Thoughts & Notes: “Overdiagnosed” by Dr. Gilbert Welch

This time I will focus on the notes! Here we go:

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📝 Overdiagnosis occur when people get diagnosed with conditions that might never cause symptoms or death.

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📝 A overdiagnosed patient can’t be treated, only harmed.

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📝 Overdiagnosis started with the diagnosis and treatment of high blood pressure. Which have helped a lot of people.

“It marked the beginning of treatment for people without syntoms”.

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📝 As we expand treatment to people with to milder abnormalities, their potential benefit from treatment becomes progressively smaller. Severity matters!

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📝 Better equipment find more abnormalities. Famous study found that 10 percent of healthy participants have had strokes without knowing about it.

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📝 “The realities are, with this level of information, I have yet to see a normal patient.” – radiologist who scanned over ten thousand people.

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📝 Overdiagnosis also leads to impressive numbers. 1000 women are diagnosed with progressive breast cancer and 700 survive. That’s 70% survival rate. Add 500 overdignosed patients (diagnoses that never would lead to any syntoms or death). That would make the survival rate go up to 80%!

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📝 Doctors fear lawyers, Love good grades from patients and are punished for not diagnosing = overdiagnosis.

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📝 “Mammography reduce breast cancer deaths AND lead to over-diagnosis.”

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⭐️ TAKEAWAY: If you are a healthy individual with no symptoms, the responsible answer to testing might be “no”. Or you might run the risk of getting treated for an abnormality that would never cause any symptoms. Ever! An options many never consider.

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A very good book, but if your not in the medical practitioner, reading half of it will suffice to get the big picture. I love the nuanced arguments and leave this book with even more admiration for the med. profession.

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3/5

Thoughts on: “Advice not Given” by Mark Epstein

“When we let the ego have free reign we suffer – but when we learn to let go, we are free.”

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Dr. Epstein explores where psychotherapy and Buddhism can complement each other in the persuit of mental wellness.

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The Buddha and Freud, Dr Epstein says, came to a similar conclusion. Ego is the enemy, the limiting factor in our wellbeing.

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Sure! We can control our egos to a large extent if we put in the effort, but I’m not as convinced as Dr. Epstein, that Sigmund’s Id, ego and super ego – and the “self” of buddhism are too similar – other than that the burden of societal norms increase our suffering – and that breaking free of those bonds is the key to inner

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📝 The Eightfold Path: Right view, right motivation, right speech, right action, right livelihood, right effort, right mindfulness, right concentration.

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📝 “Death is Apart of Life. Don’t make a big deal out of it!”

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📝 Right speech goes for both the external and the internal. Catch loops of bad self-talk!

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📝 We all need to find a way to deal with the truth of impermanence. ”Change is the Only Constant.”

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📝 Freud was a badass, Buddha was a badass!

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Epstein gives you psychotherapeutic case studies and personal stories interwoven with Zen parables – All tied together neatly with each chapter representing one of the 8 fold paths of Buddhism.

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I solid read for winding down and getting over yourself!

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3/5

Review: “The Black Swan” by Nassim Nicholas Taleb

“I make a claim against many of our habits of thought, that our world is dominated by the extreme, the unknown and the very improbable.”

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This book is about our blindness to randomness. Especially when it comes to large deviations and what Nassim calls a “black swan” event.

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A “black swan” is a highly improbable event that is unpredictable, carries a massive impact; and, after the fact, we concoct an explanation that makes it look less random and more predictable that it actually was.

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Examples of black swans would be 9/11, the amazing success of Google.

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Why are we so bad at acknowledging these type of events? We concentrate on what we know and fail to take into consideration what we don’t know. We love to oversimplify, narrate and categorize a complex reality. This hurts us when estimating risks and seizing opportunities.

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📝 “Only a few people understand that unread books are more valuable than read ones.” Focus on anti-knowledge I.e. What you don’t know.

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📝 “The movie makes the actor”

Often someone’s success is more luck than actual skill. The excellence of an director or actor is often assigned after the fact.

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📝 “In order to predict the future you need to know about technologies that will be discovered in the future. But that knowledge would almost automatically make us able to start developing those technologies right away. Ergo, we don’t know what we will know.”

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📝 That you have more information won’t make your predictions any better, but it will make you more certain they are.

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⭐️ TAKEAWAY

We can’t predict future events for shit. But more importantly, people that work with predictions are even worse predictors than your average Joe.

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Great book! What are you currently reading?

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4/5

Thoughts on: ”Eat & Run” by Scott Jurek

Scott Jurek runs and eats! By running I

mean 100 mile runs (that’s 160km!) and 24 hour races. By eating I mean only plant based foods.

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Endurance has been a theme in my reading for a while and this is the latest latest entry. I was led to this ultra marathon legends autobiography because Jurek was mentioned in “Born to Run”. But unlike “Born to Run” which I would recommend to anyone, this is better suited for running enthusiasts only.

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The most interesting aspects of the book is his search for the link between endurance sports and altered states of consciousness. I also enjoyed the more practical sections with training and dietary advice.

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📝 A common mistake for beginners is to have too long strides. Count the times you right foot skrikes the ground In 20 seconds. Multiple by 3 and you get your stride rate per minute. Speed up til you reach 85-95 strides per minutes.

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📝 Later in his career he started a more holistic view on his training:

– Yoga for body awareness, flexibility & centered focus.

– Body posture & stabilization.

– Conscious breathing.

– Upper body strength.

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📝 “The more I measure the more sure I was on my instincts” Jureks book has a more open attitude towards technology than the “back to basics” attitude of “Born to Run”.

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📝Jurek Book Recommendations:

“Running Wild” – John anorino “Running and Being”

“The Marathon Monks of Mount Hiei”

“The Power of Now”

“Bone Games”

“The Way of the Peaceful Warrior”

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⭐️ TAKEAWAY:

Every runner knows it is a hassle to time meals and workouts. Free up more time for actual training (instead of digesting) by replacing heavy meaty meals with plant based ones!

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4/5

Thoughts on: “Deng Xiaoping” by Alexander V. Pantsov

Deng Xiaoping led China through far reaching reforms in the post Mao era and is often credited as the force behind China’s spectacular economic growth. The expansion of the Chinese market and opening up the country to international trade is a part of his legacy, but also less glamorous deeds, such as the massacre on Tiananmen Square.

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This book is thick, meticulously detailed and unfortunately rather boring. I don’t think it’s the authors fault, rather its just the fact that Dengs life is not that exciting.

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The best parts of the books was the descriptions of how the communist party wanted to open up China and introduce elements from market economy within a socialist framework.

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I love the rationalizations used when the Communist party discussed if they where to allow small private businesses in China;

Someone mentioned that Marxs “Das Capital” tells the story of a capitalist who exploited 8 workers.

They argued: “If Marx spoke only of precisely 8, then the hiring of seven won’t make one a capitalist. And then if the boss also is working, what kind of possible capitalism could this be?” Going with this interpretation of Marx, the Communist party open the door for small businesses of maximum 7 employees.

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📝 “It doesn’t matter if the cat is back or yellow as long as it catches mice” 🐭 🐱 this famous quote is said to be coined by Deng.

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📝 “Self criticism” sessions: a interesting concept where politicians who have fallen out of favor have to make a detailed statements of ideological errors and affirming their renewed belief in the Party line.

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📝 Family contract system: farmers were given by the government a quota of goods to produce. What food they grew beyond the quota was sold in the free market at unregulated prices. This system became a great success and increased the standard of living In the 1980s.

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📝 Deng Xiaoping was involved in the decision behind the Tiananmen Square Massacre where hundreds of protesters where killed.

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Read it if you love Chinese politics & history. Otherwise a Wikipedia article on Deng will suffice.

Thoughts on: “Fables of Fortune” by Richard Watts

“Fable of Fortune – What rich people have that you don’t want.”

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Richard Watts has worked as a legal counsel for the super rich for many years. In his book he shares stories for this hidden world, showing that it might not be all roses after all.

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This is not a psychological study of the wealthy as much as it’s a collection of stories of the often sad faiths of the super rich.

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Who are the super rich? Forbes draws the line when you have a net worth of over 30 mil. That’s not the super rich Watts talks about. He is talking about people worth over a $100 million, the people that never ever have to ask themselves, “Can I afford this?”.

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📝 “A healthy adult will not mature without exposure to difficulty and pain”

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📝 Before Petrov became rich, he was a man of simple means and: “He worked most of his life to get ahead, and in doing so he unintentionally made several generations of Petrovs unhappy, caused divorces, fostered broken relationships between siblings, and left his wife to die frustrated and unappreciated.”

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📝 “Wealth is like snorting cocaine. It seems fun and exciting at first; the rush is addictive. But eventually you can’t recognize when you are high; you become aware of the drug only when you don’t have it. Each time you need a little bit more to feel the same ecstasy”.

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📝 the 1st generation of wealth is usually hardworking and focused. The 2nd entitled. The 3rd generation stands no chance, they have no sense of value of wealth. They have no connection to the sacrifices that made their lifestyles possible.

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⭐️ TAKEAWAY: “The wealthiest person is not who has the most, but who needs the least.”

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The book is quick read and it’s hard to put it down because it’s told through absurd and often sad stories about the lives of the haves. But it’s lacks in depth and nuance, and has a uncomfortable tabloid feel to it as you get to indulge in divorce, greed and misfortunes of the rich and famous.

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3/5

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Thoughts on: “Superintelligence” by Nick Bostrom

Bostrom paints a gloomy picture of what’s in store for us would we ever develop a superintelligence. It left me depressed, but I think it’s essential to have rudimentary understanding of the challenges a general artificial intelligence would entail. This book presents potential paths to reach superintelligence and dives deep into the problem of controlling a force with capacities far beyond our own.

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Paths to Superintelligence:

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🚸 “Seed AI” – A program learning by trial and error. Becoming more and more advanced over time. 🌱

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🚸 “Whole Brain Emulation” – Creating a digital representation of a brain by scanning and then replicate and enhance its it’s functions. 🧠

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🚸 “Biotechnological Enhancements” – at least weak forms of super intelligence can be achieved by mental and physical enhancements in the near future. 🔬

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🚸 “Iterated Embryo Selection” – Another way to reach super intelligence is through gene manipulation and breeding. Creating supersperms by matching and breeding them in labs, concentrating leaps of several generations in one go. This could create a new enhanced “race” of humans that together could be called a super intelligence. 👶🏼

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⭐️ Takeaway:

The introduction of a superintelligence will propose a potential existential risk. But it would prevents other existential risks, like a meteor strike or super Volcano eruption.

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The book is complex and sometimes painfully dense with information. But I consider it worthwhile investment of my time in hindsight! For a less academic and technical, but more accessible, starting point for learning about AI I recommend “Surviving AI” by C. Chace.

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To uplift my spirit I started reading “How to Live: A Life of Montaigne”. It’s awesome so far! What book made you depressed?

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4/4

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Photo credit: @christyharner

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Thoughts on: “Into Thin Air” by Jon Krakauer

“Into Thin Air” is Jon Krakauers gripping first hand account of the May 1996 Mt. Everest disaster. Standing on the top of the worlds highest mountain he couldn’t see any signs of a deadly storm coming in. But he was wrong. When the group arrived at base camp, the mountain had claimed 5 lives and left the ones surviving in a guilt-ridden state.

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“People who don’t climb mountains, the great majority of human kind that is to say, tend to assume that the sport is a reckless Dionysian pursuit of ever escalating thrills. But the notion that climbers are barely adrenaline junkies is a fallacy. At least in the case of Everest. …The ratio of misery to pleasure was greater by an order of magnitude than any other mountain I’ve been on. I quickly came to understand that climbing Everest was primarily about enduring pain.”

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It’s a really good and my first one the topic of mountaineering. One thing that stuck with me was the climbers anti-climactic feeling of reaching the peak. There is no beer and BBQ being served at the top of the world. No warming tea and campfires to comfort you while enjoying the view. And that’s because, you know, people need air! Instead it’s just a few painful minutes of snapping photos before you have make the climb down again, realizing you are only halfway to the finish line.

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📝 Sherpa people are an ethnic group living in the Himalayas. They are fantastic mountaineers and are frequently used to support expeditions to Everest because of their ability to endure high altitudes.

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📝 For mountaineering purist the only “real” Everest climbs are done without bottled oxygen.

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📝 There is a movie based on this book called “Everest”. I didn’t know it was base on this book and now I’m excited to see it!

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⭐️ TAKEAWAY: Don’t climb Everest.

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Maybe it’s because stepping out of society and into the wilderness is more enticing to me, than ascending a cold mountain, but I like “Into the wild” a lot more than this book. Situations where one cannot breath just isn’t for me.

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What is your favorite books about endurance?

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4/5

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Thoughts on: “Born to Run” by Christopher McDougall

4 years ago I was in the worst shape of my life. I felt that something needed to be done and that it was time to get my priorities straight.

About this time I found this book and it really sold me on long distance running. It was a perfect fit for me. I’m not fast, but persistent. I’m not into team sports, but love to compete against myself. And I rather spend time in nature than in a sports hall.

The books tells the story of the authors search for the mysterious Tarahumara Indians, the running people, that live most hard to reach areas of the Copper canyons.

Caballo Blanco, a running lone wolf, who lives among them becomes the key to finding out the secret to their amazing endurance.

The problem is that this Caballo guy is not easy to find either. And he has a plan of his own; To arrange one of the worlds toughest races, where the worlds top ultra runners will compete head to head with the Tarahumara under the scorching Mexican sun.

This is the second time I read “Born to Run” and the arguments about how modern footwear is the source of all running injuries and that chia seeds is the silver bullet when it comes to a healthy diet, feel extremely week and exaggerated this time around.

My own theory to why we have seen an increase in running related injuries, while shoes get more and more high tech and bouncy, is that people live more sanitary lives today. And they have done that for a long time. To expect yourself to be able to run a Marathon with just a couple of months of training, after spending 25 years in an office cubicle, is naive at best.

This will lead to all kinds of injuries because nature don’t allow for the same type of instant gratification that Netflix and overnight shipping does.

What really makes this book shine is not the science it presents, but the story and the characters. I hate to use the word “inspiring”, but I think I have to in this case, because this book brings a smile to my face and makes me want to run all day.

📝 You don’t stop running because you get old, you get old because stop running.

📝 Runners peak around 27 but you will reach an age of 64 before you get back to a teenagers ability.


5/5

 

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Thoughts on: “Walk Like a Buddha” by Lodro Rinzler

“All of you are perfect as you are, and you can use a little improvement”

Zen Master Suzuki Roshi


This is a very practical and accessible book about how to apply the teachings of the buddha to different aspects modern life. It has a question/answer format like: What would the buddha do in this and that situation or what would his stance be on one thing or another.


The book is good, but I feel that most of the value I got from it comes from cited sources rather than from the authors own experiences and insights.


📝 An elderly man teaches his grandson about peace. He said that he has two wolves that lives within his heart. One is fueled by anger and aggression and the other by kindness. They are always at war with each other for his heart.. The grandson asked: “who will ultimately win?”. The man answers:

“The one that wins will be the one I choose to feed”.


📝 Everyone think they are busy all the time. It’s easy to be busy! Get a dedicated time for meditation.


📝 Impermanence is a bitch. Going through Hell is not punishment, it’s training. We have to learn to deal with. A big part of life is pain and if you don’t learn to relate to it you are missing out on big aspects of life.


📝 At work: if you feel boredom. Drop it like a meditator drops an intrusive thought. The present moment is a perfect point from which to start anew.


📝 “Always don’t know”. Keep an inquisitive mind.


📝 There are so many things that can make an office environment toxic, but Mindless speech seems to be is chief among them.

The Four Gates of Speech:

1. Is what I’m about to say true?

2. Is what I’m saying necessary?

3. Is what I’m saying kind?

4. Is it a good time?


📝 From “The Top 5 Regrets of the Dying” by author Bronnie Ware:

“I wish I had the courage to live a life true to myself and not the life others expected from me.”


💡 Takeaway. “Live your life as an experiment”. Nothing new here! BUT I’m a big proponent doing experiments. Going forward I will post about concluded and ongoing experiments I’m conducting. Stay tuned!What are you experimenting with in your life?

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