Category Archives: News

Moderna mRNA-4157 (V90) news for head and neck cancer patients like me

April 12, 2024 By in News, Personal Tags: , , 1 Comment

The best treatment candidate for keeping me alive that I’m aware of is Moderna’s mRNA-4157 personalized cancer vaccine: in very early data from 2020, a 10-person dosing study found that the treatment “shrank tumors in five patients with head and neck cancer (50%), eliminating the tumors in two of those patients.” By recurrent / metastatic head and neck squamous cell carcinoma (R / M HNSCC) standards, that’s spectacular, so I perked up on Monday when Moderna announced phased 1b trial results showing that, of 22 patients who were dosed, two-thirds saw at least some “disease control” (meaning that their tumors stayed about the same size or shrank), and two saw their tumors disappear altogether. Pretty much everyone who has R / M HNSCC dies, and R / M HNSCC doesn’t readily respond to treatment, so anything with effectiveness like this is important.

Still, this is not so great: “About 27% of those receiving the vaccine showed an overall response rate, or ORR, with 3.4 months of progression-free survival, or PFS, and 24.6 months of overall survival, or OS.” Having only three and a half extra months without tumor progression is good, but not something like, say, three years. And surviving 24.6 months is nice—the R / M HNSCC median lifespan is just twelve months after diagnosis—but could, again, be longer. Moreover, on a personal level, if I’m going to survive I need access as soon as possible, and, at least as of January, one oncologist who works closely with Moderna told me she’s not aware of any phase 2 trial planned for 2024. That was three months ago, so things might’ve changed since.

I also note this, from the poster presentation: “Part C of this study enrolled patients ¬18 years old with checkpoint inhibitor (CPI)-naive, recurrent / metastatic HPV- HNSCC.” “CPI-naïve” means patients who haven’t receive pembrolizumab (Keytruda), which I have. If the phase 2 trial also requires that I be CPI-naïve, I’ll be out of luck. While phase 2 drugs can sometimes be petitioned for compassionate use if a terminal patient doesn’t qualify for a trial, it’s less likely that a personalized, tumor-specific treatment that requires more intensive preparation than, say, mailing an IV bag of a batch-produced drug, will be acquirable.

There’s another ominous phrase in the presentation, too: “Randomized assessment of the mRNA-4157 + pembrolizumab treatment effect in the advanced disease setting may be warranted.” So there will probably be a placebo group that gets only pembro, which I’ve already failed.

I don’t understand why the results so far aren’t enough for accelerated FDA approval, given the grim prognosis for R / M HNSCC, the limited treatments available, and the safety of mRNA-4157. It could be that Moderna doesn’t have the capacity to mass produce mRNA vaccines yet—the company is building a factory in Massachusetts that won’t come online until 2025—though that article also notes that “In 2018, the company opened a $110 million, 200,000-square-foot mRNA plant in Norwood.” Part of the approval process could I guess be proving not only efficacy, but the ability to mass-produce the vaccine; so Moderna won’t file paperwork for approval until the facility is running, which means that patients like myself, who so desperately need better treatment options now, will likely not be running at all by then, having run out of time.

Right now I’m about to begin a clinical trial of Seagen’s PDL1V antibody drug conjugate, which is good, though it’s unclear whether I’ll get dosed soon enough for PDL1V to work well enough to stop the tumors in my neck from breaching critical structures. Knowing what I know now, I probably should’ve gotten chemo immediately upon getting the tumor-growth news on March 13. But I didn’t for somewhat complex reasons I’ll explain in the next essay—primarily because PDL1V, like many clinical trials, has an arbitrary-seeming limit on the number of “systemic therapies” a patient can have undergone. Cruelly, the clinicaltrials.gov page for PDL1V doesn’t even appear to list a lines-of-therapy limitation, which means patients like me have to call sites to eventually get the news. That should be publicly stated, so as not to waste everyone’s time. But “wasting time” is normal, though maddening, in clinical trials. Ultimately, the time that matters to the sponsoring drug companies is not the patient’s, but the persnickety FDA’s.

Overall, we should be working to have drugs like mRNA-4157 get much, much faster approval, rather than leaving people dead and dying at the gates of oncology clinical trials. Particularly frustrating is the unavailability of mRNA-4157 when considered with the other highly promising, low-side-effect, unavailable drugs in the pipeline: petosemtamab / MCLA-158 (which I just failed), Purple Biotech’s NT219 small molecule, the Seagen (now Pfizer) ADCs like PDL1V.

The real benefit is likely to come by combining therapies with differing mechanisms of action. Getting mRNA-4157 or petosemtamab or PDL1v as monotherapies or duotherapies is nice, but R / M HNSCC has time to adapt to and defeat treatment. Using multiple drugs at once might make a larger number of “complete responses”—cures—conceivable. Instead, playing whack-a-mole with cancer by trying a new drug every time an old drug pressures the cancer to mutate, creates a recursive loop until there are no more drugs to try, or the next drug doesn’t work. It’s possible, though unlikely, that some unforeseen interaction among treatments will prove fatal, but so what? R / M HNSCC is already fatal. I should have the right to try, without the FDA blocking me and thousands of other dying patients. We need faster treatments, not more trials that let the dying languish.

In other HNSCC news, Transgene is moving its personalized vaccine to a phase 2 trial. That vaccine targeted at patients who have an initial surgery and then want to prevent recurrence; in the phase 1 trial, patients “were randomized to one of two treatment arms: one in which patients received repeated injections of the personalized vaccine as an additional adjuvant therapy and another in which they did not receive any additional adjuvant therapy.” No patients who received the vaccine relapsed; three of those who didn’t, did. “Roughly 40 percent of head and neck cancer patients are expected to experience cancer recurrence within two years of surgery and adjuvant therapy, according to Transgene.” If that TG4050 vaccine had been available in October 2022, when I had my initial surgery, I’d probably still have a tongue, be able to work, and look forward to spending years if not decades with Bess. Instead, every day is a fight and every month I’m alive a surprise. The technology exists but we’re slow-walking it to patients, which is insane.

This recent essay by Bess describes more about the FDA’s failures to consider real cost-benefit analyses, including the cost of delay, in approval decisions. The FDA is letting people like me die, which I find frustrating, as does my family.

If you’re involved in drug development and have first-hand knowledge of the FDA’s torpor, get in touch

August 2, 2023 By in Culture, miscellaenous, News, Personal 4 Comments

The title says it: if you’re involved in drug or medical development and have experienced the FDA’s torpor, or vengeance, consider getting in touch; anonymously is fine. I want to make explicit something a few people caught in “I am dying of squamous cell carcinoma, and the treatments that might save me are just out of reach:” many of the people with first-hand knowledge of the costs of the FDA’s slowness don’t want to speak out about it, even anonymously. They’re justifiably worried about their lives and careers, as well as what appears to be the FDA’s penchant for punishing companies or individuals who criticize or want to reform it. So the people who know most about the problem are incentivized not to speak up about it, kind of like the way mafioso were discouraged from discussing what they knew for fear of retribution. Some of them will talk about their experiences and knowledge over beer or coffee, but they won’t go further than that.

There are reform efforts and at least three serious people I now know of who are working on books about the invisible graveyard that I’m likely to join soon—and perhaps become a mascot for: a million deaths are a statistic but one is a tragedy, as they say. If the life and death of one man can stand for the millions who have died, maybe people will pay more attention. So if you have any direct experience that you’re willing to share, including anonymously, consider doing your bit for reform.

Some of that experience might include:

* General FDA slowness and lack of responsiveness.
* The sense of vendetta—that criticizing the FDA in public, especially over specific decisions, will lead to retribution later.
* Patients who wish to try drugs but can’t.
* Scientists, doctors, or companies that deliberately slow down what they’re doing.
* Whatever else I might be missing.

Many observers are aware of these problems but also the extent to which many people with rich specifics are reluctant to share those specifics, for good reason. I will respect anonymity and am aware of people working on projects designed to help FDA reform—and, hopefully, to save the lives of people like me, who are suffering from maladies that are likely curable with existing technologies, if the FDA made those technologies legal to consistently test and try, and if the FDA worked harder to make the existing trial process faster, easier, and more transparent.

The FDA situation is a specific example of the country’s love of process and bureaucracy, rather than a love of effectiveness and success. We’re suffering from huge bureaucratic drag in doing anything; we see the same general problem recur in building out subways or other forms of transportation infrastructure, in building new electricity transmission lines, in permitting new electrical generating capacity, in building new housing, in the Nuclear Regulatory Commission (NRC), and in the FDA. Works in Progress is a good publication covering these kinds of issues. We’re stuck with the sclerotic processes implemented in the ’70s instead of the dynamic, transparent, and far faster processes we should have today. We’re all suffering the results, some of us more acutely (like yours truly, who is doing for lack of large-scale, deployed, and debugged customized vaccine technology) and some of us less directly.

Anything that is small enough to build in a factory and ship via container is cheap and abundant; anything that requires opaque regulatory approvals or that goes into the body is expensive and tragically scarce. Ezra Klein and Derek Thompson are writing a book presently titled Abundance: What Progress Takes, which is about this subject and which I’d write about if I were likely to last until April 2024.

Practitioners on the ground, like doctors, see the deaths of their patients. The FDA is more concerned about political issues. There’s nothing like watching people die to alter your risk tolerance.

The author may be doing poorly, but he still exists, as of Aug. 2, 2023.

Global warming is here and it’s everyone’s fault

July 22, 2023 By in Culture, News Tags: , Leave a comment

Maybe you’ve seen: “The 15 hottest days, in the world’s hottest month.”

It’s not like we weren’t warned: Nasa scientist James Hansen testified to Congress in 1988 about what was coming. We ignored it. By now, it’s everyone’s fault.

It’s the fault of:

* People who have spent decades voting against nuclear power.

* People who support NEPA. People who have never heard of NEPA.

* NIMBYs who work and vote to keep the vast majority of domiciles car-dependent.

* NIMBYs who make sure we can’t build more housing in dense, green cities like NYC (where I used to live, but moved, due to affordability issues).

* People who vote against bike lanes.

* People who could have picked the smaller vehicles and didn’t.

* People who could have picked up the bikes and didn’t.

* People who could have installed solar and didn’t.

* People who vote against mass transit (“It will never be practical”).

* Me. I only have so much effort to push into resisting the efforts of hundreds of millions if not billions of other people who are enacting the system. I try to resist but it’s hard for one person.

* People who realize that they’d like to live differently but are pushed into that single exurban direction by the legal and regulatory structure of American and, often, Canadian life.

Even the people who’d like to live greener—without a car, without relentless parking lots blighting the landscape, without having to live in single-unit housing—mostly can’t, in the United States. Or if we can, we’re merely moving the next marginal candidate who’d like to live densely into the exurbs of Phoenix, Dallas, Houston, Miami, and so on. Those are the places where it’s legal to build housing, so that’s where most people are going. I’ve moved from New York to Phoenix because I can afford the latter and can (barely) afford the former. Most of Phoenix is impossible without a car, and dangerous on a bike. It’s tragic, and I’d love to see change, but the system is forcing me in a particular direction and it’s incredibly expensive to try resisting it.

It’s the fault of no one, and everyone. There are some green shoots of change happening, albeit slowly, but we needed to get serious about nuclear power and the removal of non-safety zoning restrictions decades ago. We didn’t, and now the price is showing up. We need to get serious today, but we’re not.

Because fault is diffused, most of us, me included, feel there’s nothing substantial we can do—so we do nothing. Years pass. The problems worsen, though we can justify to ourselves that the problems are just headlines. Insurance becomes hard to get. The deniers set up their own alternative universes, where information only confirms and never disconfirms their worldviews. The bullshit asymmetry principle plays out: “The amount of energy needed to refute bullshit is an order of magnitude bigger than that needed to produce it.”

“What if scientists have over-predicted the consequences of global warming?” people ask. The flipside is never considered: “What if they’re underpredicting the consequences?”

The system goes on. Maybe solar, wind, and geothermal get cheap fast enough to partially save us. Maybe direct air capture (DAC) of carbon dioxide proceeds fast enough.

But maybe it doesn’t. And then the crisis will be all of our faults. And no one’s.

Experiencing the consequences of diminished world trade:

November 8, 2016 By in News Tags: , Leave a comment

All the fools who voted for Brexit and Trump may also have to live with the consequences of diminished world trade. It is one thing to claim that trade is bad; it is another to actually attempt to dramatically restrict or curtail it. We’ve been living with trade tailwinds for the last couple decades. Now we may get to experience the opposite.

In the meantime, the dollar and peso are both plunging, as are stocks. Trade is an incredible net good and yet both major political parties in the U.S. are rhetorically fleeing from it. So far it is rhetoric, anyway, but soon it may be policy.

Recession in 3…, 2…, 1…

Someone on Twitter observed that the best-case Trump scenario is that he’s too lazy, uninterested, or incompetent to do much in the next four years. Let us hope. Still, overall this is one of those scenarios in which we collectively deserve what we get.

News is comedy:

December 11, 2015 By in Links, News Tags: , 1 Comment

Luttwak spends much of his time at the computer. He follows the news closely and interprets it as an ongoing comedy.

That’s how I read the news, too, because to interpret it as other than a comedy is too depressing to contemplate for more than a second. The only consistently good news comes from the science and technology sections.

That dictators are, when viewed from the proper light, comedic has of course been long known, yet the dictators never themselves seem to realize this. Right now, in U.S. politics Trump is the funniest candidate in memory, and he also strikes one as one of the people least likely to recognize himself as comedic.

Everyone gets their own sandbox? On Syria:

November 27, 2015 By in Links, News Tags: , 1 Comment

From “What is going on in Syria? (model this):”

I think first in terms of Yugoslavia in the 1990s, which also saw the collapse of an untenable-once-placed-under-pressure nation-state, followed by atrocities.

My own pet theory as a very much non-expert who wastes some attention on the news is that Iraq and Syria need to be broken into smaller pieces based on ethnicity: Kurdistan, Sunni-stan, and Shia-stan, and perhaps others. From what I understand Kurdistan is already more or less operating, just without an official declaration of statehood; there still isn’t an Iraqi “state” per se. “Iraqis” don’t really fight for Iraq: they fight for their ethnic groups.

Breaking countries into single-ethnicity pieces may be the major lesson of Yugoslavia and perhaps World War II, which had the unfortunate effect of making many European countries close to monoethnic.

There are problems with this solution in the Middle East (e.g. Turkey and Kurds) but there also seem to be many problems with the status quo, to the extent there is a status quo.

Perhaps the only thing average individuals can do is attempt to use less oil at the margin (shift from a hybrid car to a plug-in hybrid when necessary, from a standard car to a hybrid, and there are others), since oil is indirectly funding so much of the violence. When I read about large-scale, seemingly intractable problems, I often want more writers to ask, “What is an average person supposed to do?” and then attempt to answer the question.

Note, however, that Iraq and Syria also have cousin marriage problems that may destabilize the state and empower smaller groups.

Still, take this analysis skeptically, given my views on Iraq War II when it happened, and given too that foreign policy seems like William Goldman’s description of Hollywood: nobody knows anything. The CIA famously missed the fall of the Soviet Union. Pretty much no one expected World War I. The U.S. thought Vietnam, Afghanistan, and Iraq War II were going to go well. And so on.

The U.S. has been fighting little wars (apart from the obvious big ones) for its entire existence, and while the tools have changed the rhetoric only sometimes has. In addition, overall I see the world as getting better. One account of this can be seen in Steven Pinker’s The Better Angels of Our Nature. Most of Latin America is doing well. Even Africa is doing better than is sometimes assumed. The thing the U.S. and the West in general most have on our side is time and immigration patterns. Pretty much no one is fighting to emigrate from their current country to, say, Russia. Even current scare-story China sees more Chinese leaving than others trying to enter. Most parts of the world that aren’t tremendously fucked up are attempting to emulate the U.S. and Europe in many, though not all, dimensions. The long-term trends are positive for most people in most places even if Syria is a disaster.

To my mind giving everyone their own sandbox is a move in the right direction, despite opposition.

The Charlie Hebdo response:

November 15, 2015 By in Briefly Noted, News Tags: , , , Leave a comment

Is here:

Charlie_Hebdo on the paris massacre

Still, it is not obvious to me that religion, especially in its modern Western forms, is intrinsically opposed to the other items on that list, all of which I support and ideally enact.

The Tyler Cowen response is “So many questions…” That was posted almost two days ago and more questions still remain than answers.

My next novel, THE HOOK, is out today

August 26, 2015 By in Books, Fiction, News, Personal Tags: , , , 3 Comments

The HookMy latest novel, The Hook, is out today as a paperback and Kindle book. It’s even available on the iTunes Bookstore for the masochists among you. The Hook is fun and cheap and you should definitely read it. Here’s the dust-jacket description:

Scott Sole might be a teacher, but outside of school hours he likes to think he lives in the adult world. That’s why he indulges his sometime-girlfriend’s request to install an adjustable length hook in his apartment wall—of the sort appropriate for hanging people, not paintings. The project goes so well that, at her urging, he writes a blog post about it. Nobody cares about Scott’s blog—until three students find the post and think they can use it for their own purposes.

Each has a motive: Stacy wants to find out if there’s any truth in the whispers that Scott and her older sister had an affair during her sister’s senior year; Arianna thinks she can use it to weasel out of a semester-long writing assignment; and Sheldon wants a way onto the school newspaper to pad his college application. At the same time, one of Scott’s former students returns to his classroom as a student-teacher with a crush on her supervisor. But as accusations fly regarding the blog post, his students, and the rest of Scott’s less-than-perfect life, Scott discovers that once rumors begin, they’re as hard to stop as dirty pictures on the Internet. They might not just cost him his job, but his freedom. It turns out that a good hook can keep you reading, hold up a kinky girlfriend, and hang your career all at the same time.

My last novel, Asking Anna came out on January 17, 2014. In the last year I’ve quit some things and started others; written about a quarter of my next (likely) novel; read a lot; almost died; and wrote down too many ideas to execute in the next twenty years. But the Asking Anna announcement post is similar to this one, and everything I wrote then is still true:

I’ve been writing fiction with what I’d call a reasonably high level of seriousness since I was 19; I’d rather not do the math on how long ago that was, but let’s call it more than a decade. It took me four to six false starts to get to the first complete novel (as described in slightly more detail here) and another two completed novels to finish one that someone else might actually want to read. Asking Anna came a couple novels after that.

What else? Other writers warned me about bad reviews. They were right that I’d get them, but they were wrong about my reaction: I mostly view bad reviews as entertainment. This “review” may be the best in that respect: “This is surely one of the worst books I have ever read.the author envisions himself as being cerebral by using vocabulary that does not even have any place in the story.” I’m not sure how anyone would envision the author of a novel envisioning himself just through reading the novel in question, but life on the wilds of the Internet entails some pretty confusing commentary.

I’d also like to thank everyone reading this who bought a copy of Asking Anna, and everyone who has bought or is going to buy a copy of The Hook. Books exist to be read. It’s because of your support of Asking Anna that I’ve been able to bring out The Hook. If you’ve gotten this far, let me suggest that you stop by Goodreads and leave comments there.

Why you really can’t trust the media: Claire Cain Miller and Farhad Manjoo get things wrong in the New York Times

July 3, 2015 By in Links, News Tags: , , , , , , 5 Comments

In “The Next Mark Zuckerberg Is Not Who You Might Think,” the New York Times‘s Claire Cain Miller repeats an unfortunate quote that is a joke but was taken out of context: “‘I can be tricked by anyone who looks like Mark Zuckerberg,’ Paul Graham, co-founder of the seed investor Y Combinator, once said.”* But Graham has already publicly observed that this is a joke. As the link shows he’s publicly stated as much. Thousands of people have already read the column, but yesterday morning I thought that it’s not too late to correct it for those yet to come. So I wrote to both Miller and to the corrections email address with a variant of this paragraph.

In response I got this:

Thanks for your email. I’m confident that most readers will understand that the line was tongue in cheek, however. The idea that a co-founder of Y Combinator could be persuaded to part with seed funding simply by dint of the solicitor’s wearing a hooded sweatshirt is, of course, preposterous. At any rate, there is nothing to “correct,” so to speak, as Mr. Graham did in fact say those words.

Best regards,

Louis Lucero II
Assistant to the Senior Editor for Standards
The New York Times

But that’s not real satisfying either: nothing in the original article to indicate that Miller meant the line tongue-in-cheek. Based on the surrounding material, it seems like she took it seriously. Here is the full paragraph:

Yet if someone like that came to a top venture capitalist’s office, he or she could very well be turned away. Start-up investors often accept pitches only from people they know, and rely heavily on gut feelings, intuition and what’s worked before. “I can be tricked by anyone who looks like Mark Zuckerberg,” Paul Graham, co-founder of the seed investor Y Combinator, once said.

I wrote back:

Thanks for your response, but it’s pernicious because Graham, as he explains at the link, does not actually think he can be tricked by anyone who looks like Mark Zuckerberg, and his statement is part of the reason why he can’t, and why he doesn’t necessarily expect the next tech titan to look like Zuckerberg. One of the epistemological roles of humor is to say something but mean the opposite: have your read Umberto Eco’s The Name of the Rose? In addition to being a fantastic book, many sections deal with precisely this aspect of humor, and the role it plays in human discourse.

There’s actually a Wikipedia article on quoting out of context that’s both relevant here and helps explain why some reasonably famous people are becoming more cagey about speaking in public, in uncontrolled circumstances, or to the press.

To say that anyone even slightly familiar with Graham’s thought or writing—which is available publicly, for free, to anyone with an Internet connection (as most New York Times reporters have) will understand that the quote is absurd. Graham has probably done more to promote women in technology than anyone else. He wrote an entire essay, “Female Founders,” on this subject, which arose in part because he was “accused recently of believing things I don’t believe about women as programmers and startup founders. So I thought I’d explain what I actually do believe.” Miller didn’t bother reading that. She got it wrong, and it goes uncorrected. So this bogus quote that says the opposite of what Graham means is still going around.

Meanwhile, Farhad Manjoo wrote “As More Tech Start-Ups Stay Private, So Does the Money,” in which he cites various reasons why startups may stay private (“rooted in part in Wall Street’s skepticism of new tech stocks”) but misses a big one: Sarbanes-Oxley.** It’s almost impossible to read anything about the IPO market for tech companies without seeing a discussion of the costs of compliance (millions of dollars a year) and the other burdens with it.

I tweeted as much to him and he replied, “@seligerj a whole article about a complex issue and no mention of my pet interest that is just of many factors in the discussion!!!!??” Except it’s not a pet interest. It’s a major issue. Manjoo could have spent 30 seconds searching Google Scholar and an hour reading, and he’d conclude that SBO is really bad for the IPO market (and it encourages companies to go private). But why bother when a snarky Tweet will do? A snarky Tweet takes 10 seconds and real knowledge takes many hours. General problems with it are well-known. Not surprisingly, Paul Graham has written about those too. So has Peter Thiel in Zero to One. Ignoring it is not a minor issue: it’s like ignoring the role of hydrogen in water.

Manjoo’s article is at least a little better because his is a misleading oversight instead of an overt misquotation. But it’s still amazing not just for missing a vital issue in the first place but the response to having that issue pointed out.

If the articles were posted to random blogs or splogs I’d of course just ignore them, because the standards to which random blogs are held are quite low. But they were posted to the New York Times, which is actually much better than the rest of the media. That two writers could get so much so wrong in so short a space is distressing because of what that says not only about the Times but the rest of the media. I’m not even a domain expert here: I don’t work in the area and primarily find it a matter of intellectual curiosity.

This post is important because the Times is a huge megaphone. Policymakers who don’t know a lot about specific issues related to tech read and (mostly) trust it. While sophisticated readers or people who have been reading Graham for years might know the truth, most people don’t. A huge megaphone should be wielded carefully. Too often it isn’t.

Oddly, one of my earliest posts was about another howler in the New York Times. I’ve seen some since but yesterday’s batch was particularly notable. There are many good accounts of why you can’t trust the media—James Fallows gives one in Breaking the News and Ryan Holiday another in Trust Me, I’m Lying—but I’ve rarely seen two back-to-back examples as good as these. So good, in fact, that I want to post about them publicly both to inform others and for archive purposes: next time someone says, “What do you mean, you can’t trust even the New York Times?”, I’ll have examples of why ready to go.

* I’m not linking to the article because it’s terrible for many reasons, and I’d like to focus solely on the one cited, which is provably wrong.

** I’m not linking directly to this article either; The Hacker News thread about it is more informative than the article itself.

What a bizarre set of sentences:

March 29, 2015 By in Links, News Tags: , , Leave a comment

The first paragraph from a New York Times article:

Kleiner Perkins’s victory Friday in the gender discrimination suit brought by Ellen Pao could be seen as an affirmation of the Silicon Valley old boys club. But venture capitalists have said that the trial has already put the tech industry on notice: It can no longer operate as a band of outsiders, often oblivious to rules that govern the modern workplace — even if that has been a key to its success.

So venture capitalists have to stop doing the very things that have “been a key to [their] success?” Won’t they then presumably be outcompeted by those who are willing to do those things? The “rules that govern the modern workplace” may also be one of the reasons startups are popular: they don’t have those rules. Paul Graham notes that “Nothing kills startups like distractions.” “Workplace rules” seem like they’d fall under the heading “distractions.”

The most intelligent commentary I’ve seen on this matter is Philip Greenspun’s. The gap between the press’s portrayal and what I’ve seen from people in the industry is even vaster than the gap between what I see in the press about nonprofits / government, and what actually happens on the ground.