Dhruv Khullar describes The Trouble With Medicine’s Metaphors:

The words we choose to describe illness are powerful. They carry weight and valence, creating the milieu in which goals of care are discussed and treatment plans designed. In medicine, the use of metaphor is pervasive. Antibiotics clog up bacterial machinery by disrupting the supply chain. Diabetes coats red blood cells with sugar until they’re little glazed donuts. Life with chronic disease is a marathon, not a sprint, with bumps on the road and frequent detours.

Khullar goes on to discuss in depth the use of military metaphors in medicine, such as the common saying “We’ll fight this together,” and why it can be counter-productive.

Want to read some philosophical pontification about selfies? Well, I’m here to help you out. Start with the recent Can you have self-worth without self-love?, in which Simon Blackburn believes we can do better:

If culture shifts one way, it can also shift back. Is it possible to imagine a reversal, so that something approaching a social contract, or a feeling of public spirit, a contempt for indecent expenditure, an embarrassment at vulgar display, or simply a desire to leave as modest a footprint as possible, begins to take over our sense of what we can expect from ourselves and others? We know that there are cultures in which it is poor form to shout that you are a taller poppy than any other.

But perhaps, above all, we should encourage the joyous, subversive spirit of mockery. If there are few things more awful than the arrogance and hubris of conceit, is there anything more ridiculous than a display of vanity? The word itself carries its own condemnation (Latin: vanus, empty; vanitas, emptiness). We can learn not to care about display, and not to crave the admiration of others. We could even learn to display fewer selfies.

Once you’ve whet your appetite, fill your Instapaper queue with these:

• A Good Angle Is Hard to Find
• Google Makes You Smarter, Facebook Makes You Happier, Selfies Make You A Better Person
• The Documented Life
• In Praise of Selfies: From Self-Conscious to Self-Constructive

You’re welcome. Seriously though, it’s a pretty interesting phenomenon, and like most new things, we’re in that phase where it’s either really horrible and going to destroy everything, or it’s making us better people, depending on who writes the article.

Two recent articles about technology and our perception of time make some interesting related points. From the clickbaity (yet surprisingly good) Feeling More Antsy and Irritable Lately? Blame Your Smartphone1:

Our gadgets train us to expect near instantaneous responses to our actions, and we quickly get frustrated and annoyed at even brief delays. I know that my own perception of time has been changed by technology. If I go from using a fast computer or Web connection to using even a slightly slower one, processes that take just a second or two longer—waking the machine from sleep, launching an application, opening a Web page—seem almost intolerably slow. Never before have I been so aware of, and annoyed by, the passage of mere seconds. […]

More interesting is [a recent study of online video viewing’s] finding of a causal link between higher connection speeds and higher abandonment rates. Every time a network gets quicker, we become antsier. As we experience faster flows of information online, we become, in other words, less patient people.

Turns out this phenomenon isn’t new — technology just makes it worse. We’ve always adjusted to our circumstances quickly, and we respond by wanting more. From Elizabeth Kolbert’s No time:

“Most types of material consumption are strongly habit-forming,” Gary Becker and Luis Rayo observe in their contribution to Revisiting Keynes. “After an initial period of excitement, the average consumer grows accustomed to what he has purchased and … rapidly aspires to own the next product in line,” they write. By Becker and Rayo’s account, this insatiability is hardwired into us. Human beings evolved “so that they have reference points that adjust upwards as their circumstances improve.”

The more we have, the more we want. The faster the internet gets, the faster we want it. What can we possibly do with 1000Mbps that we can’t do just as well with 50Mbps? It doesn’t matter. 50Mbps is the standard now. We’re adjusted. And so up we go…

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1. This is at least better than the original title, which was — I kid you not — You are an impatient monster—but you weren’t born this way. Guess what’s to blame? ↩

In What If Doctors Could Finally Prescribe Behavior Change? Sean Duffy explains why behavior change is so difficult, particularly in healthcare:

Whether it’s for weight loss, smoking cessation, diabetes, or otherwise, the best research shows that meaningful behavior change outcomes require not just guidance from a trusted health professional, but also positive social support, easy-to-digest insights about their condition, a carefully orchestrated timeline, and a process that follows validated behavioral science protocols. That’s hard to squeeze into a phone call. Or a doctor’s visit, for that matter.

The good news is that this research is resulting in a new field called Digital Therapeutics, and despite quite a bit of snake oil out there, some apps are having success:

Another example is Jenna Tregarthen, a PhD candidate in clinical psychology and eating disorder specialist. She rallied a team of engineers, entrepreneurs, and fellow psychologists to develop Recovery Record, a digital therapy that helps patients gain control over their eating disorder by enabling them to self-monitor for destructive thoughts or actions, follow meal plans, achieve behavior goals, and message a therapist instantly when they need support.

We all know how destructive interruptions at work are, and how a constant pressure to always be online increases stress levels exponentially. The thing is, we can fix this problem. Clive Thompson asks Are You Checking Work Email in Bed? At the Dinner Table? On Vacation? and reports on a recent study to measure the effects of changing that behavior:

[Harvard professor Leslie] Perlow suggested they carve out periods of “predictable time off”—evening and weekend periods where team members would be out of bounds. Nobody was allowed to ping them. The rule would be strictly enforced, to ensure they could actually be free of that floating “What if someone’s contacting me?” feeling.

The results were immediate and powerful. The employees exhibited significantly lower stress levels. Time off actually rejuvenated them: More than half said they were excited to get to work in the morning, nearly double the number who said so before the policy change. And the proportion of consultants who said they were satisfied with their jobs leaped from 49 percent to 72 percent. Most remarkably, their weekly work hours actually shrank by 11 percent—without any loss in productivity. “What happens when you constrain time?” Lovich asks. “The low-value stuff goes away,” but the crucial work still gets done.

More of this in our workplaces, please.

I had a particularly noisy weekend, so I’ve been thinking about silence quite a bit. This morning I came across Chloe Schama’s How Silence Became a Luxury Product, and it really resonated with me:

Unwanted noise is perhaps the most irksome form of sensory assault. A bothersome sight? Close your eyes or turn the other way — eyesores are, generally, immobile. An annoying taste? Spit it out. (Why was it in your mouth?) Sound, on the other hand, is ambient, elusive, enveloping. Even the softest drone can echo cacophonously if it worms itself into your head. Ulysses was not seduced by the sight of the sirens. Poe’s telltale heart does not torment with its smell. “Noise is the most impertinent of all forms of interruption,” groused the nineteenth-century German philosopher Arthur Schopenhauer. “It is not only an interruption, but also a disruption of thought.”

The article goes on to explain how silence has become a commodity — one that people are willing to pay a lot of money for. I found the article through Atossa Araxia Abrahamian’s Enjoy the Silence, a great piece on the proliferation of noise-canceling headphones:

I also discovered that an artificially imposed lack of noise can make perfectly normal sounds—the hum of a fan, or a colleague’s phone conversation—feel like an assault on the senses. The quiet becomes habit-forming, and I’m not entirely convinced that that’s desirable. What good is it to live in the world if we just choose to ignore it?

The articles reminded me of Jeremy Mesiano-Crookston’s exploration of imposed silence in How Silence Works: Emailed Conversations With Four Trappist Monks. Here is how one monk answered the question What do you feel like silence adds to your actions?:

The silence does make me aware of my inner workings — what we call in the monastery, “self-knowledge.” I can’t pretend that I’m always a nice guy, always patient, always calm and receptive. I have to admit that I can be abrupt, cold to offenders, or would often prefer efficiency to the messiness of other people’s moods. Silence seems to keep me from idealizing myself.

Since we’re on the topic of silence we might as well look back to Pope Benedict XVI’s thoughts about it in his message for World Communications Day back in 2012:

Silence is an integral element of communication; in its absence, words rich in content cannot exist. In silence, we are better able to listen to and understand ourselves; ideas come to birth and acquire depth; we understand with greater clarity what it is we want to say and what we expect from others; and we choose how to express ourselves. By remaining silent we allow the other person to speak, to express him or herself; and we avoid being tied simply to our own words and ideas without them being adequately tested. In this way, space is created for mutual listening, and deeper human relationships become possible.

I’ve been thinking about Miya Tokumitsu’s In the Name of Love for days now. Miya argues that the mantra “Do what you love” devalues work and hurts workers:

There’s little doubt that “do what you love” (DWYL) is now the unofficial work mantra for our time. The problem with DWYL, however, is that it leads not to salvation but to the devaluation of actual work—and more importantly, the dehumanization of the vast majority of laborers. […]

“Do what you love” disguises the fact that being able to choose a career primarily for personal reward is a privilege, a sign of socioeconomic class. Even if a self-employed graphic designer had parents who could pay for art school and co-sign a lease for a slick Brooklyn apartment, she can bestow DWYL as career advice upon those covetous of her success.

If we believe that working as a Silicon Valley entrepreneur or a museum publicist or a think-tank acolyte is essential to being true to ourselves, what do we believe about the inner lives and hopes of those who clean hotel rooms and stock shelves at big-box stores? The answer is: nothing.

It’s a tough critique, and at first I was looking for reasons to dismiss the argument. But the more I think about it, the more sense it makes to me. The “do what you love” idea is related to another theme I often see on social networks. It’s some variation of the message “If you don’t want to go back to work after vacation, you should find a job that doesn’t make you want to go on vacation all the time.” This has always felt wrong to me. I love my job — I really do. But that doesn’t mean I can’t also enjoy spending several days with my family, hiking, climbing, and hopefully with my nose buried in a zombie book.

This doesn’t mean I’m lazy, it doesn’t mean my job isn’t meaningful, it doesn’t mean I don’t like the people I work with. I will just always find a different kind of enjoyment in actively doing nothing than I do when I work. And it turns out that leisure time — and in particular, being bored — is really good for us. Nicholas Carr says this in The web expands to fill all boredom:

We don’t like being bored because boredom is the absence of engaging stimulus, but boredom is valuable because it requires us to fill that absence out of our own resources, which is process of discovery, of doors opening. The pain of boredom is a spur to action, but because it’s pain we’re happy to avoid it. Gadgetry means never having to feel that pain, or that spur. The web expands to fill all boredom.1

So I just think that it’s ok to split up work and leisure. If we’re lucky we get to have jobs that we love doing — and we should absolutely work hard to accomplish that goal. But spending time away from work (or working on side projects) is important and healthy, and we shouldn’t be afraid to acknowledge that. It doesn’t diminish your job satisfaction or dedication if you enjoy being on vacation.

Anyway, I’ll have Miya have the last word:

Do what you love and you’ll never work a day in your life! Before succumbing to the intoxicating warmth of that promise, it’s critical to ask, “Who, exactly, benefits from making work feel like nonwork?” “Why should workers feel as if they aren’t working when they are?” In masking the very exploitative mechanisms of labor that it fuels, DWYL is, in fact, the most perfect ideological tool of capitalism. If we acknowledged all of our work as work, we could set appropriate limits for it, demanding fair compensation and humane schedules that allow for family and leisure time.

And if we did that, more of us could get around to doing what it is we really love.

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1. Also see Joseph Epstein’s excellent essay on boredom called Duh, Bor-ing. ↩

Mark O’Connell wrote a very interesting article about a fairly unsettling iOS app called Days of Life — “a counter for the days you have left to live.” In Deathwatch he explores just how weird and absurd this app turns out to be:

Days of Life is one of those technologies that seems to incidentally satirize our relationship with technology more broadly. It sits in the “Productivity” folder on my iPhone’s home screen, along with my calendar and a to-do list app called Remember the Milk, but it would be as appropriately housed in a folder called “Existential Terror.”

So much of what we value in technology is its promise to upgrade the hardware of our lives, to make us more useful to ourselves — more productive, more profitable, more effective. Days of Life functions like a reductio ad absurdum of the logic of personal productivity. The pie chart becomes a special way of being afraid: an image of the self as a micro-economy of numbered days.

We sometimes have such a warped view of what it means to be “productive”, and this essay does a good job of shining a spotlight on that.

Small human beings learn by mimicking and so they learn patience by mimicking patience. Perhaps this means that a larger human being somewhere many thousands of generations back took a long and patient breath as the smaller human being in his or her arms squirmed. Perhaps the smaller human being saw this long and patient breath and internalized it and began to understand. Perhaps all of the patience in the world is a copy of one sigh.

— Paul Ford, What I’ve learned from fatherhood

I’m most aware of my shortcomings when I lose patience with my daughters. Of the many things I know I need to improve on, it’s the one that I wish the most I could fix with the flip of a switch.

“Oh, I see the problem, sir — your patience switch was turned off. It happens sometimes… There you go, that should do it.”

But of course, it doesn’t work like that. Yesterday I was watching a mother trying to get her 3-year old son to stop screaming at her. After a few minutes they were both yelling — which isn’t a very effective way to diffuse a situation like that. The thing is, I’m sure she knows that. And before I had kids I probably would have judged her. Not any more. I’ve made enough bad decisions in the heat of the moment that it would be hypocritical of me to judge anyone for their parenting techniques1. In fact, I’m pretty sure that no matter what decision I make at any given time (should I give her the cookie, or is this a teachable moment?), there’s about a 50% chance that it will be the wrong decision.

But that doesn’t mean I shouldn’t strive to do better — to be better. I’ve already made most of the mistakes I didn’t want to make with my daughters. However, that doesn’t stop my desire to be a better dad. I’m painfully aware of how cheesy that sounds, but hey — it’s the truth.

I often ask my wife if she thinks we’re doing it wrong. It just seems like other parents have it all together, all the time. Yet, every once in a while I see cracks in the veneer — an honest moment on Twitter, a knowing look of camaraderie in a coffee shop — and I know I’m not alone. We all love our children very much. We’re also all human and selfish. And patience — like money — doesn’t grow on trees.

So maybe I need to stop trying to be “a better dad”. That’s just too vague (how will I know when I’m “better” enough?). Instead, I need to focus on that one sigh. The one breath that could be the difference between letting a difficult moment pass, or letting it get the best of me.

One moment of patience. That will be my focus in 2014 — in parenting, but also online, and in my work.

Will you join me?

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1. Well, except for leashes. Seriously, don’t put your kid on a leash. Unless you have twins. Then do whatever you need to do to stay alive. ↩

Craig Mod’s newsletter is one of the few emails I always look forward to reading. In the most recent one Craig gives some advice for people in their 20s:



To the younger folks reading now: If you’re willing to live in that small apartment, forgo that fancy food and expensive clothing, and uphold a semblance of disciplined and focused work ethic, you can probably hack more experience into your life than you’d imagine. […]
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The emotional textural quality of my memory of life then is so intense because it was a period of only the ephemeral. Those years can only reverberate in my gut because there is no material thing upon which to place those feelings. No physical token to help me remember. It’s a period of my life where I learned to walk a city (because it was cheaper than eating through a city, or five-star hoteling a city), learned to find great pleasure in the night-sounds of one piece of town winding down or the stirring of another the dawn following.
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His thoughts brought me back to my own story, and the similar circumstances I was in when I first moved to the US years ago. I moved into my first apartment with only a blow-up mattress I borrowed from my then-fiancé, and a coffee machine she bought me as a housewarming gift. I bought my first chair for $20 at a Salvation Army store, and since I didn’t have a car I had to leave my passport with them so I could borrow a dolly and push the chair back to my apartment (what a sight that must have been to passers-by).



But you know what? It was an amazing time. It taught me not to take anything for granted. It taught me how to really get to know a city (on foot — always on foot). And it taught me the value of working hard, and always keeping an eye out for things to make me laugh, especially when it’s not going well.



Starting from the bottom of a mountain teaches us that there’s more to life than standing at the top. What matters is the people you’re with and the conversations you have and the lessons you learn — not how far up you go. I’m not saying we shouldn’t be ambitious. I’m just saying that as long as you enjoy the views with those who give your moments meaning, who cares where you’re standing?