Category: Entrepreneurship

“Precautionary Principle Would Have Vastly Slowed” Anesthesia, Antibiotics, Chemotherapy and Other Medical Innovations

(p. 15) In his new book, “You Bet Your Life,” Paul A. Offit wants to understand the failures and tragedies that help pave the way to medical innovation. For most of human history, anesthesia did not exist. Patients had to be forcibly restrained while their limbs were amputated and their cancers were removed, typically amid piercing screams and unbearable agony. Things did not start to change until the 1840s, when a carnival barker named Gardner Colton charged people 25 cents to sniff “laughing gas,” also known as nitrous oxide, which made them fall down in hysterics and then go to sleep for a few minutes. On Dec. 10, 1844, a dentist named Horace Wells attended Colton’s show. Soon after inhaling the gas (and making a fool of himself), he told a friend that a person could probably “have a tooth extracted or a limb amputated and not feel any pain.”

Wells sought out Colton immediately after the show, and the very next day, he became the first person to use nitrous oxide as an anesthetic: He asked a fellow dentist to extract one of his own teeth. The procedure was painless. Over the following weeks, Wells used nitrous oxide on 15 of his patients. It worked every time. In January 1845, he asked if he could demonstrate his method to specialists in a large amphitheater at the Massachusetts General Hospital. The demonstration failed. Wells gave too little of the anesthetic to his patient, who woke up during the extraction, in intense pain and screaming. Members of the audience shouted out, “Humbug!” Wells was disgraced.

. . .

Offit is a good storyteller, and he has some terrific stories to tell. He also draws important lessons. In the domain of medical innovation, tragedies cannot be prevented, no matter how many regulations we put in place. Science moves forward in fits and starts, with blunders, failures and losses along the way. New discoveries are rarely immediate; we inevitably learn more over time. Ours is not a risk-free world, which means that we need to choose the lesser risk. New technologies are always a gamble.

All of those claims are true, but I think that Offit also pulls out an even deeper and more provocative moral from this history. In life and in public policy, many people in Europe and the United States are drawn to the “precautionary principle,” which essentially calls for a high degree of risk aversion: Whenever an innovation threatens to cause harm, we should be exceedingly cautious before we allow it. Offit’s examples, and the history of medical advances, demonstrate that in its most extreme forms, the precautionary principle is self-defeating. Simply put, precautions kill. Whether we are speaking of anesthesia, heart transplants, antibiotics, chemotherapy or blood transfusions, the precautionary principle would have vastly slowed down innovations that, yes, carried serious risk and led to real harm, but were ultimately a great boon to humanity.

For the full review, see:

Cass R. Sunstein. “Side Effects.” The New York Times Book Review (Sunday, October 17, 2021): 15.

(Note: ellipsis added.)

(Note: the online version of the review was updated Oct. 25, 2021, and has the title “A History of Medical Innovation That Doesn’t Ignore the Side Effects.”)

The book under review is:

Offit, Paul A. You Bet Your Life: From Blood Transfusions to Mass Vaccination, the Long and Risky History of Medical Innovation. New York: Basic Books, 2021.

California Labor and Environment Policies Reduce Nimble Response to Supply Chain Backups

(p. A17) The backup of container ships at the Long Beach and Los Angeles ports has grown in recent weeks despite President Biden’s intervention to get terminal operators to move goods 24/7.

. . .

The two Southern California ports handle only about 40% of containers entering the U.S., mostly from Asia. Yet ports in other states seem to be handling the surge better. Gov. Ron DeSantis said last month that Florida’s seaports had open capacity. So what’s the matter with California? State labor and environmental policies.

Some 20 business groups recently asked Gov. Gavin Newsom to declare a state of emergency and suspend labor and environmental laws that are interfering with the movement of goods. Opening the Port of Los Angeles 24 hours a day “alone will do little without immediate action from the state to address other barriers that have created bottlenecks at the ports, warehouses, trucking, rail, and the entire supply chain,” they wrote.

One barrier is a law known as AB5. Before its enactment in 2019, tens of thousands of truck drivers worked as independent contractors, which gave them more autonomy and flexibility than if they were employees. As contractors, truck drivers can work for multiple companies, which allows them to nimbly respond to surges in demand.

. . .

Another problem: a shortage of storage space. “There is absolutely no available capacity in the warehousing sector due to the difficulty in developing any new capacity,” the businesses noted in their letter. The vacancy rate for warehouses near the Los Angeles and Long Beach ports was a mere 1%, compared with 3.6% nationwide.

If warehouses don’t have space in their facilities or parking lots to unload goods, drivers can’t make deliveries. Some truck drivers are leaving container boxes along with the chassis outside storage facilities and are picking them up later, but that results in a shortage of chassis at the ports. (About half of chassis are leased to truckers from a common pool supplied by private companies.)

. . .

. . . in California warehouse growth ignited opposition from environmental groups, which complain of pollution and noise. Many cities have limited new logistics facilities.

For the full commentary, see:

Allysia Finley. “California Is the Supply Chain’s Weakest Link.” The Wall Street Journal (Friday, Nov. 5, 2021): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 4, 2021, and has the same title as the print version.)

Good Anxiety “Helps Us Rebound and Refocus”

(p. A15) “Good Anxiety” is especially effective in arguing that anxiety shouldn’t be something we seek to hide, numb or even fix. Instead we can use it as a form of energy, thanks to the power of brain plasticity, our ability to rewire this potentially destructive response process. It’s what enables us to learn how to calm down, reassess situations and reframe our thoughts and feelings. “Anxiety is changeable, adaptable like any other feature of our brain,” Ms. Suzuki argues. The promise of her book, she writes, is a better understanding of “how anxiety works in the brain and body” so that we can learn how to adjust our own misfiring neurons.

Anxiety can even give us “hidden superpowers.” Resilience, for example, is learned through dealing with stress, and helps us rebound and refocus after difficult, challenging events. Even bigger payoffs come, Ms. Suzuki suggests, by adopting what she calls an “activist mindset”—the belief that we can reframe our thoughts in a positive and opportunistic way. This gives us agency over how we react to situations. “When it feels like a door has slammed on you, anxiety can lead you to feel like there’s no way out of the room; the activist mindset allows you to take a step back and look for a window,” she writes.

. . .

If anxiety is uncontrolled, our focus is liable to turn sour: Overstating real or imagined threats leads to hypervigilance and dwelling on danger. But Ms. Suzuki argues that anxiety plays a role in executive function, the interaction between attention, thinking and emotion, where it can be used for good. By decreasing distractions, meditating, exercising and transforming a “what-if” list into a productive “to-do” list, anxious thinkers can channel their energy toward progress.

For the full review, see:

Taylor Cromwell. “BOOKSHELF; The Upside Of Worry.” The Wall Street Journal (Friday, Sept. 17, 2021): A15.

(Note: ellipsis added.)

(Note: the online version of the review was updated Sept. 3, 2021, and has the title “BOOKSHELF; ‘Good Anxiety’ Review: The Upside of Worry.”)

The book under review is:

Suzuki, Wendy. Good Anxiety: Harnessing the Power of the Most Misunderstood Emotion. New York: Atria Books, 2021.

Communist China Pays World Bank for Higher Ranking in “Doing Business” Report

(p. A1) The World Bank canceled a prominent report rating the business environment of the world’s countries after an investigation concluded that senior bank management pressured staff to alter data affecting the ranking of China and other nations.

The leaders implicated include then World Bank Chief Executive Kristalina Georgieva, now managing director of the International Monetary Fund, and then World Bank President Jim Yong Kim.

The episode is a reputational hit for Ms. Georgieva, who disagreed with the investigators’ conclusions. As leader of the IMF, the lender of last resort to struggling countries around the world, she is in part responsible for managing political pressure from nations seeking to advance their own interests. It was also the latest example of the Chinese government seeking myriad ways to burnish its global standing.

(p. A10) The Doing Business report has been the subject of an external probe into the integrity of the report’s data.

. . .

The World Bank was in the middle of difficult international negotiations to receive a $13 billion capital increase. Despite being the world’s second largest economy, China is the No. 3 shareholder at the World Bank, following the U.S. and Japan, and Beijing was eager to see its power increased as part of a deal for more funding.

In October 2017, Ms. Georgieva convened a meeting of the World Bank’s country director for China, as well as the staff economists that compile Doing Business. She criticized “mismanaging the Bank’s relationship with China and failing to appreciate the importance of the Doing Business report to the country,” according to the investigative report’s summary of the meeting.

. . .

Ultimately, the team identified three data points that could be altered to raise China’s score, the investigative report said. For example, China had passed a law related to secured transactions, such as when someone makes a loan with collateral. The World Bank staff determined it could give China a significant improvement to its score for legal rights, citing the law as the reason.

World Bank employees knew the changes were inappropriate but “a majority of the Doing Business employees with whom we spoke expressed a fear of retaliation,” the investigative report said.

Although the data-gathering process for the 2018 report was finished, the World Bank’s economists reopened the data tables and altered China’s data, the investigative report said. Instead of ranking 85th among the world’s countries, China climbed to 78th due to the alterations.

For the full story, see:

Josh Zumbrun. “World Bank Cancels Report After Investigation.” The Wall Street Journal (Friday, Sept. 17, 2021): A1 & A10.

(Note: the online version of the story has the date September 16, 2021, and has the title “World Bank Cancels Flagship Report After Investigation.”)

Auntie Sewing Squad Made, and Distributed, 350,000 Free Masks

(p. C7) Kristina Wong is an in-your-face performer who, until this month, hadn’t performed for an in-person audience since March 2020.

. . .

While Wong was stuck at home in Los Angeles, she stayed busy leading the Auntie Sewing Squad, a volunteer group of mostly Asian American women she founded in March 2020 to make face masks for health care workers, farm workers, incarcerated people and others. She recruited 6-year-old children, her 73-year-old mother and others for the operation, which ballooned to more than 800 “Aunties,” a cross-cultural term of respect and affection for women, as well as “Uncles” and nonbinary volunteers in 33 states. Together, they distributed more than 350,000 masks.

“I feel like I got more done for the world by running a mutual aid group than as an elected official,” said Wong, a third-generation Chinese American from San Francisco.

. . .

In March 2020 your tour for “Kristina Wong for Public Office” was postponed. What made you want to start a mask-making group?

I was home without income feeling sorry for myself, and I stumbled across some articles that said there was a need for homemade masks. It started with me taking my Hello Kitty sewing machine and fabric and making a naïve offer to the internet: “If you need masks and don’t have access to them, I will help you!” But my ego wrote a check my body couldn’t cash, and within four days I was inundated with requests, so I started a Facebook group of people whom I knew could sew. We had Aunties cutting the elastic off their fitted sheets, the straps off their bras. It was a Robinson Crusoe situation.

Why did you call yourself a “sweatshop overlord”?

My first volunteers were all Asian women, and I was like, “Oh, my God, this is the sickest moment, we are a modern-day sweatshop.” Our mothers and grandmothers did garment work — my grandmother and grandfather did laundry work as part of their rite of passage to America — and now we find ourselves doing this work again, for free, because the government hasn’t prepared us for this moment. So it was this gallows humor joke that I was the sweatshop overlord — also humor about child labor because I was ordering children around.

For the full interview, see:

Sarah Bahr, interviewer. “Kristina Wong’s Story: Sewing With Her Aunties.” The New York Times (Saturday, October 30, 2021): C7.

(Note: ellipses added; bold in original. The questions in bold are from the interviewer. The words under each question are quotes from Kristina Wong.)

(Note: the online version of the interview has the date October 19, 2021, and has the title “Kristina Wong’s Pandemic Story: Sewing With Her Aunties.”)

Musk Wants to Use His Billions “to Get Humanity to Mars”

(p. B1) In the negotiations over President Biden’s infrastructure bill, Senator Ron Wyden, Democrat of Oregon and chairman of the Finance Committee, proposed the idea of a tax on billionaires specifically. Thursday morning, Mr. Biden announced his framework for paying for the bill, which promised additional taxes on the income of “the wealthiest 0.02 percent of Americans.”

Mr. Wyden’s proposed tax will likely never make it into law.

. . .

(p. B5) Elon Musk, in a tweet, seemed to come out against the proposal. “Eventually, they run out of other people’s money and then they come for you,” he wrote. It is fairly safe to say that Mr. Musk will never run out of money. A back-of-the-envelope calculation from Forbes’s real-time net worth tracker suggests that he could spend $1 million a year for 100,000 years and still have more money than Bill Gates, with an estimated $136.2 billion.

. . .

Abigail Disney, granddaughter of Roy Disney and a longtime critic of income inequality, said in an interview that she believes the immense displays of wealth by the country’s richest during the pandemic — particularly the ostentatiousness of last summer’s space race — helped foster a serious discussion about the tax burdens on billionaires.

. . .

In comments denouncing the proposed billionaire tax, Mr. Manchin described the ultrawealthy as people who “create a lot of jobs and invest a lot of money and give a lot to philanthropic pursuits.”

That was an implicit endorsement of the idea, often repeated in discussions around high-net worth giving, that regular people pay taxes while rich people pursue philanthropy, giving not to the Treasury but to their preferred causes. “My plan is to use the money to get humanity to Mars and preserve the light of consciousness,” Mr. Musk said in a subsequent tweet in response to the tax proposal.

“That idea that ‘it’s my money and I should decide what to do with it’ is very dominant, and it goes along with the culture of individualism that allows people to feel that they’ve done this on their own and haven’t benefited from social goods like roads and education and laws,” Professor Sherman said.

Ms. Disney, who is an active member of the Patriotic Millionaires, said she sees that thinking as a primary obstacle to raising taxes on the richest Americans. “Billionaires may be brilliant — and I don’t doubt Elon Musk’s I.Q. — but they don’t do anything on their own,” she said. She also questioned the prevailing wisdom among the country’s wealthiest that they know best and the government shouldn’t be trusted with their money.

“The last time I was in the Bay Area, I went walking in the marina and saw seven consecutive boats named after characters from Ayn Rand,” Ms. Disney said. “They need to come to their senses.”

For the full story, see:

Nicholas Kulish, Ephrat Livni and Emma Goldberg. “Billionaires Of America Are Thriving.” The New York Times (Friday, October 29, 2021): B1 & B5.

(Note: ellipses added.)

(Note: the online version of the story was updated Nov. 2, 2021, and has the title “Who Are America’s Billionaires, Anyway?”)

Substack CEO Defends Free Speech

(p. B5) Substack Inc. co-founder and CEO Chris Best said he wouldn’t have removed a post or delisted Dave Chappelle if the comedian had published something on the platform that echoed his recent stand-up special on Netflix Inc.

. . .

“We don’t think the answer to speech you disagree with or that you find offensive or challenging is to shut it down,” he said, adding that people should be able to speak freely and discuss ideas.

For the full story, see:

Talal Ansari. “Substack Chief Says Dave Chappelle Is Welcome.” The Wall Street Journal (Wednesday, October 20, 2021): B5.

(Note: ellipsis added.)

(Note: the online version of the story has the date October 19, 2021, and has the title “‘Dave Chappelle Is Welcome on Substack,’ CEO Says.”)

To Survive a Disaster You Need “Basic Skills and Self-Reliance” in Time Before First-Responders Respond

(p. C17) The coronavirus has challenged us in ways that our society hadn’t been challenged for decades.

. . .

. . . being stressed and anxious doesn’t mean you can’t be resilient. Actively working to mitigate the damage from a disaster can help to reduce stress, because it makes you feel more empowered and less like a helpless bystander.

. . .

Experience and preparation paid off for me in September 2017, as Hurricane Irma, a Category 5 storm, approached Key West, Fla., where my husband and I had spent two years building our home together. We didn’t freak out: We knew about the risk of hurricanes when we moved there. I had studied the maps to see which areas of Key West were prone to flooding, and we prepared our property accordingly.

. . .

My long experience has taught me that when a disaster strikes, you can’t wait for someone else to bail you out. You have to have some basic skills and self-reliance initially. If a grease fire breaks out in my kitchen and I have a fire extinguisher, I can probably put it out. But if I call the fire department and wait for them to arrive, my grease fire could turn into a house fire. I will still call the fire department, in case I can’t control the fire, but the first response has to be mine.

For the full essay, see:

Robert Jensen. “Staying Resilient When Disaster Strikes.” The Wall Street Journal (Saturday, Oct. 2, 2021): C17.

(Note: ellipses added.)

(Note: the online version of the review has the date September 30, 2021, and has the same title as the print version.)

The essay quoted above is adapted from Jensen’s book:

Jensen, Robert A. Personal Effects: What Recovering the Dead Teaches Me About Caring for the Living. New York: St. Martin’s Press, 2021.

Michael Dell Is a Project Entrepreneur

(p. C18) A decade ago, the rise of smartphones and tablets seemed to spell doom for the Dell computer company, which had tried to enter both markets without success. (Does anyone remember the “phablet”?) By 2012 Dell’s market share for PCs had eroded to just over 10%, and its share price had sunk below $9, from around $30 in 2007.

“I felt abandoned by the public shareholders,” admits Michael Dell, the company’s founder and CEO, in his new autobiography, “Play Nice But Win,” published next week. But Dell’s historically low stock price also offered a silver lining. With help from Silver Lake, a private-equity firm, in 2013 Mr. Dell paid $24.9 billion to take his company private. This rare maneuver freed him to transform his company “without the tyranny, the ever-ticking shot clock, of a quarterly earnings report,” he writes.

Today the company rebranded as Dell Technologies is worth around $80 billion, more than four times its value before going private.

. . .

In his efforts to take the company private in 2013 and then take it public again in 2018, Mr. Dell locked horns with Carl Icahn, an activist investor, who publicly compared Mr. Dell to Machiavelli and threatened to purchase the company himself and install a new CEO. In his book and in conversation, Mr. Dell is unsparing about Mr. Icahn, calling him a “circus clown” with “zero moral compass” and “no idea what Dell does.” Mr. Icahn, in turn, calls Mr. Dell a “bamboozler” who tried to “swindle” shareholders.

. . .

A range of supply-chain problems have meant that demand for PCs has been outstripping supply. But Dell has done a better job than its rivals of getting the relevant parts, and the company has moved more quickly than Hewlett-Packard Inc. and others in anticipating a shift in PC sales from consumers to businesses as offices open back up. Mr. Dell explains that the company’s approach to manufacturing has shifted in recent years from “just in time to just in case,” with supply chains that are geographically diverse enough to handle disruptions. He adds that the company’s longstanding approach of selling directly to customers has meant Dell’s “signal quality is higher” than its competitors when it comes to registering what people and companies actually want.

. . .

Mr. Dell is the last computer pioneer who is still running his own company. Although he acknowledges it is harder at his age to cultivate the “beginner’s mind” capable of generating radical new ideas, he says he has no plans to step aside any time soon. The work feels too interesting and too important, he explains, and he’s having too much fun: “I love what I do.”

For the full essay, see:

Emily Bobrow, interviewer(?). “WEEKEND CONFIDENTIAL; Michael Dell.” The Wall Street Journal (Saturday, Oct. 02, 2021): C18.

(Note: ellipses added.)

(Note: the online version of the review has the date October 1, 2021, and has the title “WEEKEND CONFIDENTIAL; Tech Founder Michael Dell Is Navigating a Changing Industry.” The article does not indicate whether the quotes from Michael Dell are from his book or from an interview. I am guessing that except for a quote explicitly identified as from the book, the quotes are from an interview.)

The book by Dell mentioned in the essay is:

Dell, Michael. Play Nice but Win: A CEO’s Journey from Founder to Leader. New York: Portfolio, 2021.

Union Pacific Buying More Chassis to Carry More Containers

(p. B6) Union Pacific is buying more chassis that can carry shipping containers, and opening facilities outside of Los Angeles and in Minnesota to handle the increased volume.

Mr. Foote of CSX said that while supply chains are strained globally, the railroads are handling their role of moving goods between destinations well. A bigger problem of late has been what happens after the cargo gets to its destination.

He said containers carrying finished goods often sit idle because of a lack of truck drivers, equipment to put shipping containers on trucks and warehouse workers to unload them.

For the full story, see:

Paul Ziobro. “Railroads Shun Some Business Amid Congestion.” The Wall Street Journal (Wednesday, October 22, 2021): B6.

(Note: the online version of the story has the date October 21, 2021, and has the title “Rail-Yard Congestion Holds Down Shipping Volumes,’ CEO Says.”)

Entrepreneur Stewart Butterfield Failed With “Glitch” Before Succeeding With “Slack”

(p. A15) Entrepreneur Stewart Butterfield once tried to build a multiplayer online game but switched to photo sharing, selling Flickr to Yahoo in 2005 for $25 million. Success, but not a home run in Silicon Valley. Mr. Butterfield left Yahoo in 2008 to help found a company called Tiny Speck and build another multiplayer online game called “Glitch.” Persistence! “Glitch” attracted tens of thousands of gamers, but not enough to cover its costs, so Mr. Butterfield killed it in 2012.

Tiny Speck pivoted, which in Silicon Valley means fail and scramble to do something else. The company had built its own crude internal communications system for employees to chat digitally during the development of “Glitch.” Maybe others would use it. Seven months after they started work on Slack, the company announced its preview release. On the first day of the press blitz, 8,000 people requested the preview version. In February 2014 Slack had 16,000 users and by November it had 285,000, with 73,000 paying for it. Now more than 10 million people use it daily. Mr. Butterfield sold Slack to Salesforce for $27.7 billion last year. That’s failing upward!

For the full commentary, see:

Andy Kessler. “INSIDE VIEW; Failure Is Always an Option.” The Wall Street Journal (Monday, Oct. 18, 2021): A15.

(Note: the online version of the commentary has the date October 17, 2021, and has the title “INSIDE VIEW; Failure Was Always an Option for Elizabeth Holmes.”)