I’ve noticed a weird trend where scrolling short form media alone-together has become a social trend. I work as a firefighter and we eat our meals communally. While the eating portion has continued to be social, the lingering time has become a lot of folks scrolling on their phones then sharing something they found funny or interesting with the rest of the group. I don’t have TikTok or Reels on my phone, yet I find myself sucked into other people’s algorithms by proximity and social bonding.
I can see the appeal/compulsion which is why I don’t have these apps, but it does become harder to avoid. I suppose we’re all melting together.
Keep the faith, Deron. Humankind will eventually free itself from these shallow dopamine hits, and regain its thirst for intimate understanding of all things.
I do honestly believe this is true. Many of us will develop the skills and habits to turn to other things, the slow dopa if you will. Life turns out better than we suspect it might.
My girlfriend and her roommate sometimes "co-scroll" where they airplay one of their phones to the tv and watch together. Or she and I will watch the reels she has sent me throughout the day together before bed.
It's like smoking at the back alley. Your secretary smokes, so does your boss, so does her boss. You lose connections if suddenly one day you get up and quit smoking
On item 23 and optimism: being optimistic/pessimistic about the future is less about the actual state of things than the (perceived) direction of change. A lot of people hold a bleak view not necessarily because they believe things to be better in plague-ridden Europe, but because they expect things mostly to get worse from now on. And, in fact, if you read most of the points here, it's hard to refute them. Sure, there are some new drugs for tackling obesity, but people don't read, don't party, don't have a religious community, houses, and jobs. And AI is getting exponentially better and, if we grapple with the reality, will probably outpace humans in middle-class white-collar jobs soon enough. A lot of them would really like to change places with their parents! I think a case for optimist can be made, but it should be a bit stronger and more cohesive than the 'child mortality fell in Africa' and 'at least there is no black plague and Mongol hordes around anymore' arguments that we so often see being made.
Derek, you cite the meta-analysis showing heavy short-form video users have deficits in attention, memory, and inhibitory control. And you note that "a daily diet of hyper-rewarding, rapid-fire stimuli may gradually reshape attention and regulatory systems."
I think you're exactly right, and I'd push it further. The mechanism isn't just cognitive. It's somatic. The attention economy induces the same defensive architecture as trauma: constriction, narrowing, the collapse of presence. That's why the reading crisis isn't really about reading. It's about whether the body can stay with anything that doesn't offer variable reinforcement. Books require duration. Duration requires a nervous system that hasn't learned to treat presence as unsafe.
Congrats to you and your wife, Derek. Sending good wishes to your family.
Re: liberal young people and meaninglessness, I have a strong sense that this is from the Doom Dogma that rules the commentary. "We'll never have a good job, we'll never have a house, climate change will kill us all if AI doesn't first." When I read "youth-oriented" threads and the like, I am not at all surprised that despair is so high with young people.
I know old people always think the latest invention will destroy a generation, but I think social media might be the real deal in this sense.
I couldn’t agree with you more. Social media along with plastics are hard core plagues. We just haven’t felt or understood their true affects just yet as of now. Seeing in the minds of 8 billion people is not healthy. I use the word health on purpose. I think it destroys our health. While we use socials to spark ideas of what we might want to learn, we can’t become so addicted that they take the place of memory. There’s so much more I want to say, but all I know is that social is devastating for the planet and the people on it.
You wrote "(Y)oung people care much less than their parents or grandparents about getting married or having children. What they do say they care about is finding a job and getting rich." and I'm going to gently push back on that framing, as a young person myself.
It's not that we care more about getting rich than we do about having kids. I want kids. The vast majority of my friends want kids. But I think the issue here is that we care more about being financially prepared to have and raise children (apparently it's expensive) than previous generations did. I know it's what I care about. Hopefully that provides some clarity on that particular issue :)
Yes I had a pushback reaction, too. I am 66 so my perspective is different than yours. Is “get rich” really what’s most important to young people? I’m not so sure, but perhaps they have a fundamental understanding that money equals freedom, protection, and ultimately, contentment. If you’re not financially stable, life is an escalating series of problems. No amount of idealism and enlightenment will change that. And no amount of assistance from the government or nonprofits will ultimately provide a stable and sustainable life.
I vehemently disagree with your thesis about money. True freedom comes from having nothing to take away, no manuals to read for all the toys. Mr. Dylan said it best: "When you ain't got nothin', you got nothin' to lose."
Just anecdotally, domestic beer and wine haven't necessarily decreased, but I haven't really noticed an increase either, unlike just about every other grocery product.
Heard about this *today* from a distiller and expert on the industry. Short answer is, people are buying more expensive booze and drinking less of it. "Collectible" bourbons instead of a house handle of Four Roses for cocktails...or the new-entrant "prestige" bourbon that's actually artificially-aged bulk spirit from MGD.
There was a severe whiskey shortage about eight years ago or so. Thousands of people rushed into the industry. Now many have been washed out. But they still have big stocks of whiskey they put down. Some are being resold, others are just being warehoused: eight years aging is eight years, after all, and eventually someone will want it at 15 years old. It's happened many many times before. It's a question of high supply and falling demand. A glut leads to lower prices, sometimes, if the glut is put on the market. More often with booze, you stick it away and wait for it, and economic times, to get better.
Distilleries are currently going for a song. But like houses, one problem is that the old people want more for them than they're actually worth.
Well, because pricing is no longer tied directly to demand like it was in the olden days. Pricing is now an algorithmic / big data / AI game. Companies are leveraging AI to maximize the price we are willing to pay per individual for a given product in order to maximize profit and shareholder value. Looks like our MBAs are now even more worthless lol
That's why I don't use grocery store apps even if I miss their promotions. My phone is probably tattling on me anyway. Price fixing on the functional drunks.
This point "But once researchers fine-tuned ChatGPT on an individual author’s full body of work, the results flipped," refutes the idea that AI is better at writing than humans. The only AI that experts preferred was the AI writing that was TRAINED on a human's complete body of work. 10/10 on everything else here.
Holy crap at the rollercoaster this post was. Kudos on the tempo between the points.
I'm truly at a loss between the getting high and getting drunk points. I recall back in college that the biggest detractors to legalizing weed were the stoners that were literally wasting away on a couch instead of showing up to class. Kind of scary to see that playing out in the present.
To me it seems like the worst case of alcohol use, drunk driving and abusive anger, are worse than the worse case of weed use. However, nominal alcohol use (more social, some health issues) is better than nominal weed use (social isolation, sloth, stupidity)
I mean, driving under the influence of weed is also not exactly safe. Quite dangerous, even. :)
That said, I did mean that as a tongue in cheek callout to the partying culture that was much bigger in the drinking crowd. Seems the rise of "sitting at home high" is directly related to the lack of people drinking.
We also know that an 80-proof bourbon is 40% alcohol. Period. It's well-established, though not often talked about, that 10 mg of CBD might actually be 16, with potency 40% higher than claimed on the label. California, the most highly-regulated state, did a study where *not one* of the samples they tested was accurately labeled. More troubling, the samples all ranged from somewhat to extremely more powerful than claimed.
As someone who always finds data analytics interesting, I genuinely enjoyed reading the article. However, I wonder if its use of data (26 charts in the article) also illustrates the illusion of data as a change mechanism. Over the course of my career, I've seen many organizations pursue "data-driven" decision making only to fall into the trap of paralysis by analysis
Consider that towards the end of every year comes a spike in writing on future year trends with more and more data available to forecast nearly anything. Yet, for all that analysis, it seems to get only more difficult to write something like the "26 Most Important Decisions You Need to Make."
Perhaps in response to analysis by paralysis, we are all becoming more comfortable using decisions to drive searches for data that provide after-the-fact justification for our choices. This is what I tell myself to rationalize the comfort/confidence people have in opting out of common vaccines (like those for measles), or opting in to "medicinal" drugs, or choosing to do things in general that seemingly go against their best interests (from my perspective at least).
On a lighter note, as someone who writes a substack that gets critiqued by his daughter, here are 26 things you should expect your daughters to say about you and your substack after you teach them how to read and write:
1. This is so long, do people ever finish reading?
2. LOTR was a book? You were alive when people read it?
3. You typed this? You didn't just dictate it to your phone?
4. No way I'm getting to 26 - you're making it way too deep. (I can't believe you taught me to read and write so I'd have to read this and write about it.)
5. Uncle Ezra gets a lot more views on his podcast.
Best wishes to you and your family. Congrats on the new baby girl.
I feel that points 19-21 could be better understood by the finding in the book "Poorly Understood" that nearly 60% to 75% of Americans will experience at least one year in or near poverty (150% of the poverty line) between ages 20 and 75. And that's a full year, think about what that means for people that spend 11 months under those lines but are able to pull above at the very end and don't actually "count." America has a ton of poverty and a lot of people that spend time in it because of our lack of welfare state and that has to be in the mix for explaining at least some of the misery you're describing.
In line with the affect-versus mood polling discourse, I wonder if religious conservatives are less likely to answer that their life is meaningless because their value system tells them that a meaningless life is sinful, and a clever investigator could find the same level of purpose in that subgroup as anywhere else, or if within that group, purposefulness is correlated with some underlying metric of genuine belief.
It would seem that one of those two things must be true. If it’s the latter, intuition would say that secular meaning-giving institutions like family or community must have similar benefits.
I think it's more likely that they have stronger near-field or local ties and are in fact wired to think in terms of local connections and relationships. Liberals and city dwellers are optimized to deal with complete strangers all the time. In part this is an artifact of education, because education isn't about knowledge, it's about abstracting knowledge so you can organize and work with it. That's one reason many conservatives hate education: you lose the ability to put up with your racist Uncle Ralph because he's your uncle, and this leads to intra-group friction.
Regarding valuing money — and heightened gambling — I think we’re all trying to grasp a sense of control & frankly, any kind of safety net in a time when we realize the systems are not set up to help us — *and* that acting like they are is no longer beneficial/as imperative to our safety.
To push it a bit further, were people *actually* more patriotic back in the day or had past generations metabolized an expectation of assimilation in order to survive? Same goes for having children — it was such an expectation & in previous generations (like when women couldn’t have their own credit cards), they were expected to birth children and their livelihoods depended on it.
Of course, I recognize these were high-level overviews, but looking at them from an intersectional lens is so important ex. We keep hearing about the male loneliness epidemic — and I’m fascinated by the thoughts you’ve presented here — but I always wish the discussion included statistics about the harm done to women/all genders at the hands of men (which further isolates us all), along with context around societal expectations for boys/men to shut themselves down emotionally, rather than open themselves up to vulnerable connection.
Comments on several of the ideas from a physician-clinical trialist:
7. Standard LLMs (let alone specialized medical ones) are already way better at being doctors than the best doctors. In all aspects except procedures.
9. There is a clear tie between teen anxiety and depression and the brilliant book "Paradox of Choice" from Barry Schwartz.
10. The ascendancy of money should be a good thing, ethically and morally, if markets are allowed to function properly. The "invisible hand" of the market is the best decision maker about what's good and bad. Not saying it gets it right all the time, but it gets it right more than any other system.
12. Fascinating reason teens don't drink that I haven't heard anyone talk about, but that I hear from my own kids - if alcohol is visible at a party, you can't post pics to your public social media accounts. Thus, they don't go to parties where there is alcohol.
14/15. Weed makes people gain weight. GLP1s are the perfect complement to the rise of weed.
18. You got vaccines totally wrong. Think of them just like exercise. Excercise is good. But there is such a thing as too much exercise and such a thing as the wrong kind of exercise to achieve a particular goal. It is highly likely that at some point there is such as thing as too many vaccines, but we don't have any science to answer that question. Kennedy is doing exactly the right thing by requiring placebo controlled vaccine trials. If vaccines are great, those trials will show it. If vaccines have harms, those trials will show it. It is literally the epitome of what science is supposed to do. Anyone who says science has proved vaccines are safe is lying. We have essentially zero placebo controlled trials for modern vaccines and in the abscence of such trials, we have no idea if there are harms or not. Anyone who claims that adjuvant controlled trials are placebo controlled trials is either uninformed or intentially misleading. You've falled into the trap that people fell into with climate - lots of people with vested interests in vaccines being safe as is (most of the experts) keep repeating that the science is settled, so non-experts (includes 99% of physicians) accept it, despite it being obviously wrong.
20. The interesting fundamental change in the stock market is the rise of the 401(k). Huge monthly cash inflows that HAVE to be invested and cannot be withdrawn. This has led to a constantly rising market (over the long term) and that will continue as long as 401(k)s and similar vehicles are the primary way to prepare for retirement.
22. The "centrist" news outlet list is hilariously non-centrist. But AI (Grok in particular) has fixed the 'what to believe' problem for anyone who cares to know what is true, partially true or false.
Thank you for the citation. In that study an AI model didn’t actually see or manage any real patients did it? So the study doesn’t support your claim that “LLMs …are already way better at being doctors than the best doctors.” Of course medical knowledge is important, but there is much more to being a good doctor than regurgitating facts. Empathetic interactions and management of the fear and anxiety that are common aspects of patient visits are essential to providing optimal care.
Here's the citation that turned my opinion (based on extensive use of various LLMs to help me with real life patient scenarios in areas where I have deep expertise) into something I'm quite comfortable stating as fact:
People talk about it kind of like autonomous driving - they LOVE to point out when AI gets a case wrong, basically using "perfect" as the benchmark, as opposed to real world human provider performance. I'd imagine that the very best human doctors, in ideal scenarious (not running behind, not tired, not distracted, etc) would probably still outperform, but this was published months ago (preprint) so that may no longer be true.
#9: A plea from a very pro-vaccine, scientifically minded physician. Could there be "something rotten" in our federal health agencies? (A sorry literary reference to the recent comparison of Danish vaccine policy to US given at the ACIP Hep B meeting.) It's more than looney RFK, jr and "anti-vaxxers" asking questions.
Re: TikTok.
I’ve noticed a weird trend where scrolling short form media alone-together has become a social trend. I work as a firefighter and we eat our meals communally. While the eating portion has continued to be social, the lingering time has become a lot of folks scrolling on their phones then sharing something they found funny or interesting with the rest of the group. I don’t have TikTok or Reels on my phone, yet I find myself sucked into other people’s algorithms by proximity and social bonding.
I can see the appeal/compulsion which is why I don’t have these apps, but it does become harder to avoid. I suppose we’re all melting together.
Keep the faith, Deron. Humankind will eventually free itself from these shallow dopamine hits, and regain its thirst for intimate understanding of all things.
We eventually did denormalise smoking as a habit
I do honestly believe this is true. Many of us will develop the skills and habits to turn to other things, the slow dopa if you will. Life turns out better than we suspect it might.
My girlfriend and her roommate sometimes "co-scroll" where they airplay one of their phones to the tv and watch together. Or she and I will watch the reels she has sent me throughout the day together before bed.
It's like smoking at the back alley. Your secretary smokes, so does your boss, so does her boss. You lose connections if suddenly one day you get up and quit smoking
I agree. We can revive our third places and lift a glass with joy and Gemütlichkeit. GreatGoodPlace.org
On item 23 and optimism: being optimistic/pessimistic about the future is less about the actual state of things than the (perceived) direction of change. A lot of people hold a bleak view not necessarily because they believe things to be better in plague-ridden Europe, but because they expect things mostly to get worse from now on. And, in fact, if you read most of the points here, it's hard to refute them. Sure, there are some new drugs for tackling obesity, but people don't read, don't party, don't have a religious community, houses, and jobs. And AI is getting exponentially better and, if we grapple with the reality, will probably outpace humans in middle-class white-collar jobs soon enough. A lot of them would really like to change places with their parents! I think a case for optimist can be made, but it should be a bit stronger and more cohesive than the 'child mortality fell in Africa' and 'at least there is no black plague and Mongol hordes around anymore' arguments that we so often see being made.
Attitude is a choice.
Derek, you cite the meta-analysis showing heavy short-form video users have deficits in attention, memory, and inhibitory control. And you note that "a daily diet of hyper-rewarding, rapid-fire stimuli may gradually reshape attention and regulatory systems."
I think you're exactly right, and I'd push it further. The mechanism isn't just cognitive. It's somatic. The attention economy induces the same defensive architecture as trauma: constriction, narrowing, the collapse of presence. That's why the reading crisis isn't really about reading. It's about whether the body can stay with anything that doesn't offer variable reinforcement. Books require duration. Duration requires a nervous system that hasn't learned to treat presence as unsafe.
I wrote about this last week in "The Attention Wound: What the Economy Extracts and what the Body Cannot Surrender" https://yauguru.substack.com/p/the-attention-wound?r=217mr3
Congrats to you and your wife, Derek. Sending good wishes to your family.
Re: liberal young people and meaninglessness, I have a strong sense that this is from the Doom Dogma that rules the commentary. "We'll never have a good job, we'll never have a house, climate change will kill us all if AI doesn't first." When I read "youth-oriented" threads and the like, I am not at all surprised that despair is so high with young people.
I know old people always think the latest invention will destroy a generation, but I think social media might be the real deal in this sense.
I couldn’t agree with you more. Social media along with plastics are hard core plagues. We just haven’t felt or understood their true affects just yet as of now. Seeing in the minds of 8 billion people is not healthy. I use the word health on purpose. I think it destroys our health. While we use socials to spark ideas of what we might want to learn, we can’t become so addicted that they take the place of memory. There’s so much more I want to say, but all I know is that social is devastating for the planet and the people on it.
Congratulations Derek!
You wrote "(Y)oung people care much less than their parents or grandparents about getting married or having children. What they do say they care about is finding a job and getting rich." and I'm going to gently push back on that framing, as a young person myself.
It's not that we care more about getting rich than we do about having kids. I want kids. The vast majority of my friends want kids. But I think the issue here is that we care more about being financially prepared to have and raise children (apparently it's expensive) than previous generations did. I know it's what I care about. Hopefully that provides some clarity on that particular issue :)
Yes I had a pushback reaction, too. I am 66 so my perspective is different than yours. Is “get rich” really what’s most important to young people? I’m not so sure, but perhaps they have a fundamental understanding that money equals freedom, protection, and ultimately, contentment. If you’re not financially stable, life is an escalating series of problems. No amount of idealism and enlightenment will change that. And no amount of assistance from the government or nonprofits will ultimately provide a stable and sustainable life.
I vehemently disagree with your thesis about money. True freedom comes from having nothing to take away, no manuals to read for all the toys. Mr. Dylan said it best: "When you ain't got nothin', you got nothin' to lose."
We all need to drink more if we are to survive 2026
What I don't understand is if people are drinking less, why hasn't the price of booze gone down?
Just anecdotally, domestic beer and wine haven't necessarily decreased, but I haven't really noticed an increase either, unlike just about every other grocery product.
Heard about this *today* from a distiller and expert on the industry. Short answer is, people are buying more expensive booze and drinking less of it. "Collectible" bourbons instead of a house handle of Four Roses for cocktails...or the new-entrant "prestige" bourbon that's actually artificially-aged bulk spirit from MGD.
There was a severe whiskey shortage about eight years ago or so. Thousands of people rushed into the industry. Now many have been washed out. But they still have big stocks of whiskey they put down. Some are being resold, others are just being warehoused: eight years aging is eight years, after all, and eventually someone will want it at 15 years old. It's happened many many times before. It's a question of high supply and falling demand. A glut leads to lower prices, sometimes, if the glut is put on the market. More often with booze, you stick it away and wait for it, and economic times, to get better.
Distilleries are currently going for a song. But like houses, one problem is that the old people want more for them than they're actually worth.
Well, because pricing is no longer tied directly to demand like it was in the olden days. Pricing is now an algorithmic / big data / AI game. Companies are leveraging AI to maximize the price we are willing to pay per individual for a given product in order to maximize profit and shareholder value. Looks like our MBAs are now even more worthless lol
https://www.youtube.com/watch?v=osxr7xSxsGo
That's why I don't use grocery store apps even if I miss their promotions. My phone is probably tattling on me anyway. Price fixing on the functional drunks.
The top 20% of drinkers are responsible for 70% of alcohol sales.
Top 10% often consume a bottle of liquor *daily*.
This point "But once researchers fine-tuned ChatGPT on an individual author’s full body of work, the results flipped," refutes the idea that AI is better at writing than humans. The only AI that experts preferred was the AI writing that was TRAINED on a human's complete body of work. 10/10 on everything else here.
Holy crap at the rollercoaster this post was. Kudos on the tempo between the points.
I'm truly at a loss between the getting high and getting drunk points. I recall back in college that the biggest detractors to legalizing weed were the stoners that were literally wasting away on a couch instead of showing up to class. Kind of scary to see that playing out in the present.
To me it seems like the worst case of alcohol use, drunk driving and abusive anger, are worse than the worse case of weed use. However, nominal alcohol use (more social, some health issues) is better than nominal weed use (social isolation, sloth, stupidity)
I mean, driving under the influence of weed is also not exactly safe. Quite dangerous, even. :)
That said, I did mean that as a tongue in cheek callout to the partying culture that was much bigger in the drinking crowd. Seems the rise of "sitting at home high" is directly related to the lack of people drinking.
We also know that an 80-proof bourbon is 40% alcohol. Period. It's well-established, though not often talked about, that 10 mg of CBD might actually be 16, with potency 40% higher than claimed on the label. California, the most highly-regulated state, did a study where *not one* of the samples they tested was accurately labeled. More troubling, the samples all ranged from somewhat to extremely more powerful than claimed.
"Greening out" didn't use to be a thing.
As someone who always finds data analytics interesting, I genuinely enjoyed reading the article. However, I wonder if its use of data (26 charts in the article) also illustrates the illusion of data as a change mechanism. Over the course of my career, I've seen many organizations pursue "data-driven" decision making only to fall into the trap of paralysis by analysis
Consider that towards the end of every year comes a spike in writing on future year trends with more and more data available to forecast nearly anything. Yet, for all that analysis, it seems to get only more difficult to write something like the "26 Most Important Decisions You Need to Make."
Perhaps in response to analysis by paralysis, we are all becoming more comfortable using decisions to drive searches for data that provide after-the-fact justification for our choices. This is what I tell myself to rationalize the comfort/confidence people have in opting out of common vaccines (like those for measles), or opting in to "medicinal" drugs, or choosing to do things in general that seemingly go against their best interests (from my perspective at least).
On a lighter note, as someone who writes a substack that gets critiqued by his daughter, here are 26 things you should expect your daughters to say about you and your substack after you teach them how to read and write:
1. This is so long, do people ever finish reading?
2. LOTR was a book? You were alive when people read it?
3. You typed this? You didn't just dictate it to your phone?
4. No way I'm getting to 26 - you're making it way too deep. (I can't believe you taught me to read and write so I'd have to read this and write about it.)
5. Uncle Ezra gets a lot more views on his podcast.
Best wishes to you and your family. Congrats on the new baby girl.
I feel that points 19-21 could be better understood by the finding in the book "Poorly Understood" that nearly 60% to 75% of Americans will experience at least one year in or near poverty (150% of the poverty line) between ages 20 and 75. And that's a full year, think about what that means for people that spend 11 months under those lines but are able to pull above at the very end and don't actually "count." America has a ton of poverty and a lot of people that spend time in it because of our lack of welfare state and that has to be in the mix for explaining at least some of the misery you're describing.
Wow! This is the most densely depressing data dump I've read in weeks. Data tells our stories, right? So, I guess thanks are in order? Not really ...
In line with the affect-versus mood polling discourse, I wonder if religious conservatives are less likely to answer that their life is meaningless because their value system tells them that a meaningless life is sinful, and a clever investigator could find the same level of purpose in that subgroup as anywhere else, or if within that group, purposefulness is correlated with some underlying metric of genuine belief.
It would seem that one of those two things must be true. If it’s the latter, intuition would say that secular meaning-giving institutions like family or community must have similar benefits.
I think it's more likely that they have stronger near-field or local ties and are in fact wired to think in terms of local connections and relationships. Liberals and city dwellers are optimized to deal with complete strangers all the time. In part this is an artifact of education, because education isn't about knowledge, it's about abstracting knowledge so you can organize and work with it. That's one reason many conservatives hate education: you lose the ability to put up with your racist Uncle Ralph because he's your uncle, and this leads to intra-group friction.
Regarding valuing money — and heightened gambling — I think we’re all trying to grasp a sense of control & frankly, any kind of safety net in a time when we realize the systems are not set up to help us — *and* that acting like they are is no longer beneficial/as imperative to our safety.
To push it a bit further, were people *actually* more patriotic back in the day or had past generations metabolized an expectation of assimilation in order to survive? Same goes for having children — it was such an expectation & in previous generations (like when women couldn’t have their own credit cards), they were expected to birth children and their livelihoods depended on it.
Of course, I recognize these were high-level overviews, but looking at them from an intersectional lens is so important ex. We keep hearing about the male loneliness epidemic — and I’m fascinated by the thoughts you’ve presented here — but I always wish the discussion included statistics about the harm done to women/all genders at the hands of men (which further isolates us all), along with context around societal expectations for boys/men to shut themselves down emotionally, rather than open themselves up to vulnerable connection.
Comments on several of the ideas from a physician-clinical trialist:
7. Standard LLMs (let alone specialized medical ones) are already way better at being doctors than the best doctors. In all aspects except procedures.
9. There is a clear tie between teen anxiety and depression and the brilliant book "Paradox of Choice" from Barry Schwartz.
10. The ascendancy of money should be a good thing, ethically and morally, if markets are allowed to function properly. The "invisible hand" of the market is the best decision maker about what's good and bad. Not saying it gets it right all the time, but it gets it right more than any other system.
12. Fascinating reason teens don't drink that I haven't heard anyone talk about, but that I hear from my own kids - if alcohol is visible at a party, you can't post pics to your public social media accounts. Thus, they don't go to parties where there is alcohol.
14/15. Weed makes people gain weight. GLP1s are the perfect complement to the rise of weed.
18. You got vaccines totally wrong. Think of them just like exercise. Excercise is good. But there is such a thing as too much exercise and such a thing as the wrong kind of exercise to achieve a particular goal. It is highly likely that at some point there is such as thing as too many vaccines, but we don't have any science to answer that question. Kennedy is doing exactly the right thing by requiring placebo controlled vaccine trials. If vaccines are great, those trials will show it. If vaccines have harms, those trials will show it. It is literally the epitome of what science is supposed to do. Anyone who says science has proved vaccines are safe is lying. We have essentially zero placebo controlled trials for modern vaccines and in the abscence of such trials, we have no idea if there are harms or not. Anyone who claims that adjuvant controlled trials are placebo controlled trials is either uninformed or intentially misleading. You've falled into the trap that people fell into with climate - lots of people with vested interests in vaccines being safe as is (most of the experts) keep repeating that the science is settled, so non-experts (includes 99% of physicians) accept it, despite it being obviously wrong.
20. The interesting fundamental change in the stock market is the rise of the 401(k). Huge monthly cash inflows that HAVE to be invested and cannot be withdrawn. This has led to a constantly rising market (over the long term) and that will continue as long as 401(k)s and similar vehicles are the primary way to prepare for retirement.
22. The "centrist" news outlet list is hilariously non-centrist. But AI (Grok in particular) has fixed the 'what to believe' problem for anyone who cares to know what is true, partially true or false.
Thank you for the citation. In that study an AI model didn’t actually see or manage any real patients did it? So the study doesn’t support your claim that “LLMs …are already way better at being doctors than the best doctors.” Of course medical knowledge is important, but there is much more to being a good doctor than regurgitating facts. Empathetic interactions and management of the fear and anxiety that are common aspects of patient visits are essential to providing optimal care.
For #7, do you have a citation or is this just your opinion?
Here's the citation that turned my opinion (based on extensive use of various LLMs to help me with real life patient scenarios in areas where I have deep expertise) into something I'm quite comfortable stating as fact:
https://arxiv.org/pdf/2508.08224
People talk about it kind of like autonomous driving - they LOVE to point out when AI gets a case wrong, basically using "perfect" as the benchmark, as opposed to real world human provider performance. I'd imagine that the very best human doctors, in ideal scenarious (not running behind, not tired, not distracted, etc) would probably still outperform, but this was published months ago (preprint) so that may no longer be true.
Love your work. Learn so much.
#9: A plea from a very pro-vaccine, scientifically minded physician. Could there be "something rotten" in our federal health agencies? (A sorry literary reference to the recent comparison of Danish vaccine policy to US given at the ACIP Hep B meeting.) It's more than looney RFK, jr and "anti-vaxxers" asking questions.
#18