Very much a fun one, here is the audio and transcript, here is part of the opening summary:
Do we overrate the importance of doctors? What’s the importance of IQ versus EQ in the practice of medicine? What are the prospect for venture capital in biotech? How should medical training be changed? Why does he think the conventional wisdom about a problem tends to be wrong? Would immortality be boring? What would happen if we let parents genetically engineer their kids?
Tyler questions Emanuel on these topics and more, including the smartest thing his parents did while raising him, whether we have right to medical self-defense, healthcare in low- versus high-trust institutions, and much more.
Here is one excerpt:
COWEN: How can we improve medical education?
EMANUEL: Cut it down. Make it shorter.
COWEN: Cut it down? Why does that make it better? Or does it just make it cheaper?
EMANUEL: No, I think it will make it better. So, we have a lot of memorization, a lot of . . . So, let’s go back to the start. The four years of medical school: two years of preclinical in the classroom learning about biochemistry, genetics, anatomy, microbiology; and the two years of clinical time in the hospital, on the wards.
That dates from 1910. We haven’t really updated it much, except in this one way: we’ve cut down the preclinical time because — less of it — and it changes so fast, by the time you learn it in medical school, get out as a doctor, it’s out of date, A; and B, it’s more or less irrelevant to managing most patients…
And then, by the way, in med school, spending your time in a hospital is not the future. The future of American medicine is out of the hospital. So we need more rotations, more experiences for students out of the hospital.
No med school has made that big shift, and those are the shifts that are going to have to happen over the next 15 or so years.
COWEN: Is there a right to medical self-defense that should override FDA bans on drugs and medical devices? I want to try something that’s not approved —
EMANUEL: No. I don’t like that.
COWEN: I’m saying it’s my body. But why don’t you like it?
EMANUEL: No, no, no, no, no, no, no, no, no, Tyler.
COWEN: Now, you’ve written a much-misunderstood article about how hard you would try yourself to live past the age of 75. Would not the suspense of world and national history always keep you wanting a bit more extra time?
So, say I’m 75. I’ve decided I agree with you, but the NBA Finals aren’t over yet. I want to see game seven. I want the Mueller report to come out. Isn’t there always something?
And then, it’s kind of intransitivity of indifference. Every day there’s something, and you just keep on hanging on, even if one accepts your arguments in the abstract. Can you talk me out of that?
EMANUEL: No, no, Tyler, I think you’re exactly right. That’s why people do hang on. It’s because . . . you know, so I talked to my father, who — he says, “Zeke, you’re absolutely right. I’ve become slower, physically slower, mentally slower. My life” . . . what ends up happening is your life cones down, and you begin to overvalue certain small things. Like the NBA Finals. Like what’s in the Mueller report.
We all know, from any cosmic standpoint — even not a cosmic standpoint, just a 2,000-foot standpoint — most of those things are not irrelevant. It’s really cool to know.
You often ask — and this happens to me all the time. I teach undergraduates. Pretty smart undergraduates. Very smart undergraduates. MBA students, nurses, doctors, right? They have no understanding of history. So, whoever finishes in the NBA Finals, in five years, people have forgotten.
Recommended, interesting throughout.
The current grant opportunities for starting a new independent research career in academia have not only become increasingly unavailable to young scientists and engineers, but are also disastrously risk-averse. At the NIH, the proportion of all grant funds awarded to scientists under the age of 36 fell from 5.6% in 1980 to 1.5% in 2017. One might ask the rhetorical question: How successful would Silicon Valley be if nearly 99% of all investments were awarded to scientists and engineers age 36 years or older, along with a strong bias toward funding only safe, nonrisky projects? Similarly, at the U.S. Department of Energy and its National Laboratories, high-risk, high-reward research and development has been severely limited by extreme volatility in research funding and by very limited discretionary funding at the laboratory level.
That is by Bruce Alberts and Ventakesh Narayanamurti, via Larry Summers.
That is the driving question behind my latest Bloomberg column, perhaps some of you can be talked up to one in a thousand. Here is the opening bit:
For the last several years, the U.S. military has observed an increase in what it calls “unexplained aerial phenomena.” The rest of us may know them by their more common name — unidentified flying objects — and we should all strive, as the Navy is doing, to take these reports more seriously.
Sometimes, according to the Washington Post, well-trained military pilots “claimed to observe small spherical objects flying in formation. Others say they’ve seen white, Tic Tac-shaped vehicles. Aside from drones, all engines rely on burning fuel to generate power, but these vehicles all had no air intake, no wind and no exhaust.” They also appear to exceed all known aircraft in speed and have been described by a former deputy assistant secretary of defense as embodying a “truly radical technology.”
Meanwhile, Avi Loeb, chair of the Harvard astronomy department, recently suggested that a passing object in space, named Oumuamua, might be a lightsail from an advanced alien civilization, as evidenced by its apparently strange movements.
Also keep in mind the history of the New World before the European arrival and conquest. There were legends of fair-skinned visitors from abroad, perhaps stemming from the Vikings and their explorations, but one day this “alien contact” turned out to be very real indeed — through Columbus, Cortés and others. To be oblivious of another civilization for a long time, and then suddenly encounter it, is a common theme in human history. Perhaps this has not happened for the last time.
There is much more at the link.
José Luis Ricón, for blogging and to develop further platforms for information dissemination.
Arun Johnson, high school student in the Bay Area, to advance his work in physics, chemistry, nuclear fusion, and for general career development.
Thomas McCarthy, undergraduate at Dublin, Trinity College, travel grant to the Bay Area, and for his work on nuclear fusion and running start-up programs to cultivate young Irish entrepreneurs.
Natalya Naumenko, economist, incoming faculty at George Mason University, to study the long-term impact of nuclear explosions on health, and also more broadly to study the history of health in the Soviet Union and afterwards.
Paul Novosad, with Sam Asher, assistant professor at Dartmouth, to enable the construction of a scalable platform for the integration and dissemination of socioeconomic data in India, ideally to cover every town and village, toward the end of informing actionable improvements.
Alexey Guzey, travel grant to the Bay Area, for blogging and internet writing, plus for working on systems for improving scientific patronage.
Dylan DelliSanti, to teach an economics class to prisoners, and also to explore how that activity might be done on a larger scale.
Neil Deshmukh, high school student in Pennsylvania, for general career support and also his work with apps to help Indian farmers identify crop disease and to help the blind interpret images.
Here is my previous post on the third cohort of winners, with links to the first and second cohorts. Here is my post on the underlying philosophy behind Emergent Ventures. You can apply here.
It now seems there will be a Conversations with Tyler with him, no associated public event. So what should I ask him?
Not so much:
Organizations in science and elsewhere often rely on committees of experts to make important decisions, such as evaluating early-stage projects and ideas. However, very little is known about how experts influence each others’ opinions, and how that influence affects final evaluations. Here, we use a field experiment in scientific peer review to examine experts’ susceptibility to the opinions of others. We recruited 277 faculty members at seven US medical schools to evaluate 47 early stage research proposals in biomedicine. In our experiment, evaluators: (1) completed independent reviews of research ideas, (2) received (artificial) scores attributed to anonymous “other reviewers” from the same or a different discipline, and (3) decided whether to update their initial scores. Evaluators did not meet in person and were not otherwise aware of each other. We find that, even in a completely anonymous setting and controlling for a range of career factors, women updated their scores 13% more often than men, while very highly cited “superstar” reviewers updated 24% less often than others. Women in male-dominated subfields were particularly likely to update, updating 8% more for every 10% decrease in subfield representation. Very low scores were particularly “sticky” and seldom updated upward, suggesting a possible source of conservatism in evaluation. These systematic differences in how world-class experts respond to external opinions can lead to substantial gender and status disparities in whose opinion ultimately matters in collective expert judgment.
That is the new book by Tom Chivers, and the subtitle is Superintelligence, Rationality and the Race to Save the World. Here is one excerpt:
Overall, they have sparked a remarkable change. They’ve made the idea of AI as an existential risk mainstream; sensible, grown-up people are talking about it, not just fringe nerds on an email list. From my point of view, that’s a good thing. I don’t think AI is definitely going to destroy humanity. But nor do I think that it’s so unlikely we can ignore it. There is a small but non-negligible probability that, when we look back on this era in the future, we’ll think that Eliezer Yudkowsky and Nick Bostrom — and the SL4 email list, and LessWrong.com — have saved the world. If Paul Crowley is right and my children don’t die of old age, but in a good way — if they and humanity reach the stars, with the help of a friendly superintelligence — that might, just plausibly, be because of the Rationalists.
There is also material covering Scott Alexander and Robin Hanson, among others. Due out in the UK in June.
That is the topic of my latest Bloomberg column, here is one bit:
The first new study focuses on performance in high school, and the startling result is this: Girls with more exposure to high-achieving boys (as proxied by parental education) have a smaller chance of receiving a bachelor’s degree. Furthermore, they do worse in math and science, are less likely to join the labor force, and more likely to have more children, which in turn may limit their later career prospects.
Those are disturbing results. Exposure to high-achieving peers is normally expected to be a plus, not a minus. It is what parents are trying to do when they place their children into better schools, or when school systems work hard to attract better students.
A second new study finds that even blind review does not avoid gender bias in the processing of grant proposal applications, drawn from data from the Gates Foundation. It turns out that women and men have different communications styles, with the women more likely to use narrow words, and the men more likely to use broader ones. And reviewers, it turns out, favor broad words, which are more commonly associated with more sweeping claims, and disfavor the use of too many narrow words.
The net result is that “even in an anonymous review process, there is a robust negative relationship between female applicants and the scores assigned by reviewers.” This discrepancy persists even after controlling for subject matter and other variables. Notably, however, it disappears when controlling for different rhetorical styles.
These two studies probably are connected to each other. While the two sets of researchers do not address each other’s claims, it is not a huge leap to think of broader, more sweeping language as reflecting a kind of confidence, whether merited or not. Narrow words, on the other hand, may reflect a lower level of confidence or a greater sense of rhetorical modesty. Not only might lower confidence hurt many women in life, but a greater unwillingness to signal confidence — regardless of whether it’s genuine — might hurt them too.
There is much more at the link, recommended.
Or is it that there’s something wrong with culture, with the funding? Almost no grants go to younger scientists. When it’s scientists under age 40 that make […] of the most big discoveries, 2% of NIH grants go to scientists under age 40. That seems a little bit off. You have a peer-review process where anything heterodox can’t get funded. You have sort of a publish or perish dynamic where you have to do small, incremental things to publish lots of articles that don’t add up to anything ever…
And again, my sort of libertarian cut on what happened would be the history of was that we had a healthy, scientific world that was non-governmental. It was decentralized. It was idiosyncratic. Different people were doing different kinds of things. And in the 1930s, 1940s, it got centralized accelerated. The Manhattan Project…there was actually a way you could accelerate science temporarily by adding tons of money and centralizing…
So the centralization worked. But to use an ecological metaphor, it worked by creating a monoculture. And we’re now two generations in to where that monoculture has been just catastrophic.
That is from this taped dialogue between Peter and Bill Hurlbut, previously linked on MR.
The FDA may be too conservative but it does subject new pharmaceuticals to real scientific tests for efficacy. In contrasts, many medical and surgical procedures have not been tested in randomized controlled trials. Moreover, dental care is far behind medical care in demanding scientific evidence of efficacy. A long-read in The Atlantic spends far too much time on a single case of egregious dental fraud but it’s larger point is correct:
Common dental procedures are not always as safe, effective, or durable as we are meant to believe. As a profession, dentistry has not yet applied the same level of self-scrutiny as medicine, or embraced as sweeping an emphasis on scientific evidence.
…Consider the maxim that everyone should visit the dentist twice a year for cleanings. We hear it so often, and from such a young age, that we’ve internalized it as truth. But this supposed commandment of oral health has no scientific grounding. Scholars have traced its origins to a few potential sources, including a toothpaste advertisement from the 1930s and an illustrated pamphlet from 1849 that follows the travails of a man with a severe toothache. Today, an increasing number of dentists acknowledge that adults with good oral hygiene need to see a dentist only once every 12 to 16 months.
The joke, of course, is that there’s no evidence for the 12 to 16 month rule either. Still give credit to Ferris Jabr for mentioning that the case for fluoridation is also weak by modern standards–questioning fluoridation has been a taboo in American society since anti-fluoridation activists were branded as far-right conspiracy theorists in the 1950s.
The Cochrane organization, a highly respected arbiter of evidence-based medicine, has conducted systematic reviews of oral-health studies since 1999….most of the Cochrane reviews reach one of two disheartening conclusions: Either the available evidence fails to confirm the purported benefits of a given dental intervention, or there is simply not enough research to say anything substantive one way or another.
Fluoridation of drinking water seems to help reduce tooth decay in children, but there is insufficient evidence that it does the same for adults. Some data suggest that regular flossing, in addition to brushing, mitigates gum disease, but there is only “weak, very unreliable” evidence that it combats plaque. As for common but invasive dental procedures, an increasing number of dentists question the tradition of prophylactic wisdom-teeth removal; often, the safer choice is to monitor unproblematic teeth for any worrying developments. Little medical evidence justifies the substitution of tooth-colored resins for typical metal amalgams to fill cavities. And what limited data we have don’t clearly indicate whether it’s better to repair a root-canaled tooth with a crown or a filling. When Cochrane researchers tried to determine whether faulty metal fillings should be repaired or replaced, they could not find a single study that met their standards.
For sale on eBay: what’s claimed to be “maybe the only” young Tyrannosaurus rex ever discovered for $2.95 million. Paleontologists decried the sale, saying that the specimen’s cost was artificially inflating the cost of other valuable fossils. “Only casts and other replicas of vertebrate fossils should be traded, not the fossils themselves,” an open letter from the Society of Vertebrate Paleontology in Bethesda, Maryland. read. “Scientifically important fossils like the juvenile tyrannosaur are clues to our collective natural heritage and deserve to be held in public trust.”
…“The asking price is just absurd,” one researcher said.
Here is the full story, via Ze’ev. Might this increase the incentive to find such fossils?
Setbacks are an integral part of a scientific career, yet little is known about whether an early-career setback may augment or hamper an individual’s future career impact. Here we examine junior scientists applying for U.S. National Institutes of Health (NIH) R01 grants. By focusing on grant proposals that fell just below and just above the funding threshold, we compare “near-miss” with “near-win” individuals to examine longer-term career outcomes. Our analyses reveal that an early-career near miss has powerful, opposing effects. On one hand, it significantly increases attrition, with one near miss predicting more than a 10% chance of disappearing permanently from the NIH system. Yet, despite an early setback, individuals with near misses systematically outperformed those with near wins in the longer run, as their publications in the next ten years garnered substantially higher impact. We further find that this performance advantage seems to go beyond a screening mechanism, whereby a more selected fraction of near-miss applicants remained than the near winners, suggesting that early-career setback appears to cause a performance improvement among those who persevere. Overall, the findings are consistent with the concept that “what doesn’t kill me makes me stronger.” Whereas science is often viewed as a setting where early success begets future success, our findings unveil an intimate yet previously unknown relationship where early-career setback can become a marker for future achievement, which may have broad implications for identifying, training and nurturing junior scientists whose career will have lasting impact.
That is the abstract of a new paper by Yang Wang, Benjamin F. Jones, and Dashun Wang.
From my email:
We are now starting to get a hint of the future transformative technologies that you guessed were on their way in “The Great Stagnation”. You had not speculated on what they might be, but there are faint hints on what is likely to happen.I believe this article is one leg: extremely fast air travel. The second leg is the Hyperloop and similar: extremely fast ground travel. The third leg is synthetic biology (e.g: https://www.economist.com/leaders/2019/04/04/the-promise-and-perils-of-synthetic-biology). The fourth leg is quantum computing, which is finally starting to show that it might work. And the fifth, and final leg, is fusion energy, which looks eerily like it will actually come to fruition this time.Put those 5 together and you have the makings of a new economy, with a huge burst of growth to come for many decades. These are just faint hints, of course, but they’re starting to get increasingly clear.
COWEN: You’ve trained in chemistry, physics, electrical engineering, and neuroscience, correct?
BOYDEN: Yeah, I started college at 14, and I focused on chemistry for two years, and then I transferred to MIT, where then I switched into physics and electrical engineering, and that’s when I worked on quantum computing.
COWEN: Five areas, actually. Maybe more.
BOYDEN: Guess so.
COWEN: Should more people do that? Not the median student, but more people?
BOYDEN: It’s a good question.
COWEN: Are we less creative if all the parts of our mind become allies? Maybe I’m afraid this will happen to me, that I have rebellious parts of my mind, and they force me to do more interesting things, or they introduce randomness or variety into my life.
BOYDEN: This is a question that I think is going to become more and more urgent as neurotechnology advances. Already there are questions about attention-focusing drugs like Ritalin or Adderall. Maybe they make people more focused, but are you sacrificing some of the wandering and creativity that might exist in the brain and be very important for not only personal productivity but the future of humanity?
I think what we’re realizing is that when you intervene with the brain, even with brain stimulation, you can cause unpredictable side effects. For example, there’s a part of the brain called the dorsolateral prefrontal cortex. That’s actually an FDA-approved site for stimulation with noninvasive magnetic pulses to treat depression. But patients, when they’re stimulated here . . . People have done studies. It can also change things like trust. It can change things like driving ability.
There’s only so many brain regions, but there’s millions of things we do. Of course, intervening with one region might change many things.
COWEN: What kind of students are you likely to hire that your peers would not hire?
BOYDEN: Well, I really try to get to know people at a deep level over a long period of time, and then to see how their unique background and interests might change the field for the better.
I have people in my group who are professional neurosurgeons, and then, as I mentioned, I have college dropouts, and I have people who . . . We recently published a paper where we ran the brain expansion process in reverse. So take the baby diaper polymer, add water to expand it, and then you can basically laser-print stuff inside of it, and then collapse it down, and you get a piece of nanotechnology.
The co–first author of that paper doesn’t have a scientific laboratory background. He was a professional photographer before he joined my group. But we started talking, and it turns out, if you’re a professional photographer, you know a lot of very practical chemistry. It turns out that our big demo — and why the paper got so much attention — was we made metal nanowires, and the way we did it was using a chemistry not unlike what you do in photography, which is a silver chemistry.
COWEN: Let’s say you had $10 billion or $20 billion a year, and you would control your own agency, and you were starting all over again, but current institutions stay in place. What would you do with it? How would you structure your grants? You’re in charge. You’re the board. You do it.
COWEN: If you’re designing architecture for science, what do you do? What do you change? What would you improve? Because presumably most of it is not designed for science. Maybe none of it is.
BOYDEN: I’ve been thinking about this a lot, actually, lately. There are different philosophies, like “We should have open offices so everybody can see and talk to each other.” Or “That’s wrong. You should have closed spaces so people can think and have quiet time.” What I think is actually quite interesting is this concept that maybe neither is the right approach. You might want to think about having sort of an ecosystem of environments.
My group — we’re partly over at the Media Lab, which has a lot of very open environments, and our other part of the group is in a classical sort of neuroscience laboratory with offices and small rooms where we park microscopes and stuff like that. I actually get a lot of productivity out of switching environments in a deliberate way.
There is much more of interest at the link.