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31 things I learned in March 2021

1: “The NHS is ponderous, idiotic and wildly inefficient, and anyone who condemns it for being so is missing the point. Photosynthesis, after billions of years of evolution, has an efficiency of perhaps 5 per cent. People and their organizations are not so simple. Calls to reduce healthcare inefficiency should be treated with contempt unless they are detailed, specific and achievable.”

2: Annie in Michael Jackson’s Smooth Criminal is a resuscitation dummy.

3: “The author is not a very good person to quiz about a book. I try to avoid talking to authors about their books. I’ve been writing here in Britain for decades now, and I have no idea which of my author friends has ever read me or not, because there’s an understanding that you just don’t mention such things. It’s not polite conversation.”

4: “You are the result of a very complicated puzzle, consisting of thousands and thousands of pieces, and you’re only half-assembled.”

5: The national curriculum is blamed for primary school lessons being filled with jargon and acronyms.

6: Hotter summers mean wine has more alcohol by volume due to “the build-up of sugar in grapes, which yeast converts to ethanol.” And ABV labelling has wide tolerances, which means that “a wine with 12.5% ABV on the label could be anything between 11% and 14% in reality.”

I was surprised by the wide tolerance on alcohol labelling, but I really shouldn’t have been.

When I did my ready meals research a decade ago, I was surprised at the wide tolerance on nutritional labelling, which makes anything other than broad-brush calorie counting utterly pointless.

At that time, there was a legal tolerance of +/-20% in calorie labelling, meaning that someone could stick rigidly within their (say) 1500kcal daily target according to the packaging and still be a couple of Mars bars over their target.

Yet even that is an overstatement of accuracy: the tolerance of 20% could in fact be applied to the unprepared ingredients rather than the product as sold, so food could in fact be way more than +/-20% by the time they reached our stomachs.

So it really would be impossible for anyone to count calories accurately, just as it now seems it’s pretty hard for people to monitor their alcohol intake with precision.

7: “Good doctors (and good nurses) are self-effacing, humble, endlessly patient, full of common sense, constitutionally incapable of boredom. However, eminent and influential doctors – ‘key opinion leaders’ – are usually vain, arrogant, impatient and ambitious.”

8: There’s a special exemption to the rules for carrying liquids in hand luggage for pesto.

9: “No 10 introduced a new and innovative form of avoiding difficult questions yesterday, with the Downing Street spokesman telling journalists that the PM would address the royal news at the coronavirus press conference, only for the PM to show up and say he did not want to comment.”

10: “England’s test and trace programme failed to make a ‘measurable difference’ to the spread of the pandemic despite an outlay of £23bn, an ‘unimaginable’ level of expenditure, a parliamentary spending watchdog has claimed.”

11: The British people have “widespread admiration and affection” for Boris Johnson. It’s baffling to me that someone as respected as Allegra Stratton would chose to take a job where she’s having to debase herself with nonsense like that.

12: Airlines have their own trademarked scents: for example, ‘Calm’ for Delta, ‘Landing’ for United and ‘Ocean Citron’ for Alaska Airlines. Verizon has a trademarked ‘flowery musk’.

13: A book I thought was rubbish has been made into a film the NME thinks is rubbish. I think I’ll give that one a miss.

14: Some English schools think it appropriate to use a teaching resource “that tells girls their role is to be ‘receiver-responders’ in their relationships with men, that discourages the use of contraception, and tells young gay and lesbian people that there is no way for them to marry or express their love for another person”. And the Government’s response is that “it is for schools to decide which resources they choose to support the teaching of RSHE”.

15: “The Covid-19 pandemic has been like a barium meal for the body politic—and what it has revealed about the innards of our society has been far from pretty. To start with, it has shown how basic public services have been hollowed out by a decade of austerity, leaving the country ill-prepared for a crisis and those dependent on such services exposed.”

16: “Environmental resource economist Marshall Burke says there is a proven link between poor air quality and premature deaths linked to breathing that air. ‘With this in mind,’ he said, ‘a natural—if admittedly strange—question is whether the lives saved from this reduction in pollution caused by economic disruption from COVID-19 exceeds the death toll from the virus itself. Even under very conservative assumptions, I think the answer is a clear ‘yes.’’ At just two months of reduction in pollution levels he says it likely saved the lives of 4,000 children under five and 73,000 adults over 70 in China alone.”

17: Yo-Yo Ma gave an impromptu performance after receiving his second dose of the covid-19 vaccine.

18: Counting isn’t always helpful. I’ve been frustrated recently by a circular conversation about covid-19 “outbreaks”. I’m often asked to enumerate the current number of “outbreaks”: but defining individual “outbreaks” in the context of widespread community transmission is fairly arbitrary. Cases generally have multiple sites of possible disease acquisition, and may pass on their illness in a number of settings. There isn’t a point source to eliminate, nor is the disease rare enough to identify with a high degree of confidence chains of transmission.

So the only logical response is to ask why someone wants the figure, so that I can help them define the measure that best answers their question: the measure will be different, for example, if one is interested in pressure on the public health response, than it would be if one is interested in a proxy measure of the number of sites of community transmission. The answer, repeatedly, seems to be “the reason for the measure is not your concern, just count them!”

And it feels like the only two possible responses to that are 🤬 or 🤷‍♂️.

19: Laughter is important. I laugh a lot, especially at work. This is something I never really realised about myself until it was pointed out to me: I am someone whose first reaction to corporate nonsense is most likely to be belly-laughter, with frustration only tending to set in later. I often revel in the absurdity of the world of work, and I know I need a break when I stop seeing the silliness in the world.

20: I was thoroughly depressed today to see adverts up around Newcastle telling men not to ask women for directions and to cross the street to avoid walking near women.

This is such a tangled web of a situation. It is horrific to hear of the violent attacks that people inflict on other people. It’s horrendous that women live in fear every day. It’s awful that many men live with similar fears but are unable to express them. It’s upsetting that people’s level of fear—high or low—is often divorced from the statistical risk they face. It’s hard to explain the lack of focus on male/male violence, which some experience as victim blaming or as men being expendable.

Most of all, it’s regrettable that fear stemming from inhumane violence is allowed to drive a wedge between us and make all of us a little less human as a result.

21: What’s the point of London City Airport? I’ve used it a couple of times and—it seems— liked it more than Jonathan, but it is hard to argue that perhaps it’s an idea whose time has passed.

22: In my experience, most people who work in health—and especially in public health—have a deep-seated passion and drive to do the right thing for patients or populations. Opinions on what “the right thing” is vary, of course, and that can be a source of profound disagreement.

Today I was reminded that some don’t share that passion: some have a natural focus on processes, not people. And those are important people to have around because processes are important, and—from the perspective of the patient-focussed people—robust processes support good outcomes for patients.

Nevertheless, the cognitive load of talking things over with someone who approaches their work from such a different angle is high, and it’s hard not to give into a cognitive bias that nags away suggesting that the other person just doesn’t get it… particularly when they are in a more senior role.

23: Times New Roman appears on the face of some luxury watches.

24: In what may be a new world record, the National Institute for Health Protection has been abolished before it even existed, replaced by the UK Health Protection Security Agency.

25: Some days, my job appears to involve making YouTube videos at home. Does this mean I’m an influencer now?

26: “If you are moved by a rapper that you listen to on YouTube, it’s really not a big deal. You shouldn’t have to apologise for it in literary environments. The same is true if you love a classical poet. It isn’t the case that you need to approach lauded works on bended knee. The pool of influence you draw from does not have to meet the approval of an academy or an institution, or be bound by the parameters of a genre, sub-genre or ‘movement’. Listen to everything. Read as much as you can. Try to stay present and connected with whatever you’re engaging with when you’re engaging with it.”

27: “We should not be afraid to note some potentially positive side effects of the epidemic. One of the lasting symbols of the epidemic is passengers trapped in quarantine on large cruise ships. Good riddance to the obscenity of such ships say I, though we have to be careful that travel to lone islands or other resorts will not once again become the exclusive privilege of the rich few, as it was decades ago with flying. Amusement parks are turning into ghost towns—perfect, I cannot imagine a more boring and stupid place than Disneyland. Car production is seriously affected—good, this may compel us to think about alternatives to our obsession with individual vehicles. The list can go on.”

28: “The technology to construct modern skyscrapers existed long before the skyscraper became modern; the problem was the number of stairs. Stepping would have replaced office work as the office workers’ chief activity. Once the lift had released time into tall buildings it made its way into shorter ones, where more important than its production of time is its ability to render marginalised sections of society publicly visible.”

29: Here’s some advice that has become commonplace: don’t sleep with your phone next to your bed. Picking up a screen first thing in the morning it not good for anyone’s mental health, but some people need a phone by the bed for emergencies. There’s no need to use the alarm on it, though.

I started using my phone as my alarm clock when I first got a Blackberry, which required daily charging and even came with a ‘nightstand’ dock which turned it into a bedside clock. I stopped about a decade ago, when I realised how much I valued a couple of minutes of allowing myself to wake up without that sort of input: we got a clock radio instead.

These days, I’m woken by FiP on our Sonos system, because in 2019 the feverish radio chatter about Brexit became too much to handle first thing. At first, the timechecks being an hour ahead made it a little more… alarming! Though we ended up enjoying it so much, we now listen in the kitchen in the morning too. Contrary to common speculation about immersion in other languages, I can confirm that our French hasn’t improved.

30: This thoughtful reflection on the Oprah/Meghan interview is worth reading. Possibly more so than the interview itself.

31: Richard Wilson, the former Cabinet Secretary, says that one method of dealing with the initial stages of a crisis is to announce a COBRA meeting for later in the day, giving the impression of seizing control while allowing time to gather information and get ducks lined up. This is, more or less, the same approach I’ve long used to scheduling Incident Management Team meetings at work.

This post was filed under: Posts delayed by 12 months, Things I've learned.

What I’ve been reading this month

I’ve four books to mention this month.

Beneath the White Coat edited by Clare Gerada

This is a recently published book about doctors’ mental health, edited by the former Chair and current President of the Royal College of GPs and founder of the Practitioner Health Programme. I’ve had the pleasure of meeting Clare Gerada a couple of times and found her to be inspirational, and have also met or worked with an almost frightening proportion of the chapter authors at one point or another!

I read this book and was surprised by how much of myself I recognised in the descriptions of doctors’ personalities, and the aspects of their work they find particularly challenging. I found the practical content on “surviving and thriving in medicine” insightful and helpful. The chapter on burnout in doctors, and how most doctors have periods of burnout in their career, was particularly relevant to me right now, after two exceptionally demanding years of pandemic practice.

There is much to think about in here, and much of immediate practical value. It is brilliant.

These Violent Delights by Micah Nemerever

This 2020 first novel by Micah Nemerever was brilliant. Set in 1970s Pittsburgh, the plot follows two precocious college freshmen who are drawn together by their intelligence and slightly offbeat interpretation of the world. But—and this can’t possibly be a spoiler, as it’s the content of the prologue—their obsession (love?) for each other ultimately drives them to committing terrible crimes.

Nemerever does a fantastic job of weaving together the intense emotion of attraction with a sense of growing foreboding. The writing is almost poetic at times, with no wasted words or throwaway lines. The intensity and claustrophobia Nemerever creates is intense enough to feel a little exhausting at times, in the best possible way.

I thoroughly enjoyed this.

Jews Don’t Count by David Baddiel

This short TLS book published about a year ago has been widely praised. It features a combination of lived experience, polemic, and humour used to illustrate that antisemitism has been left out of much of the current present social discourse about racism. I thought it was excellent, and well worth an hour of your time: it helped me to much better understand some of the issues discussed, in particular the feelings experienced in response to the recent issue of antisemitism in the Labour Party. It’s a book which is light on detail and critical analysis, but is most certainly an easy-to-read introduction to some of the key issues.

I was slightly distracted by quite how much of the discussion was rooted on Twitter, a platform that actively promotes outrage and strong negative emotions, though Baddiel did at least acknowledge multiple times that Twitter is not a true proxy for the ‘real world’.

Beach Read by Emily Henry

I can’t remember what made me pick up this bestselling 2020 novel, but I’m afraid it just wasn’t my kind of thing. It seemed like fairly basic romance genre fiction to me: two young adults who are ‘polar opposites’ fall in love. I found the writing uninspiring and the plot predictably leaden.

The book is enormously popular, so it clearly has merit, but it just wasn’t up my street. I came close to giving up on it, and when I decided I may as well finish it, I couldn’t manage more than a chapter per day for the last section of the book.

The two most popular quotations from this book on Goodreads are:

“When I watch you sleep,” he said shakily, “I feel overwhelmed that you exist.”


“I’ve never met someone who is so perfectly my favorite person.”

Both of those strike me as clunky and wooden; clearly, by virtue of their popularity, many other people feel differently. Perhaps if these quotations speak to you, the book will too. Please don’t let my lack of enthusiasm put you off.

This post was filed under: What I've Been Reading, , , , .

Weeknotes 2022.12

A few things I’ve been thinking about this week. The twelfth post of a series.

In this month’s reading list email, Ryan Holiday points out that

just some twenty years ago, everyone listed their address and phone number in a phone book that was circulated to homes for free. In fact, you had to pay to NOT be included.

These days, my parents are careful about shredding everything with their address on it, even junk mail, and they’re hardly alone. How did we get here?

For much of this week, two petrol stations which are virtually opposite each other in Newcastle priced their regular diesel differently by 19.2p per litre (170.7p and 189.9p). It is surprising that a difference that big is seemingly sustainable.

I’ve been deep into automation this week: writing Microsoft Power Automate routines to automatically rename and file certain email attachments on OneDrive, and playing with Apple Shortcuts and HomeKit on personal devices. It’s years since I last played with these sorts of tools. They have become addictively straightforward and—shock—genuinely useful and time saving now that almost everything lives in the cloud.

I mentioned last week that I was enjoying Coco Mellors’s Cleopatra and Frankenstein, and I still am, but I’m now also reading Haruki Murakami’s What I Talk About When I Talk About Running. The former has a line

”Running is for children and thieves”

which I think summarises my feelings on Murakami’s subject rather well, even if his enthusiasm is somewhat infectious.

Diamond Geezer wrote this week:

I don’t know about you but if there’s a long gap until the next bus I always like to walk ahead along the route until just before it eventually catches up.

I share this habit, and have long been frustrated that Citymapper doesn’t seem to automatically understand that behaviour—but discovered this week that Transit does, so I’m a convert.

This post was filed under: Weeknotes.

Weeknotes 2022.11

A few things I’ve been thinking about this week. The eleventh post of a series.

Here in the Northern Hemisphere, it’s the vernal equinox, so…

I’m currently reading Cleopatra and Frankenstein by Coco Mellors, in which (at least) one of the chapters is set in Nice. Reading it made me want to visit the city again. I visited very briefly in 2018 and wasn’t all that taken with Nice, but I did take some warm-looking photographs (it was actually a bit nippy) which, I think, have had the effect of retrospectively improving my impression of the place. Maybe I’ll end up returning—and if I do, I hope I won’t be disappointed.

I’ve decided it’s spring and put the garden furniture out, which probably calls for gales next week.

A Prime Minister with a long history of using offensive and inappropriate comparisons as rhetorical flourishes is in the headlines for exhibiting that trait again. After his toadying supporters have toured the radio and television studios to tell us what The Prime Minister meant to say, we can all look forward to being told before long what a brilliant communicator he is. The merry-go-round of nonsense never stops.

This post was filed under: Weeknotes, , .

Weeknotes 2022.10

A few things I’ve been thinking about this week. The tenth post of a series.

I went for a walk in Sunderland this week, and was amazed to find a full-size sculpture of one of the Martian tripod machines from HG Wells’s War of the Worlds towering over me. I was amazed that I’d never heard about it, striking as it was, and spent a while after getting home searching the web for more information.

After initially turning up nothing, I ended up discovering that it isn’t a Martian sculpture at all, but is supposed to represent something else entirely. Most embarrassingly, I realised that I did know that this other sculpture existed, I just didn’t recognise it for what it was.

I didn’t take a picture of the sculpture, which perhaps is just as well, but if you’re near these impressive cliffs, you’re not far away from it. Hopefully, you would know it when you saw it, even if I didn’t.

There’s nothing more boring than other people’s dreams. I dreamt this week about being on a plane which was landing in heavy fog. The pilot came to sit in the main cabin, explaining that this was a new regulation for landing in fog, as human intervention in the automated landing was more frequently associated with causing disaster than averting it.

It’s made me ponder whether (or perhaps when) we’ll get to the point of banning human intervention in automated processes.

I was a couple of years late to this, but Bunga Bunga, Wondery’s nine part podcast on the political career of Silvio Berlusconi, is brilliant. Not only is the story itself simply unbelievable, Whitney Cummings’s presentation of it is perfectly pitched and laugh-out-loud hilarious while avoiding making light of serious issues. I highly recommend it.

Bus stop adverts have recently appeared for Macmillan Cancer Support, with the tagline “Whatever it takes. Donate today.”

I have a strongly negative reaction to that. People shouldn’t be donating “whatever it takes,” they shouldn’t be getting into debt to support Macmillan, they shouldn’t be diverting resources from other charities they support. It’s unduly pushy.

This post was filed under: Weeknotes.

Weeknotes 2022.09

A couple of things I’ve been thinking about this week. The ninth post of a series.

After two and a half years of subscribing, this week I reached the milestone of having funded the planting of more than 1,000 trees through Ecologi. I also found this week that I could see a breakdown of where they’d be planted: 825 in Madagascar, 136 in Mozambique, 42 in the UK, 18 in Kenya, 10 in Nicaragua and 5 in Uganda.

They even have pictures of some of them: here’s a Rowan, an Alder and a Silver Birch they planted for me in Scotland last year, none of which are species I’d have a hope of recognising even once fully grown if they weren’t labelled:

You might imagine that this would produce a warm, fuzzy feeling, but in fact it leaves me a bit conflicted. Half the stuff I read seems to say “trees are wonderful and we should plant gazillions of them” and half seems to say “mass tree planting projects destroy biodiversity and mess up the planet” (which Ecologi obviously denies). Who really knows whether I’m doing the right thing, or just assuaging my climate guilt in a way which is actually making things worse? Surely trees are basically great?

There have been flyers around town this week advertising a protest with the headline “We’ve heard enough climate change bullshit.” I’m confused as to what the protest is about. Do they think that politicians have been spouting “bullshit” while taking inadequate action? Or do they think that climate change itself is “bullshit” which doesn’t actually exist?

This post was filed under: Weeknotes.

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