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Happy Friday — and welcome all new subscribers!
I’m rebounding from LASIK and my doctors say that the uncommon complication — called DLK or Diffuse Lamellar Keratitis — is trending better. So, fingers crossed — and thank you to everyone who sent their well wishes!
On My Mind
More on DLK: While today the complication is somewhat uncommon — the clinic I went to gets 1 or 2 cases per 500 procedures or so — DLK following LASIK used to have incidence rates as high as 10% (depending on the source I find and what my doctor has said).
As technology improved — and lasers were used for a part of the surgery that previously involved a very sharp blade — the entire LASIK procedure became easier on the eye, reducing the body’s inflammatory reaction to the cuts and tissue ablation.
Thus, when I got DLK, it was a bit unexpected.
Fortunately, my opthamologist knows the treatment protocol and we started that immediately. However, given the low incidence rate, once it looked like the standard method of treatment might not be working as well as hoped, she was rather unconfident on next steps to take with treatment protocols.
Because of her lack of experience (which was not any fault of her own — there was no way she could have the experience given the progress of technology), she routinely consulted with a semi-retired doctor that started doing LASIK-like surgeries 30 years ago. Given DLK was more common in the past, he has significant experience with treatment protocols and disease progression.
I am lucky that this older doctor is around to help. But that will not always be the case.
30 years from now, and after these doctors with experience move on — and when technology improvements might mean 1 in 5,000 patients get DLK — how will the then-opthamologists understand treatment progressions and protocols?
Writing, drawings, scientifics studies, photos and videos all help — and you can memorialize things through those mediums. But those mediums transmit knowledge / learnings and not experience. My doctor knew the facts of how to treat DLK — but having less experience, she was unsure of herself when things became a little less standard.
First-hand knowledge like this is lost over time as it becomes less relevant — this is nothing new. I bet 1,000 years ago more people could self-start a fire in the woods for survival than can do so today. It is still useful to be able to start a fire — but you rarely ever need to anymore. So we don’t know how.
I do wonder if there is a step change about to happen in the speed of lost edge-case-related competence. While it sounds like an overused word by now, AI is getting pretty clever. We are seeing companies using it to read medical images without doctors in the loop, analyze legal documents for changes that need to be made, and serve up answers to questions in fractions of a second.
Right now, doctors still know how to read medical images, attorneys know what legal tricks to look for, and humans can leaf through paper books not yet digitized in order to find answers.
Will that always be the case? What happens when we lose some of those skill sets because a computer handles it so well that the average person doesn’t ever need those skills again?
Or — let’s think about programmers leveraging AI to write code. Often, the programmers leveraging AI for real use cases are incredibly experienced developers that generally use more junior programers for the bulk of code writing. The experienced folks focus only on the hard, nuanced parts of code.
What happens if AI replaces the junior programers — can we ever get experts that solve the hardest problems if people don’t first grind through years as junior code writers to build sold foundational skills and understanding?
I don’t know. I guess we will see. I’m optimistic everything will work out alright.
But — after having watched the uncertain face on my opthamologist frown defeatedly before she dashed off to call an older doctor — these things worry me a bit more than they had before.
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Quote of the Week
It is always thus — impelled by a state of mind which is destined not to last, we make our irrevocable decisions.
— Michael Proust
Poll of the Week
Last Week
Question: Do you wear glasses / contacts?
Results: 54% of responders do NOT wear glasses. At the end of May, I would have been in the minority — but given LASIK is trending well, it seems like I will have to vote “No” here as well.
Things to Read (and Listen to)
Genghis Khan | From Wrath of the Khans by Dan Carlin, 2012
Part One
In one of the most violent outbursts in history a little-known tribe of Eurasian nomads breaks upon the great societies of the Old World like a human tsunami. It may have ushered in the modern era, but at what cost?
Part Two
The Mongol leader Genghis Khan displays an unmatched level of strategic genius while moving against both Northern China and the Eastern Islamic world. Both civilizations are left stunned and millions are slaughtered.
Part Three
The expansion of Genghis Khan’s conquests continue, with locations as far apart as Europe and China feeling the bloody effects of Mongol warfare and retribution. Can anything halt the carnage?
Part Four
The death of Genghis Khan, the founder of the Mongol Empire, should have slowed the momentum of Mongol conquests, but instead it accelerated it. This time though, all of Europe is on the Mongol hit list.
Part Five
Succession issues weaken the Mongol Empire as the grandchildren of Genghis Khan fight over their imperial inheritance. This doesn’t stop them from dealing out pain, suffering, and ironically good governance while doing so.
Given LASIK a couple weeks ago, I am still getting re-ramped on reading. My eyesight feels great, but reading tends to wear down my eyes. Apparently, that might be the case for a couple more months — especially on screens.
Thus, I’ve allocated more time to Dan Carlin’s Hardcore History. Two weeks ago, I was going through his series on Japan in WWII. This week, I’ve kicked off his Genghis Khan / 13th century Mongolian Conquest series.
I’ve always had an interest in Mongolian history — partially from just being a bit of a history nerd growing up and partially because Richard Feynman went on an adventure to find Tannu Tuva — but my understanding of that Mongol Conquest-related history was a somewhat romanticized version.
Carlin shattered the rose-colored glasses I was wearing and highlights the brutal reality that was 10 to 50 million people losing their lives at the hands of the Mongols in this period.
While the military strategy and tactics the Mongols deployed were exceptionally forward thinking at the time, it is a bit nearsighted to focus there and not realize the human cost for those on the receiving end of Mongolian triumph.
Long-term | From Quiet Compounding by Morgan Housel, 2024
Long-term investing is about being able to absorb manageable damage; if you can’t do that, you’re pushed into the much harder trick of attempting to avoid short-term volatility. You’re only durable when you care more about surviving volatility than you do looking dumb for getting hit by it in the first place.
Instead of trying to look smarter than everyone else, you make a quiet bet that things will slowly get better over time.
You’re not in a hurry, yet everything is accomplished.
Disagreement | From A Lesson in Restraint by Kingswell, 2024
In a column on April 25, 2014, Joe Nocera of the New York Times called Buffett a “coward” and a “hypocrite” for wimping out with said abstention. That was just the first salvo of a bizarrely aggressive (and personal) series of attacks from Nocera on the matter. In the end, The Gray Lady eventually issued a flurry of corrections on his articles and the paper’s ombudsman even took Nocera to task for his slanted coverage of Buffett’s decision.
But, while Nocera kinda went off the deep end in his criticism, he was far from alone. Even at the usually friendly home cooking of the Berkshire AGM, one shareholder called the abstention “very strange, un-Buffett-like behavior”.
For one of the very few times in his professional life, Warren Buffett found himself on the back foot.
Laughing | From Our Sense of Humor and Age by Daniel Parris, 2024
When the scene finally came, the entire theater erupted with laughter, and the person laughing loudest of all was my dad. I was in shock: How was this possible? I always assumed that there was adult humor and child humor and that never the twain shall meet. Weirder still, I had never seen my dad laugh so hard during a movie.
After a few seconds of confusion, I decided to stop overthinking things and simply laugh along—father and son laughing at a stylish montage of phalluses. In hindsight, I had underestimated my father's ability to find things funny and his desire for laughter. For some reason, I always thought adults didn't want to laugh as much as children. I assumed that as we aged, our need for humor was replaced by reading The New York Times, eating charcuterie, perusing Wirecutter articles, complaining about the price of gas, and watching The Sopranos. Well, I was wrong. Everybody wants to laugh—even grown-ups.
Visuals
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Have a great weekend,
EJ
Twitter / X: @HistoryEJ
Disclosure: Nothing in this article constitutes investment advice. More detailed disclosure here.
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