Category: Entrepreneurship

How Did Ed Smylie and His Team Create the Kludge That Saved the Crew of Apollo 13?

Gary Klein in Seeing What Others Don’t analyzed cases of innovation, and sought their sources. One source he came up with was necessity. His compelling example was the firefighter Wag Dodge who, with maybe 60 seconds until he would be engulfed in flame, lit a match to the grass around him, and then laid down in the still-hot embers. The roaring fire bypassed the patch he pre-burned, and his life was saved. The story is well-told in Norman Maclean’s Young Men and Fire.

Pondering more cases of necessity might be useful to help us understand, and encourage, future innovation. One candidate might be the kludge that Ed Smylie and his engineers put together to save the Apollo 13 crew from suffocating after an explosion blew up their command capsule oxygen tank.

Necessity may be part of it, but cannot be the whole story. Humanity needed to fly for thousands of years, but it took Wilbur Wright to make it happen. (This point is made in Kevin Ashton’s fine and fun How to Fly a Horse.)

I have ordered the book co-authored by Lovell, and mentioned in a passage quoted below, in case it contains insight on how the Apollo 13 kludge was devised.

(p. B11) Ed Smylie, the NASA official who led a team of engineers that cobbled together an apparatus made of cardboard, plastic bags and duct tape that saved the Apollo 13 crew in 1970 after an explosion crippled the spacecraft as it sped toward the moon, died on April 21 [2025] in Crossville, Tenn. He was 95.

. . .

Soft-spoken, with an accent that revealed his Mississippi upbringing, Mr. Smylie was relaxing at home in Houston on the evening of April 13 when Mr. Lovell radioed mission control with his famous (and frequently misquoted) line: “Uh, Houston, we’ve had a problem.”

An oxygen tank had exploded, crippling the spacecraft’s command module.

Mr. Smylie, . . ., saw the news on television and called the crew systems office, according to the 1994 book “Lost Moon,” by Mr. Lovell and the journalist Jeffrey Kluger. The desk operator said the astronauts were retreating to the lunar excursion module, which was supposed to shuttle two crew members to the moon.

“I’m coming in,” Mr. Smylie said.

Mr. Smylie knew there was a problem with this plan: The lunar module was equipped to safely handle air flow for only two astronauts. Three humans would generate lethal levels of carbon dioxide.

To survive, the astronauts would somehow need to refresh the canisters of lithium hydroxide that would absorb the poisonous gases in the lunar excursion module. There were extra canisters in the command module, but they were square; the lunar module ones were round.

“You can’t put a square peg in a round hole, and that’s what we had,” Mr. Smylie said in the documentary “XIII” (2021).

He and about 60 other engineers had less than two days to invent a solution using materials already onboard the spacecraft.

. . .

In reality, the engineers printed a supply list of the equipment that was onboard. Their ingenious solution: an adapter made of two lithium hydroxide canisters from the command module, plastic bags used for garments, cardboard from the cover of the flight plan, a spacesuit hose and a roll of gray duct tape.

“If you’re a Southern boy, if it moves and it’s not supposed to, you use duct tape,” Mr. Smylie said in the documentary. “That’s where we were. We had duct tape, and we had to tape it in a way that we could hook the environmental control system hose to the command module canister.”

Mission control commanders provided step-by-step instructions to the astronauts for locating materials and building the adapter.

. . .

The adapter worked. The astronauts were able to breathe safely in the lunar module for two days as they awaited the appropriate trajectory to fly the hobbled command module home.

. . .

Mr. Smylie always played down his ingenuity and his role in saving the Apollo 13 crew.

“It was pretty straightforward, even though we got a lot of publicity for it and Nixon even mentioned our names,” he said in the oral history. “I said a mechanical engineering sophomore in college could have come up with it.”

For the full obituary, see:

Michael S. Rosenwald. “Ed Smylie Dies at 95; His Team of Engineers Saved Apollo 13 Crew.” The New York Times (Tuesday, May 20, 2025): B11.

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

(Note: the online version of the obituary was updated May 18, 2025, and has the title “Ed Smylie, Who Saved the Apollo 13 Crew With Duct Tape, Dies at 95.”)

Klein’s book that I praise in my introductory comments is:

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

Maclean’s book that I praise in my introductory comments is:

Maclean, Norman. Young Men and Fire. new ed., Chicago: University of Chicago Press, 2017.

Ashton’s book that I praise in my introductory comments is:

Ashton, Kevin. How to Fly a Horse: The Secret History of Creation, Invention, and Discovery. New York: Doubleday, 2015.

The book co-authored by Lovell and mentioned above is:

Lovell, Jim, and Jeffrey Kluger. Lost Moon: The Perilous Voyage of Apollo 13. Boston, MA: Houghton Mifflin, 1994.

If Universities Disbanded Would Learning and Discovery Cease?

The university is a medieval institution that in many ways in recent decades has become less efficient and less supportive of diversity of ideas. some analysts are calling for fundamental change in universities, maybe even the defunding of universities and the creation of alternative institutions to carry out the legitimate functions of universities. See Richard Vedder’s recent book Let Colleges Fail.

What are those functions? The two most important are 1) educate and 2) create new knowledge. Some, e.g., Christensen and Eyring in The Innovative University, identify a third function as providing a memorable and enjoyable early-adulthood experience of peer-camaraderie.

If universities were disbanded, could these functions be well-done by other institutions? Philip Hamburger in a passage quoted below points out that a huge store of diverse knowledge is now available on through the internet. Some of it is especially designed to help teach a variety of subjects at a variety of levels. With a basic knowledge of reading and of how to access the internet, the dedicated autodidact is not limited in what he can learn.

If universities were disbanded, could the creation of new knowledge continue? Here there is even greater uncertainty, but we have some proofs of concept of how alternative institutions and activities might fill the gap. In the early days of the Royal Society many of the members were not associated with any university. Many members pursued science in their spare time, with their own funds.

New forms of peer review could be tried that might allow anyone the chance to participate as citizen scientists. The new Journal of the Academy of Public Health will publish peer review comments along with the original article. Many scholars and citizen scientists are finding Substack a fruitful platform for publishing their ideas. Substack calls itself “a new economic engine for culture.”

Much science has been done, and can still be done, in entrepreneurial ventures and in industry. Terence Kealey documented the history and made the case. More science would be done by those seeking practical applications, and less by those seeking useless, but pretty, theory. Milton Friedman condemned NSF funding of economics, because it made economics too mathematical.

Science would be more highly valued and would produce more value.

(p. A15) Academic institutions think they have a problem and that its name is Donald Trump. But he’s only the beginning of their problems. The difficulties are systemic, not only legal or political, and that means it’s time to reconsider what higher education should look like.

. . .

. . ., although today the immediate threat comes from the Trump administration, academic institutions are fragile because knowledge is now available through the internet and artificial intelligence. For balanced inquiry, even academics increasingly look outside their universities.

For the full commentary see:

Philip Hamburger. “Don’t Just Fix Higher Education, Reconstitute It.” The Wall Street Journal (Tues., June 3, 2025): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 2, 2025, and has the same title as the print version.)

The sources mentioned in my comments are:

Christensen, Clayton M., and Henry J. Eyring. The Innovative University: Changing the DNA of Higher Education from the inside Out. San Francisco, CA: Jossey-Bass, 2011.

Friedman, Milton. “An Open Letter on Grants” Newsweek, May 18, 1981, 99.

Kealey, Terence. The Economic Laws of Scientific Research. New York: St. Martin’s Press, 1996.

Vedder, Richard. Let Colleges Fail: The Power of Creative Destruction in Higher Education. Oakland, CA: Independent Institute, 2025.

Kennedy Defends Patients’ Freedom to Try “Experimental Therapies”

I agree with Kennedy that people with diseases or conditions that cannot be cured by mainstream medicine have the right try experimental therapies, and should be allowed what some are calling “health freedom.” For those who want certification of safety, private labels would emerge if the government exited from its role of allowing or banning. In the unregulated supplement business, multiple such organizations exist, e.g., the United States Pharmacopeial Convention (USP).

If the public decides the Kennedy/Diamond position is too radical, a step in the right direction would be for the government to provide informational certification of therapies or providers, but not to mandate that patients use only those therapies and providers.

(p. A1) Health Secretary Robert F. Kennedy Jr. recently declared that he wanted to expand access to experimental therapies but conceded that they could be risky or fraudulent.

In a podcast with Gary Brecka, who describes himself as a longevity expert, Mr. Kennedy vowed to end what he called the Food and Drug Administration’s war with alternative medicine. He said that would include stem cells, vitamins, peptides and chelation therapy, which involves removing heavy metals from the blood.

“If you want to take an experimental drug — you can do that, you ought to be able to do that,” Mr. Kennedy said.

“And of course you’re going to get a lot of charlatans, and you’re going to get people who have bad results,” he added. “And ultimately, you can’t prevent that either way. Leaving the whole thing in the hands of pharma is not working for us.”

Mr. Kennedy cited his own experience at a clinic in Antigua, where he said he received a stem cell treatment that “enormously” eased his neurological condition, spasmodic dysphonia, which affects his voice and has few treatment options.

. . .

(p. A11) Neither Mr. Kennedy nor the F.D.A. has released a formal plan to change agency standards for stem cell treatments, which have typically been reviewed by the agency as individual therapies to treat a specific disease.

Widening overall access could also happen informally if the agency decided to relax enforcement, an approach the F.D.A. used in the past to indicate that it wouldn’t crack down on unauthorized products. During the pandemic, for example, the agency allowed providers to retrofit infusion pumps and ventilators to treat hordes of sick patients.

. . .

Dr. Moreno and his colleagues found that the trials with funding from the red meat industry were nearly four times as likely to report favorable or neutral cardiovascular results after eating unprocessed red meat when compared with the studies with no such links.

. . .

“We don’t want to have the Wild West,” Mr. Kennedy said. “We want to make sure that information is out there. But we also want to respect the intelligence of the American people — the capacity of people who explore the outcomes that are going to benefit them the most.”

. . .

The field of stem cell treatments is so complex that the Harvard Medical School created a free course to help doctors navigate patient questions, said Insoo Hyun, the director of life sciences at the Museum of Science in Boston.

. . .

Some providers sidestep the costly, yearslong process of careful work that can lead to an F.D.A. approval. Among them is Dr. Chadwick Prodromos, a Chicago doctor who offers stem cell treatments in Antigua. Mr. Kennedy welcomed him warmly at the March meeting, Dr. Raizman recalled. Reached for comment, Dr. Prodromos’s office said that he was in Antigua doing treatments and was not available.

. . .

A website for Dr. Prodromos’s clinic says that he and colleagues offer injections in Antigua into the joints, back, neck, scalp, penis and pelvic floor for an array of conditions including autism, thinning hair and lupus. He uses AlloRX cells, which are derived from the umbilical cord, in a manner that in the United States would require an F.D.A.-cleared clinical trial.

People can seek out unregulated treatments using their own cells that are processed, purified and amplified in different ways. They can also find treatments using others’ cells that vary widely in quality and sterility.

Some low-quality clinics process cells in a back room, which is the opposite of a clinical-grade cell processing site. Dr. Hyun said he recently toured one in the Netherlands that used specialized air filtering, layers of gowns and a ban on bacteria-laden cellphones in their sterile area. “It’s kind of like you’re entering a space station,” he said.

For the full story see:

Christina Jewett. “‘Charlatans’ No Reason to Curb Untested Drugs, Kennedy Says.” The New York Times (Fri., June 6, 2025): A1 & A11.

(Note: ellipses added.)

(Note: the online version of the story has the date June 5, 2025, and has the title “Kennedy Says ‘Charlatans’ Are No Reason to Block Unproven Stem Cell Treatments.”)

Computer Chip Industrial Policy Subsidies Are an Unfair Waste of Taxpayer Funds

An “industrial policy” occurs when the federal government attempts to pick a technology that will be important in the future, and then subsidize it. T.J. Rodgers is an insider in the computer chip industry and has written a credible op-ed analyzing two attempts at industrial policy in his industry, the Sematech consortium in 1987, and the Chips and Science Act in 2022.

He makes a compelling case that Sematech did not work and that the Chips and Science Act is not working either.

Rodgers gives us more evidence that Secretary of the Treasury and Harvard President Larry Summers was right when he wrote “the government is a crappy venture capitalist.”

If the feds’ industrial policy on computer chips has failed, why do we think its industrial policy on cancer cures will succeed? (Nixon and Biden’s cancer “moonshots” amounted to picking, and then subsidizing, what they hoped would be cancer cures.)

By the way, when Rodgers stood up against welfare to his industry, he appears to have been an exemplar of Robert Nozick’s ideal CEO: maximizing profits subject to ethical side-constraints.

(p. A15) My mother was a fifth-grade teacher in Oshkosh, Wis. She earned $25,000 a year. Why should chip companies, some of the wealthiest corporations in the world, take money from her and other ordinary citizens? Today’s massive $280 billion Chips and Science Act of 2022, the latest semiconductor welfare program, is even less justified than Sematech was.

. . .

To my knowledge, Sematech contributed nothing of note to U.S. semiconductor technology. Its Final Report in 1997 served up platitudes about “catching up with Japan” and fostering “industry cooperation.”

Decades later, the Semiconductor Industry Association—now a group of lobbyists in Washington—began “saving” the chip industry again. This time the target is China, despite the fact that its best wafer foundry is SMIC, an also-ran in the foundry business. China is less a competitive threat today than Japan was in 1987.

. . .

Today, 100 high-performance computers can be put on one chip. The companies that know how to design 100-billion-transistor chips for a critical function such as artificial intelligence are much more valuable than the companies that carve commodity chips out of silicon wafers, like those in China. While the biggest chip-manufacturing company in China is worth $54 billion, a single U.S. chip company, Nvidia, is worth $3.4 trillion—58 times as much—and it doesn’t even make its own chips. Why are we doing this again?

For the full commentary see:

T.J. Rodgers. “Semiconductor Subsidies? Tried and Failed.” The Wall Street Journal (Weds., June 4, 2025): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 3, 2025, and has the same title as the print version.)

Robert Nozick discusses ethical side constraints in:

Nozick, Robert. Anarchy, State, and Utopia. New York: Basic Books, Inc., 1974.

The Newest A.I. “Reasoning Models Actually Hallucinate More Than Their Predecessors”

I attended an I.H.S. Symposium last week where one of my minor discoveries was that a wide range of intellectuals, regardless of location on the political spectrum, share a concern for the allegedly damaging labor market effects of A.I.  As in much else I am an outlier–I am not concerned about A.I.

But since so many are concerned, and believe A.I. undermines my case for a better labor market under innovative dynamism, I will continue to occasionally highlight articles that present the evidence and arguments that reassure me.

(p. B1) “Humanity is close to building digital superintelligence,” Altman declared in an essay this week, and this will lead to “whole classes of jobs going away” as well as “a new social contract.” Both will be consequences of AI-powered chatbots taking over all our white-collar jobs, while AI-powered robots assume the physical ones.

Before you get nervous about all the times you were rude to Alexa, know this: A growing cohort of researchers who build, study and use modern AI aren’t buying all that talk.

The title of a fresh paper from Apple says it all: “The Illusion of Thinking.” In it, a half-dozen top researchers probed reasoning models—large language models that “think” about problems longer, across many steps—from the leading AI labs, including OpenAI, DeepSeek and Anthropic. They found little evidence that these are capable of reasoning anywhere close to the level their makers claim.

. . .

(p. B4) Apple’s researchers found “fundamental limitations” in the models. When taking on tasks beyond a certain level of complexity, these AIs suffered “complete accuracy collapse.” Similarly, engineers at Salesforce AI Research concluded that their results “underscore a significant gap between current LLM capabilities and real-world enterprise demands.”

Importantly, the problems these state-of-the-art AIs couldn’t handle are logic puzzles that even a precocious child could solve, with a little instruction. What’s more, when you give these AIs that same kind of instruction, they can’t follow it.

. . .

Gary Marcus, a cognitive scientist who sold an AI startup to Uber in 2016, argued in an essay that Apple’s paper, along with related work, exposes flaws in today’s reasoning models, suggesting they’re not the dawn of human-level ability but rather a dead end. “Part of the reason the Apple study landed so strongly is that Apple did it,” he says. “And I think they did it at a moment in time when people have finally started to understand this for themselves.”

In areas other than coding and mathematics, the latest models aren’t getting better at the rate that they once did. And the newest reasoning models actually hallucinate more than their predecessors.

For the full commentary see:

Christopher Mims. “Keywords: Apple Calls Today’s AI ‘The Illusion of Thinking’.” The Wall Street Journal (Sat., June 14, 2025): B1 & B4.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 13, 2025, and has the title “Keywords: Why Superintelligent AI Isn’t Taking Over Anytime Soon.” In the original print and online versions, the word “more” appears in italics for emphasis.)

Sam Altman’s blog essay mentioned above is:

Altman, Sam. “The Gentle Singularity.” In Sam Altman blog, June 10, 2025, URL: https://blog.samaltman.com/the-gentle-singularity.

The Apple research article briefly summarized in a passage quoted above is:

Shojaee, Parshin, Iman Mirzadeh, Keivan Alizadeh, Maxwell Horton, Samy Bengio, Mehrdad Farajtabar. “The Illusion of Thinking: Understanding the Strengths and Limitations of Reasoning Models Via the Lens of Problem Complexity.” Apple Machine Learning Research, June 2025, URL: https://machinelearning.apple.com/research/illusion-of-thinking.

Puzzling Studies Claim Economic Downturns Encourage Innovation

A recent paper co-authored by Talay joins several other studies (e.g., Anthony 2009 and Field 2011) in claiming that economic downturns encourage economic innovation.

I have always found these studies deeply puzzling. When I acquire infinite time, I plan to hunker down and try to figure out what is going on.

My initial hypothesis is that downturns do not actually help innovators, but that those entrepreneurs who persist in bringing new goods to market during a downturn either have higher levels of perseverance or else have better new goods.

In other words the puzzling results are due to a selection issue–other things are not equal, and downturns do not encourage innovation.

The WSJ article that summarizes the recent paper is:

Lisa Ward. “When a Recession Helps Product Launch.” The Wall Street Journal (Tues., June 17, 2025): B6.

(Note: the online version of the WSJ article has the date June 12, 2025, and has the title “Yes or No: It’s Smart to Launch a New Product in a Recession.”)

The recent academic published paper co-authored by Talay and summarized in The Wall Street Journal article mentioned and cited above is:

Talay, M. Berk, Koen Pauwels, and Steven H. Seggie. “Why and When to Launch New Products During a Recession: An Empirical Investigation of the U.K. FMCG Industry and the U.S. Automobile Industry.” Journal of the Academy of Marketing Science 52, no. 2 (March 2024): 576-98.

The two books cited above that support the claim that downturns encourage innovation are:

Anthony, Scott D. The Silver Lining: An Innovation Playbook for Uncertain Times. Boston, MA: Harvard Business School Press, 2009.

Field, Alexander J. A Great Leap Forward: 1930s Depression and U.S. Economic Growth, Yale Series in Economic and Financial History. New Haven, CT: Yale University Press, 2011.

Citizen Scientist Tim Friede Is Now “Director of Herpetology” at Centivax Startup

An earlier blog entry told the story, quoting The New York Times, of citizen scientist Tim Friede who injected himself with venom from multiple snakes, and allowed many to bite him, in order to develop antibodies that would protect him from all snake bites, and allow scientist Jacob Glanville to create a universal snakebite antivenom.

Now The Wall Street Journal has run a similar story, but adds a minor satisfying twist. The scientist Jacob Glanville has co-founded a startup called Centivax to develop the universal antivenom, and Friede is Centivax’s “director of herpetology.”

The Wall Street Journal article is:

Nidhi Subbaraman. “A Universal Antivenom, From a Man Bitten by Snakes 200 Times.” The Wall Street Journal (Sat., June 14, 2025): C5.

(Note: the online version of the WSJ article has the date June 10, 2025, and has the title “A Man Let Snakes Bite Him 200 Times. His Blood Inspired a Universal Antivenom.”)

Development of IVF Took 10 Years of Trial and Error

If the Joy television movie accurately reflects the history of the development of IVF (in vitro fertilization) then it illustrates a couple of themes that are important. One is the frequent fruitfulness of trial-and-error experimentation. The other is that some medical entrepreneurs are motivated by having some form of ‘skin-in-the-game,’ in this case nurse Jean Purdy. (Support for the second theme is more speculative than for the first, since the evidence that the real Jane Purdy experienced endometriosis and infertility is circumstantial.)

(p. A10) “Joy,” . . . begins in 1968 and charts the 10-year journey of trial, error and more trial and error by an odd trio of pioneers: Bob Edwards (James Norton), a biologist and true-believer in the possibilities of IVF; Patrick Steptoe (Bill Nighy), a surgical obstetrician who is less than convinced but can be; and Jean Purdy (Thomasin McKenzie), a nurse who signs on as Bob’s assistant and, as we learn, has her own agenda regarding infertile women. (Edwards received the 2010 Nobel Prize in Medicine, his partners having passed away.)

Jack Thorne’s screenplay massages the IVF medical story into a personal one, mostly about Jean, who is portrayed as a critical member of the team and the one whose life reflects the social uproar over the mission—giving childless women a choice about becoming mothers.

For the full television review see:

John Anderson. “The Birth of a Medical Miracle.” The Wall Street Journal (Monday, Nov 22, 2024): A10.

(Note: ellipsis added.)

(Note: the online version of the television review has the date November 21, 2024, and has the title “‘Joy’ Review: The Birth of a Medical Miracle on Netflix.”)

Impact of Weight Loss Drugs Underlines the Importance of Serendipity and Medical Entrepreneurship

The story of the creation of the weight loss drugs involves a fair amount of serendipity and medical entrepreneurship. A case has been made that we would have had these drugs 25 years sooner if Pfizer had not abandoned the development of their version due to the dauntingly huge costs of drug development. Recall that the largest component of those huge costs are the mandated Phase 3 randomized double-blind clinical trials.

Almost everyone now views these drugs as a major medical advance. The question is: how big? According to the reviewer quoted below, Dr. Eric Topol speculates: very big indeed. He raises the possibility that to improve lifespan and healthspan eventually most of us will be on one of these drugs.

If so then the weight loss drugs will be even more compelling examples of the importance of regulating so as to allow entrepreneurs to take quick advantage of serendipity. How many lives were lost that could have been saved, how much suffering was experienced that could have been avoided, if over-regulation by the F.D.A. had not delayed the availability of these drugs by 25 years?

(p. A13) More than half of American adults suffer from at least one chronic illness—most commonly diabetes, heart disease, cancer or neurodegeneration. By age 65, 80% are afflicted with two or more conditions. Among those fortunate enough to reach 80, it’s rare to find anyone who has arrived unscathed. In 2008 a group of scientists at the Scripps Research Institute in San Diego set out to recruit 1,400 of these healthy souls—known as the Wellderly—to figure out how they managed it.

Led by the cardiologist Eric Topol, the researchers hoped to identify the genetic factors associated with healthy aging. To their surprise, they found little in the DNA that stood out. They did, however, notice several striking traits. Compared with their peers, the disease-free subjects were generally thinner, exercised more frequently and seemed “remarkably upbeat,” often with rich social lives. These observations encouraged the research team to think about longevity (years of life) and healthspan (years of health) more broadly. In “Super Agers” Dr. Topol shares the results of this intellectual exploration.

. . .

Expensive new weight-loss drugs like Ozempic and Zepbound, Dr. Topol writes, have “extraordinary potential to promote health span.” In addition to stanching appetite, these drugs also seem to rapidly reduce harmful inflammation—an effect that “precedes and is independent of weight loss.” In the future, the author believes it’s “conceivable that most people will be taking” such medications, . . .

For the full review see:

David A. Shaywitz. “Bookshelf; Living the Good Life.” The Wall Street Journal (Wednesday, May 7, 2025): A13.

(Note: ellipses added.)

(Note: the online version of the review has the date May 6, 2025, and has the title “Bookshelf; ‘Super Agers’: Living the Good Life.”)

The book under review is:

Topol, Eric. Super Agers: An Evidence-Based Approach to Longevity. New York: Simon & Schuster, 2025.

Correll Managed Georgia-Pacific Well and Then Used Those Skills to Save a Failing Hospital

In my Openness book, I make the case for the many benefits of an economic system of innovative dynamism. One of the lesser, but still important, benefits was first identified by Joseph Schumpeter. He argued for a spillover effect of innovative dynamism. The skills, knowledge, and technologies created by innovative entrepreneurs in the for-profit sector of the economy, are also applied and imitated in the nonprofit and government sectors. So where there is innovative dynamism, not only is the market more creative and efficient, but both the nonprofit and the government sectors are more creative and efficient.

A good example may be Pete Correll who acted entrepreneurially as CEO of Georgia-Pacific to bring more stability to the business by acquiring the James River Corporation, maker of Quilted Northern, and guided the Georgia-Pacific firm through years of lawsuits over asbestos. He eventually sold Georgia-Pacific to Koch Industries, Inc. My impression is that Charles Koch then applied his market-based management system to make the Georgia-Pacific part of his business much more efficient and innovative. [Query: does Koch’s achievement undermine my claim that Pete Correll had acted entrepreneurially in his earlier management of Georgia-Pacific? Or can both Correll and Koch have been good manager/entrepreneurs, but in different ways at different times?]

But according to his obituary in the WSJ, his greatest achievement may have been in taking over a near-bankrupt Atlanta public (aka government) hospital, reorganizing it from government to nonprofit, and modernizing its management and technology.

Carrell’s obituary in the WSJ:

James R. Hagerty. “CEO Helped Save A Public Hospital.” The Wall Street Journal (Sat., June 5, 2021 [sic]): A9.

(Note: the online version of the WSJ obituary has the date June 2, 2021 [sic], and has the title “Retired CEO Saved an Atlanta Public Hospital.”)

For Charles Koch’s entrepreneurial market-based management system see:

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

My book mentioned in my initial comments is:

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

It May Take a “Thorny Character” to Be “Willing to Challenge Entire Establishment Belief Systems”

The obituary quoted below misidentifies Richard Bernstein’s main contribution. Yes, it is noteworthy that he was probably the first diabetes sufferer to effectively and continually monitor his own blood glucose level. But his main contribution was that by careful self-monitoring and trial-and-error experimentation he discovered that his health improved when he cutback on both carbs and insulin.

The obituary writer quotes Gary Taubes, but either didn’t read his book or disagrees with it, because Taubes is clear about Bernstein’s main contribution.

I am halfway through Taubes’s book. It is long and sometimes deep in the weeds, but comes highly recommended by Marty Makary and Siddhartha Mukherjee, both of whom I highly respect. The book sadly highlights how mainstream medicine can be very slow to reform clinical practice to new knowledge.

(p. C6) Richard Bernstein was flipping through a medical trade journal in 1969 when he saw an advertisement for a device that could check blood-sugar levels in one minute with one drop of blood. It was marketed to hospitals, not consumers, but Bernstein wanted one for himself. He had been sick his entire life and was worried he was running out of time.

. . .

Since he wasn’t a doctor, the manufacturer wouldn’t even sell him a device. So, he bought one under the name of his wife, Dr. Anne Bernstein, a psychiatrist.

He experimented with different doses of insulin and the frequency of shots. He eased off carbohydrates. He checked his blood sugar constantly to see how it was reacting.

After experimenting for several years, he figured out that if he maintained a low-carb diet, he didn’t need as much insulin and could avoid many of the wild swings in his blood-sugar levels. By checking his blood sugar throughout the day, he learned how to maintain normal levels. It changed his life.

. . .

With his diabetes under control, he tried to spread the word and change the way the disease is treated. In the early years, he was dismissed by much of the medical establishment. His ideas went against accepted wisdom and he was, after all, not a doctor. In 1979, at the age of 45, he enrolled at the Albert Einstein College of Medicine, where he received his M.D.

“I never wanted to be a doctor,” he told the New York Times in 1988. “But I had to become one to gain credibility.”

Bernstein went into private practice in Mamaroneck, N.Y., where he treated diabetics and continued to advocate for his ideas—to his patients, in articles, YouTube videos, letters to the editor, and writing books, including “Dr. Bernstein’s Diabetes Solution.”

. . .

Gary Taubes, the author of “Rethinking Diabetes,” said that it was Bernstein’s work that eventually led to the Diabetes Control and Complications Trial, a landmark study that demonstrated that diabetics could blunt the destructive effects of the disease by keeping their blood-sugar levels nearer normal. Released in 1993, the results led to the kind of self-monitoring and frequent shots of insulin that remains part of the standard treatment plan for Type 1 diabetes today—part of what Bernstein had been pushing for years.

This was only partial vindication for Bernstein. The medical establishment never fully embraced Bernstein or the strict low-carb diet that he prescribed, which some considered unrealistic.

Taubes said that Bernstein was a bit of a “thorny character” who was easy for the establishment to dislike. He also noted that’s something that comes with the territory when you spend your career telling people they’re wrong and you’re right.

“But often it’s the people who are not easy to like,” Taubes said, “who are the ones who are willing to challenge entire establishment belief systems.”

For the full obituary see:

Chris Kornelis. “A Diabetic Who Pioneered Self-Monitoring for Blood Sugar.” The Wall Street Journal (Sat., May 10, 2025): C6.

(Note: the online version of the WSJ obituary has the date May 9, 2025, and has the title “Richard Bernstein, Who Pioneered Diabetics’ Self-Monitoring of Blood Sugar, Dies at 90.”)

Bernstein’s book mentioned above is:

Bernstein, Richard K., MD. Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars. New York: Little, Brown Spark, 2011.

Taubes’s book mentioned above is:

Taubes, Gary. Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments. New York: Knopf, 2024.