Monthly Archives: February 2024

Food and friends, part 2: Edible food-like substances and the need to swallow again

February 28, 2024 By in Culture, Personal Tags: , , , Leave a comment

Part 1 is here, although “Edible food-like substances and the need to swallow again” is meant to stand alone. Part III is here.

I went into the May 25 surgery that unexpectedly took my entire tongue weighing around 155 to 160 lbs. When I came to, I probably didn’t weigh much less than I had when the anesthesia hit, but I felt like the heft of my body had been replaced with the weight of all that had gone wrong, and I was what was left over. Insubstantial. Without appetite.[1] Although it’s a cliché that you feel dread in “the pit of your stomach,” I instead felt dread in my nasal cavity—a horrible nasal tube was anchored with a stitch into my right nostril. It snaked up my nose and down my esophagus, terminating in my stomach.[2] Tube feeds were how I “swallowed,” although I had no agency in the process: a nurse pressed a button on the machine and the machine pumped food, regardless of my feelings or sensations.

Any calories had to go in through that tube. To say I hated consuming calories via nasal tube is an understatement. If I’d had an “off, forever” switch available to me in those first days after surgery, I’d likely have flicked it. Instead, I had oxycodone and dilaudid, which weren’t as good as an “off” switch, but adequate doses did make me feel like I was nowhere. Like most medical treatments, though, oxycodone and dilaudid come with a cost: opioids are severely constipating, and taking them may have led to what was one of the most dangerous moments after surgery.

In the hospital, it felt like every 10 minutes something or other had to happen: medications, cleanings, probings, vitals. “Tube feeds” weren’t just unpleasant because of the uncomfortable tube— the feeds themselves were a source of both pain and nausea. The word “feed,” makes me sound like I went from being a man to some kind of farm animal or hamster or alien. Or may an alien hamster farm animal? Before the surgery I never once looked at Bess and said, “Hey, why don’t we sit down to feed,” or “Baby, let’s go out to feed.” And if I ever did, I was joking.

The tube feeds made me nauseous and gave me terrible reflux. Part of the problems no doubt came from the surgery trauma and all the drugs I was on. But the ingredients in the substance itself couldn’t have helped. I had two choices, or assignments, depending on who was in command of the tube feed situation on a given day: either Nutren® 2.0 (made by Nestle Health Science) or Boost® Balanced Nutritional Drinks. Calling “Boost” a “nutritional drink” is like calling a junkyard a “pristine Redwood forest.” Boost’s website lists the ingredients as “WATER, GLUCOSE SYRUP, SUGAR, MILK PROTEIN CONCENTRATE, CANOLA OIL, AND LESS THAN 2% OF COCOA. [. . .]” I don’t think humans are supposed to eat diets rich in glucose syrup (which is just another sugar), sugar (this is also a sugar), and canola oil (the writer and gadfly Gary Taubes wrote a persuasive book called The Case Against Sugar). Whatever the problems I was having with digestion, I don’t think those problems were aided by vitamin-infused liquid sugar solutions.

I was barely alive and unsure about which side of the life-death line I would wind up on, which was not an ideal position for investigating alternatives to Nutren® or Boost®. At some point, a few days after the surgery, interventional radiology installed a PEG tube, and that installation let doctors remove the nasal tube. Getting the nasal tube out was an improvement, although injecting Nutren® or Boost® via PEG tube wasn’t, as you’d imagine, a real satisfying eating experience. In the hospital, I got enough calories to not die, and I guess that was enough from a medical perspective, if not a human one.

The Mayo ENTs said I’d likely be able to swallow again one day, albeit by blending food. I didn’t believe them. I couldn’t imagine much of a future and drifted in a present defined by either miserable, excruciating pain and nausea, or by opioids that allowed me to feel like I didn’t exist. I got out of the hospital in early June, and food injections continued to be a massive struggle, in part because I didn’t get the right injection pump until two weeks after discharge. My digestion improved when a friend suggested I try “Liquid Hope,” a liquid food product made from actual foods. The ingredients include ones I actually ate before the surgery: “Filtered water, organic garbanzo beans, organic green peas, organic carrots, organic hydrolyzed pea protein.” Garbanzos, peas, and carrots are good for humans in the way “hydrolyzed palm oil” is not.

For someone who prides himself on cooking and likes to try lots of different foods, this period was hard, and made harder by the belief I wouldn’t eat for life. I didn’t get to swallow again until late July, when Mayo speech pathologist Jessica Gregor showed me that I could, despite my reluctance and fear of choking, and she lovingly bullied me (that is Bess’s phrase) into choking down a glass of melted, diluted ice cream. It was the first thing I’d tasted in two months. It was a revelation. By then the trache tube was out of my throat and the trache wound had healed. I wrote about those first swallows in “On being ready to die, and yet also now being able to swallow slurries—including ice cream:”

With Jessica, I swallowed some ice cream slurry: the Van Leeuwen’s honeycomb flavor. We melted it and blended it with some extra milk, to thin it. And, although I was intensely skeptical that this would result in a meaningful sensory experience, there are taste buds at the back of the throat and esophagus. So I could taste ice cream. Since that night I’ve tried lots of things. Anything acidic, like lentil-soup slurry with too much lemon, doesn’t work well yet. Anything salty, same problem. But savory foods work and so do sweet ones. There’s a fun bakery and wine shop in Tempe called Tracy Dempsey Originals that we’ve been going to. Tracy Dempsey makes spectacular ice cream flavors—particularly her cardamom with fig jam. It turns out I can eat things like cookies and brownies if they’re blended with milk or coffee.

Over many months of practice I’ve gotten pretty good at swallowing. Swallowing isn’t like it was before the surgery, but I can taste foods at the back of my throat and, to a lesser extent, in my cheeks. I’m much better at handling acid, salt, and spice than I was when I wrote “On being ready to die.”

One of the scarier moments hit in the first few days after I began swallowing again. I was trying to drink water, and some of it got caught in my airway—I don’t know how, exactly. Bess was home and heard me making some horrible noise like a fish on a boat. She ran over to help but didn’t know what to do, as there wasn’t much to do, and she justifiably feared worsening the choking problem. I think she pounded on my back as I alternated between trying to expel the water and take a breath. I couldn’t get a breath in. I don’t remember which happened first, or how, though I do remember thinking: “I’m about to die by drowning.” And I remember the desperate gasps as I began to get air again. I’d wrongly thought water would be easier than solids, but melted ice cream was, for a while, the only thing that required a mere struggle, as opposed to a titanic struggle.

I’d lost so much taste and texture sensation when I lost my tongue, just as I’d lost much of my life’s animating energy, along with one of my chief means of hanging out with friends and friends-to-be, but enough taste sensation remained for me to enjoy the ice cream. Although that enjoyment was mixed with the terror of drowning.

Part III will continue in a few days. If you’ve gotten this far, consider the Go Fund Me that’s funding ongoing care.

[1] Appetite for anything: food, sex, life, status—all the things that make us human and keep us going.

[2] Horrible, but probably better than dying.

Food and friends, part I: Food is social life

February 26, 2024 By in Essays, Life, Personal Tags: , , Leave a comment

Before I lost my tongue to cancer, having friends over for dinner was my most common form of hanging out:

No sane person wants their tongue removed, but having it out and not being able to swallow has particularly awful resonances for me: I’ve been into food and cooking since I was a teenager, and “going out to dinner” was the most common form of going out for Bess and me. “Having friends over for dinner” was our most common form of socializing. I chronically experimented with new food and gadgets in the kitchen. What can I make with fish sauce? Is the sous vide machine worth it? Can an air fryer replace the oven for many dishes? Will the capers in cauliflower piccata alienate our guests?

After the surgery, the questions changed. Would I meaningfully survive at all? In that first week after the surgery, I felt I should be dead. What would happen to me? Would any semblance of normal life be achievable?

I like to eat—or, rather, liked to eat—and, at current levels of technology, everyone needs food. So why not combine what I like to do, what everyone needs to do, and what I can afford to do? “Come over for dinner” is low stakes: eat for an hour and discuss the projects we’re working on, the things we’ve learned lately, or the ideas we’ve been having. Then go somewhere else, or do something else, or finish the work.

Most people experience diminishing marginal returns from hanging out: the first hour might be great, the second okay, and the third drags. How many times have you wanted to leave some event that was good for a while but ceased being so, yet you felt socially obligated to? For this reason, a time constraint, true or not, improves a lot of meetings: “Let’s go for that walk at 3:00, but I have to run by 4:00.” A lot of us aren’t that interesting, or don’t vibe as well with one another as we could or should, or aren’t working on projects that are fun to share.

Things are past the optimal point when phones come out and videos or whatever start being passed back and forth. For some reason, a lot of people want to fill the time they have with hanging out, but my ideal is different: we should hang out for the right amount of time—which is, I think, usually the length of a long meal—and that’s typically not all day, even if theoretically all day is available. Because the ice cream is there doesn’t mean all of it should be eaten; because the day is there doesn’t mean the whole thing should be spent.[1]

That a lot of us aren’t maximally interesting is a weakness mostly ignored in David Brooks’ book How to Know a Person: The Art of Seeing Others Deeply and Being Deeply Seen, as I describe in “The quality of your life is the quality of the people you get to know.” Yet Brooks says some people are better at eliciting the best in others, and that we can consciously improve our ability to elicit the best. I want to think I am one of those people, and that the act of feeding people interesting things helps to bring out the best in them, but, if I’m being honest or realistic, I’m likely not.

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Links: Adverse selection in advice giving, the holes we leave behind, cancer-treatment stuff, and more!

February 17, 2024 By in Links Tags: 1 Comment

* “You Don’t Hate Polyamory, You Hate People Who Write Books.” Notice: “Advice is disproportionately written by defective people. Healthy people perform naturally and effortlessly.” And many other interesting remarks about the types of people inclined in certain ways.

* “Humanity’s Legacy Might Be The Holes We Leave Behind.” We should dig more holes—tunnels, specifically—for subways. One tragedy is that we mostly stopped using “cut and cover” construction strategies, which are way cheaper than some deep boring strategies, particularly for stations. There’s too little interest right now in doing more with less.

* “Do Americans really only want sprawl?” Probably not, or NIMBYs wouldn’t have to pass laws mandating sprawl.

* Review of Framework’s impressive 16″ laptop. I think the reviewer underestimates the value of modularity.

* On Invitation to a Banquet, by Fuchsia Dunlop.

* “Unleashing Our Immune Response to Quash Cancer: An array of diverse and potent therapies to turbocharge our immune system.” Also, in the same vicinity: “The future of precision cancer therapy might be to try everything.” Highly relevant to me right now; hopefully less relevant to you, but a lot of people with cancer or around people with cancer are reading TSS now.

* “Why it’s impossible to agree on what’s allowed,” by Dan Luu.

* “The cost of Russia’s collapsing empire.” Russia is committing a murder-suicide: it’s likely destroying Ukraine, but it’s also destroying itself. Between the literal death on the battlefield and the displacement of millions of people to other, more stable and functional countries, both Ukraine and Russia face massive depopulation. Anyone smart has either gotten out of Russia or has been trying to get out of Russia for more than a century. That dynamic continues today. Who will be left? Hardly anyone.

* “As Much As You Ever Wanted To Know About 155mm Artillery Shell Production and More.” This is an article about complacency; notice: “[T]he DOD is attempting to plug the Ukraine-sized hole with shells from allied nations including Canada, South Korea, Finland, and Germany—places where it’s still possible to build new things.” Germany is a place that allows the building of new things? If we’re being outcompeted by Germany, that’s bad. Much of what Rob writes here applies to the FDA too:

What troubles me here, though, is that the US is pursuing that option [of having allies make weapons] because the domestic defense industrial base, inclusive of DOD and its contractors, is sclerotic. It treats time like it’s free. It does not respond quickly.

On Jan. 29 I wrote in The dead and dying at the gates of oncology clinical trials: “The FDA has created systemic problems, and it can also create systemic solutions. For example, the FDA doesn’t really account for the time-value of money,[3] which is especially important in a high-interest-rate environment.” The time-value of money is a basic finance/investment idea. If the federal government is incapable of incorporating it into analysis and plans, that speaks poorly of its ability to do just about anything.

* “China’s Shipyards Are Ready for a Protracted War. America’s Aren’t. While Chinese shipyards are thriving and primed to build at wartime rates, U.S. shipbuilding is in disarray” (wsj, $) The Navy problem is severe and, apparently, worsening.

* You’ve heard of lab grown meat, are you ready for rice-grown beef?” That’s cool. “After 9-11 days, they say the rice became a safe, usable ingredient that contained 8% more protein and 7% more fat than regular rice.” When I wore a blood-glucose monitor acquired through Levels Health, I was shocked by how much even brown rice spiked my blood glucose.

* “‘Accelerationism’ is an overdue corrective to years of doom and gloom in Silicon Valley.” Yes! Accelerationism is good.

* Against gerontocracy. We keep voting for gerontocracy, though—in some ways literally, in elections, and in other ways when e.g. corporate boards favor the elderly. Note:

In 1890, James Frazer – author of the landmark anthropological study of comparative religion, The Golden Bough – came to the conclusion that our ancient predecessors were in many respects wiser than us. They knew that gerontocracy was an age-old form of human organization, and they often embraced it, but they also put limits on rule by the old, especially rule by the faltering and senile, who were not only dispossessed of their power, but also often marked for death at an appointed time.

* Argument that Israel is winning in Gaza.

* “The Loss of Things I Took for Granted: Ten years into my college teaching career, students stopped being able to read effectively.” Have things changed that much? Since 2008, I’ve not noticed big changes, and most people don’t seem to read carefully for comprehension. But the people who do are the most interesting! I’ll also note that too few people in education seem to focus on reading, writing, and math skills.

* “Creating video from text: Sora is an AI model that can create realistic and imaginative scenes from text instructions.” Incredible. I hope OpenAI builds the machine god fast.

Links: Tumors defined by genetics, contemporary non-conformity, technology accelerationism, and more!

February 9, 2024 By in Links Tags: Leave a comment

* From Nature: “Forget lung, breast or prostate cancer: why tumour naming needs to change: The conventional way of classifying metastatic cancers according to their organ of origin is denying people access to drugs that could help them.” Notice: “To improve treatments for people with metastatic cancer, the community urgently needs to shift from using organ-based classifications of cancer to using molecular-based ones. This will require radical changes in how medical oncology is structured, conducted and taught.” Plus, this is consistent with my low view of the FDA’s current drug-denial regime:

For about a decade, millions of people with tumours expressing high levels of PD-L1 were not able to access relevant drugs because trials had not yet been conducted for their type of cancer when they became unwell. Those with certain breast or gynaecological cancers expressing PD-L1 had to wait 7–10 years to access PD1 inhibitors.

And how many people died while waiting? Why aren’t those estimates considered by the FDA?

* From my wife, Bess: “In defense of boring. An exciting story.” The start of the second paragraph still makes me laugh: “‘You’re boring,’ declares Dr. Sacco, Jake’s oncologist.”

* “Natalism as Non-Conformism.”

* “Interview: Sarah C. Paine: A scholar of the 20th century explains the conflicts of the 21st.” Impressive and thorough.

* “Taylor Swift, Donald Trump and the Right’s Abnormality Problem.” I don’t find football interesting—George will allegedly described it, memorably, as: “Football combines two of the worst things in American life. It is violence punctuated by committee meetings”—and Taylor Swift’s music is fine (“Bad Blood” is catchy), though I’m not her target audience. Yet this gets at something vital, though maybe not dispositive, if one is to believe polls. Another version of the argument may be found in “Taylor Swift Democrats: Conservatives are losing the ‘don’t be weirdos’ contest.”

* Biden should run on a message of abundance. IMO abundance is good. I’d prefer a substance of abundance over a message of abundance, personally.

* The end of Vitalik’s childhood. “[W]atching all of these people go further than I did, younger than I did, made me clearly realize that if that was ever my role, it is no longer.”

* How’d China come to dominate electric cars? Without Tesla, China would likely totally rule the electric car market. Tesla is among the most important companies, ever.

* “How cancer hijacks the nervous system to grow and spread.” Of particular interest because my tumor exhibited “perineural invasion,” which appears to have been way worse than I knew or thought at the time.

* “Citation cartels help some mathematicians—and their universities—climb the rankings.” In case you’re still somehow thinking that all is well in academe.

* “FDA devastation during the pandemic.” The FDA kills, and hardly anyone seems to care.

* “GoFundMe Is a Health-Care Utility Now: Resorting to crowdfunding to pay medical bills has become so routine, in some cases health professionals recommend it.” A problem and challenge I feel acutely. I love the mealy-mouthed bureaucratic responses from the hospitals.

* The problems of therapy.

* Podcast with “Jerry Hendrix: The Age of U.S. Naval Dominance Is Over.” His book is To Provide and Maintain: Why Naval Primacy Is America’s First Best Strategy. One of these things that is a lot more important than much of what one sees. Hendrix says China is building a new surface warship every six weeks, and the U.S. is building just six a year. Relatedly: why we can’t build enough artillery shells, in detail.

* Ten technologies that won’t exist in five years—but most of them could, and should, exist.

The meathead margin: how lifting weights might have saved my life

February 6, 2024 By in Essays, Personal Tags: , , , 4 Comments

Before the May 25 cancer surgery that took my tongue, I’d been lifting weights, steadily but poorly, for a decade, and that habit is in part responsible for me pulling through the horrific aftermath of the surgery. The more physically robust a person is, the greater the margin for pain and for recovery—and I feel like I barely made it through the long, brutal surgical recovery period, which constituted the whole summer, followed by chemo in July and August, and then by an indolent infection in September and October. I weighed 175 lbs before my first cancer surgery, in October 2022, and bottomed out in the 133 – 136 range last summer. Now I’m hovering between 138 – 142, despite extensive, annoying, continuous efforts to eat more, via both mouth and feeding tube injection. Eating can be a pleasure or pain, but eating for weight gain isn’t fun, particularly when the weight gain is elusive.

For months, food has stolen too much focus from me, because I need to avoid missing meals to maximize calories. Did I just wake up? Time to make a smoothie, or blend some leftovers, and then inject a bag of Liquid Hope through my feeding tube. Is the sun scooching past its zenith, which means lunch time is a little behind me? Then some calories need to go in. Are we getting past 8:00 p.m.? That’s a potential problem because of acid reflux if I lie down too soon after eating. Whatever else I’m doing, or learning, or concentrating on, there’s an annoying cognitive process weighing my food needs running in the back of my mind. Weight training can help me gain weight, yes, but to make the weight training effective, I have to consume enough calories—with “enough” tending to mean “somewhat more than I’ve been able to ingest on any given day.” Since I can’t chew or swallow normally, food must be blended with water for either injection or swallowing, and water reduces caloric density.

Eating is important, but, as noted, I hope to augment food with lifting. Before that first surgery, I could rep 145 lb on the squat fairly easily, and I was working my deadlift reps towards 225 lbs—”two plates,” in meathead parlance.[1] Not a lot, but better than no training. When I got back into the gym maybe a month after my first partial glossectomy in November 2022, I felt like I could barely lift my arms, and had to re-start with the bar on the squat rack, and 15 lbs training bumpers on either side of the deadlift hex bar. I started re-building as best I could, though I knew that radiation therapy would probably knock me back again.

In being knocked back, I feel some kinship with the totality of humanity. For most of human existence, humans have been building up all kinds of tribes, structures, and/or civilizations, only to be knocked back by weather, climate change, internal dissension, greed, barbarians, technological regression, disease, or some other force. It’s only since the Industrial Revolution that humans have managed to mostly transcend the condition of agricultural misery and paucity, though we might wind up in such horrifying conditions again, via nuclear war or plague or some other malady. As individuals, we’re less robust than contemporary societies or cultures, and we’re prone to setbacks like the ones I’ve experienced. I suspect that how a person responds to setbacks says something about them; my view is that the appropriate response to adversity is to persist, even futilely, even as one possibly rages against the dying light.

That philosophical outlook is evident in me going to the gym despite feeling wretched and janky. To not go is to risk not replenishing my margin for future, and (realistically) inevitable setbacks. To not go means there is worse to come. Sure, as long as the clinical trial drug petosemtamab keeps working, I can probably hover in the 140 lbs range without risk of organ failure or starvation. Apart from being skeletally thin, the other worry is the next bump in the road. What if I need another surgery? What if there’s more chemo in my future—which I expect before the end, even if “more chemo” is an effort to hold the line as I exit one clinical trial and before beginning another? What if a clinical-trial drug causes nausea? What if re-irradiation comes, and the pain that already accompanies swallowing worsens? I list the known unknowns: the unknown unknowns are infinite.

As I write this, I take a break to check my weight: 140.1 lbs. Not great but could be worse. The last week hasn’t been ideal regarding the gym : on Monday I was wrapped up in a project, Tuesday I flew to San Diego and got settled there, Wednesday I had a petosemtamab infusion, Thursday I flew home, Friday I withdrew from the prescribed dexamethasone—a steroid—that is supposed to help prevent infusion reactions to petosemtamab, and today, Saturday, I finally got in to do overhead press, hangs, and the leg press. I should’ve squatted but delayed, making excuses. The fire that used to inspire me to pump iron is gone. Meatheads speak of the “pump” when they lift; Arnold Schwarzenegger described it in Pumping Iron:

The greatest feeling you can get in a gym or the most satisfying feeling you can get in the gym is the pump. Let’s say you train your biceps, blood is rushing in to your muscles and that’s what we call the pump. Your muscles get a really tight feeling like your skin is going to explode any minute and its really tight and its like someone is blowing air into your muscle and it just blows up and it feels different, it feels fantastic. It’s as satisfying to me as cumming is, you know, as in having sex with a woman and cumming. So can you believe how much I am in heaven? I am like getting the feeling of cumming in the gym; I’m getting the feeling of cumming at home; I’m getting the feeling of cumming backstage; when I pump up, when I pose out in front of 5000 people I get the same feeling, so I am cumming day and night. It’s terrific, right? So you know, I am in heaven.

I personally haven’t experienced the level of, um, endorphin rush that Arnold describes—I suspect few people do, or gyms would be packed—but I’ve gotten a pale imitation of the physical satisfaction he cites. My occupations have been thinky and sedentary, and running or lifting contrasts with sitting in the chair or standing and typing. Unfortunately, whatever physical pleasures lifting once brought have dissipated. Now, it’s more chore than not. An important chore, but a chore. It used to be fun. I used to know how to make it fun. I’m sad that that sense of fun is gone, and I’ve not really been able to rekindle it.

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Links: The need for medical tech acceleration, the need for new cities, the need for the new, and more!

February 4, 2024 By in Links Tags: Leave a comment

* “On conditional approval for human drugs.” This will almost certainly be too late for me, but it would be a real step forward—as Alex writes: “Dare I say it, but could the FDA be lumbering in the right direction?” I hope so. I’ve been encouraging it to lumber in that direction. Particularly in oncology drugs, not making the process for people with fatal diagnoses to try even long-shot drugs easy is madness. It should be criminal. If I’m going to die anyway, why not try something unusual? The drug I’m on now, petosemtamab, should’ve been approved for recurrent / metastatic squamous cell carcinoma at least ten months ago, if not longer. Give us the right to try! I’m almost certainly going to die of squamous cell carcinoma anyway; might as well find out if any of the drugs coming out of labs work. Drugs to treat fatal diseases are not like drugs to treat some dubious ailments like high cholesterol, or ailments like depression in which it’s hard to say if any of the drugs available really work.

* “Irene Bosch developed a quick, inexpensive COVID-19 test in early 2020. The Harvard-trained scientist already had a factory set up. But she was stymied by an FDA process experts say made no sense.” The FDA is killing more people than it’s helping / “protecting,” a theme you’ll also see in the link above. And the collective response to this is to shrug, and go back to pointless culture wars.

* “The California Forever project is a great idea.” We need new cities. I suspect we’re not going to get a new frontier until we can build O’Neill Habitats, which probably won’t be for a long time.

* “Making every researcher seek grants is a broken model.” True, and an important point for effective accelerationism.

* The Dan Wang 2023 letter. Excellent. Too many sections to quote, but:

The disappointment I feel mostly concerns food. You can find pretty good food in America at fairly high prices, but you will never be able to find mindblowing food at the cost of a few dollars — which is the default in Asia. Americans who have never been to Asia will never appreciate how one never needs to cook, because right outside will be a mom-and-pop shop that is preparing a meal that is one order of magnitude tastier and cheaper than one could make at home.

Maybe one day cooking at home will be as peculiar or rare growing all of one’s food at home. Gains from trade and specialization are real!

I think the U.S. is too heavily invested in parking lots to generate sufficient proximity to restaurants to in turn generate the possibility of mindblowing food at relatively low prices.

* The culture of Boeing, and what happens when engineers aren’t in charge. Facebook/Meta seems to work well in part because it’s kept the MBAs out.

* “A vote for Trump is a vote for chaos.” Obvious, and yet here we are.

* Scientists at Strand Therapeutics Will Test a Cancer-Hunting mRNA Treatment. This is great. Unfortunately for me, their first clinical-trial drug appears to be a tumoral-injection drug, which would work for the tumors in my neck but is probably not ideal for the tumors in my lungs. Their pipeline page lists STX-003 as a systemic interleukin-12 (“IL-12”) therapy that is in preclinical development, and the indication is for non-small cell lung cancer (NSCLC), since sticking needles into the lungs is not ideal. There’s already an IL-2 therapy called SAR444245, being tested as “THOR-707,” but the last wave of IL-2 trials didn’t seem to go well. Biology is hard. This sort of failure is also why I’m leery of many phase 1a trials.

* “Will China squander its moment in the sun?”

* Massive lithium deposits found in the U.S. Whatever you read about lithium shortages is likely BS. The biggest problem in the U.S. is NEPA, the National Environmental Protection Act, which, despite its name, often does net harm to the environment—like many putative environmentalists.

* “Why do people post on [bad platform] instead of [good platform]?” By Dan Luu, and a topic I’ve also wondered about. The information density of text is still so much greater than video, and the production costs so much lower, that I find the shift to video dumb. But I find a lot of common behaviors and choices dumb. Maybe I am the dumb one.

* Funding for “revolutionary” science, outside of the typical foundation and grant-making apparatuses.

* The Housing Famine, and how we should build a lot more housing.

* The need to build a more resilient navy—which is another way of saying: “The need to build more stuff, faster.”

* “How cancer hijacks the nervous system to grow and spread.” One of the high-risk features of my cancer was “perineural invasion”—that is, the cancer had invaded nerves in my tongue.