Libertarian Economist Thomas Sowell Praises Trump’s “Defiant Response to Being Shot At”

(p. A13) Although the attempt to assassinate Donald Trump failed, it was part of a long and growing pattern of threats and violence that can be fatal to American society.

. . .

Over the years, too many people have used too many clever words to play down threats and violence. “No justice, no peace” has been one of the more fashionable phrases.

. . .

If one side keeps getting away with threats and violence, it is only a matter of time before their opponents also start using threats and violence. At that point, whatever they initially disagreed about is no longer the issue. It is now a question of revenge and counter-revenge, especially for unforgivable acts on both sides. And no compromise on the original issues can stop that.

If anything positive can be salvaged from this ominous attempt on Donald Trump’s life, it may be his defiant response to being shot at. It may be important to let foreign enemies know that there are still some strong American leaders that they may have to deal with.

For the full commentary see:

Thomas Sowell. “Lessons of the Attack on Trump.” The Wall Street Journal (Tuesday, July 16, 2024): A13.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 15, 2024, and has the title “Lessons of the Trump Assassination Attempt.”)

A Founding Manager (aka Project Entrepreneur) Has the Motivation, Knowledge, and Power to Keep His Firm Innovative

In my Openness book, I discuss “project entrepreneurs” who overlap considerably with what is called “founder mode” in the commentary quoted below.

(p. B4) People like Elon Musk and Steve Jobs at times seemed to have a je ne sais quoi that allowed them to act and behave as leaders of their companies in ways that would have tripped up mere mortals.

This past week, Silicon Valley put a name to it: “Founder Mode.”

It’s a term coined by Paul Graham, co-founder of Y Combinator, an influential startup incubator in the San Francisco Bay Area. He wrote an essay this month gaining a lot of attention in tech circles that pits his “Founder Mode” against what he calls “Manager Mode.”

Graham tries to put his finger on the special relationship entrepreneurs have with their companies that he argues outsiders just lack.

. . .

In a podcast late last year, Chesky, who co-founded Airbnb originally as AirBed and Breakfast, talked about the three traits he said better equip a company’s founder over an outside manager.

“They’re the biological parent—you can love something but when you’re the biological parent of something, like, it came from you, it is you, there’s a deep passion and love,” Chesky said. “The second thing a founder has is they have the permission…like I can’t tell another child what to do but if they were my child I probably could.”

This empowers a founder to make dramatic changes, such as rebranding.

And finally, according to Chesky, a founder knows how the company was built in the first place. “You know how to rebuild it, you know the freezing temperature of a company, you know at what temperature it melts,” he said.

. . .

Before publishing his essay, Graham ran it by a few tech titans, including Musk. After it was published, Musk weighed in on X with his own endorsement: “Worth reading.”

For the full commentary see:

Tim Higgins. “Micromanaging Is Cool Again in Tech.” The Wall Street Journal (Monday, Sept. 9, 2024): B4.

(Note: ellipses between paragraphs added; ellipsis within paragraph in original.)

(Note: the online version of the commentary has the date September 7, 2024, and has the title “With ‘Founder Mode,’ Silicon Valley Makes Micromanaging Cool.” The French phrase is italicized in the print version.)

My book, mentioned above, is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Hygiene Hypothesis Says Parasites Help the Immune System to Develop

(p. D6) The kakapo, a large flightless parrot that can live 95 years and perhaps longer, is dangerously close to extinction. Once found throughout New Zealand, the population has dwindled to fewer than 150.

Conservation biologists are doing everything they can to keep the kakapo from vanishing. And so, when they discovered a few years ago that a pair of captive kakapos were infected with tapeworms, they did the obvious thing: They dewormed the birds.

Hamish G. Spencer, a geneticist at the University of Otago in New Zealand, thinks that was unwise. If endangered species are going to escape extinction, he argues, they may need parasites to survive.

“Some of these parasites may turn out to be quite good for their hosts,” Dr. Spencer said.

. . .

Evidence accumulated over the decades for what came to be known as the hygiene hypothesis. Supporters argued that over the past two centuries, modern civilization has radically changed our relationship with our inner residents.

For millions of years, our evolving bodies had to strike a tricky balance. We depended on a powerful immune system to fend off deadly infections. But if the immune system were to attack indiscriminately, it could destroy the body’s beneficial bacteria, for example, or damage its tissues with relentless inflammation.

According to the hygiene hypothesis, our ancestors came to tolerate low levels of infection. They even came to depend on parasites to help the immune system develop properly.

. . .

It’s possible, Dr. Spencer said, that the lack of parasites may help explain why some species restoration projects have been disappointing. “There are a number of cases where reintroduced populations haven’t done very well,” he said. “It might be that their immune systems are not very good.”

. . .

A first step, Dr. Spencer said, would be to stop medicating captive animals so freely. “We are arguing against the idea that you just dose the hell out of everything before you put animals back in the wild,” he said.

For the full story see:

Carl Zimmer. “Parasites as Welcome Guests.” The New York Times (Tuesday, April 5, 2016 [sic]): D6.

(Note: ellipses added.)

(Note: the online version of the story has the date March 31, 2016 [sic], and has the title “Tapeworms and Other Parasites Can Make Good Guests.” The paragraph that starts “For millions of years,” appears in the online version, but not in the print version.)

For more on the hygiene hypothesis see the following academic article:

Versini, Mathilde, Pierre-Yves Jeandel, Tomer Bashi, Giorgia Bizzaro, Miri Blank, and Yehuda Shoenfeld. “Unraveling the Hygiene Hypothesis of Helminthes and Autoimmunity: Origins, Pathophysiology, and Clinical Applications.” BMC Medicine 13, no. 1 (2015). DOI: https://doi.org/10.1186/s12916-015-0306-7.

Patients Lack Key Information About Our Heavily Regulated Healthcare System

Amazon is widely criticized for its size, but it is big because so many consumers choose to buy from it. Consumers value the wide selection and the quick delivery. But I hypothesize that what consumers value most is the information. Product ratings are informative. The ratings themselves are rated. Comparisons within categories are offered. Price changes can be tracked for a given product, and compared among different products. Features can be easily compared. In healthcare the government, as with HIPAA, often mandates the protection over the provision, of information. But even when healthcare information is provided, it is often provided too slowly and too obscurely to be actionable by patients. In the example discussed in the passages quoted below, quick and accurate information is literally a matter of life and death. Entrepreneurs like Jeff Bezos in a free enterprise system have the freedom and the incentive to please consumers by providing them with quick and accurate information. Bureaucrats in government or highly regulated systems, lack the freedom to violate rigid rules and are rewarded if they please their bosses by preserving the status quo.

(p. A3) After her water broke early, doctors told Fatima Goines to prepare for her newborn’s death.

Goines was 22 weeks into her pregnancy, just past the halfway mark. Doctors at Methodist Hospital in suburban Minneapolis said they couldn’t save such a premature baby and that no hospital could. They told her that once the baby girl was born, Goines could hold her until the infant died.

Goines didn’t want to give up. She checked herself out of Methodist Hospital and, on the recommendation of a fellow mom on Facebook, went to a birthing center connected to Children’s Minnesota hospital, 7 miles away from Methodist. After Goines gave birth, doctors there immediately intubated the baby to help her breathe and placed her in an incubator.

Me’Lonii is now a healthy 4-year-old, and has surpassed all the developmental milestones for her age. “She’s doing wonderfully well,” said Dr. Thomas George, who directs (p. A7) the Children’s Minnesota neonatal intensive care unit.

Medical advances over the past several decades have given hospitals the ability to save younger and younger premature newborns. Yet most hospitals don’t try—and parents often aren’t aware of what’s possible or that other hospitals, even just a few miles away, might offer their newborns a fighting chance.

Doctors are now capable of saving the lives of babies born at 22 weeks and, in rare cases, a week earlier, with improved techniques to help tiny lungs develop and protect fragile skin and organs. Hospitals with extensive experience resuscitating extremely premature babies report survival rates as high as 67% for babies born at 22 weeks.

Fragile infants

Some U.S. hospitals aren’t sufficiently equipped or capable of pulling off the new advances. Others have chosen not to offer the care, saying it is likely to fail, is expensive—typically more than $100,000 a child, and sometimes much more—and subjects tiny, fragile infants to needless pain and the risk of long-term disabilities.

Instead, they often provide comfort care: wrapping the newborn in a blanket, placing it on the mother’s chest and sometimes giving medicines to ease the child’s final moments.

The difference can be a matter of life or death for the roughly 8,000 infants born between 22 and 24 weeks gestation in the U.S. each year.

Doctors agree that babies born at 25 or 26 weeks can and should be treated as long as they don’t have other complications, while those born at 20 weeks or less are too small to save.

In between is a “gray zone,” as doctors call it, where newborns’ fate can depend on which hospital happens to be delivering.

. . .

No way to know

Rachel Sherman, a hairstylist who now lives in Florence, Ariz., wishes she had had more information.

When her water broke at 22 weeks pregnant in 2021, while she was living in Utah, the first Salt Lake City-area hospital she went to told her they couldn’t help until her baby was 24 weeks. She and her husband drove about 30 minutes to the University of Utah Hospital instead. It has a Level 3 NICU and shares a campus with a children’s hospital with a Level 4 NICU.

The staff there also told Sherman it wouldn’t save a 22-week baby and there wasn’t a neonatal unit in the U.S. that would treat an infant under 24 weeks, she recalled. But another hospital within half an hour’s drive was offering active treatment for babies at 22 weeks that year, The Wall Street Journal confirmed.

For the full story see:

Liz Essley Whyte. “A Life-or-Death Divide For Very Premature Babies.” The Wall Street Journal (Friday, Aug. 9, 2024): A1 & A7.

(Note: ellipsis added.)

(Note: the online version of the story has the date August 7, 2024, and has the title “Doctors Can Now Save Very Premature Babies. Most Hospitals Don’t Try.” The “Fragile infants” sub-heading quoted above appears in the print, but not in the online, version.)

The paper co-authored by Christensen and mentioned above, is:

Christensen, Kaare, Gabriele Doblhammer, Roland Rau, and James W. Vaupel. “Ageing Populations: The Challenges Ahead.” Lancet 374, no. 9696 (Oct. 3, 2009): 1196-208.

The 2021 paper co-authored by Vaupel and mentioned above, is:

Vaupel, James W., Francisco Villavicencio, and Marie-Pier Bergeron-Boucher. “Demographic Perspectives on the Rise of Longevity.” Proceedings of the National Academy of Sciences 118, no. 9 (2021): e2019536118.

Musk Will Downsize Government and “Remove Absurd Regulations”

(p. B4) If Elon Musk becomes chief red-tape cutter in a second Trump administration, he is already giving a taste of what’s to come.

. . .

. . ., he often talks about how regulations can be like little strings that collectively tie down a giant like Gulliver, and strip us of our freedoms.

. . .

A Trump victory could give the country, according to Musk, a rare opportunity to clean house unseen since the Reagan administration’s massive deregulation effort.

“It’s been a long time since there was a serious effort to reduce the size of government and to remove absurd regulations,” Musk said during an appearance this month at the “All-In Podcast” conference.

While he skirted what exactly he would do, Musk made it clear that the EPA was the kind of agency on his mind. He pointed to a proposed fine of about $148,000 by the EPA announced this month over claims of SpaceX improperly discharging deluge water and spilling liquid oxygen at its South Texas launchpad.

Musk called it an example of “irrational regulation” and compared the company’s actions to dumping drinking water on the ground. “There was no actual harm done,” he said. “It was just water to cool the launchpad during lift off.”

. . .

Neuralink announced a regulatory win this past week. Musk’s brain-implant company said the Food and Drug Administration had awarded its experimental Blindsight microchip, which aims to restore sight, a special designation intended for medical devices aimed at treating life-threatening or irreversible debilitating conditions.

If successful, it sounds like the stuff out of TV’s “Star Trek: The Next Generation.”

“Provided the visual cortex is intact, it will even enable those who have been blind from birth to see for the first time,” Musk said this past week.

It is those kinds of advancements that excite his fans and why it can be so hard to rein him in amid public support.

For the full commentary see:

Tim Higgins. “As Musk Picks Fights, Stakes Are Rising.” The Wall Street Journal (Monday, Sept. 23, 2024): B4.

(Note: ellipses added.)

(Note: the online version of the commentary has the date September 21, 2024, and has the title “The Fight Elon Musk Is Ready to Pick in a Trump Administration.”)

Regulations Slow the Creation and Adoption of Healthcare Breakthroughs

CPR is “cardiopulmonary resuscitation.” ECPR is “extracorporeal CPR.” The ATTEST randomized double-blind clinical trial (RCT) provided dramatic evidence of the efficacy of ECPR. But the INCEPTION RCT seemed to provide equally strong evidence of a lack of efficacy. The key difference is the high level of experience and dedication of those implementing the ATTEST RCT, and the lack of experience, and likely lower dedication of those in the INCEPTION RCT. Dr. Demetris Yannopoulos has improved his techniques through trial and error, probably in some ways that he can articulate and in other ways that are harder to articulate. Gary Klein with his naturalistic decision-making research, writes that experience gives emergency workers a quick “recognition” of what needs to be done in different situations.

At what point in the development of a therapy do you perform the canonical RCT? In the case of Emil Freireich’s four drug chemo-cocktail for curing childhood leukemia, he continually improved the ingredients and doses of the cocktail. If an RCT had been performed too early in that process, the result would have been a lack of efficacy, and a therapy would have been abandoned that had the potential to be developed into a useful efficacious therapy. Ditto for Vince DeVita’s development of his chemo-cocktail for curing Hodgkin’s Lymphoma. Ditto also for the development of the drug that eventually proved efficacious in the For Blood and Money book, where Stanford cancer doctor and Pharmacyclics co-founder acquired and developed cancer therapy Imbruvica, but abandoned it after an RCT of it failed. But Miller was ousted by major Pharmacyclics stock-holder, and entrepreneurial non-scientist, Bob Duggan, who did not want to give up on Imbruvica. Duggan persevered, overseeing its further development, until a later RCT was performed that proved efficacy.

In an earlier entry, I documented a much simpler and cheaper CPR innovation that also promises to improve heart failure therapy, called “neuroprotective CPR” (NCPR). Which one, if either, of ECPR or NCPR should we endorse? Ideally, in a fully function medical marketplace, we could comfortably say: “let the market decide.” Entrepreneurial scientists and physicians could develop the therapies and see how many willing patients would be willing to pay for each. Maybe the more expensive ECPR therapy would initially only be bought by the better-off. But as Yannopoulos improves it, as he is already working to do, making it simpler and cheaper, it would eventually be appealing to a broader customers. In Openness, I claim that this is the common path of a great many breakthrough innovations in areas outside of medicine.

Notice that the ECPR was heavily funded by the Helmsley Trust, a private foundation. This is consistent with my claim that medical innovation benefits from a diversity of funding sources, especially of private funding sources that are more likely to fund a diversity of methods and to take chances with heterodox ideas, partly motivated by private funders’ greater mission-orientation due to having more ‘skin-in-the-game.’

Notice also that Yannopoulos’s implementation of ECPR was constrained by a scarcity of trained personnel. Yannopoulos could not act as a nimble entrepreneur because massive regulations limit nimble entrepreneurship in healthcare. This is especially try on labor market issues where massive labor market regulations pile on top of massive healthcare regulations. Breakthrough innovations are usually implemented by small nimble start-ups. To create Disneyland, Walt Disney created WED Enterprises, instead of try to created it with the large incumbent The Walt Disney Company. Jonathan Bush tried nimble labor market innovation in healthcare, but was stymied by regulations. So in the ECPR case, Yannopoulos had the beds to care for more cardiac arrest patients, but could not fill those rooms because of a lack of trained healthcare workers. He could not simply offer higher pay. He was part of a larger organization where he had limited decision-rights that reduced his nimble control. (On the importance of decision-rights, see Koch 2007.)

(p. 27) In reality, by the time a patient without a pulse arrives in the E.R., we know what the outcome is going to be. We continue CPR and shock the patient if we can. We insert a breathing tube and connect it to a ventilator. We inject medications: adrenaline, heart-rhythm drugs. But these treatments almost always fail.

. . .

Demetris Yannopoulos, an interventional cardiologist and professor at the University of Minnesota Medical School who created its Center for Resuscitation Medicine, refused to accept that this was the best doctors could do. In 2014, he began performing ECPR, a treatment that was starting to catch on in a few places, mostly in Asia and Europe. To his surprise, patients he didn’t expect to survive ended up doing well.  . . .

When a patient in cardiac arrest is placed on an extracorporeal membrane oxygenation (ECMO) machine, as Sauer was, the treatment is called ECPR. The type of ECMO intervention used in ECPR provides full life support, which means it does the work of both lungs and heart. (Another type of ECMO, used on Covid-19 patients, helps just with breathing.) ECMO evolved from the heart-lung machines that started being used during heart surgery in the 1950s.

. . .

ECPR by itself doesn’t actually cure anything. But by providing fresh blood flow to the brain and other organs, it lets the body rest and gives doctors time to fix the underlying problem, if it’s fixable.  . . .  After patients are hooked up to ECMO, angiograms of their hearts are typically performed to determine whether they have clogged arteries — as about 85 percent do. In Sauer’s case, Yannopoulos found a blockage in his largest heart vessel, the left anterior descending artery, also known as “the widow maker.” He inserted a stent to open it back up.

. . .

(p. 28) Several years after the program started, Yannopoulos, Bartos and their team conducted the first randomized, controlled trial of ECPR. The results were published in The Lancet in 2020 as the ARREST trial.  . . .

After enrolling just 30 patients, the ARREST trial was stopped early by an N.I.H. board because the patients who got ECPR did so much better than the control-group subjects who received standard resuscitation, and it would have been unethical to continue the study. After six months, 43 percent of the 14 patients who got ECPR were alive with good brain function, compared with zero in the control group.

. . .

The Helmsley Trust gave Yannopoulos grants totaling $19.4 million, which enabled him to add this “hub and spoke” mobile component to his program: The university hospital would be the hub, and a truck and some local hospitals would be the spokes. “It was a real big bet,” Panzirer told me.

To reach patients in areas that were more suburban and rural, Yannopoulos first had to team up with surrounding health systems. Competition is more often the norm among health systems, rather than collaboration, but he persuaded his chief executive, James Hereford, to gather his counterparts from other institutions. Eventually, they were willing to work together. But they had to sort out a lot more than simply agreeing to collaborate. How would insurers pay for what they were doing? Would the initial hospital get the money, or would the university hospital? Would malpractice coverage protect doctors outside their own institutions? What about transport?

Every question could be turned into a reason for hospital administrators and lawyers to say no.

. . .

(p. 29) The economics of ECPR are in line with those of other established lifesaving interventions, like dialysis and heart transplants. And if patients don’t survive, ECPR may perfuse their bodies with enough oxygen to keep their organs eligible for donation. The program in Minnesota costs about $3.2 million a year to operate, which is covered by its revenue. This doesn’t include the start-up funding from the Helmsley Trust, however, or the significant groundwork Yannopoulos laid before that — or his personal sacrifices. “When I started, I had hair and my beard was black,” says Yannopoulos, who is mostly bald and gray. For seven years, he was not paid for his ECPR work; some years, he was on call every day. Today, he still spends about 6,500 hours on call annually. “It’s the force of his will more than anything,” Hereford says when explaining why the program has succeeded.

. . .

Yannopoulos has invited physicians from all over to visit his program; afterward, he often hears from them that replicating his work at their home institutions — getting health and E.M.S. systems to collaborate, finding institutional support and start-up funding, coordinating 24/7 staffing — seems too daunting. For these reasons, Yannopoulos regards his ECPR program as “an administrative and political achievement, rather than a scientific or technological one.”

. . .

(p. 30) The trial, called INCEPTION, compared ECPR with standard care across 10 medical centers in the Netherlands. It was the first randomized, controlled trial to look at ECPR across multiple facilities, and unlike the ARREST trial, it found that ECPR resulted in similar survival as standard treatments.  . . .

Yet there are reasons to interpret the study as saying more about the real-world challenges of developing and implementing ECPR programs than it does about the treatment itself. In the INCEPTION trial, it took roughly a half-hour longer for patients to get on an ECMO machine once they arrived at the hospital than it did in the ARREST study. Of the patients who got ECPR, 12 percent were not successfully connected to the machines, compared with zero in ARREST. Several Dutch hospitals handled only a couple of ECPR cases a year, which means they hadn’t yet acquired the right skills. “I think they were destined for failure because of that rollout, with no experience up front,” Bartos says.

Experience matters profoundly: According to a 2022 paper based on data from the Extracorporeal Life Support Organization, an international nonprofit that Robert Bartlett founded, patients treated at centers that perform fewer than 10 ECPR procedures yearly have 64 percent lower odds of survival; for every 10-case increase, the odds go up 11 percent. (The Minnesota program treats about 150 every year.)

Not only does the procedure itself require mastery, but so, too, does the care in the I.C.U. afterward — an ineffable art as much as a precise science.

. . .

(p. 45) . . . it’s not much of a surprise to hear Yannopoulos ask, “What does INCEPTION have to do with what we’re doing?” His program was carefully developed, with deep expertise, over years, to achieve the best outcomes; INCEPTION studied what would happen if a lot of hospitals started doing ECPR tomorrow.

Engineering the ideal ECPR program can feel like a maddening calculus involving experience, availability and distance — all to beat time. To treat patients faster, maybe doctors should go directly to the scene. For more than a decade, doctors in France have been doing just that, performing ECPR on the streets of Paris, in Métro stations, even on the oak parquet floors of the Louvre. Early on, Lionel Lamhaut, the head of Paris’s ECMO team, was told that he was “a cowboy to try to do something outside the hospital.” But as he and his colleagues persisted, they “started a new way of thinking.”

. . .

. . . as much money as the Helmsley Trust has given, it is not enough to overcome some of the structural limitations in the American health care system. The organization funded a multimillion-dollar expansion of the cardiovascular I.C.U. at Yannopoulos’s hospital to add 12 more spacious rooms specifically designed to accommodate patients on ECMO. But on a weekend in January when I visited, the I.C.U. was closed to new ECPR patients: Not enough nurses were available to work, so four beds in the unit were kept empty.

Even as Yannopoulos and his team hit administrative roadblocks like these, they are still trying to redefine what is medically possible. Recently, a 74-year-old man collapsed on the streets of St. Paul and went into cardiac arrest. Forty-two minutes after the first 911 call, the man was already on ECMO and had regained his pulse. Yannopoulos was optimistic about the case, given how quickly ECMO was started, even though the patient had not been shocked with a defibrillator — which meant he technically fell outside the protocol and should not have received ECPR at all. (After a week in the I.C.U., the man died when his family decided to stop all treatment.)

The man’s heart was almost certainly in pulseless electrical activity (P.E.A.), which many experts think should not be treated with ECPR. Of the three published ECPR randomized, controlled trials, only one did not limit the intervention to people with shockable rhythms. That ambitious trial, in Prague, included patients whose hearts were in the same P.E.A. pattern as the St. Paul man’s. The study was stopped early when it appeared that ECPR wasn’t saving significantly more people than standard care was. These enigmatic cases that lack shockable rhythms are vexing: When the Prague data was reanalyzed without these patients, the findings were favorable for ECPR.

Yannopoulos is undeterred by the Prague results. “You have to decide what’s more important: your survival rate” — what is often used in studies and by institutions to justify support for a program — “or the number of patients you actually save.” Because its program is now well established, Yannopoulos’s team is starting to treat patients with less promising rhythms, even though that may drive down its overall survival rate.  . . .

Yannopoulos wonders if, in a decade or perhaps less, ECPR science will still require the same specially trained teams using the same high-tech equipment — at least before patients get to the hospital. Instead, he imagines small cannulas that will be easy to place in the patient’s neck and attached to compact, simple machines that provide some blood flow to the brain. In his vision, which he is currently working to realize, medics could be trained to start people on this, and then doctors could transition them to regular ECMO once they reach the hospital. If the brain is protected, the rest of the body can eventually recover.

. . .

“There is this idea that people in cardiac arrest, you cannot harm them,” Yannopoulos says. For some doctors, that means cycling relentlessly through chest compressions and medications, so they feel as if they did everything they could. For others, it means briefly going through the motions, so they feel as if they did something. And for still others, it has always seemed kindest to do nothing at all, to let their patients die peacefully. Because almost none of them lived — no matter what the doctors did. “But now we know what is possible,” Yannopoulos says. “So if you’re not achieving that, then you are harming them in a way, right?”

For the full story see:

Helen Ouyang. “Reinventing CPR.” The New York Times Magazine (Sunday, March 31, 2024): 22-31 & 45.

(Note: ellipses added.)

(Note: the online version of the story was updated June [sic] 19, 2024, and has the title “The Race to Reinvent CPR.”)

Some references relevant to my discussion at the start of this entry are:

Bush, Jonathan, and Stephen Baker. Where Does It Hurt?: An Entrepreneur’s Guide to Fixing Health Care. New York: Portfolio, 2014.

DeVita, Vincent T., and Elizabeth DeVita-Raeburn. The Death of Cancer: After Fifty Years on the Front Lines of Medicine, a Pioneering Oncologist Reveals Why the War on Cancer Is Winnable–and How We Can Get There. New York: Sarah Crichton Books, 2015.

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Klein, Gary A. Seeing What Others Don’t: The Remarkable Ways We Gain Insights. Philadelphia, PA: PublicAffairs, 2013.

Klein, Gary A. Sources of Power: How People Make Decisions. 20th Anniversary ed. Cambridge, MA: The MIT Press, 2017.

Klein, Gary A. Streetlights and Shadows: Searching for the Keys to Adaptive Decision Making. Cambridge, MA: The MIT Press, 2009.

Koch, Charles G. The Science of Success: How Market-Based Management Built the World’s Largest Private Company. Hoboken, NJ: Wiley & Sons, Inc., 2007.

Silberner, Joanne. “How a Plunger Improved CPR.” The New York Times (Tues., June 27, 2023): D5.

Taleb, Nassim Nicholas. Skin in the Game: Hidden Asymmetries in Daily Life. New York: Random House, 2018.

Vardi, Nathan. For Blood and Money: Billionaires, Biotech, and the Quest for a Blockbuster Drug. New York: W. W. Norton & Company, 2023.

For Nov. 5 Vote Diamond Ponders Deregulation of Entrepreneurs, Survival of Israel, Defense of Freedom of Speech

Art Diamond on 9/26/24 with red Nebraska sign.

I requested a red Nebraska sign that was delivered yesterday. Our Omaha district is sometimes called “the blue dot” because it sometimes votes against the rest of red Nebraska. To decide what to do on Nov. 5, I mostly ask three questions. Who will most reduce regulations so that entrepreneurs can create the goods and services that allow us to flourish? Who will stand firm for the survival of the freedom sanctuary that is Israel? And especially, who will stand firm for the nonpoliticized rule of law and for freedom of speech?

Is Longevity Constrained by Nature or by Government Regulations?

I am a longevity optimist. If regulatory constraints are loosened, I believe entrepreneurs will bring us quicker progress.

(p. A12) S. Jay Olshansky, who studies the upper bounds of human longevity at the University of Illinois Chicago, believes people shouldn’t expect to live to 100.

. . .

Kaare Christensen, co-author of a paper predicting most newborns born in the 2000s would live to 100 if medical progress continued, said it is too soon to know who is right. Future advances could make up for stalled life expectancy gains.

“The setback could be temporary,” he said.

Christensen, who runs studies on very old people at the Danish Aging Research Center in Denmark, said people in their 90s have better cognitive function and healthier teeth over their lifetimes than counterparts of the same age born just 10 years earlier.

“I would say prepare for your 90s instead,” Christensen said.

Old-age debate

Olshansky’s foray into the limits of lifespan began in 1990 when he published a paper in Science stating that life expectancy wouldn’t rise dramatically even if diseases including cancer and heart disease are eliminated. He has been fighting about it ever since.

James Vaupel, a demographer, pushed back. In a 2021 paper, Vaupel pointed to statistics showing that since around 1840 life expectancy at birth has increased almost 2.5 years per decade in some countries.

Vaupel and Olshansky published dueling papers over the decades until Vaupel’s death at age 76 in 2022.

Steven Austad, a professor of biology at the University of Alabama at Birmingham, was asked at a 2001 scientific meeting when he thought the first person to live to 150 would be born. “I think that person is already alive,” Austad replied. Austad said he based his answer on optimism that scientists will figure out how to change the biology of aging.

When Olshansky heard about the exchange, he bet Austad that wasn’t true. In 150 years, he argued, there still wouldn’t be a person alive at 150. The men wagered $150 each, which they put in a fund to pay out in 150 years, with the winner’s heirs to reap the profit. A decade ago, they each added another $150 to the account.

Austad said he agreed with Olshansky that most newborns born now won’t live to 100. But he thinks his optimism that someone will live to 150 is justified. He pointed to a study showing the compound rapamycin extended the lifespan of mice, even if they start getting it later in life. Some longevity enthusiasts are taking rapamycin themselves. Studies on other potentially antiaging compounds are under way.

“If any turn out to work,” Austad said, “they will win my bet for me.”

For the full story see:

Amy Dockser Marcus. “Live Until 100? Our Chances Are Slim.” The Wall Street Journal (Wednesday, July 17, 2024): A12.

(Note: ellipsis added.)

(Note: the online version of the story has the date July 11, 2024, and has the title “Think You Will Live to 100? These Scientists Think You’re Wrong.”)

The paper co-authored by Christensen and mentioned above, is:

Christensen, Kaare, Gabriele Doblhammer, Roland Rau, and James W. Vaupel. “Ageing Populations: The Challenges Ahead.” Lancet 374, no. 9696 (Oct. 3, 2009): 1196-208.

The 2021 paper co-authored by Vaupel and mentioned above, is:

Vaupel, James W., Francisco Villavicencio, and Marie-Pier Bergeron-Boucher. “Demographic Perspectives on the Rise of Longevity.” Proceedings of the National Academy of Sciences 118, no. 9 (2021): e2019536118.

United Nations “Innovation Matters” Podcast Posts Second Part of Episode on Diamond’s Openness to Creative Destruction

Innovation history and policies continue to be the themes of this second part of my conversation with Lars Anders Joensson on the United Nations’s Innovation Matters podcast. The discussion of “Innovation Matters: Innovative Dynamism” is mostly related to the process of innovative dynamism as discussed in my book Openness to Creative Destruction. Anders was especially energized in this second part of the conversation. (Recorded Weds., Aug. 3, 2022; posted Thurs., Sept. 19, 2024.) [Links to first part of podcast conversation.]

Part 2 is available on: SoundCloud, Spotify, Apple Music, Amazon Music.

Volcanoes Release Enough Carbon Dioxide to Raise the Temperature by 60 Degrees

So an Oxford geologist finds that “volcanoes release vast amounts of carbon dioxide” and that release is mostly a good thing since without it the Earth “would chill by nearly 60 degrees.” Environmentalists are stressing that the temperature of the Earth may go up by a few degrees. Imagine how the environmentalists would stress if the volcanoes stopped releasing carbon dioxide and the temperature started going down by 60 degrees. That would indeed be something to stress about.

(p. 8) Tamsin Mather, a geologist at the University of Oxford, has no such difficulty. She has spent her career visiting volcanoes to understand how they work, and she has come to see Earth not as a peaceful world encased in a stable crust, but a globe of barely contained geological storms.

“Adventures in Volcanoland” is organized around trips Mather has taken throughout her career, starting with Vesuvius, which she first visited as a child on a family vacation. Next comes the Nicaraguan volcano Masaya, which she studied as a graduate student, and then volcanoes on other continents.

. . .

In her own research, Mather has specialized in measuring the gases that volcanoes emit. Even when they’re not erupting, volcanoes release vast amounts of carbon dioxide. Without that heat-trapping gas, an icehouse effect would replace the greenhouse effect, and the planet’s temperature would chill by nearly 60 degrees.

For the most part, Earth is able to keep its climate stable. While volcanoes warm the planet, chemical reactions draw off carbon dioxide from the air, ultimately delivering it deep underground.

This planetary thermostat is not enough to keep volcanoes from periodically unleashing hell, though. Vast eruptions may be responsible for most of the mass extinctions in life’s history.

For the full review see:

Carl Zimmer. “Lava Lamp.” The New York Times Book Review (Sunday, August 11, 2024): 8.

(Note: ellipsis added.)

(Note: the online version of the review has the date June 19, 2024, and has the title “The Eternal Pull of the Fascinating, Deadly Volcano.”)

The book under review is:

Mather, Tamsin. Adventures in Mather, Tamsin. Adventures in Volcanoland: What Volcanoes Tell Us About the World and Ourselves. New York: Hanover Square Press, 2024.

Diet Low in Fat and Sugar May Have Helped Morera Become Oldest Person in World

But at least it appears that she was able to keep drinking coffee. She also apparently embraced new technology and stayed intellectually sharp (maybe the coffee helped ;).

(p. A1) Maria Branyas Morera, an American-born Spanish woman believed to be the oldest person in the world, died on Monday [Aug. 19, 2024] in Olot, Spain. She was 117.

Her family wrote in a post on her X account that she had died in her sleep. She had been living in a nursing home.

“A few days ago she told us: ‘One day I will leave here. I will not try coffee again, nor eat yogurt, nor pet my dog,’” her family wrote in Catalan in the post. “‘I will also leave my memories, my reflections, and I will cease to exist in this body. One day I don’t know, but it’s very close, this long journey will be over.’”

. . .

Having been born before the emergence of the telephone, Ms. Branyas came to embrace the digital revolution, fashioning herself on social media as “Super Àvia Catalana,” or “Super Catalan Grandma.” She posted bite-size pieces of life advice, observations and jokes to thousands of followers.

In her biography on X, she wrote, “I’m old, very old, but not an idiot.”

. . .

Like many supercentenarians, Ms. Branyas became the subject of scientific fascination. Dr. Esteller, the researcher who studied her genetics and lifestyle, found that her genes were protective against DNA damage, and that she had low levels of fat and sugar in her blood — all of which he said was helpful for living a long life. His research also found that her cells aged much slower than she did, meaning that she had a lower “biological age” than her actual age.

The Catalan diet, which is similar to the Mediterranean diet and includes a lot of olive oil, has also been linked to longer survival, he said. He added that Ms. Branyas liked to eat yogurt.

“What do you expect from life?” a doctor once asked Ms. Branyas while retrieving blood samples for study, according to El País.

Ms. Branyas, unmoved, answered simply: “Death.”

For the full obituary see:

Ali Watkins. “Maria Branyas Morera, 117; Was Oldest Person in the World.” The New York Times (Friday, August 23, 2024): B11.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the obituary was updated Aug. 22, 2024, and has the title “Maria Branyas Morera, World’s Oldest Person, Dies at 117.”)