Max Mednik
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Readings and musings

Notes on 1984 by George Orwell

9/28/2012

1 Comment

 
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I finally got around to reading the classic 1984 by George Orwell (I like to mix it up between technical/programming books, fiction, and non-fiction/business/design books). This book was a chilling account of a future, uber-totalitarian world. Reading it shortly after Atlas Shrugged, I actually found a lot in common between the two texts. In Ayn Rand's book, the heroes overtly portray the virtues of selfishness, individualism, and capitalism, whereas in George Orwell's book, he teaches the same lessons by contrast: the heroes can only try to subvert the system, and the reader sees the horrors that happen when the opposite (collectivism and loss of rationality) takes over.

Some of the descriptions in the book were so graphic and emotional that I had a hard time at first figuring out whether the author was serious (a fan of collectivism) or not; I was pretty sure he wasn't, but he made the point very clear of how a mass of people could be brainwashed into accepting it and losing individual rationality. I also wondered whether there were elements of satire and commentary on the political environment of his time or whether he was just commenting on a (bad) possible future.

Part 1
Ch 1
  • Tele screen two way watching and showing
  • Big brother is watching
  • Party political
  • Police patrol
  • Thought police
  • War is piece
  • Freedom is slavery
  • Ignorance is strength

  • Ministry of truth: news
  • Ministry of peace: war
  • Ministry of plenty: economics
  • Ministry of love: law and order

  • Victory gin
  • Victory cigs

  • Propaganda
  • Politics in all
  • Buying book, pen, writing in diary a crime
  • No one knows exact date
  • How do you communicate with the future?

  • Thought crime
  • Revolutionary

Ch 2
  • Mother taken away

Ch 3
  • No externally recorded facts
  • Who controls the past controls the future
  • Who controls the present controls the past
  • Countries at war

Ch 4
  • Continuous alteration of past news and records so predictions match reality
  • Data created, deleted, or falsified
  • Can create dead men but not living ones
  • Create facts in past
  • Oceania against Eurasia 

Ch 5
  • comrades
  • Destruction of words to make common language
  • Newspeak vs oldspeak
  • Narrows the range of thought by narrowing vocabulary
  • Rations of all goods

Ch 6
  • Chastity brainwashing

Ch 7
  • Anti-capitalist lies
  • Fossils of evidence of falsification by government
  • Past changes continuously

Ch 8
  • Rebellion by buying antiques
  • Writing in diary

Part 2

Ch 1
  • Met girl
  • In love
  • All has to be secret

Ch 2
  • Secret meeting

Ch 3
  • Break the rules and trying to get away
  • Animal impulses dangerous to party
  • To escape focus on life not death

Ch 4
  • Secret room

Ch 5
  • Hate week
  • Political power through fear
  • War as sham
  • No one remembers
  • Lies becoming truths

Ch 6
  • Thoughts to words to action

Ch 7
  • They can't change you on inside if you hold on to feelings


Ch 8
  • Distributed mesh brotherhood of revolutionaries

Ch 9
  • Starts reading Goldstein book
  • Long speech in book (like John Galt's!)

Goldstein Book Ch 1: ignorance is strength
  • High, mid, low classes tied to part of political party
  • no deviation of opinion
  • Contradictions and denial of reality

Goldstein Book Ch 3: war is peace
  • Super states permanently at war
  • War effort increases production for no reason
  • Inner party vs outer party vs prols
  • Extinguishing independent thought
  • Only science for weapons
  • No contact with foreigners or languages
  • Denial of reality

  • Knowing truth vs untruth

Ch 10
  • Caught by thought police


Part 3

Ch 1
  • Thought crime prison

Ch 2
  • Brotherhood guy double crossed him
  • Past exists only in past and memories
  • Nature of reality as objective
  • Brainwashing

Ch 3
  • Power is aim of party
  • Reality inside the mind
  • We make the laws of nature
  • Power over men instead of things
  • Winston hero of man

Ch 4
  • Mind converted and deceived but heart not

Ch 5
  • Room 101
  • Learn to love big brother
  • Give up heart 

Ch 6
  • Both lovers betrayed each other
  • Only care about self
  • Won victory over himself by killing brain and loving big brother

Epilogue
  • Engsoc: English socialism
  • Newspeak
  • heretical thought unthinkable in the language
  • A words just for plain life
  • B words specifically for political ideas
  • Impossible to translate old books into newspeak

1 Comment

Problems in medicine that interest me

9/26/2012

4 Comments

 
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Healthcare is an enormous part of our economy and arguably the part of our lives that is the most fundamentally important to determining our quality of life and happiness. But there is so much that is inefficient and can be improved. I wanted to briefly describe a few of the major problems, trends, and opportunity areas that excite me about the field.

Doctor payment models

Problem: Most doctors get paid on a fee for service model rather than an outcome model. This incentivizes more treatment and tests and does not punish readmissions/disease relapses. Measuring quality and outcomes in medicine is actually a very ill-defined and difficult challenge in and of itself. A medical problem could come from four areas (doctor's advice, patient genetics, patient choices, and external events), with the doctor only involved in one of them. Nonetheless, there must be something better we can do than the current state of affairs.

Somehow, it would be nice to align doctor incentives with patient health and allow more fluid access to care when people need it. Some of the current quality-tied compensation schemes are a step in that direction, but they are too narrowly defined and promote gaming the system. Projects like "medical homes" as well as some HMOs are making good progress in this direction. It would be nice if primary care doctors earned more so we had more of them (we are in desperate shortage now, which will only exacerbate with health care reform). They should also have more authority and pay when they keep their patients healthy as well as earn money for extra counseling around lifestyle issues (currently they don't earn for that).


Insurance company incentives

Insurance companies should incentivize health, not just pay for cures. While it is difficult, prevention is preferable to treatment. Not just HMOs, but all insurance companies should be paying our gym memberships and giving us rewards for using them (check in at the gym), subsidizing our expensive Whole Foods organic food purchases and multivitamins, giving us money for not smoking or drinking, etc. I learned that the reason a lot of this doesn't happen is that people switch individual insurance carriers frequently, and the benefits of positive lifestyle choices are only reaped over the long-term (by which point the insurance company might have been changed out).

Insurance companies that see patient claims as "losses" as opposed to normal operating costs seem backwards. I want companies that will incentivize health and be customer-service organizations, chosen by people for their helpfulness rather than simply as a lesser among evils.


Electronic medical records

There are many EMR systems out there already, and the government provides incentives to install them and "meaningfully use" them. However, from doctors I've spoken to, I've learned that most are still clunky and limited, aren't designed with the doctor and patient in mind (i.e., not human-centered), and most painfully of all, aren't interoperable. The vision of electronic records is that they would enable people to carry their data across providers and improve communication across organizations, but that hasn't yet been solved. Many people complain of doctors who don't communicate effectively, and part of it is behavior change and training, but another part is the tools available.

I'm wondering whether countries that offer "universal healthcare" are different in regards to the problems mentioned above. I know they are much worse in terms of doctor waiting times (which are expected to increase substantially in the US after health care reform) and have worse access to the top-of-the-line medical tech. But are their doctors more collaborative? What other problems do they have?


Real-time home monitoring technology

This is very closely related to what Paul Graham wrote about as "ongoing diagnosis." We only seek care when we have symptoms, as opposed to knowing much earlier if something is sub-optimal in our body and correcting it then and there. This is very aggressive and difficult from the technology standpoint, but that's why it also makes it really exciting for me. I've always dreamed of a machine that can scan my body quickly at home and tell me if I have broken bones or infections. Taking this one step further, it would "push" this info to me whenever my body state changes adversely instead of me having to repeatedly poll for it. This seems really cool and also really hard.
4 Comments

Notes on No Easy Day by Mark Owen

9/20/2012

1 Comment

 
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A friend of mine told me about No Easy Day by Mark Owen way before it got its press notoriety. The story was written by a Navy SEAL who participated in many historic missions, such as saving the hostages from the Somali pirates and the raid on Osama bin Laden. I was interested in checking it out for the details of how SEALs train and organize and less so for the political details surrounding the UBL raid. Luckily, this was how the author felt as well, as his story was direct, fact-based, and with practically no political or emotional rhetoric.

I enjoyed learning about how SEALs train, how they organize their own gear, and how they manage their attitude in the face of grueling hours and immense physical burden. The book was inspiring and gave me some good advice about perseverance, like just focusing on getting to the next meal when enduring difficult work or training. Despite the author's incredibly significant accomplishments, he remained humble throughout the entire book, and several times, he even said that when you start celebrating your own hype, that's when you're in for trouble. I like that attitude of focusing on reality and getting stuff done. I was also impressed with his immense dedication to his work and his love of it, and how that drove him to make difficult decisions for the benefit of his work. That was an example of the good/right definition of selfishness.

  • Book: Men in Green Faces
  • Read it when was kid
  • Wanted to be SEAL
  • Being their best
  • Team effort
  • Brotherhood
  • Live a life bigger than youu

Prologue
  • Complete trust of team
  • Trained when Sept 11 happened

Ch 1 green team
  • Training
  • Simulation middle east compounds
  • Just focus on making it to next meal
  • Clearing rooms under stress
  • Decided to be seal at 13
  • Dev group
  • Book: Black Hawk Down
  • Fear of failure
  • Bullshit excuses
  • Stand ground and take responsibility

Ch 2 top 5 bottom 5
  • Can't move without moving call
  • Must do all in training by the book and exactly as specified
  • Ladder rope exercise
  • Everyone in community has reputation
  • Shooting pool
  • Smack talk
  • Small community
  • San Diego ca and Virginia beach va locations for seals
  • Charity calendar
  • Father taught him how to shoot
  • Learned huge lesson once and doesn't repeat mistake
  • Ferreting out weakest
  • Peer rankings of best and worst
  • Green team
  • Mental toughness
  • Culture of command
  • Pages by boss
  • Sacrifice lives for greater good
  • He was great shooter

Ch 3 second deck
  • First deployment
  • 6 pages packing list
  • Big boy rules with little management
  • Personal locker with different kits
  • Gerber tool
  • Best tools and armory
  • Afghanistan
  • Cramped helicopter
  • When in doubt load it out and prepare for contingencies
  • But weigh a lot
  • Luck played big role in first mission and that was bad
  • Train like u fight; only use equipment u know

Ch 4 delta
  • Calm clear decision making
  • Operations at night from helicopters
  • Vampire hours
  • Always dual prime charges with two detonators
  • One is none, two is one
  • Saved by random mistake
  • No more bullshit rivalries between army delta force and navy Dev crew
  • Only 2 weeks of leave

Ch 5 point man
  • Night operations in copters
  • Be comfortable being uncomfortable
  • Cold
  • Hung out with father in Alaska
  • Taught him to shoot and fish
  • Pranks on team

Ch 6 maersk Alabama
  • High altitude high opening haho
  • Parajumps
  • Quitting wasn't an option when was scared
  • Somali pirates hostage situation on ship
  • Slow Washington decisions
  • Aerial drones
  • Saved life 

Ch 7 wrong war
  • Combat assault dogs
  • Families last priority
  • Always training or deployed
  • Two families
  • Loved work

Ch 8 goat trails
  • Became leader
  • Good planning and stealth

Ch 9 special dc
  • Found UBL

Ch 10 The pacer
  • Found him in Pakistan
  • Special secret operation of dream team across orgs
  • bin laden started al qaeda
  • Detailed model of compound
  • 2 helicopters for main and guest houses
  • Pro words: 1 word messages for fast radio communication
  • Fly to the x vs fly to the y and sneak in after walking over
  • Construction crew built full mockup of compound
  • Got whatever info they needed
  • Waited on dc for approval of mission beyond planning
  • Dress rehearsal for suits in dc

Ch 11 killing time
  • politicians making decision
  • Got orders to stage in Pakistan
  • Bombing vs ground assault options
  • Rituals to kill time, set up gear, make coffee from scratch

Ch 12 go day
  • Set of checks of all tools
  • Tools listed
  • Helicopter problem

Ch 13 in fill
  • Cleared guest house successfully after some mishaps

Ch 14 Khalid
  • Killed bin laden son

Ch 15 third deck
  • Took their time

Ch 16 Geronimo
  • Had to take good photo
  • DNA samples
  • Saliva samples
  • Leaders less willing to fight
  • UBL didn't put in ammunition

Ch 17 x ville
  • Refueling copter
  • Helicopter crash was biggest problem

Ch 18 confirmation
  • All came back safely
  • CIA analysts beat him intellectually
  • One big team

Ch 19 touch the magic
  • Don't believe your own hype
  • Wanted to fade out of attention
  • Met with Obama

Epilogue
  • Never worked in non-operational job
  • Stepped down instead
  • Time for his own life to take priority
  • Live for a purpose
  • Donate to veterans foundations like Tip of the Spear and All-In

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