Digital Exhaust #203

Scaling propaganda, fraudulent doctors, and handwriting to counter AI-generated slop

Thanks for opening. Here are a few things that caught my eye this week.

Propaganda at scale

Things are never what they seem. We’re not even a week into our time with the chatbot DeepSeek and the fix is in: DeepSeek’s output reflects the warped worldview of the Chinese Communist Party. Sobering overview here. But no one really seems to care.

The deepest danger with AI is that we view it as a black box — a mysterious Oracle summoned to deliver under the assumption that it’s objective. But it isn’t.

And the idea isn’t that we should avoid emerging technologies like this. You can’t, really. Rather, we need to understand the tool’s origins and relation to power. Who created it and what’s their intent? Who does it serve? What are the incentives? Who stands to gain from what we put in and get out? Ditto for tools like TikTok where it’s even harder to discern.

Like we learned in the early days of social media, when a digital tool is free, your the product, not the customer.

What I’m reading

Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. This is a deep dive into the profit and fame-driven scandal that derailed the fight to cure Alzheimer’s. It’s a dramatic read — it’s got Bad Blood vibes, if you were into that. I’ve got a special thing coming up with the author, Charles Pillar. So grab a copy and stay tuned!

Organized physicians

A new study in JAMA showcases the rising tide of physician organization. Nothing new, but the graph is dramatic. My take: If you ignore the core needs of doctors, you’ll have to deal with organized labor. IMHO, those needs: Mission, safety and agency.

My friend Graham Walker has started a new business/site fueled by this rising tide of professional malaise. It’s called Offcall (he’s got a cool tool that lets you anonymously see how your salary compares with your peers). Add this to other mini-movements like Physician Sidegigs and Dana Corriel’s Doctors on Social Media that are all about how to be happy doing other things besides just being a clinician.

Telabortion

A grand jury in Louisiana indicted a New York doctor for remotely providing abortion pills to a Louisiana resident. The case appears to be the first time criminal charges have been filed against an abortion provider for teleprescribing in a state with an abortion ban. And as far as I can tell, the doctor is not licensed in Louisiana. Irrespective of your view on abortion, there’s a corner of the 'telemedicine' world moving fast and loose for ED meds, GLP-1s, and apparently now abortifacients.

Handwriting as a business positioning play

Starbucks beat Wall Street expectations in the 4th quarter. Their explanation? Bringing back handwritten ditties on their cups. Like the good old days, baristas are serving up Sharpie-generated hearts and smiley faces. This makes sense in a world of soulless, AI-generated slop being passed off as human communication. While the throwback idea of the written word could be a differentiator for some organizations, Starbucks might consider penmanship as part of their employee onboarding. The Guardian this week suggests we’ve lost the ability to write by hand. And doctors? We were a lost cause long ago.

We have zero control over technology

File under chilling: Sam Altman, Founder of ChatGPT, overheard on X discussing AI:

There will be some change required to the social contract given how powerful we expect this technology to be…..The entire structure of society will be up for debate and reconfiguration.

Hot take: Don’t expect much debate. AI so far has been totally deterministic. I use this term around technology and it refers to the fact tools are given to us that do things and we don’t have any power over what they do. In other words, technology is showing us the way, instead of the other way around. And sometimes this is okay; other times, not so much. James Bridle, in New Dark Age - Technology and the End of the Future, said it well:

Technology comes with an aura of fixedness: once immured in things, ideas seem settled and unassailable.

Sure, you can fight City Hall. But let me know how that works out.

Sid Mukherjee, author of Emperor of All Maladies, has an AI drug development company

He’s teamed up with LinkedIn founder, Reid Hoffman. I’m a huge fan of his writing but skeptical of where this may be headed. Here’s my take on LinkedIn, short video and all. If you are a LinkedIn user, follow me there. I drop things there that don’t make it into Digital Exhaust. I’m starting to experiment with short vid clips — I hate appearing on ‘film’ so all of this is some kind of self-imposed immersion therapy.

Thanks for opening up and checking in. Please pass this along to someone who might like this.

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