Astral Codex Ten and Slate Star Codex
My favourite blog is Scott Alexander’s Astral Codex Ten.
the doxxing
the kidney
see below for ep and eugenics
cystic fibrosis below control F
the Trump…art of the deal ctrl F
‘The Big Bad has destroyed so much stuff he doesn't even remember: "For you, the day [I burned] your village was the most important day of your life. For me, it was Tuesday.""‘
Great post here on what Scott learned
The book review competitions are fantastic, here are 3 of my favourites:
a review of Kieran Egan
and Junger
and Elon Musk
Here’s Scott trying to change things
Here’s a great piece by Jason Crawford
explaining why he follows Scott and his favourite pieces.
https://jasoncrawford.org/guide-to-scott-alexander-and-slate-star-codex
He also notes the first post he read- the first one I read was on conspiracies.
Scott’s favourites:
:
The Life Cycle Of Medical Ideas about how people identify which promising treatments to pursue.
Sleep – Now By Prescription, about the fuzzy border between prescription and nonprescription medications
Fish – Now By Prescription, a continuation of the above.
An Iron Curtain Has Descended Upon Psychopharmacology, about how Russia uses different drugs than we do and our system hasn’t found a way to incorporate their knowledge
Pharma Virumque on pharmaceutical company advertising, and how it’s even worse than you’ve heard.
Who By Very Slow Decay, on my depressing experiences with end-of-life care
Evening Doc, on various others of my depressing experiences
Medicine As Not Seen On TV, looking back after one year or medical residency
Reflections From The Halfway Point, looking back after two years of medical residency
Burdens, on what I want to tell my suicidal patients
My interest in drug discovery naturally segues into scientific and statistical methods in general. My longest piece on this is ‘The Control Group Is Out Of Control’, linked above, but I’ve also written about:
Statistical Literacy Among Doctors Is Lower Than Chance on the abysmal statistical knowledge of doctors and what it means for you
Dark Side Statistics Papers, an explanation of how to fudge research results
Specific criticism of various sketchy studies on euthanasia, Victorian IQ, gender, welfare, and bullying
I write a lot about politics from a vaguely centrist point of view with occasional forays to the right or left. Some especially interesting political threads here include:
A Thrive-Survive Theory Of The Political Spectrum, about whether “left” and “right” are real internally consistent things
A Something Sort-Of-Like-Left-Libertarian Manifesto on using regulations versus taxes and subsidies to solve political problems
Archipelago and Atomic Communitarianism on how atomic individualism can fit together with people’s concern for their communities
Right Is The New Left, about how the same dynamics that supported the leftist counterculture of the 1960s are leading to a rightist counterculture today
Black People Less Likely, about what we can learn from checking which fields African-Americans are/aren’t underrepresented in.
In Favor Of Niceness, Community, and Civilization, about how just because your cause is important doesn’t mean you get to be a jerk about it.
Reactionary Philosophy In An Enormous Planet-Sized Nutshell, which is my attempt to see if I can blast several metric tons of highly concentrated conservative political philosophy into the brains of unsuspecting people.
Slate Star Codex Political Spectrum Quiz, which is exactly what it says on the tin.
Although I acknowledge the importance and danger of racism and sexism, I also think a lot of the social justice movement as it currently exists is an attempt to sanctify ad hominem arguments and poor epistemology that can be used by a would-be cognitive elite to abuse and humiliate anyone who disagrees with them. I start the explanation in ‘I Can Tolerate Anything Except The Outgroup’, linked above, but there is more in:
A Response To Apophemi on Triggers, about competing access needs
Living By The Sword, which was supposed to be about toxicity in the social justice community but is better remembered more for its complicated whale cancer metaphor.
Social Justice and Words, Words, Words about the way language gets weaponized and used as a tool to confuse people.
The Categories Were Made For Man, Not Man For The Categories, about why it’s important to treat transgender individuals as their preferred gender.
Social Psychology Is A Flamethrower, about the poor condition of the social justice evidence base.
The Wonderful Thing About Triggers, in which I come out in favor of trigger warnings despite all of the above
Sometimes I get bored and just research the hell out of something to try to resolve a difficult question to my own satisfaction. Thus far this has resulted in cost-benefit analyses like:
Marijuana: Much More Than You Wanted To Know, on whether we should legalize marijuana.
Wheat: Much More Than You Wanted To Know, on whether wheat/bread/gluten is bad for you.
Race And Justice: Much More Than You Wanted To Know, on which steps of the criminal justice system are/aren’t racist.
SSRIs: Much More Than You Wanted To Know, on the effectiveness of SSRI antidepressants.
I’m also very interested in rationality – questions like how debates work in general and how we can conduct them better. I find the current set of logical fallacies mostly orthogonal to the way debates between smart people fail, so I have tried to do better:
Arguments From My Opponent Believes Something, ie fully general counterarguments that don’t add anything to a debate.
All Debates Are Bravery Debates, on how a lot of hard problems are trade-offs between two goods and debates are difficult because we can’t tell which side people are erring towards.
Weak Men Are Superweapons and Cardiologists and Chinese Robbers, both on how straw men are less dangerous than real-but-irrelevant “weak men” that let people cherry-pick stupid examples.
If It’s Worth Doing, It’s Worth Doing With Made-Up Statistics, on how sometimes using numbers – even messy, potentially inaccurate numbers – can shed light on a problem
Beware Isolated Demands For Rigor, on not setting impossibly high burden of proof for ideas you don’t like – plus an Old West shootout scene between Greek philosophers
I’ve also tried writing a little bit of fiction, of which I most like:
Universal Love, Said The Cactus Person, kind of hard to explain
Answer To Job, also kind of hard to explain
The Study of Anglophysics, which is definitely hard to explain
Other people who might be less biased have put together their own recommended lists here and here. And you can find a full archive of all SSC posts here.
My top 5;
one of my favourite topics- chronic pain:
https://slatestarcodex.com/2016/06/26/book-review-unlearn-your-pain/
https://slatestarcodex.com/2014/09/30/i-can-tolerate-anything-except-the-outgroup/
https://slatestarcodex.com/2014/11/21/the-categories-were-made-for-man-not-man-for-the-categories/
https://slatestarcodex.com/2020/01/08/what-intellectual-progress-did-i-make-in-the-2010s/
More bits from the doxxing:
“the story of Richard Horton, a police officer in the UK. He wrote a blog about his experience on the force which was by all accounts incredible - it won the Orwell Prize for being the best political writing in Britain that year. The Times (a British newspaper unrelated to NYT) hacked his email and exposed his real identity, and his chief forced him to delete the blog in order to keep his job. I wonder whether maybe if police officers were allowed to write anonymously about what was going on without getting doxxed by newspapers, people wouldn't have to be so surprised every time something happens involving the police being bad. See for example The Impact Of The Cessation Of Blogs Within The UK Police Blogosphere, a paper somebody apparently needed to write.”
“One of the veterans of this era is Lawrence Lessig, who I was delighted to see coming to my defense.”
I went from skepticism of birth order effects to saying Fight Me, Psychologists: Birth Order Effects Exist And Are Very Strong. This was bolstered by Eli Tyre and Bucky’s posts on Less Wrong about birth order in mathematicians and physicists respectively. Last year I expanded on that with a post on how birth order responded to age gaps (somewhat updated and modified here, thanks Bucky).
“some of the replication issues of growth mindset. I started in 2015 by pointing out that the studies seemed literally unbelievable, but so far nobody had tried attacking them. I claim to have been way ahead of the curve on this one – if you don’t believe me, just read the kind of pushback I got. But by 2017, that situation had changed – Buzzfeed posted an article that called the field into question, but still without clear negative evidence. Finally, over the past few years, the negative studies have come pouring in,”
He also does highlights of the best comments-
Here’s a piece by Scott Aaronson (another great blogger) on the New York Times piece
******** KIDNEY
Here’s Scott Alexander on donating his kidney
A person has two kidneys; one advises him to do good and one advises him to do evil. And it stands to reason that the one advising him to do good is to his right and the one that advises him to do evil is to his left.
— Talmud (Berakhot 61a)
Dylan Matthews’ Why I Gave My Kidney To A Stranger - And Why You Should Consider Doing It Too. Six years ago, Matthews donated a kidney. Not to any particular friend or family member. He just thought about it, realized he had two kidneys, realized there were thousands of people dying from kidney disease, and felt like he should help. He contacted his local hospital, who found a suitable recipient and performed the surgery. He described it as “the most rewarding experience of my life”:
As I’m no doubt the first person to notice, being an adult is hard. You are consistently faced with choices — about your career, about your friendships, about your romantic life, about your family — that have deep moral consequences, and even when you try the best you can, you’re going to get a lot of those choices wrong. And you more often than not won’t know if you got them wrong or right. Maybe you should’ve picked another job, where you could do more good. Maybe you should’ve gone to grad school. Maybe you shouldn’t have moved to a new city.
So I was selfishly, deeply gratified to have made at least one choice in my life that I know beyond a shadow of a doubt was the right one.
My girlfriend made it her project to dissuade me from donating, did a few hours’ research, and reported back that although the risk of dying from the surgery was indeed 1/10,000, the risk of dying from the screening exam was 1/660 .
I regret to inform you she might be right. The screening exam involves a “multiphase abdominal CT”, a CAT scan that looks at the kidneys and their associated blood vessels and checks if they’re all in the right place. This involves a radiation dose of about 30 milli-Sieverts. The usual rule of thumb is that one extra Sievert = 5% higher risk of dying from cancer, so a 30 mS dose increases death risk about one part in 660. There are about two nonfatal cases of cancer for every fatal case, so the total cancer risk from the exam could be as high as 1/2202. I’m not a radiologist, maybe I’m totally wrong here, but the numbers seemed to check out.
I discussed this concern with transplant doctors at UCSF and the National Kidney Foundation, who seemed very surprised to hear it, but couldn’t really come up with any evidence against. I asked if they could do the kidney scan with an MRI (non-radioactive) instead of a CT. They agreed3.
The studies showing this are a bit of a mess. Non-controlled studies find that kidney donors have lower lifetime risk of kidney disease than the general population. But this is because kidney donors are screened for good kidney health. It’s good to know that donation is so low-risk that it doesn’t overcome this pre-existing advantage. But in order to quantify the risk exactly, we need to find a better control group.
Still, my girlfriend ending up begging me not to donate, and I caved. But we broke up in 2019. The next few years were bumpy, but by 2022 my life was in a more stable place and I started thinking about kidneys again. By then I was married. I discussed the risks with my wife and she decided to let me go ahead. So in early November 2022, for the second time, I sent a form to the University of California San Francisco Medical Center saying I wanted to donate a kidney.
IV.
Something else happened that month. On November 11, FTX fell apart and was revealed as a giant scam. Suddenly everyone hated effective altruists. Publications that had been feting us a few months before pivoted to saying they knew we were evil all along. I practiced rehearsing the words “I have never donated to charity, and if I did, I certainly wouldn’t care whether it was effective or not”.
People got so mad at some British EAs who used donor money to “buy a castle”. I read the Brits’ arguments: they’d been running lots of conferences with policy-makers, researchers, etc; those conferences have gone really well and produced some of the systemic change everyone keeps wanting. But conference venues kept ripping them off, having a nice venue of their own would be cheaper in the long run, and after looking at many options, the “castle” was the cheapest. Their math checked out, and I believe them when they say this was the most effective use for that money. For their work, they got a million sneering thinkpieces on how “EA just takes people’s money to buy castles, then sit in them wearing crowns and waving scepters and laughing at poor people”. I respect the British organizers’ willingness to sacrifice their reputation on the altar of doing what was actually good instead of just good-looking.
I worry that people use suffering as a heuristic for goodness. Mother Teresa becomes a hero because living with lepers in the Calcutta slums sounds horrible - so anyone who does it must be really charitable (regardless of whether or not the lepers get helped). Owning a castle is the opposite of suffering - it sounds great - therefore it is fake charity (no matter how much good you do with the castle).
Finally, five months after I originally applied, I got a phone call from the Transplant Coordinator. The test results were in, and . . . I had been rejected because I’d had mild childhood OCD.
This was something I’d mentioned offhandedly during one of the psych evaluations. As a child, I used to touch objects in odd patterns that only made sense to me. I got diagnosed with OCD, put on SSRIs for a while, finally did therapy at age 15, hadn’t had any problems since. I still go back on SSRIs sometimes when I’m really stressed, and will grudgingly admit to the occasional odd-pattern-touching when no one’s looking.
But it’s nothing anyone would know about if I didn’t tell them! It was mild even at age 15, and it’s been close-to-nonexistent for the past twenty years! Now I’m a successful psychiatrist who owns his own psychiatry practice and helps other people with the condition! I told them all this. They didn’t care.
I asked them if there was anything I could do. They said maybe I could go to therapy for six months, then apply again.
I asked them what kind of therapy was indicated for mild OCD that’s been in remission for twenty years. They sounded kind of surprised to learn there were different types of therapy and said whatever, just talk to someone or something.
I asked them how frequent they thought the therapy needed to be. They sounded kind of surprised to learn that therapy could have different frequencies, and said, you know, therapy, the thing where you talk to someone.
I asked them if they actually knew anything about OCD, psychotherapy, or mental health in general, or if they had just vaguely heard rumors that some people were bad and crazy and shouldn’t be allowed to make their own decisions, and that a ritual called “therapy” could absolve one of this impurity. They responded as politely as possible under the circumstances, but didn’t change their mind.
I wasn’t going to waste an hour a week for six months, and spend thousands of dollars of my own extremely-not-reimbursed-by-UCSF money, to see a randomly-selected therapist for a condition I’d gotten over twenty years ago, just so I could apply again and get rejected a second time.
This was one of the most infuriating and humiliating things that’s ever happened to me. We throw around a lot of terms like “stigma” and “paternalism”, and I’ve worked with patients who have dealt with all these issues (it’s UCSF in particular a surprising amount of the time!). But I was still surprised how much it hurt when it happened to me. Being denied the right to control your own body because of some meaningless diagnosis on a chart somewhere is surprisingly frustrating, even compared to things that should objectively be worse. I thought I was going to be able to do a good deed that I’d been fantasizing about for years, and some jerk administrator torpedoed my dreams because I had once, long ago, had mild mental health issues.
So I gave up.
I spent the next few weeks unleashing torrents of anti-UCSF abuse at anyone who would listen. This turned out to be very productive! When I was unleashing a torrent of anti-UCSF abuse to Josh Morrison of WaitlistZero, he asked if I’d tried other hospitals.
I hadn’t. I’d assumed they were all in cahoots. But Josh said no, each hospital had their own evaluation process. Weill Cornell, a hospital in NYC, was one of the best transplant centers in the country, and had a reputation for fair and thoughtful pre-donor screening. Why didn’t I talk to them?
NYC was far away, and I hate to travel, but I was just angry enough to accept. At this point I’d forgotten whatever good altruistic motivations I might have originally had and was fueled entirely by spite. Getting my kidney taken out somewhere else felt like it would be a sort of victory over UCSF. So I went for it.
VII.
In polls, 25 - 50% of Americans say they would donate a kidney to a stranger in need.
This sentence fascinates me because of the hanging “would”. Would, if what? A natural reading is “would if someone needs it”. But there are 100,000 strangers on the waiting list for kidney transplants. Between 5,000 and 40,000 people die each year for lack of sufficient kidneys to transplant. Someone definitely needs it. Yet only about 200 people (0.0001%) donate kidneys to strangers per year. Why the gap between 25-50% and 0.0001%?
Some of you will suspect respondents are lying to look good. But these are anonymous surveys. Lying to themselves to feel good, then?
My kidney donation “mentor”8 Ned Brooks is starting a new push - the Coalition To Modify NOTA - which proposes a $100,000 refundable tax credit - $10,000 per year for 10 years - for kidney donors. There would be a waiting period and you’d have to get evaluated first, so junkies couldn’t walk in off the street and get $100K to spend on fentanyl. No intermediate company would “profit” off the transaction, and rich people wouldn’t be able to pay directly to jump in line. It would be the same kidney donation system we have now, except the donors get $100,000 back after saving the government $1MM+.
from the comments
I can't help but think of another blogger I loved to read, Shamus Young, who was diagnosed with end stage kidney failure in 2022 and died three months later. Actions like yours could have made a difference in his case.
https://www.shamusyoung.com/twentysidedtale/?p=54058
https://www.shamusyoung.com/twentysidedtale/?p=54513
As for my story, I had kidney failure 1 year ago. I was on peritoneal dialysis (not hemo, where blood is taken out of the body, this is the usual one in the hospitals). To illustrate what this is like. There is a catheter attached to your abdomen. This catheter goes in through your abdominal wall, creating an open, oozing wound. I had huge psychological troubles with the catheter. It essentially made me feel disgusted with myself. I would carry it around attached to an elastic belt. Every breath I would take would lead to me noticing the catheter, noticing my disease. Noticing that I was a failed organism that had lost its ability to get rid of its waste.
The other end was connected to the dialysis machine, essentially a big pump. Every night you set up the machine at home. This involves connected about 10l of dialysis solution to the pump. During the night it pumps about 2l in to your abdomen every 1.5 hours or so and pumps it out. The waste in your blood diffuses in to the dialysate contained within your peritoneal cavity. This is then pumped out by the machine.
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I planned to donate my left kidney to my father, who had ESRD. […] In the end, I flunked out during psychological screening just as you did. The social worker asked me how I was doing and I told her (like an idiot) that being under lockdown made me feel isolated, and seeing my dad suffer from kidney disease made me feel sad. She then recommended to the doctor that I not donate a kidney to my dad until I got a handle on my dad-sadness, lest I make an irrational decision. Let this be another takeaway: HOSPITAL SOCIAL WORKERS EXIST TO TICK BOXES! DO NOT TREAT THEM LIKE HUMAN BEINGS!
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That’s pretty bad, but I think I can beat it - I got an email from someone telling a story (won’t reveal details) about someone they knew. They got cleared and everything. Then on the day of the surgery, the nurses/doctors asked how she was feeling. She said anxious (about the upcoming surgery). They immediately cancelled everything and demanded she get six months of therapy to deal with her anxiety before they would consider letting her donate.
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Here’s a sort of daydream: some charity gets the list of the 40,000 people who are predicted to die next year for lack of a kidney. Then it chooses 40,000 random Americans in a 1:1 correspondence with the kidney patients. Then it sends each of those random Americans a letter, saying “Dear John, you have been paired with Bob Smith of Topeka, Kansas. He will die of kidney failure next year unless someone donates a kidney. We have randomly selected you as a potential donor. If you say no, we will not randomly select anyone else, and Bob will probably die. If you’re willing, please call this phone number.”
There’s some sense in which this charity would be doing zero work - just choosing random names from the phone book! - but it sure would be an interesting experiment. Would 25 - 50% of the people involved really go for it? I don’t know.
People would probably get very angry at this charity. Would the anger be justifiable? I can feel the urge to get angry with them. But all they’re doing is taking a background fact of existence and bringing it to the foreground.
The main challenges to doing this in real life are HIPAA (you can’t actually get a list of people who need transplants) and probably nobody would believe you if they just got a letter. If you think you have a way around these challenges, I’m not exactly urging you to apply for an ACX Grant, but any such application would certainly catch my interest!
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I did register for bone marrow transplantation. There they screen huge databases for the best match, and you are only contacted if you are a best match. Which happens for less than 1% of registered potential donors.
This system works very well. If you are contacted and told that they particularly need your bone marrow because there is this one person who needs it, then I do believe that many people would say yes. Perhaps the 25-50% who answer yes in the surveys.
In principle, this could also work for kidneys. Build a huge data base, for each patient try to find the best donor, and ask them whether they would help this particular patient, because their help would work better than anyone else's.
It's almost a shame that kidneys are compatible between so many different people. Because that might be the main reason why the solution doesn't work. (Even if chosen, you are not really a much better pick than many other people.) So the ethical pressure is diluted. We might have much less trouble to find kidney donors if they weren't so widely compatible.
Or the solution does work, and we just need to try it.
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This exactly - the regret seems terrible to me. I'm very worried about the regret.
But can you possibly believe the regret of a donor who decides they made a mistake would be more intense than the sadness of a person (and their family) who doesn't get a transplant?
Does it make a difference in the imaginary scenario where there is exactly one potential donor and one potential recipent (so no chance they'll get a different donor organ)?
It's not that it would be more intense - that's not the point.
The status quo is that people with kidney disease will likely die anyway. No one has any obligation to try to change that. We do have an obligation to put our own health first and to not harm ourselves, with rare exceptions for those we are close to.
So it's not about what emotion is more intense. It's about the horror of someone cutting out part of their body and then regretting it. That speaks to me in a really deep and disturbing way.
much more on transplants
Trump the art of the deal review
Trump is no psychology expert, but after a few months of attributing his victories to blind luck, most people have accepted Scott Adams’ hypothesis that he’s really a “master persuader”. Salon, Daily Caller, Bill Maher, and the Economist all use the word “genius”. The less you respect Trump’s substance – and I respect it very little – the more you’re forced to admire whatever combination of charisma, persuasion, and showmanship he uses to succeed without having any. If this guy has written a book on how to be persuasive and successful, that’s a book I want to read.
The downside of buying a book by a master manipulator is that sometimes you learn you were manipulated into buying the book.
Trump’s sixth rule of deal-making is “Get The Word Out”. He says:
One thing I’ve learned about the press is that they’re always hungry for a good story, and the more sensational the better. It’s in the nature of the job, and I understand that. The point is that if you are a little different, or a little outrageous, or if you do things that are bold or controversial, the press is going to write about you…
The funny thing is that even a critical story, which may be hurtful personally, can be very valuable to your business. [When I announced my plans to build Television City to the press], not all of them liked the idea of the world’s tallest building. But the point is that we got a lot of attention, and that alone creates value.
The other thing I do when I talk with reporters is to be straight. I try not to deceive them or to be defensive, because those are precisely the ways most people get themselves into trouble with the press. Instead, when a reporter asks me a tough question, I try to frame a positive answer, even if that means shifting the ground. For example, if someone asks me what negative effects the world’s tallest building might have on the West Side, I turn the tables and talk about how New Yorkers deserve the world’s tallest building, and what a boost it will give the city to have it again. When a reporter asks why I build only for the rich, I note that the rich aren’t the only ones who benefit from my buildings. I explain that I put thousands of people to work who might otherwise be collecting unemployment, and that I add to the city’s tax base every time I build a new project. I also point out that buildings like Trump Tower have helped spark New York’s renaissance.
The final key to the way I promote is bravado. I play to people’s fantasies. People may not always think big themselves, but they can still get very excited by those who do. That’s why a little hyperbole never hurts. People want to believe that something is the biggest and the greatest and the most spectacular.
I call it truthful hyperbole. It’s an innocent form of exaggeration – and a very effective form of promotion.
In the immortal words of Marco Rubio, “Let’s dispel once and for all with this fiction that Donald Trump doesn’t know what he’s doing. He knows exactly what he’s doing.”
On the other hand, his eighth rule of business is “Deliver The Goods”. He gives an interesting example:
You can’t con people, at least not for long. You can create excitement, you can do wonderful promotion and get all kinds of press, and you can throw in a little hyperbole. But if you don’t deliver the goods, people will eventually catch on.
I think of Jimmy Carter. After he lost the election to Ronald Reagan, Carter came to see me in my office. He told me he was seeking contributions to the Jimmy Carter Library. I asked how much he had in mind. And he said, “Donald, I would be very appreciative if you contributed five million dollars.
I was dumbfounded. I didn’t even answer him.
But that experience also taught me something. Until then, I’d never understood how Jimmy Carter became President. The answer is that as poorly qualified as he was for the job, Jimmy Carter had the nerve, the guts, the balls, to ask for something extraordinary. That ability above all helped him get elected president. But then, of course, the American people caught on pretty quickly that Carter couldn’t do the job, and he lost in a landslide when he ran for reelection.
Ronald Reagan is another example. He is so smooth and so effective a performer that he completely won over the American people. Only now, nearly seven years later, are people beginning to question whether there’s anything beneath that smile.
I started the book with the question: what exactly do real estate developers do? They don’t design buildings; they hire an architect for that part. They don’t construct the buildings; they hire a construction company for that part. They don’t manage the buildings; they hire a management company for that part. They’re not even the capitalist who funds the whole thing; they get a loan from a bank for that. So what do they do? Why don’t you or I take out a $100 million loan from a bank, hire a company to build a $100 million skyscraper, and then rent it out for somewhat more than $100 million and become rich?
As best I can tell, the developer’s job is coordination. This often means blatant lies. The usual process goes like this: the bank would be happy to lend you the money as long as you have guaranteed renters. The renters would be happy to sign up as long as you show them a design. The architect would be happy to design the building as long as you tell them what the government’s allowing. The government would be happy to give you your permit as long as you have a construction company lined up. And the construction company would be happy to sign on with you as long as you have the money from the bank in your pocket. Or some kind of complicated multi-step catch-22 like that. The solution – or at least Trump’s solution – is to tell everybody that all the other players have agreed and the deal is completely done except for their signature. The trick is to lie to the right people in the right order, so that by the time somebody checks to see whether they’ve been conned, you actually do have the signatures you told them that you had. The whole thing sounds very stressful.
The developer’s other job is dealing with regulations. The way Trump tells it, there are so many regulations on development in New York City in particular and America in general that erecting anything larger than a folding chair requires the full resources of a multibillion dollar company and half the law firms in Manhattan. Once the government grants approval it’s likely to add on new conditions when you’re halfway done building the skyscraper, insist on bizarre provisions that gain it nothing but completely ruin your chance of making a profit, or just stonewall you for the heck of it if you didn’t donate to the right people’s campaigns last year. Reading about the system makes me both grateful and astonished that any structures have ever been erected in the United States at all, and somewhat worried that if anything ever happens to Donald Trump and a few of his close friends, the country will lose the ability to legally construct artificial shelter and we will all have to go back to living in caves.
Trump’s greatest pride is his ability to construct things on time and under budget. He gives the story of an ice rink that New York City was trying to renovate in Central Park. After six years and $13 million, the city had completely failed to renovate it and just made things worse. Trump offered as a charitable gesture to do it himself, and the mayor, who was a political enemy, refused. The press hounded the mayor, Trump eventually was allowed to try, and he finished it in four months for only $2.5 million. He boasted that he finished fixing the rink in less time than it took the city to complete their study on why their rink-fixing project had failed.
He had a couple more stories like this – but throughout all of it, there was a feeling of something missing. Here is a guy whose job is cutting through bureaucracy, and who is apparently quite good at it. Yet throughout the book – and for that matter, throughout his campaign for the nomination of a party that makes cutting bureaucracy a big part of their platform – he doesn’t devote a lot of energy to expressing discontent with the system. There is no libertarian streak to Trump – in the process of successfully navigating all of these terrible rules, he rarely takes a step back and wonders about a better world where these rules don’t exist. Despite having way more ability to change the system than most people, he seems to regard it as a given, not worth debating. I think back to his description of how it’s all just a big game to him. Most star basketball players are too busy shooting hoops to imagine whether the game might be more interesting if a three-pointer was worth five points, or whatever. Trump seems to have the same attitude – the rules are there; his job is to make the best deal he can within those rules.
Maybe I’m imagining things, but I feel like this explains a lot about his presidential campaign. People ask him something like “How would you fix Medicare?”, and he gives some vapid answer like “There are tremendous problems with Medicare, but I’m going to hire the best people. I know all of the best doctors and health care executives, and we’re going to cut some amazing deals and have the best Medicare in the world.” And yeah, he did say in his business tips that you should change the frame to avoid being negative to reporters. But this isn’t a negative or a gotcha question. At some point you’d expect Trump to do his homework and get some kind of Medicare plan or other. Instead he just goes off on the same few tangents. This thing about hiring the best people, for example, seems almost like an obsession in the book. But it works for him. When somebody sues him (which seems like an hourly occurrence in real estate development no matter how careful you are) his response is to find the best lawyer, hire them, and throw them at the problem. When he needs a hotel managed, he hires the best hotel managers and tells them to knock themselves out. Even his much-mocked tendency to talk about all the people he knows comes from this being a big part of his real estate strategy – one of the reasons he can outcompete other tycoons is because he knows people on the planning board, knows people in the banks, knows people in all the companies he works with. It’s a huge advantage for him.
These strategies have always worked for him before, and floating off into some intellectual ideal-system-design effort has never worked for him before. So when he says that he’s going to solve Medicare by hiring great managers and knowing all the right people, I don’t think this is some vapid way of avoiding the question. I think it’s the honest output of a mind that works very differently from mine. I’ve been designing ideal systems of government for the heck of it ever since I was old enough to realize what a government was. Trump is at serious risk of actually taking over a government, and such design still doesn’t appeal to him. The best he can do is say that other people are bad at governing, but he’s going to be good at governing, on account of his deal-making skill. I think he honestly believes this. It makes perfect sense in real estate, where some people are good businesspeople, others are bad businesspeople, and the goal is to game the system rather than change it. But in politics, it’s easy to interpret as authoritarianism – “Forget about policy issues, I’m just going to steamroll through this whole thing by being personally strong and talented.”
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Lately we’ve been discussing some of the ethics around genetics and embryo selection. One question that comes up in these debates is - are we claiming that some people are genetically inferior to other people? If we’re trying to select schizophrenia genes out of the population - even setting aside debates about whether this would work and whether we can do it non-coercively - isn’t this still in some sense claiming that schizophrenics are genetically inferior? And do we really want to do this?
I find it clarifying to set aside schizophrenia for a second and look at cystic fibrosis.
Cystic fibrosis is a simple single-gene disorder. A mutation in this gene makes lung mucus too thick. People born with the disorder spend their lives fighting off various awful lung infections before dying early, usually in their 20s to 40s. There’s a new $300,000/year medication that looks promising, but we’ve yet to see how much it can increase life expectancy. As far as I know, there’s nothing good about cystic fibrosis. It’s just an awful mutation that leads to a lifetime of choking on your own lung mucus.
So: are people with cystic fibrosis genetically inferior, or not?
The case for yes: they have the cystic fibrosis mutation. Having the cystic fibrosis mutation seems vastly worse than not having it. Surely if “genetically inferior” means anything at all, it means having genetics which it is vastly worse to have than not have.
The case for no: if you say ‘yes’, you sound like a Nazi. Or at least you sound like some sort of callous jerk who hates people with cystic fibrosis and thinks they’re less than human and maybe wants to kill them.
(Some people will object that nobody is “genetically inferior”, because “inferior” means “worse in every possible way”, and nobody is worse in all ways - maybe the person with cystic fibrosis has a gene for great memory or something. But first of all, if we come up with a contrived example where this isn’t true - eg identical twins who have exactly the same genes, except one has a somatic mutation causing cystic fibrosis - I’m still reluctant to say the mutated twin is “genetically inferior”. And second of all, this isn’t how we use the word “inferior” anywhere else - we might say that eg a Yugo is inferior to a Cadillac, even if the Yugo is better on some trivial dimension like having a slightly longer tire life.)
So I think there are two different questions here.
“Do you think cystic fibrosis is a genetic condition which it is bad to have?” is a question that bioethicists might ask in order to discuss a medical or epidemiological course of action.
“Do you think people with cystic fibrosis are genetically inferior?” is a question journalists might ask in order to trick people into saying a naughty word so they can cancel them.
There’s no shame in answering two totally different questions differently, so you should answer “yes” to the first and “no” to the second.
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epi
and taking ideas seriously. The only difference between their presentation and mine is that I’m saying that for 99% of people, 99% of the time, taking ideas seriously is the wrong strategy. Or, at the very least, it should be the last skill you learn, after you’ve learned every other skill that allows you to know which ideas are or are not correct.
The people I know who are best at taking ideas seriously are those who are smartest and most rational. I think people are working off a model where these co-occur because you need to be very clever to resist your natural and detrimental tendency not to take ideas seriously. But I think they might instead co-occur because you have to be really smart in order for taking ideas seriously not to be immediately disastrous. You have to be really smart not to have been talked into enough terrible arguments to develop epistemic learned helplessness.
Even the smartest people I know have a commendable tendency not to take certain ideas seriously. Bostrom’s simulation argument, the anthropic doomsday argument, Pascal’s Mugging – I’ve never heard anyone give a coherent argument against any of these, but I’ve also never met anyone who fully accepts them and lives life according to their implications.
A friend tells me of a guy who once accepted fundamentalist religion because of Pascal’s Wager. I will provisionally admit that this person “takes ideas seriously”. Everyone else gets partial credit, at best.
Which isn’t to say that some people don’t do better than others. Terrorists seem pretty good in this respect. People used to talk about how terrorists must be very poor and uneducated to fall for militant Islam, and then someone did a study and found that they were disproportionately well-off, college educated people (many were engineers). I’ve heard a few good arguments in this direction before, things like how engineering trains you to have a very black-and-white right-or-wrong view of the world based on a few simple formulae, and this meshes with fundamentalism better than it meshes with subtle liberal religious messages.
But to these I’d add that a sufficiently smart engineer has never been burned by arguments above his skill level before, has never had any reason to develop epistemic learned helplessness. If Osama comes up to him with a really good argument for terrorism, he thinks “Oh, there’s a good argument for terrorism. I guess I should become a terrorist,” as opposed to “Arguments? You can prove anything with arguments. I’ll just stay right here and not blow myself up.”
Responsible doctors are at the other end of the spectrum from terrorists here. I once heard someone rail against how doctors totally ignored all the latest and most exciting medical studies. The same person, practically in the same breath, then railed against how 50% to 90% of medical studies are wrong. These two observations are not unrelated. Not only are there so many terrible studies, but pseudomedicine (not the stupid homeopathy type, but the type that links everything to some obscure chemical on an out-of-the-way metabolic pathway) has, for me, proven much like pseudohistory – unless I am an expert in that particular subsubfield of medicine, it can sound very convincing even when it’s very wrong.
The medical establishment offers a shiny tempting solution. First, a total unwillingness to trust anything, no matter how plausible it sounds, until it’s gone through an endless cycle of studies and meta-analyses. Second, a bunch of Institutes and Collaborations dedicated to filtering through all these studies and analyses and telling you what lessons you should draw from them.
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interesting comment frpm
eugenics
Law student here: I’m coming down off a large project that involved researching the history of eugenics, particularly the legal aspects. Virtually everyone involved from the supreme court on down had VERY good, VERY convincing arguments for compulsory sterilization (both legal and scientific).
I enjoy pointing out that in Buck v. Bell, the only time the supreme court has touched this issue (and upheld a compulsory sterilization law) the lone dissent was not the uber-progressive Louis Brandeis, or the chimeric but utterly brilliant Oliver Wendall Holmes, or most of the court’s conservative wing that later opposed the New Deal almost whole cloth… it was the curmudgeonly catholic, Pierce Butler…who was just about the most unlikeable guy to a modern legal analyst. He was wrong about EVERYTHING…except this.
Maybe he just got lucky. His dissent was silent. I can’t say whether it was his catholicism, his curmugeonlyness, or something else, that lead him to what I must assume is the “correct” conclusion that the state cannot compel sterilization using the same powers it uses to, say, compel vaccination..but it intrigues me that somehow, he was the ONLY ONE that got this right.
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utilitarian (trolley car)
the good of the many
coments
“If you mhave a strong inclination towards “the good of the many”/group over individual / communitarianism then it’s easier to argue for eugenics. It sucks for people who want kids but who get disallowed from having them but it also sucks for the people who lost the lottery and ended up divided up to deal with the organ shortage at the hospitals.
If you have a strong inclination towards individualism then involuntary eugenics is kinda gonna fly in the face of a lot of your precepts.”