33c from Bryan Vartabedian

Mom as JFK Jr, the collapse of writing, and really smart ECGs

Good morning. It’s been a minute, for sure. As many of you know I’ve been busy opening Texas Children’s Hospital | Austin. We’re hitting our anniversary next month. The last time I grew this much was the year I opened my medical practice.

I’m resurrecting the newsletter. Beyond pushing out shitlinks and random takes, I miss connecting with you. I’m going to flirt with a couple of different formats. Some curation, some original thinking. Either way, it’s good to see everyone.

If you wouldn’t mind, I’d love feedback on what you think. I don’t know why you individually signed up to let me into your inbox, so I could use some help — what originally drew you in? If you know me, what works? Let’s use fox42@me.com if you have ideas — put 33c Feedback at the front of the subject line. I’d send a survey, but everyone hates them.

This is on my mind...

The collapsing value of internet writing

I’ve been thinking about how AI-generated writing is making what we see potentially less relevant.

Let's do a thought experiment involving doctors on LinkedIn. Consider a scenario where each one of the thousands of doctors begin creating posts twice a day — 750 word pieces that analyze or break down a timely event or study. We'll assume that they conceive and outline these posts, but that they're heavily augmented by ChatGPT or Claude. And let's go ahead and push this beyond doctors and on to nurses, health care leaders, or everyone.

What happens then? We'll have tens of thousands of ChatGPT generated, four point summaries floating across our feeds. All with clever summary points. All strangely similar in voice. Because when everyone uses the same tool, everyone starts to sound alike. And when everyone is suddenly creative, what we create is dimished in value. The thoughtful analysis that once marked the insightful thinker becomes a commodity.

So how do you define yourself as a creator? The quick solution is to use the tool differently, or use a different tool. But that's short-lived.

The best answer is to make the thing that's scarce. Time will tell what that thing is or what it looks like. But I suspect it will be found in some form of unique human connection or experience between a creator and their audience, or followers.

If you like this, check out Don’t Count Out Writers in the Age of AI in Wired. Susie Algre offers the interesting angle, “Ironically, the advent of AI-generated search, stalling traffic to original websites, will kill off the need for pointless “content” to game the system and will push people to demand better.”

Moms as the original RFJ Jr.

This is a hilarious take on the FDA's ban of Red dye No. 3. It's from Mike Solana in The Pirate Wires Daily. I love the format of their daily newsletter, btw.

Yesterday, the FDA finally banned Red No. 3, a cherry dye found in close to ten thousand processed foods in grocery stores across America, as it probably causes cancer. Shout out to my mom, who from my earliest memories looked at the ingredients in packaged food and said “What the hell is that? We’re not eating that, that probably causes cancer.” And now I’m thinking: maybe we should listen to our moms more often? For years, moms have warned us about everything from canola oil and overmedication to the importance of running around outside. Actually, moms are sort of the original RFK Jr., and they’re right about a lot. Let’s not wait another few decades for the FDA to stop gaslighting us about Yellow No. 5 (which probably shrinks your balls). Abolish the bureaucracy, and call Kathy (my mom). She’ll fix this quick.

What's old is new | Unleashing AI on ECGs

Median waveform reconstructions for centroids reflecting individuals without (blue) and with (red) left bundle branch block

Clinicopathological correlation (CPC) is a diagnostic method in medicine that connects clinical observations with pathological findings to understand disease progression (think 19th century doctors comparing what they heard through the stethoscope with what they found on autopsy). While it’s advanced medical knowledge, CPC has been limited by the our human ability to recognize patterns between clinical presentations and underlying pathology.

But when we unleash AI on the data, previously unseen patterns emerge. Case-in-point is a study published last week in Nature’s NPJ Digital (my fav digital health journal) that showed how AI can unlock hidden information in (of all things) electrocardiograms.

This is a great example of new data emerging from an old technology examined with a new tool. Look for this application of AI to play itself out over and over in medicine.

I have to wonder if the Apple Watch and other single lead monitors may be able to go to the next level in predicting physiologic events?

If you’re interested in seeing the innards of my office, I did a brief video on LinkedIn.

Are food calorie labels helpful?

A new Cochrane Review asked whether food calorie labels actually do anything. Apparently, folks desperate for the Outback Steakhouse Bloomin’ onion aren’t deterred. The authors found that labels result in a tangible, but small, difference in consumption.

Meaninglessly busy

I picked up this quote from Jaron Lanier in the January Wired. It stuck with me, for some reason.

When tech makes life infinitely convenient, we get meaninglessly busy.

I’m a strong believer in adding friction to different points in our life. Now more than ever, some things should be done slower. Silicon Valley wants to drive health care toward the kind of transactional, ‘swipe right’ engagement found in the consumer space. No bueno, unless you’re requesting med refills, appointments, etc.

Bone dry January

I’m doing Dry January, FWIW. Interesting experiment. No cravings, but more of an exploration of lifestyle patterns and strange cues. I haven't enjoyed the sleep changes that everyone raves about. I’m imagining that my complexion is a little better, which is a miracle. I have had some days of what I might call high brain clarity (eerily similar to what I feel when I fast — which is 1-2 20h fasts per week). As I socialize the Dry January experience I'm floored by the number of colleagues who have suggested that they could never do it. Wondering what y'all have experienced.

Thank you for hanging in there with me. I’ll continue to work to bring value to you with whatever hits your inbox. Pass this along if there is someone who might be interested.