn’t get a raise or a good review. Steve looks at him in stunned disbelief and says, “I can tell you why. Because you’re asking this question in front of ten thousand people.”

On quitting:

Anyone who’s ever stuck with a job they hated knows the feeling.

Every meeting, every pointless project, every hour stretches on and on. You don’t respect your manager, you roll your eyes at the mission, you stagger out the door at the end of the day exhausted, dragging yourself home to complain to family and friends until they’re as miserable as you are. It is time and energy and health and joy that disappear from your life forever. But hey, that title, that stature, that money it’s worth it all, right?

(He’s asking a rhetorical question.)

The threat of leaving may be enough to push your company to get serious and make whatever change you’re asking for. But it might not. Quitting should never be a negotiating tactic. It should be the very last card you play.

So before you quit, you’d better have a story. A good, credible, and factual one. You’ll need to have a rationale for why you left.

And you’ll need one for why you want to join whatever company you’re heading to next. These should be two very different narratives. You’ll need them for the interview, but also for yourself to make sure you’ve really thought things through. And to make sure you’re making the right choice for the next job.

The last part I think is sometimes underappreciated. You don’t just quit from something. Until you retire, you’re also quitting to something.

I wrote a brief article last year on evaluating jobs, where I referenced a 2020 study that showed 41% of radiologists had changed jobs in the past 4 years. I bet it’s even higher now given the current market. Lots of folks are quitting. The question is, are they learning from their experiences?

On the benefits of integrating old and young people:

The best teams are multigenerational Nest employed twenty-year-olds and seventy-year-olds. Experienced people have a wealth of wisdom that they can pass on to the next generation and young people can push back against long-held assumptions. They can often see the opportunity that lies in accomplishing difficult things, while experienced people see only the difficulty.

The generational conflict is real, and it’s often amazing to see in person how easily both groups generously weigh only their own strengths.