In ancient times, people had wisdom, aphorisms and rules of thumb they would put into Almanacs. In the current lingo, they’re called mental models. Here’s a list of some of my favorite bits of knowledge from around the web — some because they are useful, others because they are just fun. Continue reading “Almanac – Some Random Rules of Thumb I Like”
This year Professor Laurie Santos created Yale’s most popular class of all time. The class is titled Psychology and the Good Life but it’s really a course on how to be happy both in the short and long term. I was excited to hear that Yale was offering the course but even more excited to see that the class is available online. While there’s little I hadn’t heard before, it did a great job of focusing me on what’s important and helped me get into the practice of being happier.
I spotted a technology executive walking down the street. He used to wear expensive tailored suits. Now he’s coming to work in high-end jeans and a polo shirt. Then it hit me. Jeans and a turtleneck or jeans and a polo shirt (or really jeans and anything) is the new innovation wardrobe. On one level, it makes sense because everyone wants to dress like Steve Jobs. But when you dig a little bit deeper, using Silicon Valley clothes as a status symbol doesn’t make any sense at all. Continue reading “Why Do People Think That Wearing a Hoodie to Work is a Status Symbol?”
In the class The Science of Well-Being, Professor Santos focuses on how we often look at our happiness not in an absolute way but by comparing ourselves to those around us. These thoughts about absolute vs. relative comparisons got me thinking about strawberry ice cream.
Whenever I eat strawberry ice cream, I think is pretty wonderful. It’s light, sweet, and just a little bit tangy. If I like strawberry ice cream so much, why am I surprised at this fact every time I eat it. I feel like I’m carrying some sort of bias against strawberry ice cream — but why?
i·at·ro·gen·ic /īˌatrəˈjenik/ Relating to illness caused by medical examination or treatment. — Google Definitions
I learned about the word iatrogenic when reading the book Writing to Learn by William Zinsser. The book, written in 1984, used the following passage as an example of medical writing. It talks about the link between medical prescriptions and opium addiction:
The medical profession has a long record of treating patients with useless or harmful relatives, often in clinical settings of complete mutual confidence. Iatrogenic diseases, complications and injury have been, in fact, common in the history of medicine. Only look upon addiction to certain dispensed drugs as one variation among the occasional effects of drug therapy.
I thought, “What an interesting new word!” as did Zinsser who also had to look it up. Then I came across Nicholas Nassim Taleb’s book Antifragile and found that he also fell in love with the word and expanded the idea into a class of issues that he called iatrogenics that went beyond medicine.
Iatrogenics are different from malpractice. Malpractice is doing an operation wrong. Iatrogenics is about doing a treatment correctly but it still having harmful side effects. When doctors ignore these side effects, they are far more likely to use all the tools at their disposal, like drugs or surgery, whether or not it’s a good idea in the long term.
Let’s look at a recent example. The New York Times recently published Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used. While they have no medical benefit, putting in a stent makes both doctors and patients feel like they are doing something — that they are in control. And, from both points of view, “they seem to work,” even though they don’t work any better than a placebo.
So what’s the harm in that? Everyone’s happy aren’t they? Well no, they’re not. Doctors are performing an operation that does no better than a placebo so there’s no upside. However, there’s a significant downside in the complications from the operation.
Or take another example from a cruise I went on. Cruises offer Wi-Fi on the ship with tiny data limits (50MB for the whole trip). This is so small that just opening my phone will go over this limit. So a cruise director offered, “Give me your phone and I’ll make it work on the boat.” So I gave him the phone and he starting turning off these data hogging applications. A few months later I realized that one of the things he turned off was my iCloud backup. So the decision that the cruise director made, without telling me, was to give me very limited internet functionality on the boat while turning off my critical backup capability.
Another way of looking at iatrogenics is overvaluing of short term gains vs. long term risks. Take the example of Thalidomide, the poster child for drug overuse. Thalidomide was a sedative that was prescribed around 1960. While it helped women with morning sickness (a relatively minor problem) it caused tens of thousands of serious birth defects.
Indulge me with one more example. When George Washington had left the presidency he’d taken ill. His treatment was the standard for the day — bleeding. However, taking 5 to 7 pounds of blood from Washington’s body is now widely believed to accelerate his death. Bleeding stayed around for a while after that. It was still recommended by leading doctors as late as 1909.
Taleb tells one story of how this problem goes beyond medicine and into finance:
One day in 2003, Alex Berenson, a New York Times journalist, came into my office with the secret risk reports of Fannie Mae, given to him by a defector. It was the kind of report getting into the guts of the methodology for risk calculation that only an insider can see—Fannie Mae made its own risk calculations and disclosed what it wanted to whomever it wanted, the public or someone else. But only a defector could show us the guts to see how the risk was calculated.
We looked at the report: simply, a move upward in an economic variable led to massive losses, a move downward (in the opposite direction), to small profits. Further moves upward led to even larger additional losses and further moves downward to even smaller profits.
At its core, this was what caused the financial crisis. It was people adding more and more risk for smaller and smaller gains. They failed to look at the downside risks which kept growing larger and larger because they couldn’t imagine that they would occur.
Oddly enough, people don’t get in trouble for doing this. There’s a general sense that the people causing the problems were doing the best they could. The idea of “this is the best modern medicine (or modern finance) has — even if it doesn’t work” is well accepted. This is true even when the procedure is successful but the patient died or the economy collapsed.
A lot of this happens because the people making the decisions don’t have skin in the game. They get the upside benefits without being exposed to the downside risk. Taleb mentions that when Roman engineers built a bridge, they were required to sleep under it. Then, if the bridge fell down, the engineers would feel the pain (or death in this case) of the people who were hurt by the bridge.
So what can you do about all this? Try to get your doctor to put a little skin in the game. The next time you have an important medical decision to make, don’t ask your doctor for her medical opinion, ask her what she would do if she were in your place. This changes her mindset from a “disinterested professional” to someone with a personal stake in the game. You might get a very different answer.
Read this along with my story on back pain.
I’m going to do a magic trick with a number. I’m going to take a number 1700 and by doing nothing more than raising and lowering it, I’m to show how the interpretation of the number can dramatically change. Let’s see how that can happen and then I’ll explain how that works.
When my wife was pregnant with our second son, we had a test for Downs Syndrome. This test had three parts:
- A “Nucal” sonogram that measured some key ratios. This was the most important test and sets the baseline.
- A blood test that measured blood proteins in the mother.
- A test of “soft markers” that refined the initial estimates based on other sonogram features.
So we had the initial test. The chance of an issue was 1 in 1700.
“Is that good?” We asked the doctor. “It sounds good to us.”
“Well, in order to be certain, you’d need to have an amniocentesis which has a 1 in 400 chance of serious problems,” said the doctor.
So 1 in 1700 is pretty darn good. Then we got the blood test back. The numbers were even better. Our chances now were 1 in 6800. That was 4 times better than we’d had before!
So we’d finished 2 or the 3 tests. Then, things got tough. We went in for a sonogram and the technician stopped at one point and said, “I need to get the doctor.” That’s never a good sign.
When the doctor came back he said, “Well, your child had 2 soft markers for Downs.”
“What does that mean?” we asked.
“Well, it means that your child has a higher chance of having Downs Syndrome. Maybe you should see a genetic counselor,” he said.
“Before we go down that route, how does this really alter our chances?” we asked.
“Well, we’re not really sure. One soft marker could double the chance of having Downs Syndrome. So 2 soft markers might increase the chance by as much as 4 times but it’s probably less than that,” he said.
“So you’re saying our chances are back to 1 in 1700.”
How did this happen? Behavioral Economics has an answer. In contrast to typical economic theory, Behavioral Economics looks at situations and sees how people really react — not how they would react in theory. The situation above is an example of Prospect Theory — the finding that losing something causes about twice as much pain as the pleasure you get from gaining something. So gaining and then losing the same amount still feels like a net loss.
In an earlier piece, I talked about how NetFlix’s move to a subscription model. Why was this subscription model so important? It made me think of some research that I did on how people think about money about 10 years ago.
One of the big findings was that people have good and bad ways to spend money. For instance, spending money on the house and paying it off every month is a good thing. Having credit card debt every month is a bad thing. But you can get people to make credit cards bills into good payments when you show them how many airline miles they have “earned.” Notice how credit card companies use the word “earned” as opposed to “purchased.”
Getting back to NetFlix, I remember talking to a middle class couple about their finances about 10 years ago. We were in suburban Chicago and sitting on their back porch on a warm spring day. We talked about how they were saving money. They started with normal things like eating out less and spending less money on clothes. But then they said, “We have Netflix so we’re saving money that way too..”
So I asked, “Do you watch a lot of movies?” figuring that they had calculated the cost of renting from Blockbuster vs. their Netflix subscription. This was before streaming. You got one DVD at a time but you could exchange it as many times as you wanted over a month.
“No. Not really,” they said. “But having Netflix means that we don’t have to rent DVDs anymore so that saving money.”
That always stuck with me because I bet they paid a lot more for their Netflix subscription than they ever paid renting videos at Blockbuster. But to them, this was saving money.
A few months ago Microsoft released Seeing AI. This is a tool created by a blind product manager to help blind people. It’s trying to using computer vision to replace lost sight.
The most interesting piece is the person functionality. This is a fairly transparent implementation of Microsoft’s Face API. The Face API has a number of characteristics that it can determine including hair color, emotion, glasses, facial hair, makeup, smiling, gender, and age. Computer geeks, take a look at Face API, it’s pretty awesome. Here’s an example of the person functionality from Seeing.ai using the Face API.
It’s a great party trick to show your friends how AI can figure out all this stuff. The most interesting characteristic is age. Microsoft thinks so too and created an entire website called how-old.net.
So I started bringing it out at parties. But there was the problem. People who skewed older than they really were started saying “Hey, that’s not cool.” I started to realize that the app didn’t have a lot of tact.
It was like a little kid saying, “Mommy, that lady looks 45.”
And the woman saying back, “My Lord! Don’t you have any manners!”
This is similar to a scene in the Netflix series Atypical about Sam, a character with Autism Spectrum Disorder (formerly called Aspergers Syndrome). Sam doesn’t read emotions very well and is often too honest — not taking into account other people’s feelings.
At one point Sam made a list of the Pro’s and Con’s of Paige, his prospective girlfriend. Paige found an imprint of the list and used a pencil to read it.
To paraphrase their conversation:
“Why would you do that? You called me bossy and said I’m always interrupting people,” said Paige.
“But I also said that you had very clean shoes and had a nice neutral smell. So there were some good things in there,” said Sam.
“Ugh. You’re just not supposed to write that stuff down. It’s rude.”
And that’s the inherent problem with the way Face API displays people’s age. Making these things too transparent is just rude.
From all this, I’ve learned 3 things.
- It’s kind of creepy how AI can take things from the real world and “know” things about you.
- When building a computer program, features like “age” are useful in doing things like matching or making predictions but should generally be hidden from the end user.
- It’s much better to use this data for a different purpose, like figuring out which piece of artwork you look like.
Update August 16, 2018: Amazon’s Face API is a lot more sensitive in its demo. It uses the word “seems” and not focusing on a specific age but using an age range.
In this email, I’m answering some questions from a reader.
I really like what you put on this site. I’ve tried to blog myself but could use your advice on the following topics:
- Why write about something when you know that there’s bound to be someone on the internet that has written the same thing – likely better than you? Wouldn’t it make more sense to just link to that?
- How do you decide what to write about?
- How can I do what you do? Whenever I sit down to write something, I find that I want to write a treatise and I never get finished with it.
- How do I subscribe to your blog?
I’ll answer these questions one at a time.
Why write about something when you know that there’s bound to be someone on the internet that has written the same thing – likely better than you? Wouldn’t it make more sense to just link to that?
That’s a good point Dave. Here are a few reasons why I write rather than link:
- It’s not worth comparing myself to others. There’s always someone in the world who’s doing something better than me. But if I’m writing about something personal that means something to me, hopefully, I can bring something new to the conversation.
- Some people (like you) seem to be interested in what I write.
- To paraphrase Maria Popova from Brain Pickings, “I’m writing for myself. If other people want to read this that’s great. But I’m writing for me and not them.”
- It’s fun to write.
- The best way to become a better writer is to write more. Jeff Atwood, co-founder of Stack Exchange, has some great advice on how to be a great blogger. He says “If you can demonstrate a willingness to write, and a desire to keep continually improving your writing, you will eventually be successful.”
- Having a blog becomes a personal record of your thoughts and ideas. It becomes a record of who you are – hopefully of your best self.
- Think about your readers. If you look at my first posts I had a lot of links and quoted a lot of sources. This makes it difficult for your readers who just don’t have a lot of time. Paradoxically, by writing a little more, you’re having your readers read a lot less.
- You need to be confident in yourself that you have something useful to say. But you need to have your own ideas – not just parrot the ideas of others.
How do you decide what to write about?
I don’t decide what to write about as much as it finds me. I know it sounds corny but it’s true. I have a post a few weeks ago about the process I’m using.
I keep a prioritized list of ideas. When I look at the top of that list, I find a few things that are really exciting and fun to write about. I generally say, “Wow, that’s a really fun idea I’ve put on my list.”
How can I do what you do? Whenever I sit down to write something, I find that I want to write a treatise and I never get finished with it.
Going back to my previous post about writing, I’ll pick a topic that seems pretty exciting and try to figure out how I can get it across in the shortest amount possible. That keeps the boring stuff a minimum and lets me get done with pieces faster. Then I only write about things while they are still interesting. That’s what keeps it fun.
Another way to think about this is the Feynman Method of understanding:
- Describe the topic on one sheet of paper
- Simplify it so that it can be read by a non-specialist reader
- Repeat until you have gotten it simple enough
By the way, there’s a pretty cool and short video about Feynman’s view on what it really means to understand something.
Can I get notifications of your latest posts?
Yes you can! Just go to the bottom of the right column (on a desktop) or the bottom of the page (on mobile).
Thanks for your questions!
What makes a great consultant? It’s someone who get’s the job done quickly, teaches me instead of selling me and gives me the advice for the future. I’ve also got a great example of a bad consultant. The best consultant that I’ve met recently was the guy that fixed my refrigerator.
Our Viking refrigerator was broken. The water filter was stuck. It was so badly stuck that in the act of trying to get it out, I broke the holder for the water filter. At this point, we needed to call in an expert before my “home improvement” project became a “buy another fridge” project.
Calling for help
So I called Len’s Appliance in Brooklyn (718) 238-3200. In the past, I’ve learned its useful for me to be there when the repairman comes rather than trying to rope someone else in. If it’s a bad repairman, I can avoid the damage. If it’s a good repairman, there’s a lot I can learn.
Get in Quick, Get It Done and Get Out
He came in and fixed the problem within 10 seconds. He grabbed the filter, disengaged it from the holder and twisted to remove the filter. The filter holder itself was made horribly. Not only is it very flimsy but it requires a lot of force in an awkward position to remove it. This is not a good combination. The force needed to take the filter out of the refrigerator stresses the holder so every time I change the filter, it’s always on the verge of breaking it. Once he removed the filter from its holder he could easily apply enough force to remove the filter. Wow that’s bad design.
Teach Me to Fish Rather Than Selling Me a Fish
Now remember, I called Len’s because of the broken filter holder. After removing the filter he told me where I could go to buy a replacement. It was fairly easy to install myself and it wouldn’t be worth the $125 service call for him to reinstall it. Then he paused. “On second thought,” he said, “you don’t actually need this piece at all.” He explained that the poorly designed holder that made it difficult to remove the filter was only in use DURING the filter change process. So it actually wasn’t necessary at all.
Give Me Advice for the Future
Then he told me about the refrigerator itself. We’d bought this Viking fridge because we were under the impression that this fridge was unique in its size. This is a tiny Manhattan kitchen where space is a premium. He mentioned that the fridge was actually a standard size which is great! He also said that it’s out of production now and that spare parts are more expensive and will continue to go up in price. Eventually, the parts will be impossible to buy.
Did you know that refrigerators are only meant to last 7 years? That’s what he told us. That big expensive kitchen appliance that you thought would last forever goes out of production every 7 years and you’ll need to buy a new one when it breaks. He told us that if the refrigerator breaks badly, it’s probably worth just buying a new one. Oh, and from what he’s seen, the cheaper models like GE break less often than the Viking ones.
He felt bad that he was charging me $125 for the visit when he was only in my apartment for 15 minutes. But this was the best repair visit that I’d ever had.
Now read about a really bad consultant.