A really interesting, in-depth look at the state of the medicine, how it works in practice, and what it might mean for the future of obesity and healthcare.
A smidge of hope for a better future.
I’m a fan of the character and charm of old houses. Living in New England, I was surrounded by Victorians and Colonials, Federals and Cape Cods. I love to see houses that match their place. I’m delighted by row houses in New York and pictures of Pueblo architecture in the Southwest. My area is home to many Spanish style and Craftsman homes. And the California coast used to be dotted with cute, airy beach bungalows.
In recent years I have come to realize that the reality of home ownership and usage is very different from the historiocity many people subscribe to. Old houses are great, except for all the reasons that they are bad. I believe grand old homes with beautiful details and craftsmanship deserve to be respected and maintained. But the vast majority of old homes were constructed quickly and cheaply. Furthermore, homes are living objects, in that they require constant maintenance, repair, and replacement parts, not to mention modifications to support modern living styles.
I love my current house. It is a compact one story built in 1928. I find the style and layout charming. I like the stucco and arches, built-in cabinets and fireplace. But I will freely admit that my house lacks any significant architectural detail. It is nice to live in only because it was expanded in the 1990s to add a third bedroom, second bathroom, and expanded kitchen.
The previous owners also added modern air conditioning, updated the electrical service, blew in insulation, replaced all the wood floors, and put in a new roof. When we moved in, we had to embark on a variety of projects including shoring up the crumbling chimney, replacing the failing sewer line, replacing a bunch of old windows, and adding earthquake bracing. We also had to rip out all of the dangerous old knob and tube wiring and put in a new heat pump air conditioner.
How much of the original home remains? The 2×4 framing, which is too thin to provide adequate insulation. The foundation, which has had significant patching and repair, and will probably need more. The stucco has been redone many times, the plumbing has been changed and expanded over time, the bathroom redone completely. There is original cabinetry and millwork, and a few original windows, but we keep those for sentimental reasons even though they are horrendously energy inefficient.
I love my house, but I wonder more and more, were I have to have money and opportunity, would I buy another old house, or would I build a new one? As an infrastructure nerd, I see a lot of appeal in modern earthquake- and fire-resistant building methods, structured wiring, plumbing manifolds, and spray foam insulation. While old-style craftsmanship is hard to come by, it is certainly possibly to build new houses that charm and delight. Heck, every recent season of This Old House has resulted in a house that is usually charming and always more new than old – sometimes reconstructed completely!
Does an old house have intrinsic worth? I’m increasingly in the YIMBY camp with the belief that the answer is “no”, and the instinct against tearing down non-significant homes is holding cities back.
Since moving into our house in late 2019 I have wanted to replace the kitchen sink. The existing sink was an enameled cast iron double bowl that weighed around 130 lbs. My preference is for one large single bowl so that I can fit my larger pots, pans, and cutting boards. I also wanted to add an instant hot water faucet, which wasn’t possible with the existing sink.
To replace the sink, I needed to remove all of the existing plumbing and fixtures and re-plumb, which was a bit daunting but nothing that can’t be learned by watching some YouTube videos. The bigger problem was that this sink was a “drop-in” model, meaning that it is meant to be installed from the top, but for some reason this particular one was installed from the bottom in an “under-mount” configuration.
Now, there are a few standard ways to under-mount a sink, but a drop-in sink is not built to be under-mounted, so the builder took the route of placing wood cleats around the sink, adding the sink, and then putting the counter over it. This gave me no obvious way to remove the sink, and any non-obvious approach (i.e. figuring out some way to remove the cleats without removing the countertop) risked me being crushed under 130 lbs of iron.
This posed quite a conundrum, and so the sink remained for several years. Until last month, when Katy was out of town for a week and I decided to go for it. I figured it would take one day to remove everything and drop the old sink out, then one additional day to install the new sink. All told, the project took five very stressful days.Continue reading “Let That Sink In”
Perhaps we will welcome our new AI overlords and perhaps they will treat us kindly. But either way, my current preference is to put many fewer eggs in the “further advances in Computer Stuff will save us” basket and many more eggs in the “we need to directly address public policy problems that relate to macroscopic objects in physical space.”Matthew Yglesias, “I’m skeptical that powerful AI will solve major human problems“
If you find the smell of restaurants’ truffle dishes foul, it does not mean that you do not like truffles; it could indicate that you have good taste and do not like petroleum on your plate. Unlike that intense gas-like smell, the aroma of real truffles is mild and complex.The truffle industry is a big scam. Not just truffle oil, everything by Matt Babich
It is very hard to know what the right answer is these days when it comes to pandemic safety.
Government data carries lots of caveats, but roughly 1 in 100 reported cases still lead to death1 E.g. LA County reports 1017 new cases and 14 new deaths today, 3,476,928 new cases and 33,889 deaths since the beginning.. The majority of people I know have become ill with COVID-19 at least once, but most recent infections have been relatively mild with few long-term consequences2That said, I know people who have had awful symptoms that go on for months..
So what – if any – precautions are still warranted for a reasonably healthy adult?
Two weeks ago I went on a work trip to Chicago. I wore an N95 mask everywhere I could: in the airport, on the plane, in the taxi, on the crowded trade show floor, and in private meetings with vendors. I even wore an N95 mask to the cocktail hours!3I had to forego the cocktails, obviously. Guess how many other attendees were likewise adorned? By my count, no more than 1 in 500. At a convention for cleaning industry professionals.
It was awkward and uncomfortable to be masked throughout the week, but it was possible. Where it was not possible was at the group dinners. I had something resembling a panic attack when I entered this room, awash in the noise of hundreds of humans packed in like sardines in a can:
For the sake of propriety I endured the dinner and enjoyed good food, good wine, and good conversation. I flew home on a Thursday with plans to fly right back out again on Saturday for vacation in London.
On Friday I got the email that the person sitting next to me at the dinner had tested positive. Despite all my best efforts to stay safe, the dinner and social niceties did me in. So much for that trip to London! Now I get to stay home and quarantine instead.
Except, of course, that’s not true. While the CDC offers tepid and widely ignored recommendations, there are no longer any formal requirements for travel: no need for vaccination, testing, tracing, quarantine, or masking. No more government-sponsored sick time. Far fewer flexible rebooking options by airlines and hotels. Even the free vaccines are going away at the end of the year!4Pfizer plans to start charging $120 per dose in 2023.
So what is a concerned individual to do? What is the right course of action for someone who believes we live in a society and should take care of each other? Luckily, I did not get COVID (this time) and did not have to make that decision. But in the airport, waiting for our flight to London, an older couple sat down near us with coughs and sniffles. Then they pulled out COVID rapid tests and listened loudly to the audio instructions while fumbling with the packaging. In the airport. While waiting to board the flight. Surrounded by other travelers.
I know public health policy is hard. I know public health communication is hard. I know everyone is tired of this, and the politics are fraught. I know Joe Biden says the pandemic is over and we now live with endemic COVID. And I can see that for most people, the new normal is just the old normal. But it is hard to believe that this is the best approach, that we individually and collectively are doing the right thing to properly balance risks and make a just, equitable society.
Anyway, I’ll let you know how things go in London. Maybe the UK has a better approach.
A brief, no-nonsense rundown of the various stages of the pandemic leading to the “new normal” of today. My biggest takeaway from the article is the reinforcement of the idea that neither total eradication nor herd immunity were ever achievable, no matter how many lockdowns and other public health interventions we tried.
It is October 17th, 2019. We are in a drab procedure room at the Kaiser hospital complex in Hollywood. I am holding the hand of my wife – my brave, strong, amazing partner – as her procedure is about to begin.
It is June 1st, our wedding day. The celebration is joyous, we are surrounding by friends and family, we are so happy and our future is bursting with possibility.
It is June 14th. We are on our honeymoon, and we just checked in to an amazing cliffside hotel on the island of Santorini, Greece. We are sitting by the pool and sipping cocktails while gazing out at an endless expanse of blue ocean. We take the steep stairs down to our hotel room, tipsy and holding hands.
It is August 28th. We are sitting anxiously in an exam room, waiting for the doctor to perform our first ultrasound. She shows us the little clump of cells that will grow into our precious baby boy. Everything looks good, she says.
It is early October. We put a silly little sticker on her belly that says “11 weeks” and take pictures. We excitedly plan for our future. We can’t wait to tell our family and friends.
I don’t remember what day it is. I just remember the profound silence when the doctor turns on the audio loop and there is no heartbeat.
It is October 17th, 2019. We are in a drab procedure room at the Kaiser hospital complex in Hollywood, waiting for our abortion procedure to begin. We are so desperately sad. Our baby was so very wanted. My wife looks at the doctor anxiously and asks, innocently, what would have happened if this was 50 years ago, before Roe vs. Wade?
The doctor answers, without hesitation, you would have died.
[T]here is a sensation universal to all humans. It is that feeling you get when you’re standing outside somewhere and look up to see trees blowing in the wind, or stumble across a stream running over rocks. As you listen to that gentle creaking, or that low-tone burbling, what you feel at that moment is the deep satisfaction that comes from witnessing Being, in all its irreducible and incomputable eddies and swirls. Your eyes are satiated. There’s probably a German word for it, and if not, there should be. But whatever that feeling is, modern films are as distant as can be from it. For after partaking in the empty calories of modern cinema, your eyes are still hungry.Eric Hoel, CGI Did In Fact Ruin Movies
When we moved into Hacienda de la Tortuga I went a bit overboard designing a home network using the Unifi platform. I spent many hot, dirty days running ethernet cable through the basement crawl space and attic. The end result included, amongst other things, five wireless access points and six security cameras.
Our wireless coverage is pretty great, although that does not do anything to alleviate the frequent Spectrum outages. The cameras are a different story. Their motion detection is pretty awful, constantly being triggered by branches and wind, regardless of how I tweaked the sensitivity settings. Twice the system crashed and lost all of my footage. The second time was while we were in Hawaii and our sewer was backing up, which would have been an excellent time to check on the house and see what the plumber was doing.
After that I ripped out the Unifi cameras and switched to a system called Reolink. This involved running additional wires, more crawling under the house, and installing a bunch of mounting boxes. The cameras turned out to be huge, so now it looks like we are living in a secure government facility, or a prison yard. The picture quality is great and the recording is reliable, but the fancy “person and vehicle detection” does not work at all.
Today I went down to Home Depot and picked up one of those video doorbells. It was cheap, easy to install, and has cloud-based object detection that can pick out people, cars, animals, and packages pretty reliably. When someone comes to the door it lights up and sends me a push notification. I can choose 20 different chimes. For a couple bucks a month all of the storage is taken care of.
I guess there is something to be said for consumer-level technology. Reolink and Unifi both offer local storage and lots of configuration options, whereas the consumer products are simpler and require cloud subscriptions. You obviously need to choose a company that has a good security and privacy track record, and that can sometimes be hard to know. But in exchange the technology is inexpensive, feature-packed, and simple.
If I had it all to do over again I would not have run all that cable or installed all that fancy, expensive equipment. I was never concerned about playing CSI, I just wanted to see what animal was eating my vegetables and when a package was at the front door. I’m seriously considering ripping it all out and just sticking with the video doorbell and maybe a few additional cheap cameras.
But then there will be so many holes to patch. 🙁
“Humans have a fundamental need to create and maintain a narrative for their lives in which the universe is not implacable and heartless, that terrible things do not happen at random, and that catastrophe can be avoided if you are vigilant and responsible. We are vulnerable, but we don’t want to be reminded of that. We want to believe that the world is understandable and controllable and unthreatening, that if we follow the rules, we’ll be okay.”Ed Hickling in The Washington Post
A poignant meditation on living with chronic illness.
“In the long run, I think the way technocratic institutions safeguard their independence and build their legitimacy is by doing a good job. You want people to think ‘these guys seem like they know what they are doing.'”
“Maybe this is a glimpse of the inevitable heat-death of ecommerce: Bots trying to convince other bots to buy stuff no humans would ever click on.”
I loved Lovecraft Country the book, and enjoyed certain aspects of the television adaptation (notably the brilliant pilot episode), but I’m not surprised the second season has been cancelled given the unevenness and problems of the first season. This article from last October does a great job of explaining where the show went wrong, including its over-reliance on historical “name-dropping” in place of actual character and plot development.