Book Review: The Attack

(Yesterday’s review of Chasing The Sun reminded me of this book, whose review I never published here. It shares similarities of viewpoint and of pacing problems. Given that and also current events, I’m posting this review.)

The Attack, by Yasmina Khadra

The story of an Arab doctor in Tel Aviv whose wife commits a suicide attack is vividly written, and the relevance to modern times is obvious.

Dr. Jaafari’s life is turned upside down following a suicide bombing, when it emerges that his wife died in the blast – not as a victim but as the perpetrator. Jaafari goes through denial, which then turns to curiousity: how could this happen without his knowledge? He investigates his wife’s secret life while still in shock, and his investigation puts him in danger.

The setting is fleshed out in great detail, which is nice for context, and Jaafari’s inner life goes on in great detail, which is useful at first. However, the plot often has to wait while extensive description of minutiae are provided in both setting and feeling. The story is also glosses over much of the politics, giving it to us in exposition instead of story. Worth reading for an on-the-ground look at the Israeli-Palestinian conflict, but ultimately more a story of a man’s inner life, and not a great one at that.

Intriguing, but ultimately underwhelming.

Book Review: Chasing The Sun

Chasing The Sun, by Natalia Sylvester

I get one free book a month from Amazon Prime, and so far it’s delivered readable fiction – nothing lifechanging, but enough to get me through a domestic flight. Chasing The Sun fits this mold: competent but ultimately flawed.

Andres Jimenez, label manufacturing magnate in 1992 Lima, is experiencing marital troubles at the time the country is undergoing political turmoil. Car bombs and kidnappings have become more common, and soon Andres is affected when his wife Marabela is taken and held for ransom. Andres is eager to get her back, and with the help of professional negotiator Guillermo, he works to get the money to secure the release of the mother of his two children. His company, his life’s work, is at stake and his pushy mother is urging him to sell to a competitor. Meanwhile, Andres reaches out to an old friend who went through the same thing…

The setup is intriguing but the book is somewhat meandering and ultimately feels incomplete.* The kidnapping plot which drives the action suffers from the overly descriptive prose which kills any momentum. In parts this works – it captures the frustration of waiting and gives more space to the setting, but at times it feels like filler. The second half of the book also switches viewpoints and focus a bit, with makes the book feel slightly disjointed.

An okay read, although I found myself skipping descriptive passages after a while.

*I’ve noticed that most of the books whose endings I find incomplete are written by women. Not sure if that means anything.

Legislation And The Constitution And Tipping has taken a position against tipping, one that I’ve seen before but that I don’t quite get. The least persuasive part of the argument, by far, is the reference to the enlightened continent of Europe, which has largely eliminated the practice. Whoever wrote this hasn’t tried to get service in a European establishment in the last two decades.

I write, however, to correct a simple mistake that Vox’s Brandon Ambrosino repeats from the Village Voice’s Foster Kamer, another anti-tipping enthusiast:

The way we tip reflects our prejudices, argues Freakonomics’ Stephen Dubner. Here’s what he told Brian Lehrer: “The data show very clearly that African Americans receive less in tips than whites, and so there is a legal argument to be made that as a protected class, African American servers are getting less for doing the same work. And therefore, the institution of tipping is inherently unfair.”

The data is probably right, although I’ll note that “getting less for doing the same work” is an unproven assumption. It’s probably true, mind you – just not as factual as the above would lead you to believe.

This is the very case Kamer made (emphasis mine): “In 1971′s Griggs v. Duke Power, the Civil Rights Act of 1964 was ruled to prohibit businesses with discriminatory practices against those protected under it, even if that effect is unintended. Tipping, which has been proven to be discriminatory, could be downright unconstitutional.”

Well…no. This is incorrect, and it even tells you why it’s incorrect. It tells you that the Civil Rights Act of 1964 prohibits practices with a discriminatory impact, and it implies that tipping is such a practice.  Thus it would follow that tipping is illegal. So where’s the mistake?
Tipping would be illegal under the Civil Rights Act of 1964 and not the Constitution, so it would be illegal but not unconstitutional. Something being against a law doesn’t mean it’s unconstitutional, and it would be nice if people reporting on legal issues knew the distinction.

Real Estate Pricing, Compensating Differentials, And Buzzfeed

Oh real estate, you so crazy.

Sigh.  Normally I wouldn’t comment on something so silly, but it’s a teachable moment and an opportunity for me to share a passion, so I’ll take the bait.

Pieces that compare what any given amount of money can buy in terms of real estate in different locations are done with some frequency* and they are interesting and sometimes useful. They’re a decent gauge of housing costs, if little else.

*A friend of mine send me dozens of these when I was choosing post-graduation employers, pointing out how much more I could get in real estate terms in Houston over Chicago.

Housing prices are a very rough gauge of a location’s desirability: all things equal, prices are higher for nicer places than less nice places. All things, of course, aren’t equal, so housing prices reflect many things, in three rough groups:

  • Demand side: house size, house quality, house aesthetics, school district quality, local employment, local crime rates, local tax rates, local climate, traffic & commuting times, amenities (parks, lakes, sports, entertainment), and other such things.
  • Supply side: cost of construction (materials, labor), land cost, regulatory costs (environmental inspections, minimum sizes, maximum sizes, etc).
  • Individual factors: idiosyncratic desires of buyers and sellers; these tend to wash out and we can disregard when averaging, though they can matter a lot to individual buyers and sellers.

The above interact in complex but predictable ways to establish housing prices – even in bubbles, when the demand goes crazy, the direction of change is predicted by the model. The reason why housing prices aren’t a great gauge of quality of life is that these other factors get in the way. For example, San Francisco’s building restrictions make housing artificially short, while Houston’s relatively lax code makes their housing more responsive to demand.* Sometimes these codes are intentional (because they keep out poor people) and other times they mean well (although they end up keeping out the poor).

*And yes, those are not the only differences. San Francisco has a waterfront, driving access to beautiful nature and wine country, a highly educated Silicon Valley workforce, and a climate intended for human beings; Houston is a flat, half-desert/half-swamp bastion of concrete filled with recent immigrants marinating in 100% humidity at all times. Those factors also contribute to the price differences.

Basically, there’s rhyme and reason to real estate pricing. Enter BuzzFeed staffer Adam, who reviews what $300,000 can buy in 14 places – NYC, Fargo, Honolulu, Atlanta, Jackson (MS), Los Angeles, Las Vegas, Topeka, Cheyenne, Chicago, Boston, Austin, Boise, and Miami. If you’ve read this far, you can probably predict the relative quality of housing you can get in these places. If you’re Adam Davis, your conclusion is this:

What have we learned from this real estate ~exploration~? REAL ESTATE IS COMPLETELY INSANE.

Thanks Adam. Way to contribute to the human search for knowledge. I suppose I shouldn’t let this bother me, but it’s frustrating when someone uses his public influence to advance ignorance simply because they can’t be bothered to learn better. The world just delightful when it makes sense.

World Cup Knockout Stage Review

My initial World Cup predictions got 3 of the 4 semifinalists right, and the only game I missed* in my second try with the knockout stage was Belgium vs US, so a good showing overall.

*Note: I made no prediction for the third-place game, because no one cares.

We got to see one of the better tournament in recent memory, with plenty of goals in the early stages and plenty of excitement in the elimination rounds. If you watch the entire tournament, you definitely see a change after the group rounds when teams begin to think “defense first,” although that didn’t prevent us from seeing the hosts completely implode against Germany. I should say that the commentary following the Brazilian loss has been grossly overblown: Brazil wasn’t as good as they thought they were, and a single-game implosion doesn’t tell us nearly as much as people think.* That doesn’t mean that Brazil won’t go through the soul-searching that usually ensues, but their team isn’t suddenly significantly worse than we believed all along.

*Same is true of the Denver Broncos. In fact, the best comparison for something like this might be the 2003 New England Patriots, who were demolished 31-0 by the lowly Bills in the season opener and then proceeded to lose one more game en route to winning the Super Bowl.

It’s always unfortunate to see teams depart on penalties, especially overachievers like Costa Rica, but it’s also unreasonable to ask players to go more than 120 minutes. One of the bugs and the features of the world cup has been the way the tournament tends to filter down to the best teams. There are certainly exceptions – did you know that Turkey and South Korea both made the semifinals in 2006? – but the extended tournament makes consistent upsets more difficult. Perhaps that’s for the best, although a little more randomness couldn’t hurt the sport.

I’ll qualify that last statement by adding this: the sport could certainly use less randomness when it comes to officiating. Specifically, something must be done about fouls in the penalty area, where clearly an entirely different set of unofficial rules applies. Fouls that aren’t fouls in the box are fouls almost everywhere else on the field, and this should be either codified to quell the outrage every time somebody falls down there, or we should have a lot more penalty kicks. I’m also disappointed that the referees didn’t punish diving more severely, because Arjen Robben just has it coming to him. Also, as I mentioned on Twitter, I dread the health care crisis we’ll have when all these guys get older and start breaking hips because they’ve taught themselves to flail their arms helplessly instead of breaking their fall.

Arjen Robben, worsening the health care cost crisis.
Arjen Robben, worsening the health care cost crisis.

Now, only 54 more days until Euro 2016 qualifying starts.

Houston Syndrome

Wikipedia has an entry for Stockholm Syndrome:

Stockholm syndrome, or capture-bonding, is a psychological phenomenon in which hostages express empathy and sympathy and have positive feelings toward their captors, sometimes to the point of defending and identifying with them. These feelings are generally considered irrational in light of the danger or risk endured by the victims, who essentially mistake a lack of abuse from their captors for an act of kindness.

Wikipedia, however, repeatedly rejects my corollary:

Houston syndrome, or locality-bonding, is a psychological phenomenon in which individuals stuck in a particular location express sympathy and have positive feelings toward that location, sometimes to the point of defending and identifying with it. These feelings are generally considered irrational in light of the crappiness of the location. The victims essentially mistake a lack of abuse from the locality for an act of kindness.

Politics Makes You Stupid, Part X

A baffling story:

One of the nation’s largest public-sector unions is severing its ties with the United Negro College Fund because the group accepted donations from the Koch brothers and its president spoke at a Koch-funded summit.

In a letter sent Tuesday, AFSCME President Lee Saunders wrote that the UNCF has taken actions “deeply hostile” to public employees, which he considers a “profound betrayal of the ideals of the civil rights movement,” and that the union will end its relationship with UNCF.

Saunders cited the UNCF’s decision to accept a $25 million grant from Koch Industries, Inc. and the Charles Koch Foundation as a reason for the split, as well as the decision by UNCF President Michael Lomax to speak at a summit hosted by the Kochs in California.

So…the Koch brothers are out $25 million which goes to black Americans, and this is a problem for the AFSCME? If they want to weaken the Koch brothers, having them donate money to causes AFSCME approves is a good way to go.

I’m A Doctor, Help Me Please

(Long post warning.)

Someone purporting to be a doctor posted an open letter on Quartz recently with a litany of complaints about how hard it is to be a doctor in America. This may be tough to explain to most people, given that the top nine, no, ten, no, seven, no twenty-one highest-paying occupations in America are medical professions, and doctors & surgeons average $168,650-$234,950 annually,* but our dear doctor spends many excessive words trying to explain to us how tough life is.

*I understand that salary goes up big time later, so young doctors tend to make less than that. That’s true of most professions, which is why they’re pretty good investments in the long run even if they make you poorer in the short run.

Keep an eye out for the repeated slamming of basically all other professions and the possibly rose-colored view of doctors’ motivations as you read this. I’ve tried to trim the fluff, but there are a lot of words here that are just unnecessary.

Dear Washington, D.C.:

I am writing this letter because I feel that our leaders and lawmakers do not have an accurate picture of what it actually entails to become a physician today; specifically, the financial, intellectual, social, mental, and physical demands of the profession. This is an opinion that is shared among many of my colleagues. Because of these concerns, I would like to personally relate my own story. My story discusses what it took to mold, educate, and train a young Midwestern boy from modest roots to become an outstanding physician, who is capable of taking care of any medical issues that may plague your own family, friends, or colleagues.

This is not going to work for me. Let’s try this again.

I am writing this letter because I feel that our leaders and lawmakers do not have an accurate picture of what it actually entails to become a physician today; specifically, the financial, intellectual, social, mental, and physical demands of the profession. This is an opinion that is shared among many of my colleagues. Because of these concerns, I would like to personally relate my own story. My story discusses what it took to mold, educate, and train a young Midwestern boy from modest roots to become an outstanding physician, who is capable of taking care of any medical issues that may plague your own family, friends, or colleagues.

Somewhat better, Mr. Outstanding Physician. But we’re not here to mock your writing ability; we’re here to mock your ideas.

I then enrolled at St. Louis University to advance my training for a total of eight years of intense education, including undergraduate and medical school. The goal was to prepare me to take care of sick patients and to save the lives of others (four years of undergraduate premedical studies and four years of medical school). After graduation from medical school at age 26, I then pursued training in internal medicine at the University of Michigan, which was a three-year program where I learned to manage complex problems associated with internal organs, including the heart, lungs, gastrointestinal tract, kidneys and others. I then went on to pursue an additional three years of specialty medical training (fellowship) in the field of gastroenterology. The completion of that program culminated 14 years of post-high school education. It was as that point, at the tender age of 32 and searching for my first job, that I could say that my career in medicine began.

I quote this in its entirety because it’ll be important later. I will just note here that the US has a shortage of primary care doctors, not specialists, so if your goal is to “take care of sick patients and to save the lives of others” you might have done that. If you were really as selfless as you claim, you’d have done in Somalia.

 For me, it began in college, taking rigorous pre-medical courses against a large yearly burden of tuition: $27,000 of debt yearly for four years. I was one of the fortunate ones. … I was fortunate to have graduated from college with “only” $25,000 in student debt. Two weeks after finishing my undergraduate education, I began medical school. After including books, various exams that would typically cost $1,000-$3,000 per test, and medical school tuition, my yearly education costs amounted to $45,000 per year.

Unlike most other fields of study,

You know, the easy ones. Like yours.

the demands of medical school education, with daytime classes and nighttime studying, make it nearly impossible to hold down an extra source of income. I spent an additional $5,000 in my final year for application fees and interview travel as I sought a residency position in internal medicine. After being “matched” into a residency position in Michigan, I took out yet another $10,000 loan to relocate and pay for my final expenses in medical school, as moving expenses are not paid for by training programs.

… I stared meekly at numbers on a piece of paper listing what I owed for the two degrees that I had earned, knowing full well that I didn’t yet have the ability to earn a dime. I didn’t know whether to cry at the number or be happy that mine was lower than most of my friends. My number was $196,000.

Rookie. I borrowed three quarters of that in less than three years.

$196,000. That was the bill, for the tuition, the tests, the books, the late-night pizza.

You don’t get to claim pizza. You’d have eaten regardless. Same for rent. Those costs apply in every other universe.

I then relocated to Michigan and moved into a small condo in Ann Arbor, where I started my residency. As a resident in internal medicine, I earned a salary of $39,000.

I wonder if you could have known what a starting resident in internal medicine earns before you started med school. Seems like there should be some sort of place where information can be looked up.

All the while, interest continued to accrue on my motherlode of debt at the rate of $6,000 per year due to the high-debt burden. Paying down this debt was not possible while raising two children. My wife began working, but her meager salary as a teacher was barely enough to cover daycare costs.

A lot of people I know believe that poor people are at fault for having children they can’t afford. You probably know those people, too. You’re probably also one of those people, then.

During residency, my costs for taking licensing examinations, interviewing for specialty training positions, and interest on the large loan ballooned my debt further, now exceeding $230,000, all before I began my career as a “real doctor.”

Occupational licensing is a pest indeed, but I feel less bad for you than for people forced into debt to be permitted to braid hair.

Relatives and friends often ask me, “Now that you are a ‘real’ doctor, aren’t you making the big bucks?” While I am fortunate to now be making a higher salary, some basics of finance make my salary significantly less than meets the eye. First, I was 32 years old as I began training and I now had over $230,000 in debt. Had I invested my talents in other pursuits such as law school, I would not have built up this level of debt.

You clearly weren’t paying attention up there, or to the world around you.

In addition, as physicians, though we make more money than many others, we are not reimbursed for many of the services that we provide.

“We make lots of money, but it should be more.”

We, as physicians, are always available for our patients no matter the time of day. We do not record time spent with patients as a means to our reimbursement as other professions do. No, we listen to patients and answer their questions, however long it may take. Even if it is the 30-second straight hour of work, which happens very often, we listen, respond, and formulate a logical plan.

Yup, this is exactly the experience we’ve all had with doctors. Always available and endlessly patient. I see nothing to object to here.

And if we don’t do our work well, we don’t just lose business, but we can lose our livelihood through lawsuits.

Don’t you just hate it when you’re held accountable like literally everybody else (outside of government officials)?

You may ask why do we do all of this? It’s because we have pride in what we do. We truly care for the well-being of the human race. We have been conditioned to think, act, talk, and work as a very efficient machine, able to handle emotions, different cultures, different ranges of intellect, all to promote the health of America. We are doctors.

That seems accurate.

In reading this letter, one may think that one has to sacrifice a significant amount to become a great physician. You may think we face physical and mental stress that is unparalleled. You may begin to think that doctors not only have to be smart, but they have to know how to communicate with others during very emotional times. You may think that we must face adversity well and must develop very rough skin to handle all walks of life, especially when dealing with sickness and death on a daily basis.

No, I think you should not have skipped English and math class.

Now that you see this additional aspect to our career, you may think that we have a tough job to tackle several tasks at once, demanding much versatility. You may think someone needs a great work ethic to do what we do. You must think that not only do we have to know science extremely well, we also have to know other areas such as writing, history, math, even law given the multiple calculations we go through in our heads on a daily basis and conversations we have with families. And finally, you must think we know finance, as we have to try balance a $230,000 loan while making $50,000 at age 30.

Ballsy, to claim knowledge of “writing” and “math” given this letter and your shock that borrowing money causes debt to rise. Also, you make way less than the average doctor. Maybe that’s because you’re still young, or maybe that’s because you’re a terrible doctor. Either way, the problem solves itself.

Now imagine, if you would, having $230,000 dollars in debt with two young children at age 30 and listening to the news with lawmakers saying that doctors are “rich” and should have their pay cut. Or that “studies show that doctors lack empathy.”

Ugh, studies. Don’t get me started. No doctor worth his salt would pay attention to a study.

Unfortunately, we physicians do not have much of a voice on Capitol Hill. There are not enough doctors in Washington, D.C., who can give the insight of this letter while you in Washington, D.C., discuss healthcare reform. … Many of the loudest voices in the healthcare debate are those of lawyers and lobbyists for special interests. They do not care about the well being of patients; that is what doctors do.

Well, yes. Everyone but you is an asshole. They only lobby for themselves, whereas you, the selfless caregivers, only wish you were better at lobbying for yourselves.

I want to make it clear that this letter is not just another story about the difficulties of becoming a doctor and being successful in medicine. I do not want you to think I am complaining about how hard my life is and used to be. In fact, I love my job and there is no other field I would ever imagine myself doing. My true wish is to illustrate the sacrifices doctors do make because I feel we are not represented when laws are made. These sacrifices include a lack of quality family time, our large student loan debt, the age at which we can practically start saving for retirement, and the pressure we face with lawyers watching every move we make. Yet we make these sacrifices gladly for the good of our patients.

Well, “gladly” seems out of place in this paragraph.

I want to challenge our leaders

I don’t have leaders. Stop saying that.

to address the points I have made in this letter, keeping in mind that this is an honest firsthand account of the personal life of a newly practicing physician. It is a letter that speaks for almost all physicians in America and our struggles on our arduous yet personally rewarding life. It is not just a letter of my own journey, but one that represents most physicians’ path on our way to caring for America’s sick.

I have no doubt that it’s an honest account of one man’s view of his own life and his importance to the world. I doubt it’s a worthwhile to contribution to any discussion worth having.

Movie Review: Edge of Tomorrow

“Source Code” meets “Independence Day” and produces possibly a perfect action blockbuster.

Okay, if you never saw Source Code, you’re $9 richer than I and you don’t know what happens. In Edge of Tomorrow, aliens invade and are slowly taking over Europe. Humanity, armed with mechanized armor, is mounting a weak resistance until a victory led by Rita Vrataski (Emily Blunt) motivates a big push. Major William Cage (Tom Cruise), a media relations specialist, gets pushed to the front lines against his will, and his first encounter with the aliens gives him their ability – the power to rewind time to the previous day but remember what happened. Vrataski wants to harness this ability to defeat the aliens before it’s too late. Action ensues.

I should note at the outset that I have developed a huge crush on the delightfully severe and efficient Emily Blount, so this review may reflect some bias. She happens to also form an excellent on-screen pairing with Tom Cruise, and the film wisely focuses mostly on them

Meanwhile, Tom Cruise is quietly cementing his status as the go-to bankable action hero of our times. I suppose it helps that he has a history of deeper roles – it’s a lot easier to imbue a character with a history when people associate you with Risky Business and A Few Good Men. An actor without that history would make the movie much shallower than it is.

With those two at the center, instead of a largely empty action sequence (see, generally, any Transformers movie) we get probably a perfect summer movie. It’s clever but not difficult to follow; action-packed but not gory; mindless but not stupid. It’ll probably have a good run on FX before becoming a mainstay on TNT on weekend afternoons. The pacing is excellent, with just enough breaks to catch your breath before it begins again, and the action sequences are well-executed, cleaning up the chaos of battle just enough to make it manageable.

There are a few parallels to Independence Day: millions die, but we don’t see many go; mankind is fighting for survival on all fronts but is largely dependent on two people; aliens have yet to learn the lessons of decentralization, etc. Edge Of Tomorrow, however, is less contrived and more focused.

Highly recommended for a Saturday afternoon.

Book Review: Mickey Outside

Mickey Outside, by David Lender

Mickey Steinberg, a former Wall Street big shot and inside trader, leaves minimum security prison with big ambitions but few options. Ostracized from his former world but eager to recapture his status – ideally his wealth and/or ex-wife – Steinberg schemes with his former prison friend Paul. The goal is to make one big trade, one that will conveniently net Steinberg millions, ruin his ex-wife’s new fiance and drive her back to his arms, and re-establish his credentials in his former circles. Paul, meanwhile, wants one score to impress out-of-his-league girlfriend Jennifer. Meanwhile, Mickey’s old partner wants revenge for ending up in prison. Suspense ensues.

This is a short, by-the-numbers supsense novel. The deal comes together quickly – too quickly to be realistic, but just fast enough to keep the momentum moving. Similarly, the revenge angle is simple and direct and the book would simply be a cleaner, if shorter, story without it. Either way, though, the pages keep turning, and at 234 pages, it’s a very quick read.

I got this book for free from Amazon, and it was definitely worth the price. I’m not sure how much more it’s worth, though.

Thoughts on law, economics, sports, food, and pop culture. Not necessarily in that order.