2009... the year of change!

"There is nothing new under the sun."

Well, the recession continues! John Thain resigned today from Bank of America. Thain's quite an interesting man, aside from looking rather orange in recent photos. He led the NYSE during the boom era, and then in Nov. 2007, rolled over to Merrill-Lynch to take over as CEO, where he received a $15M signing bonus. During the 2007 year, he was nicely compensated with a reasonable $83.8M. Under his stellar leadership, the company entered the recession. Unfortunately, even with Thain's brilliance, the company could not stay afloat, and had to be bought by Bank of America. Despite that, Thain requested a $10M bonus for his 2008 performance. Outcry from the NY Attorney General and the public, led to Thain withdrawing his request. Apparently, the reason he's being fired is that he really didn't know what's going on with the company, hence the additional write-downs of $15.3B this last quarter! This complete lack of awareness led to the tension between Bank of America CEO Ken Lewis and Thain, ultimately resulting in Thain's exit. Either that, or without getting the $10M bonus, it really wasn't worth Thain's time... he'd probably rather go enjoy a massage or whatever $83.8M can buy you.

My key thought on all this...
...is the importance of doing your homework and sticking to the fundamentals. I was reading the prospectus of my mutual fund, which thankfully I don't have to retire on for at least another 40 years, and the fund executive summed it up very nicely. He basically said that financial people had forgotten the fundamental principle of accurate risk management. It's not difficult to imagine how you could turn a blind eye to risk, or not do your homework to identify risks, when you have the opportunity to make mad cash. I don't blame Thain for going big--hey, if I could make $83.8M, I'd definitely go for it--but the problem was that people got so excited about winning, that they forgot the fundamentals of the game. They 'were lookin' down field before they got the ball tucked away' (I still can't believe those Colts, amazing!). Unfortunately, we all now get to pay the price by enduring this recession. In the future, I don't think we'll see the same sorts of gains that we saw in the past because people will manage risk better from now on. I'm expecting mostly single digit returns for a long time, until people forget the fundamentals again, make tons of money, and then crash. Life has a way cycling. I guess the wise man was right when he said,

"There is nothing new under the sun."

Cynicism is so natural!

Its amazing to me...

...how naturally cynicism can come to anyone, even an optimist like I classically was, when confronted with the realities of graduate school. Imagine working away for three years, on several different projects (most failed, despite hard work), and finally finding your holy grail, the novel important finding--the illusive 'Na-cha-uh Pap-uh'. Then you can't repeat your finding. This is the amazingly difficult and absolutely humbling process that wet-lab scientists get to go through. From what I gather this is not uncommon. Furthermore, you have very little feedback throughout this process, and no definite end in sight. Its absolutely amazing how taxing this can be on one's optimism.

The contrast to medical training is sharp. Its much easier to be strong when there is an end in sight, an end that society appreciates, an end that has rewards such as a comfortable life (assuming you're comfortable working crazy hours, which you probably are if you've made it to this point). Its also something you share--you go through with many other classmates, generating a 'herd effect', which eases the pain.

With graduate school, you don't have an easy way out, there's no concrete end, until you get solid data, and you're on your own throughout the process. And if you don't get data? Well that's even worse--a PhD with no publications? What happened?... Grad school is similar to med school though, in that both require a lot of work, and emotional strength--yet they're differnet even within these similarities. The hard work for medical school is completely dictated by others--you have to be at rounds at 5AM, etc--you have no control over your schedule, whereas the hard work in grad school leaves you complete freedom over your schedule. However, if you want to finish your PhD in a decent amount of time, you'll definitely be working serious hours. With regards to emotional strength, in medical school you have to see difficult situations where people's lives are destroyed; you'll have to talk with people all day long and keep your composure in the face of significant fatigue, patients engaging in self-destructive behavior, and the like. With graduate school you have to stay strong in the face of significant failures and continual frustration. Additionally, you have to be emotionally strong in that you are the one motivating yourself--you have to be the one to push yourself. Its interesting...

...difficult as it may be, I'm certainly very glad to be here, where I have a guaranteed job through the end of my training, and beyond. Much better than struggling out in the real world during a recession.

Follow up to "Integrity" post...

So after considering for some time my rant on integrity, and the situation of external review, and talking with several professors, I think I've come to reconsider my thoughts. One professor put it best,

"You don't flaunt your internal problems to external reviewers. You deal with them internally."

This makes sense to me. Further contemplation helped me realize that this is actually much like a family, where you can fight it out like crazy between one another, but if there's ever an external attack, you stand up for your sibling, parent, etc. That doesn't mean you can't be objective, or you hide problems. On the contrary, you have to be objective, self-critical (as I am here regarding my previous post), and address problems that my be present. The key is to find the appropriate venue to address these issues. An external reviewer, who's only decision is whether or not to support you, doesn't need to hear about internal problems. In that situation, the key is to get the funding, so you have a venue left to deal with the problems. Lesson learned.

Driving us towards renewable energy

I read a CNN article proposing that we add new taxes onto gas and other fossil fuels in order to promote research and development of non-fossil/greenhouse gas emitting energy. The last few lines of the article are worth quoting:

To this last point, Rosenblum and other supporters say the carbon tax can be offset with tax breaks, like a reduction in the payroll tax.

That way, they say, the government could discourage something it doesn't want - pollution - and encourage something it does - employment - through the tax code.

Still, a carbon tax has attracted scant supporters in Congress.

When Rep. Peter Stark (D-Calif.) proposed one last year, it attracted a total of three co-sponsors among the 435 House members.

"I know it's widely popular and makes a lot of sense to economists and academics," said one Democrat Senate staffer. "But unless a member of Congress was considering early retirement, it's not an approach they would consider on the Hill. It's political suicide."

This is the problem with the way Congress works... or maybe its what the founders intended.

Money's Effect on Medicine

I read a fascinating article in yesterday's New England Journal of Medicine. Briefly, it was an essay by Pamela Hartzband and Jereome Groopman discussing the influence that they see money having on the ever evolving practice of medicine. They describe a fascinating sociological experiment designed to test the effect of money on people's behavior.

A truck was parked with a couch close beside it on a busy university walkway. The investigators asked passersby to help. When they asked them to help them as a favor, they got a good response; however, people's willingness to help dramatically decreased when they offered passersby 50 cents to help out. If they offered them a piece of candy to help out, they got an equal response to the control group that did it as a favor. They had to offer passersby $5.00 before they got an equal percentage of people to help as when they asked people to do it as a favor. (n=614)

The interpretation of the study, which is supported by several other studies, demonstrates the effect of money on people's responses. Simply put, even the presence of money in the room affects people's altruistic inclinations. The implications for the practice of medicine are quite staggering, particularly as medicine becomes more heavily influence by business.

We need to preserve the art, the compassionate side of medicine, while also embracing the reality that we are running a business. This has been a significant conundrum for medicine over the centuries. While typically history would have many lessons, I'm not familiar with a time where medicine has been as complex and expensive as it currently is. Only a small percentage of individual patients with significant medical problems could cover the true cost of care on their own. Clearly, we need some kind of cost-sharing system, but the best model has yet to be determined. I'll be following Tom Daschle's proposals on how to improve our health care system with great interest, assuming he is confirmed as HHS Secretary, which is still under review by the senate committee.

Integrity

I was absolutely astonished today by a comment from someone while we were discussing external reviews. I've always been a proponent of honesty... definitely put your best foot forward, but part of embracing reality is acknowledging and identifying your weaknesses. The only way you can improve yourself or the world around you is by being honest in your assessment of yourself. Anyway, the comment went something like this [quoting from memory],

"You know the external reviewers use 'SS' style interrogation techniques during their site visits. Be careful what you say, especially when they ask questions like, 'How would you improve your program; we can be an advocate for you.' When they do that, don't really tell them what you think cause they could use that as negatives during the review."

I could not believe the subtle dishonesty and lack of integrity that this demonstrated. Why wouldn't you be honest? I know, I know, you're supposed to 'play the game' to get ahead. How can you sleep at night knowing you're lying to get ahead. By avoiding acknowledging and dealing with the serious issues that this particular program faced, you prevent yourself from moving forward. This is serious business. These are the precise reasons that this type of grant was not funded. You can't go around trying to pull the coat over people's eyes, especially in education, or charity... even if you're as slick (and devoid of integrity) as Madoff, karma or justice is going to come back and bite you in the ass.

This seems to be the course taken by people who get comfortable. I know when I get comfortable in the lab, I get lazy, and tend to try to make everything look rosier than it is... that's my downfall, my weakness. I have to fight hard to stay focused, continue to work hard, and strive to maintain my integrity. Cheating the boss, whether a granting agency, a PI, or program director, or anyone, tends to come to light eventually. Its amazing that these values aren't taken more seriously, especially in a profession, medicine/science, that is so based on finding the truth--following the evidence. I'm appalled... but I better get back to work before I fall into the same trap myself and begin cheating my boss of my time.

American Spending

I came across this article, which I found fascinating; this, in particularly, is astonishing:

"The cutbacks by the Muirs and others their age mark a particularly profound shift. In the American buying spree of recent years, the most profligate spenders were those under 35. As recently as 2006, for every $100 these Americans earned, they spent about $117. Those aged 35 to 55 had negative saving rates nearly as large. Only the large number of Americans 55 and older, who have always had high double-digit saving rates, kept the overall saving rate above zero, according to data from Moody's Economy.com and the Federal Reserve."

I know we want to get the economy back to good, but isn't spending $117 for every $100 earned, and then hoping that your house, or your mom, or the lottery, will bail you out, utterly unsustainable? How can people expect increased spending to get us out of this recession? I know this has worked in past recessions, but as with everything, it seems we've come to a day of reckoning with regards to our spending. If American's habits change, as they are, we'll have a prolonged recession. This however, is the painful process that is needed to get us back to a healthy economic place! We need to stop overspending and learn to live within our means. While this may astonish some people, you need wealth to create wealth. The way to gain wealth is to live within your means and then use your discretionary income to generate wealth by making wise investments. This downward adjustment in both personal spending habits and overvalued assets is needed in order for our country to regain a strong economic foundation.

On a more pragmatic level, I hope my wife doesn't get laid off, cause she wouldn't be happy sharing my meager income, and we'd lose the house, and life would really suck.

Welcome one and all... or just me. : P

Welcome to my blog. I've started this blog to help me process my thoughts through writing. It gives me a chance to comment on and respond to the world around me. In this blog I will discuss my experience training in an MD/PhD program. I will also discuss the political world, from local to international. In addition I may occasionally vent the bitterness and frustration that goes along with being an Indianapolis Colts fan. Speaking of bitterness, I've labeled this blog 'Fighting cynicism, embracing reality'. I chose this label because I think that within this training experience, as well as with growing older, cynicism tends to take hold. I've been falling prey recently, and think that a healthy way of processing things, such as blogging, might help me fight the apparent inevitability of becoming a bitter, dirty old man. I'd much rather become just a dirty old man.