The Insightful Troll

Rants and ruminations.

Elizabeth Holmes Defense - He Made Me Do It

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Facing the possibility of up to 20 years in federal prison, Holmes has been charged with 12 felony counts including wire fraud, conspiracy to commit wire fraud, and defrauding patients and investors. She has already previewed her defense in court filings: She alleges that Theranos — the blood testing startup that she started at the age of 19 after dropping out of Stanford University — was a complicated business but was not a fraud, and that she was emotionally, physically, and sexually abused by her former business partner and boyfriend, Ramesh “Sunny” Balwani.

Danny Cevallos on a piece over at NBC News:

Recently unsealed federal court documents in Elizabeth Holmes’ wire fraud trial revealed a creative legal strategy her defense team may use to try to beat the charges to be weighed by a Northern California jury, whose selection began Tuesday. The documents argue that Ramesh “Sunny” Balwani, at one time her boyfriend and the former president and chief operating officer of Theranos, deceived Holmes about the company’s financial models and subjected her to intimate partner abuse.


Blaming your co-defendant isn’t, itself, a novel defense theory. It has been around for as long as there have been co-defendants. It’s especially popular in drug possession cases. Four guys in a car plus one baggie of drugs often equals a whole lot of: “That ain’t mine — it’s his.” The strategy of one defendant blaming his or her partner in a romantic relationship isn’t new, either. But Holmes faces particular hurdles.

For starters, it was Holmes whom the world saw Forbes name as the youngest-ever self-made female billionaire in 2014. Holmes — not Balwani — took to the airwaves to fire back at The Wall Street Journal when it began publishing stories raising doubt about her business, exposing Theranos’ flawed technology and how the company covered up its own failures. Soon after, the Justice Department charged her and Balwani with defrauding investors, as well as patients of Theranos.

Is it possible that Holmes was in the thrall of her older, more forceful, romantic partner the entire time? Maybe. But the jury might not buy it. And even if jurors think she was swayed by Balwani, is it enough for them to absolve her of responsibility if she knew what was really going on?

Basically it’s a ‘He made me do it’ defense. I’m no lawyer, but this doesn’t sound like a very good defense.

Fear & Loathing in America

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Hunter S. Thompson was prescient:

The towers are gone now, reduced to bloody rubble, along with all hopes for Peace in Our Time, in the United States or any other country. Make no mistake about it: We are At War now — with somebody — and we will stay At War with that mysterious Enemy for the rest of our lives.

It will be a Religious War, a sort of Christian Jihad, fueled by religious hatred and led by merciless fanatics on both sides. It will be guerrilla warfare on a global scale, with no front lines and no identifiable enemy. Osama bin Laden may be a primitive “figurehead” — or even dead, for all we know — but whoever put those All-American jet planes loaded with All-American fuel into the Twin Towers and the Pentagon did it with chilling precision and accuracy. The second one was a dead-on bullseye. Straight into the middle of the skyscraper.

Nothing — even George Bush’s $350 billion “Star Wars” missile defense system — could have prevented Tuesday’s attack, and it cost next to nothing to pull off. Fewer than 20 unarmed Suicide soldiers from some apparently primitive country somewhere on the other side of the world took out the World Trade Center and half the Pentagon with three quick and costless strikes on one day. The efficiency of it was terrifying.

We are going to punish somebody for this attack, but just who or what will be blown to smithereens for it is hard to say. Maybe Afghanistan, maybe Pakistan or Iraq, or possibly all three at once. Who knows? Not even the Generals in what remains of the Pentagon or the New York papers calling for WAR seem to know who did it or where to look for them.

Microsoft Mandates Vaccinations

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Paul Roberts in Seattle Times:

In a sign of growing momentum for vaccine mandates, Microsoft has reversed course and will now require employees to be fully vaccinated to enter the company’s U.S. offices and other worksites, starting next month.

The Redmond-based tech giant told employees Tuesday it will “require proof of vaccination for all employees, vendors, and any guests entering Microsoft buildings in the U.S.”

The company also said it will have a process to accommodate employees “who have a medical condition or other protected reason, such as religion, which prevent them from getting vaccinated.”

Why the exclusion for religion? Its very simple, if you choose to work here, you must be vaccinated. We don’t allow children to skip vaccinations for say Polio to attend school. Regardless of religion. Unless a valid medical reason from a physician is obtained, vaccination for Covid-19 should be a requirement for work.

Algorithmic Based Triage

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Vishal Khetpal & Nishant Shah in an opinion piece for Undark:

In the midst of the uncertainty, Epic, a private electronic health record giant and a key purveyor of American health data, accelerated the deployment of a clinical prediction tool called the Deterioration Index. Built with a type of artificial intelligence called machine learning and in use at some hospitals prior to the pandemic, the index is designed to help physicians decide when to move a patient into or out of intensive care, and is influenced by factors like breathing rate and blood potassium level. Epic had been tinkering with the index for years but expanded its use during the pandemic. At hundreds of hospitals, including those in which we both work, a Deterioration Index score is prominently displayed on the chart of every patient admitted to the hospital


The use of algorithms to support clinical decision making isn’t new. But historically, these tools have been put into use only after a rigorous peer review of the raw data and statistical analyses used to develop them. Epic’s Deterioration Index, on the other hand, remains proprietary despite its widespread deployment. Although physicians are provided with a list of the variables used to calculate the index and a rough estimate of each variable’s impact on the score, we aren’t allowed under the hood to evaluate the raw data and calculations.

Blind trust in an algorithm that is create and maintained by a for profit institution without transparency of the data or calculations performed is insane. How do we know what assumptions are made? What the actual characteristics of the calculations are? How are they validated?

We don’t just trust the word of researchers findings without peer review - why should we treat an algorithm any different?

What Makes a Good Life?

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…many of our men when they were starting out as young adults really believed that fame and wealth and high achievement are what they needed to go after to have a good life. But over and over, over these 75 years, our study has shown that the people who fared the best were the people who leaned into relationships - with family, friends and community.


The good life is built with good relationships

The Cost of the Afghansitan War

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Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed. This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children. The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities. It is two electric power plants, each serving a town of 60,000 population. It is two fine, fully equipped hospitals. It is some 50 miles of concrete highway. We pay for a single fighter plane with a half million bushels of wheat. We pay for a single destroyer with new homes that could have housed more than 8,000 people. This, I repeat, is the best way of life to be found on the road. the world has been taking. This is not a way of life at all, in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron.

Dwight David Eisenhower, “The Chance for Peace”

We spent 2.3 trillion dollars - to put it into a bit more manageable number - $300 million dollars a day for 20 years. And what did we get for that investment (I am not even going to get into the lives of US soldiers and the Afghan population that were sacrificed)? Nothing. The middle east is still a hotbed of terrorism, countries are still committing human rights violations on a daily basis, and the Taliban is still in charge.

What could we have done with $300 million dollars a day here at home? Here is a breakdown of cost for each of these possible government programs and the equivalent cost in days of the war in Afghanistan:

Program Days Cost (in Billions)
End hunger 84 $25
End homelessness 66 $20
Universal preschool 667 $200
Fix roads, bridges and dams in the US 1,960 $588
Provide clean drinking water 500 $150
Eliminate tuition at public colleges 3967 $1,190
Totals 7,244 $2,173

If the United States paid for all of these federal programs, we would still have $230 billion left over. Let that sink in for a moment - we could have solved all of our major social problems at home and it would still be cheaper than the 20 year war in Afghanistan. $230 billion dollars cheaper. Was it really worth it? How can anyone possibly justify this?

Why is it that when a plan is proposed to secure the social safety net or to help the US middle class we always ask how are we going to pay for it? Yet we as a nation spend trillions on never ending ideological based wars without blinking an eye. If we can fund a war for 2.3 trillion dollars for two decades, we as a country can find a way to house the homeless, feed the poor and educate our children.

I don’t ever want to hear a politician ever ask how we are going to pay for it.

Why Can’t We Just Make More Chips?

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The global chip shortage is battering everyone - automakers, tech giants and reaching out to everyday individuals. Goods we rely on are getting scarce and prices are going up.

So why can’t we just make make more? The usual and simple answers - build more foundries, hire more people, give tax incentives to chip makers and loosen regulations - just won’t work. Chip manufacturing is a complex and high risk proposition. Bloomberg has an excellent article on why the semiconductor industry is so hard to break into and expand:

The more complicated answer is that it takes years to build semiconductor fabrication facilities and billions of dollars—and even then the economics are so brutal that you can lose out if your manufacturing expertise is a fraction behind the competition. Former Intel Corp. boss Craig Barrett called his company’s microprocessors the most complicated devices ever made by man.

This is why countries face such difficulty in achieving semiconductor self sufficiency. China has called chip independence a top national priority in its latest five-year plan, while U.S. President Joe Biden has vowed to build a secure American supply chain by reviving domestic manufacturing. Even the European Union is mulling measures to make its own chips. But success is anything but assured.

Manufacturing a chip typically takes more than three months and involves giant factories, dust-free rooms, multi-million-dollar machines, molten tin and lasers. The end goal is to transform wafers of silicon—an element extracted from plain sand—into a network of billions of tiny switches called transistors that form the basis of the circuitry that will eventually give a phone, computer, car, washing machine or satellite crucial capabilities.


Yield—the percentage of chips that aren’t discarded—is the key measure. Anything less than 90% is a problem. But chipmakers only exceed that level by learning expensive lessons over and over again, and building on that knowledge.

The brutal economics of the industry mean fewer companies can afford to keep up. Most of the roughly 1.4 billion smartphone processors shipped each year are made by TSMC. Intel has 80% of the market for computer processors. Samsung dominates in memory chips. For everyone else, including China, it’s not easy to break in.

The amount of resources required and the time frame for profits to emerge is just to vast of a risk for the private sector to bear. The only way a country can guarantee chip independence with direct partnership chip manufacturers. Each country is going to have to treat its chip supply chain just as important to invest in as its defense industry.

We Make Monsters

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Jessica Wildfire has a great post on the recent trend of supposedly educated people railing against science and common sense:

They came from college, the kind run by boards of trustees stacked with millionaires and billionaires. We serve the children of privilege.

My own university used to focus on educating less-privileged students. Then they got it in their heads that poor people didn’t belong in college, and they didn’t really deserve an education. Since then, they’ve systematically defunded every program that was designed for them. They’ve piped that money straight into the business school and athletics, because that’s what all the rich white kids are interested in. Before the pandemic, they were throwing giant parties in the middle of campus.

The world has bent over backward to give privileged idiots college degrees, and put them in positions of money and power. That’s why we have a bunch of “educated people” who don’t believe in basic science. We’ve forced people to work for them. We’ve forced people to care for them when they get sick. We’ve sold the fiction that somehow their aggressive behavior is our fault, because we weren’t nice to them.

No, this is what happens when you let someone win at Monopoly. They don’t play fair on their own. They get entitled.

They get loud and obnoxious.

What we’re seeing across the country isn’t the result of misunderstanding or miscommunication. It’s the product of an education system that rewards affluent people without challenging them.


So you want to understand where all these anti-vaxxers and neo-Nazis are coming from, and why they don’t fit the stereotype of the backwoods redneck. You want to know why they dress well and don’t speak with deep accents. You want to know where they come from.

Well, I know

They come from the monster factory.

I work there.

Why Do We Have Lawns?

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Kathryn O’Shea-Evans writing for The Atlantic

The Falvos are among the many homeowners who’ve decided to investigate green alternatives, deeming a perfect carpet of classic grass too taxing on such resources as time, water and money. Others don’t want to use chemical fertilizers and weedkillers and prefer to provide a habitat for more diverse fauna than a monoculture lawn supports.

Why do we even have lawns? With water resources being stretched thin and climate change causing wide spread droughts throughout the country - having a lush green lawn today is simply not sustainable. I mean really - why not just have a dry garden?

Dry garden

Low maintenance, minimal water usage and great at fighting climate change. Not to mention it is much cheaper. In my opinion it looks nice too.

How Not to Die

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Michael Greger from How Not to Die:

As cynical as I’ve become about diet and nutrition in this country, I was still surprised by a 2010 report from the National Cancer Institute on the status of the American diet. For example, three out of four Americans don’t eat a single piece of fruit in a given day, and nearly nine out of ten don’t reach the minimum recommended daily intake of vegetables. On a weekly basis, 96% of Americans don’t reach the minimum for orange vegetables (two servings a week), and 99% don’t reach the minimum for whole grains (about three to four ounces a day).

Then there was the junk food. The federal guidelines were so lax that that up to 25 percent of your diet could be made up of ‘discretionary calories,’ meaning junk. A quarter of your calories could come from cotton candy washed down with Mountain Dew, and you’d still be within the guidelines. Yet we failed. Astoundingly, 95 percent of Americans exceeded their discretionary calorie allowance. Only one in a thousand American children between the ages of two and eight made the cutoff, consuming less than the equivalent of about a dozen spoonfuls of sugar a day.

And we wonder why there is an obesity epidemic?

‘In conclusion,’ the researchers wrote, ‘nearly the entire U.S. population consumes a diet that is not on par with recommendations. These findings add another piece to the rather disturbing picture that is emerging of a nation’s diet in crisis.’

So put down the soda and the potato chips and grab and apple instead.

Costa Rica’s Successful Health Care System

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Atul Gawande investigates how Costa Rica has achieved a higher life expectancy than the US for a fraction of the cost.

Life expectancy tends to track national income closely. Costa Rica has emerged as an exception. Searching a newer section of the cemetery that afternoon, I found only one grave for a child. Across all age cohorts, the country’s increase in health has far outpaced its increase in wealth. Although Costa Rica’s per-capita income is a sixth that of the United States — and its per-capita health-care costs are a fraction of ours — life expectancy there is approaching eighty-one years. In the United States, life expectancy peaked at just under seventy-nine years, in 2014, and has declined since.

People who have studied Costa Rica, including colleagues of mine at the research and innovation center Ariadne Labs, have identified what seems to be a key factor in its success: the country has made public health — measures to improve the health of the population as a whole — central to the delivery of medical care. Even in countries with robust universal health care, public health is usually an add-on; the vast majority of spending goes to treat the ailments of individuals. In Costa Rica, though, public health has been a priority for decades.

The Covid-19 pandemic has revealed the impoverished state of public health even in affluent countries — and the cost of our neglect. Costa Rica shows what an alternative looks like. I travelled with Álvaro Salas to his home town because he had witnessed the results of his country’s expanding commitment to public health, and also because he had helped build the systems that delivered on that commitment. He understood what the country has achieved and how it was done.

This is in contrast to United States for profit health care system that favors private individuals who can afford it to get access to better lives, at the expense of everyone else. It is unconscionable that the wealthiest country the world has ever known refuses to make public health a core policy of its society.

The concern with the U.S. health system has never been about what it is capable of achieving at its best. It is about the large disparities we tolerate. Higher income, in particular, is associated with much longer life. In a 2016 study, the Harvard economist Raj Chetty and his research team found that the difference in life expectancy between forty-year-olds in the top one per cent of American income distribution and in the bottom one per cent is fifteen years for men and ten years for women.

Vaccines Are Saving Lives

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With Delta endemic in the country, the vaccines are providing extraordinary protection against infections severe enough to land folks in the hospital. In a recent CDC study of infections and hospitalizations in Los Angeles County, the hospitalization rate of unvaccinated people was 29.2 times that of fully vaccinated persons. 29 times is an amazing protection outcome.

For anyone still debating if you should take the vaccine - do it as soon as possible.

Rethinking Employment

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Paul Krugman in an opinion piece for The New York Times:

My guess, however — and it’s just a guess, although some of the go-to experts here seem to have similar views — is that, as I suggested at the beginning of this article, the pandemic disruption of work was a learning experience. Many of those lucky enough to have been able to work from home realized how much they had hated commuting; some of those who had been working in leisure and hospitality realized, during their months of forced unemployment, how much they had hated their old jobs.

And workers are, it seems, willing to pay a price to avoid going back to the way things were. This may, by the way, be especially true for older workers, some of whom seem to have dropped out of the labor force.

To the extent that this is the story behind recent “labor shortages,” what we’re looking at is a good thing, not a problem. Perversely, the pandemic may have given many Americans a chance to figure out what really matters to them — and the money they were being paid for unpleasant jobs, some now realize, just wasn’t enough.


What Freedom in America Looks Like

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Ignorance. Entitlement. Paranoia. That is what freedom looks like in America. Even with over 600,000+ dead, Americans are still hesitant to take the vaccine. When did we become a nation that is this selfish and cruel?

It’s infuriating. But what more can be done?

How about broadcasting the funerals of the dead every evening on the nightly news? Maybe allow cameras in the hospital wards. Let us have a list of the people that die due to Covid-19 in every town square in every community. Maybe if people see the senseless death and suffering we can scare people into taking the vaccine and wearing a mask.

Because so far, logic does not seem to be working.

FDA Approves Pfizer/BioNTech Covid-19 Vaccine

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Jacqueline Howard over at CNN:

The US Food and Drug Administration on Monday granted full approval to the Pfizer/BioNTech Covid-19 vaccine for people age 16 and older. This is the first coronavirus vaccine approved by the FDA, and is expected to open the door to more vaccine mandates.


Hoping this will finally allow proof of vaccination mandates for restaurants, bars, stores, schools, air and train travel. Everything. Get vaccinated or get left behind.

Billionaires Don't Give a F**k

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Julia Horvath makes an excellent point:

It would cost a few billion dollars to end the world’s most painful, aggravating problems, like poverty, homelessness, and famine.

Any billionaire could pick one such problem and halt it tomorrow. Yet, they choose not to.


They squeeze their workers like lemons for profit while they hoard more money than they could spend in several lifetimes. Therefore, stop reading about billionaire morning routines. Stop writing about good billionaire habits. Don’t look up to them, paint them as role models, and encourage others or yourself to replicate their success.

In short: Don’t defend the indefensible.

The American Dream

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The vast majority of the people who still believe in the American dream are looking at the past, not the future. They’re looking at their peers in the top 10 or 20 percent, and not everyone else.

They simply don’t see the 60 percent of Americans who can’t afford to pay for a basic emergency. They don’t see the rising tide of young adults who’ve decided they won’t buy homes or start families, because it’s simply too expensive. They don’t see the 52 percent of us who have to move back in with their parents, a trend that’s accelerating.

They don’t want to.

These are the people who defend the American dream. Of course, the truth is a little bit darker. They were simply given an extra pair of dice and more startup money. Now they’re laughing in your face, and moving your piece around the board for you. It’s the American way.

These people are straight up bullies, and what they need more than anything is a hard punch in their pocket books. They need to be reminded that all their “hard won success” was supported by an infrastructure that no longer exists for the vast majority of Americans.

CNN Has Fired Three Employees for Going Into Office Without Vaccinations

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Ted Johnson in Deadline:

CNN head Jeff Zucker said that the network has fired three employees for going into the office without being vaccinated against Covid-19, and that parent WarnerMedia may ultimately require proof of the shots. […]

“In the past week, we have been made aware of three employees who were coming to the office unvaccinated,” Zucker wrote in an email to staff. “All three have been terminated. Let me be clear — we have a zero-tolerance policy on this. You need to be vaccinated to come to the office. And you need to be vaccinated to work in the field, with other employees, regardless of whether you enter an office or not. Period. We expect that in the weeks ahead, showing proof of vaccination may become a formal part of the WarnerMedia Passcard process. Regardless, our expectations remain in place.”

Each individual has a right to choose for themselves. However, that right ends when it infringes on my right to be healthy and safe. We do this in every part of society. We mandate seat belts, make drinking and driving illegal, etc. We enforce all kinds of restrictions for the safety of the greater population.

I have been saying this for a long time - if the federal government can’t issue a mandate to force vaccinations - its is upto society to enforce vaccinations. This should be the case for boarding a flight, going to a restaurant, checking into a hotel, going to shopping/entertainment venues. And yes - going to your place of employment.

I am tired of stupid American privilege. There are people in other countries that are literally dying waiting for a covid-19 vaccine dose. We have people in this country who are refusing vaccine doses out of ignorance, misguided delusions of ‘freedom’, or a ridiculous sense of ‘owning the libs’.

You are done. We have had over 600,000+ deaths from covid over the past year and a half. Sorry but your right to not vaccinate ends when it infringes on my right to live. The time has come where you will get vaccinated if you would like to participate in society. And it’s not the right wing liberals, the media, or the federal government that is enforcing this. It’s we the people.