Upon Comparing Oneself to Others (del Giorgio)

This beautiful essay by Paul del Giorgio in the Bulletin of Limnology and Oceanography is timely and prompts a lot of self-reflection on my part. I’m talking to you: all you high-achieving physicians/APP’s who had to be top of your class year after year and never turned off that competitive streak in your career…

Original Article Here:

This prompts several questions for me:

  • Who is this thoughtful person?
  • What the heck is Limnology?
  • Is he writing this for me? (yes, he is)
  • Can Dall-E draw this for me? What would that look like?

from Bing - Dall-E generator

(from Dall-E: except this unhappy self-comparing doctor has 3 hands… and maybe extra fingers too)

CMIO’s take? This is reminiscent of my Failure Resumé. And so articulate. The entire article is a brief read, maybe 5 minutes. It was very much worth my time and maybe worth it for you. Be well, friends.

Hyperdimensional Computing Reimagines AI (wired.com)

Either I’m full of myself and over-optimistic about what I can learn, or I begin to understand dimensional computing as explained in this wired article. If so, super cool what this new way of computing holds for “explainability” of AI models in the future…

From wired.com


In college I got all the way through Calculus I and II and into differential equations and a little into matrices and vectors. I can honestly say I have used NONE of that knowledge, and it has withered completely away in the intervening decades.

THIS article got me interested. Our contemporary problems: Large Language Models, at their root artificial neural networks, compute in a way that is very power-intensive. We are seeing this already in how OpenAI and others are worrying about scaling LLM’s to more users, moving the sophistication upward from GPT 3.0 to 3.5 to 4.0 with more and more layers.

Vector or Dimensional computing holds the promise of changing the paradigm for tracking findings, storing concepts, and manipulating them more easily in, lets say, instead of a flat table of data, into 10,000 dimensional vector space.

CMIO’s take? Although this sounds like a lot of woo-woo, read the article to get the low down. Ready slowly. It took me some time to begin to get it. The reward is, maybe glimpsing a future where AI models can be made to be Explainable. Something not possible at present with LLM’s. Could be game changing.

Long term lung damage from COVID infection (NYTimes)

This is a beautiful 3-D illustration of CT scan findings of COVID infection in the lungs, and the stories of the patients who survived, and now have changed lives as a result. Sobering, and illustrates, that even though our treatments and vaccines are excellent, we still have long term consequences for some with infection. Keep paying attention: Covid is not done with us.

From the NYTimes.com



ChatGPT in the classroom: professors adapt (wired.com)

If you can’t beat ’em, join ’em.


from wired.com


I love this. Time for humans to adapt. How might we use this in healthcare, the idea that students / learners / ?Patients take such an assistant (currently not good enough to be the gold standard) and use it as a tool, an assistant, a learning partner INSTEAD of rebelling against the inevitable tide of the future?

Reverse Osmosis (Wired.com) we were wrong all these years?

What we got wrong before: reverse osmosis, and a new idea


I don’t know about you, but I find reading about other scientific fields refreshing and gives me a chance to think about my own field with fresh eyes. Here’s a glance at how water engineers rethought osmosis, reverse osmosis and came up with a new theory that may lead to breakthroughs for fresh water for the world.


Your professional decline is sooner than you think (The Atlantic)

Yes, it is. Sadly, I think I’m talking about myself.

Screenshot From The Atlantic article


There is a difference, David Brooks says, between “resume virtues” and “eulogy virtues.” The challenge is recognizing when in our work lives, the second (should) become more important than the first.

A really thought provoking essay.

And, profoundly saddening.

Jump. Serve. Worship. Connect. Behave differently in the last third of your life, compared the first (primarily growing and learning) or second (working toward recognition, wealth, power).

Ray Dalio also encourages us to think about this in his book Principles (or the much more readable comic version of Principles). The arc of life is long, and many of us look at the pebbles in our path instead of the compass and the horizon.

I’ve began to value my work and home relationships more, and be less slavish to urgent, less-important emails (The ONE Thing). Turning off notifications, dipping less into social media, learning to focus, be strategic, step back and think big picture. Let others gain and grow in the spotlight.

CMIO’s take? Look at ME! I have the humility to admit that coaching and mentorship are magnificent force-multipliers and so much more gratifying than solo achievement! (see what I did there?)

Gene Expression in Neurons Solves a Brain Evo Puzzle (wired): or Brains are Amazing according to new tools

Single cell RNA sequencing is da Bomb


With the rise of Chatbots and AI, we are left to wonder: what remains for paltry humans to do in this ever-evolving world?

A partial answer is here. Allison Whitten writes an evocative piece about the mammalian neocortex and the researchers using Single Cell RNA sequencing to tease apart the difference between ancestral salamander brains, modern reptilian brains and mammalian brains that include a neocortex.

I love this stuff. And it seems that the neocortex (for now, based on best evidence) is purely a mammalian innovation, the ability for higher level reasoning and thinking (and ? the seat of consciousness) different from ancestral or reptilian brains.

It makes me wonder about Wonderful Life, the Burgess Shale, where Gould talks about evolution and the dice-rolling that has occurred and how random it is that WE are here instead of completely different beings.

CMIO’s take: Learn about how we think, in the service of making tools that align and support these thoughts. AI does not supplant human. A human augmented with AI will supplant the human alone.

Chatbot perspective from an insider (Rodney Brooks and Wired.com)

What Will Transformers Transform?

Thanks Rodney for a thoughtful discussion of

  • The Hype Cycle (peak of overinflated expectations)
  • The caution needed as our tools grow in skill exponentially
  • The ongoing risk of hallucination and unexpected errors in chatbots
  • The “grounding” problem with AI and robots

I particularly love the following quote:

Roy Amara, who died on the last day of 2007, was the president of a Palo Alto based think tank, the Institute for the future, and is credited with saying what is now known as Amara’s Law:

We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run.

I’m feeling an upward acceleration of AI skill with GPT applications, which could open up substantial risks as well as benefits.

For example, in the EHR space, there is discussion that GPT could take a patient and physician’s recorded conversation and automatically write a progress note, qualitatively more accurate and much faster than current commercial tools. Further, it could potentially summarize weeks of progress notes on hospitalized patients and write the discharge summary, a document that, when well-written, can take a human many hours of work. Or even, receive patients’ incoming MyChart messages and clinical questions and “reply to the patient in the voice of their clinician” based on the decade of writing by that clinician in the EHR.

Sure, these seem great. How about the potential deluge of GPT agents writing notes, requests ON BEHALF of patients, or other authors, that could junk up our systems? If 183,000 incoming patient messages is a lot (current monthly patient message volume at UCHealth), what if GPT somehow enabled 10x that number?

How much discussion will be GPT talking to GPT on behalf of employers/ patients/ discussants? I understand science fiction editors now have a 10x increase in sci-fi story submissions, a SUBSTANTIAL FRACTION now being written by GPT based on prior stories?

Too, wired.com has written about this:


“I worry that we are very much in a ‘move fast and break things’ phase,” says Holstein, adding that the pace might be too quick for regulators to meaningfully keep up. “I like to think that we, in 2023, collectively, know better than this.”

CMIO’s take? Take a breath, everyone. It’s going to be a bumpy ride.

I Saw the Face of God in a TSMC Factory (Wired)

Nanometer scale production, Taiwan / Ukraine geopolitics, Huawei and spying in 5G, remote surgery, democracy at risk. What more can you ask for from a Wired Longread?


I see myself in this article. Hints of:

  • My Asian background and the hunger for achievement
  • The constant threat of conflict
  • The importance of being comfortable with ambiguity
  • The unease of global tensions and political disagreement
  • The cultural clash between Asian and American habits
  • Moore’s law playing out in our lifetime
  • Lithography as art and the pinnacle of tech
  • The necessity of trust to drive innovation and growth
  • The knowledge that TSMC tech powers the vast majority of devices and servers without which American healthcare’s Electronic Health Records cannot exist.

Yes, it is a long read. This is what deeply researched, wide-ranging, thoughtful writing is about.

I’m a Taiwanese native American citizen. Taiwan Semiconductor Manufacturing Corporation (TSMC) probably isn’t a household name for most, and yet it produces the vast majority of the most advanced chips for the most advanced smartphones, laptops and computers. TSMC makes me proud to have been born on that tiny island.

CMIO’s take? I enjoyed this very much. This is a brilliant read. You may not agree with all of it, but it is a fascinating journey into the interconnectedness of our personal relationships, our technologies, our trust, our nations and leaders and nothing less than the future of our world.

AI will make human art more valuable (Wired.com)

What is it about human made art that makes us prefer that to AI art?


Partly reassuring, partly cognitive puzzle. It turns out, if shown the SAME images labelled differently “made by human” “made by robot”, we will prefer the former. What does that say about us?