One Cause of Increasing Burnout of Physicians Is “the Politicization of Science”

(p. A25) Ten years of data from a nationwide survey of physicians confirm another trend that’s worsened through the pandemic: Burnout rates among doctors in the United States, which were already high a decade ago, have risen to alarming levels.

Results released this month and published in Mayo Clinic Proceedings, a peer-reviewed journal, show that 63 percent of physicians surveyed reported at least one symptom of burnout at the end of 2021 and the beginning of 2022, an increase from 44 percent in 2017 and 46 percent in 2011. Only 30 percent felt satisfied with their work-life balance, compared with 43 percent five years earlier.

“This is the biggest increase of emotional exhaustion that I’ve ever seen, anywhere in the literature,” said Bryan Sexton, the director of Duke University’s Center for Healthcare Safety and Quality, who was not involved in the survey efforts.

. . .

The increase in burnout is most likely a mix of new problems and exacerbated old ones, Dr. Shanafelt said. For instance, the high number of messages doctors received about patients’ electronic health records was closely linked to increased burnout before the pandemic. After the pandemic, the number of messages from patients coming into physicians’ In Baskets, a health care closed messaging system, increased by 157 percent.

And physicians pointed to the politicization of science, labor shortages and the vilification of health care workers as significant issues.

For the full story, see:

Oliver Whang. “New Survey Suggests An Alarming Increase In Physician Burnout.” The New York Times (Friday, September 30, 2022): A25.

(Note: ellipsis added.]

(Note: the online version of the story has the date Sept. 29, 2022, and has the title “Physician Burnout Has Reached Distressing Levels, New Research Finds.”)

Long-Distance Trade May Help Explain Why Sapiens Flourished More Than Neanderthals

(p. 47) Sykes explains that Neanderthals were sophisticated and competent human beings who adapted to diverse habitats and climates.

. . .

At the time when they encountered the Neanderthals, Sapiens too lived in small bands, but different Sapiens bands probably cooperated on a regular basis. There is much more evidence for long-distance trade among Sapiens, and spectacular burials like the 32,000-year-old Sunghir graves clearly reflect the combined effort of more than one band.

Large-scale cooperation did not necessarily mean that a horde of 500 Sapiens united to wipe out a band of 20 Neanderthals. Cooperation isn’t just about violence. Sapiens could more easily benefit from the discoveries and inventions of other people. If somebody in a neighboring band discovered a new way to locate beehives, to make a tunic or to heal a wound, such knowledge could spread much more quickly among Sapiens than among Neanderthals. While individual Neanderthals were perhaps as inquisitive, imaginative and creative as individual Sapiens, superior networking enabled Sapiens to swiftly outcompete Neanderthals.

This, however, is largely speculation. We still don’t know enough about the psychology, society and politics of Neanderthals to be sure. Perhaps the most surprising fact in Sykes’s book is that even if we count every bone fragment and every isolated tooth, so far we have found the remains of fewer than 300 Neanderthals.

For the full review, see:

Yuval Noah Harari. “Ancient Cousins.” The New York Times Book Review (Sunday, December 6, 2020): 47.

(Note: ellipsis added.)

(Note: the online version of the review was updated Nov. [sic] 9, 2020, and has the title “At Home With Our Ancient Cousins, the Neanderthals.”)

The book under review is:

Sykes, Rebecca Wragg. Kindred: Neanderthal Life, Love, Death and Art. London: Bloomsbury Sigma, 2020.

Entrepreneur Andy Yen’s Technology Enables Russians to Elude Censors

(p. A1) After Moscow erected a digital barricade in March [2022], blocking access to independent news sites and social media platforms to hide information about its unfolding invasion of Ukraine, many Russians looked for a workaround. One reliable route they found came from a small Swiss company based nearly 2,000 miles away.

The company, Proton, provides free software that masks a person’s identity and location online. That gives a user in Russia access to the open web by making it appear that the person is logging in from the Netherlands, Japan or the United States. A couple of weeks after the internet blockade, about 850,000 people inside Russia used Proton each day, up from fewer than 25,000.

That is, until the end of March, when the Russian government found a way to block Proton, too.

Targeting Proton was the opening salvo of a continuing back-and-forth battle, pitting a team of about 25 engineers against a country embarking on one of the most aggressive censorship campaigns in recent memory.

Working from a Geneva office where the company keeps its name off the building directory, Proton has spent nine pressure-packed months repeatedly tweaking its technology to avoid Russian blocks, only to be countered again by government censors in Moscow. Some employees took (p. A9) Proton off their social media profiles out of concern that they would be targeted personally.

The high-stakes chess match mirrors what is playing out with growing frequency in countries facing coups, wars and authoritarian rule, where restricting the internet is a tool of repression. The blocks drive citizens to look for workarounds. Engineers at companies like Proton think up new ways for those people to secretly reach the open web. And governments, in turn, seek out new technical tricks to plug leaks.

. . .

Companies rarely discuss being targeted by an authoritarian government out of fear of escalating the conflict. But Andy Yen, Proton’s founder and chief executive, said that after a period of trying to keep its “head down,” Proton wanted to raise awareness about the increasing sophistication of governments, in Russia and elsewhere, to block citizens from reaching the open web and the need for technologists, companies and governments to push back.

. . .

“We’re gearing up for a long fight,” Mr. Yen said in an interview at the company’s office. “Everybody hopes this will have a happy ending, but it’s not guaranteed. We don’t see the light at the end of the tunnel, in fact, but you keep going because if we don’t do it, then maybe nobody else will.”

. . .

The battle took on a “Spy vs. Spy” dynamic in Proton’s headquarters. Mr. Yen said a network of people within the government, telecommunications firms and civil society groups had helped Proton operate in Russia, providing access to local networks and sharing intelligence about how the censorship system worked. But those contacts began to go dark as the Kremlin’s crackdown on dissent intensified.

. . .

Mr. Yen was interrupted during a staff meeting in mid-July with news that Russian censors had come up with an even more elaborate block. A corporate chart from the time shows use dropping off a cliff. Russian engineers had identified what is known as an authentication “handshake,” the vital moment when Proton’s VPN connection gets established before reaching the wider web. Blocking the link made Proton’s service essentially unusable.

“We had no idea what was happening and how they were doing it,” Mr. Cesarano said.

By August, after working around the clock for days to find a fix, Proton acknowledged defeat and pulled its app from Russia. The company has spent the months since then developing a new architecture that makes its VPN service harder to identify because it looks more like a regular website to censorship software scanning a country’s internet traffic. Proton has been successfully testing the system in Iran, where Proton has seen a sharp increase in VPN use during recent political demonstrations.

In Russia, Proton has reintroduced its apps using the new system. Mr. Yen acknowledged that it probably wasn’t a long-term fix. He has confidence in the new technology, but figures Russian engineers will eventually figure out a new way to push back, and the game will continue.

For the full story, see:

Adam Satariano and Paul Mozur. “The Cat-and-Mouse Battle for Russia’s Internet.” The New York Times (Wednesday, December 7, 2022): A1 & A9.

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

(Note: the online version of the story was updated Dec. 9, 2022, and has the title “Inside the Face-Off Between Russia and a Small Internet Access Firm.” )

In Poor Country Where “Few People Have Air Conditioning” Heat Reduces Ability of Children to Learn and Parents to Produce

A growing movement among intellectuals opposes economic growth. I doubt that the movement will catch on in Freetown, Sierra Leone, where economic growth would allow more citizens to afford air conditioning.

(p. A4) . . . Eugenia Kargbo . . . [is] Freetown’s first chief heat officer, a post created in 2021, . . .

. . .

“Heat is invisible but it’s killing people silently,” Ms. Kargbo said in an interview on one of the top floors of Freetown’s city hall, a massive air-conditioned building that towers over the dozens of informal settlements dotting the capital of the small West African nation.

“Children are not sleeping at night because of extreme temperature,” she said. “It affects their ability to learn and their parents’ productivity.”

. . .

The country is one of the world’s poorest; few people have air conditioning; . . .

For the full story, see:

Elian Peltier. “In West African Hub, She Works to Counter Rising Temperatures.” The New York Times (Tuesday, January 7, 2023): A4.

(Note: ellipses added.)

(Note: the online version of the story has the date January 6, 2023, and has the title “She Is Africa’s First Heat Officer. Can She Make Her City Livable?”)

Taiwanese Engineers Who Built Dictator Xi’s Computer Chips, Are Voting With Their Feet for Taiwan’s Democracy and Freedom

(p. B1) TAIPEI, Taiwan — The job offer from a Chinese semiconductor company was appealing. A higher salary. Work trips to explore new technologies.

No matter that it would be less prestigious for Kevin Li than his job in Taiwan at one of the world’s leading chip makers. Mr. Li eagerly moved to northeast China in 2018, taking part in a wave of corporate migration as the Chinese government moved aggressively to build up its semiconductor industry.

He went back to Taiwan after two years, as Covid-19 swept through China and global tensions intensified. Other highly skilled Taiwanese engineers are going home, too.

For many, the strict pandemic measures have been tiresome. Geopolitics has made the job even more fraught, with China increasingly vocal about staking its claim on Taiwan, a self-ruled democracy.

. . .

(p. B4) For now, Mr. Li is staying in Taiwan, working for an American chip company operating there and siding with the invigorated patriotic sentiment and the ethos of individual liberty.

“The advantage of working in Taiwan is that you don’t have to worry about officials shutting down the whole company because of one thought,” he said. “The atmosphere is very important. At least I can watch all kinds of programs criticizing the governments on both sides of the Taiwan Strait without worrying about being arrested.”

For the full story, see:

Jane Perlez, Amy Chang Chien and John Liu. “Taiwanese Who Built Up Chip Sector in China Are Fed Up and Going Home.” The New York Times (Tuesday, November 22, 2022): B1 & B4.

(Note: the online version of the story has the date Nov. 16, 2022, and has the title “Engineers From Taiwan Bolstered China’s Chip Industry. Now They’re Leaving.” The online version says that the title of the print version is “They Built Up China’s Chip Sector. Now, They’re Going Home to Taiwan” but the title of my national edition copy is “Taiwanese Who Built Up Chip Sector in China Are Fed Up and Going Home.”)

Lethality of Ebola in West Africa Mainly Due to “the Contingent History of a Population Made Vulnerable”

(p. 22) As Farmer writes in his new book, “Fevers, Feuds, and Diamonds: Ebola and the Ravages of History,” by the time he arrived in the capital city of Freetown in late September, “western Sierra Leone was ground zero of the epidemic, and Upper West Africa was just about the worst place in the world to be critically ill or injured.”

. . .

Farmer notes that even severe cases of Ebola rarely produce the horror-film symptoms featured so prominently in Preston’s “Hot Zone”: patients bleeding from their eyeballs, their organs liquefied in a matter of hours. Most cases instead involve fluid and electrolyte loss caused by vomiting and diarrhea, which can often be treated with basic supportive and critical care, like intravenous fluid replenishment or dialysis. Ebola was so lethal in upper West Africa not because the virus itself conveyed an inevitable death sentence, but because countries like Liberia and Sierra Leone lacked these health care essentials. “For all their rainfall,” Farmer writes, “their citizens are stranded in the medical desert.”

. . .

“This was not,” Farmer writes, “a history of inevitable mortality that resulted from ancient evolutionary forces.  . . .   It was the contingent history of a population made vulnerable.”

For the full review, see:

Steven Johnson “A Preventable Epidemic.” The New York Times Book Review (Sunday, December 13, 2020): 22.

(Note: ellipses between paragraphs, added; ellipsis internal to last paragraph, in original.)

(Note: the online version of the review has the date Nov. 17, 2020, and has the title “The Deadliness of the 2014 Ebola Outbreak Was Not Inevitable.”)

The book under review is:

Farmer, Paul. Fevers, Feuds, and Diamonds: Ebola and the Ravages of History. New York: Farrar, Straus and Giroux, 2020.

Disabled Workers Flourish in Robustly Redundant Labor Market

(p. A1) The strong late-pandemic labor market is giving a lift to a group often left on the margins of the economy: workers with disabilities.

Employers, desperate for workers, are reconsidering job requirements, overhauling hiring processes and working with nonprofit groups to recruit candidates they might once have overlooked. At the same time, companies’ newfound openness to remote work has led to opportunities for people whose disabilities make in-person work — and the taxing daily commute it requires — difficult or impossible.

As a result, the share of disabled adults who are working has soared in the past two years, far surpassing its prepandemic level and outpacing gains among people without disabilities.

(p. A12) In interviews and surveys, people with disabilities report that they are getting not only more job offers, but better ones, with higher pay, more flexibility and more openness to providing accommodations that once would have required a fight, if they were offered at all.

For the full story, see:

Ben Casselman. “Disabled Workers Thrive in Tight Labor Market.” The New York Times (Wednesday, October 26, 2022): A1 & A12.

(Note: the online version of the story has the date Oct. 25, 2022, and has the title “For Disabled Workers, a Tight Labor Market Opens New Doors.”)

Super PAC Heavily Funded by Associates of Bankrupt and Corrupt FTX, Donated $212,000 to John Fetterman Senate Campaign

(p. A1) In the three years since Mr. Bankman-Fried launched FTX, the company, its executives and its philanthropic arm spent or pledged hundreds of millions of dollars in political and charitable (p. A17) contributions, consulting fees, investments in media outlets and even real estate.

A network of political action committees, nonprofits and consulting firms funded by FTX or its executives worked to court politicians, regulators and others in the policy orbit, with the goal of making Mr. Bankman-Fried the authoritative voice of crypto, while also shaping regulation for the industry and other causes, according to interviews, email exchanges and an encrypted group chat viewed by The New York Times.

. . .

Mr. Bankman-Fried and Ryan Salame, another FTX executive, burst onto the big-money political scene during the 2022 election campaign.

. . .

In early March [2022], representatives for one super PAC, Web3 Forward, were pleased when the campaign of John Fetterman, the Pennsylvania Senate candidate, returned a completed questionnaire expressing support for the cryptocurrency industry, according to people familiar with the situation.

“Need nothing further from Team Fetterman. Thrilled he is pro crypto,” a consultant for Web3 Forward emailed an ally of Mr. Fetterman.

About two months after the email, Web3 Forward began airing an ad casting Mr. Fetterman as a working class champion who was not “gonna get schmoozed by lobbyists.” The super PAC spent nearly $4.7 million boosting Democratic candidates in the midterm elections, mostly in their primary campaigns, including more than $212,000 supporting Mr. Fetterman, who won his race and is set to begin his term Jan. 3 [2023].

. . .

In a statement, Adam Goldberg, a spokesman for Web3 Forward, said that neither Mr. Bankman-Fried, Mr. Salame “nor anyone else at FTX or representing its interests had any role in deciding the candidates we supported.”

But campaign filings show that Web3 Forward received almost all of the roughly $5.9 million it raised in 2021 from GMI PAC, a super PAC for which Mr. Salame was a founding board member. GMI, in turn, received about 32 percent of its nearly $11.6 million from Mr. Salame, Mr. Bankman-Fried and an FTX affiliate.

For the full story, see:

Kenneth P. Vogel, Emily Flitter and David Yaffe-Bellany. “‘It Was Relentless’: Inside a Crypto Exchange’s Bid for Influence.” The New York Times (Wednesday, November 23, 2022): A1 & A17.

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

(Note: the online version of the story has the date Nov. 22, 2022, and has the title “Inside Sam Bankman-Fried’s Quest to Win Friends and Influence People.”)

A Form of Environmentalism that Seeks Human Extinction

(p. A20) PORTLAND, Ore. — For someone who wants his own species to go extinct, Les Knight is a remarkably happy-go-lucky human.

. . .

Mr. Knight, 75, is the founder of the Voluntary Human Extinction movement, which is less a movement than a loose consortium of people who believe that the best thing humans can do to help the Earth is to stop having children.

. . .

While the United States saw an increase in births during the coronavirus pandemic, reversing the country’s declining birthrate, a 2020 poll found that one in four Americans who had not had children cited climate change as a reason.

For the full story, see:

Cara Buckley. “Movement That Insists Best Thing for Us to Do Is to Slowly Go Extinct.” The New York Times (Friday, November 25, 2022): A20.

(Note: ellipses added.)

(Note: the online version of the story was updated Nov. 29, 2022, and has the title “Earth Now Has 8 Billion Humans. This Man Wishes There Were None.”)

Dolly Parton’s Favorite Fictional Hero Is the Little Engine That Could

(p. 10) Who is your favorite fictional hero or heroine? . . .

My favorite hero is the Little Engine That Could. . . .

What kind of reader were you as a child? Which childhood books and authors stick with you most?

When I was a little kid, my dad didn’t want us to have library books around the house because the younger kids would ruin them and he couldn’t afford to replace them. I have always loved “The Little Engine That Could,” so I started my Imagination Library with it to show kids that they can do anything. I’m really proud that we’ve given away over 145,000,000 books to kids and have more than 1.7 million children registered around the world — in fact, last September [2020] was our highest enrollment of children yet. Books were a lifeline to me as a child — I know they make a difference.

For the full interview, see:

“BY THE BOOK; Dolly Parton.” The New York Times Book Review (Sunday, December 6, 2020): 10.

(Note: ellipses added. Questions quoted above are by the anonymous NYT interviewer. Answers are by Dolly Parton.)

(Note: the online version of the interview has the date Dec. 3, 2020, and has the title “BY THE BOOK; Dolly Parton Likes to Read by the Fire in Her Pajamas.”)

Dolly Parton’s favorite fictional hero is the focus of:

Piper, Watty. The Little Engine That Could. New York: Grosset & Dunlap, 1990 [1930].

Bruce Yandle has argued that books like The Little Engine That Could, can help build a culture of entrepreneurship:

Yandle, Bruce. “I Think I Can! Does the Little Engine That Could Matter?” Journal of Private Enterprise 26, no. 2 (Spring 2011): 127-42.

Elon Musk Asks Twitter Employees for “Long Hours at High Intensity”

(p. B5) SAN FRANCISCO — Elon Musk gave Twitter employees a deadline of 5 p.m. Eastern time on Thursday [Nov. 17, 2022] to decide if they wanted to work for him, and he asked those who did not share his vision to leave their jobs, in his latest shock treatment of the social media company.

Mr. Musk made the announcement in an early-morning email to employees on Wednesday [Nov. 16, 2022]; The New York Times obtained the message, which had the subject line “A Fork in the Road.” In the note, Mr. Musk, 51, reiterated that Twitter faced a difficult road ahead and offered employees three months of severance if they did not want to continue working there “to build a breakthrough Twitter 2.0.”

. . .

In his note to Twitter employees on Wednesday, Mr. Musk said they would need to work hard — very hard. “In an increasingly competitive world, we will need to be extremely hard core,” he wrote. “This will mean working long hours at high intensity. Only exceptional performance will constitute a passing grade.”

For the full story, see:

Kate Conger. “Musk’s Ultimatum: Buy In or Get Out.” The New York Times (Thursday, November 17, 2022): B5.

(Note: ellipsis, and bracketed dates, added.)

(Note: the online version of the story has the date Nov. 16, 2022, and has the title “Elon Musk Gives Twitter Employees a Deadline to Stay or Leave.”)