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November Newsletter!




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November 2021

Welcome to the November issue of WonderWell, a newsletter intended to gather the most groundbreaking research and insightful commentaries in evidence-based medicine, wellness, healthcare leadership, writing, and innovation to help you live and work in alignment with your purpose and well-being. 

Some things that had me wondering last month:

1. COVID and…
Counterfeit:  from STATNews — the frightening burgeoning secondary industry of fake vaccines and COVID medicines. 

Children: in the NYT, preparing them for the trauma of COVID, and (an oped from the American Academy of Pediatrics) preparing ourselves for their vaccines  in the NYT

What it will take to end the pandemic: A smart, and pragmatic, take from Leana Wen, in the WashPo.

Rapid tests: First read this eye-opening tweet thread by David Leonhardt (of the NYT) about issues with accessing rapid tests in the US (also applies to Canada), then read this profile of Michael Mina, an early proponent of these tests, in Bloomberg. For what it’s worth, it does seem that access to free rapid tests is around the corner for North America (below, an example from London, where the NHS provides them for free).

2. Podcasts (& shows/books) worth listening to/watching 
Not a podcast or show or book (Sadly I have started nothing new this month…) but I did really love Ryan Holiday’s newsletter (a yearly one he puts out for his birthday).  

This is from the archive but it made me think and re-think.

Lastly, I was very late to this viral piece, “The Bad Art Friend,” but finally listened to it on The Daily, and it was immensely horrifying and sad. In my view, there’s no question who the person in the wrong was: Dawn Dorland was gaslit and tormented for years — make no mistake: this was not an impulsive petty comment or bit of gossip. It was an orchestrated campaign over years to take her story, and associated themes around it (including perhaps the question of altruism vs validation — a great film about this theme is underway), her own words, with the goal of profiting off of it and dehumanizing her. Brene Brown discusses the idea of “common enemy intimacy” — this was certainly at play here: a group of very insecure writers, or perhaps a group of neutral writers, who were swayed (groupthink/social psychology stuff) by an individual with sociopathic and/or Machiavellian tendencies to partake in this abuse and gaslighting. It’s all made worse by two things: that Dawn had openly disclosed her trauma and mistrust (and they did it anyway, to re-traumatize her) and that the perpetrator used the excuse of being a woman of color as a way to paint Dawn as a person abusing her ‘white privilege’ (which only does harm to legitimate claims of bias and systemic racism in writing and beyond). 

I’m hopeful Dawn will find justice, and more importantly, healing. I also hope this experience might plant the seed for her own memoir — could this just be a turning point in a fascinating story about altruism, kidney donation, and healing from trauma? I hope so.

3.On…when to quit (not grit)
In the NYT Opinion section, an incredible ‘video oped’ from Lindsay Crouse, on  video when to quit (over grit).

4.Sound (and wise) reflections
This is very old (if May 2021 is old), and sadly I just found it a few weeks ago, but it’s one of the best ‘think pieces’ about the pandemic, in the Tyee (which is Canadian!). 

Dr Eric Warm’s paper on game theory and the Match is well worth the time and introspection. The only thing that might have made it a bit better: incorporating the “Secretary Problem,” which someone told me about a month ago, and I can’t get enough out of my head (it’s brilliant…and applicable to many things).

Somewhat unrelated to this, is the “Avocado Problem” (which I believe I just made up…but I’m anxious to google it, in case it isn’t exactly original). It began with this….(M & S is a fine food shop, part of Marks & Spencers)… on and tell me if there’s anything to this…(by the way — it’s great that they specify that the ‘eat now’ avocado and the ‘eat later’ one are from two different places…)

It begins with a question: is there an optimum number of avocados that one (a buyer) can purchase in order to maximize satisfaction (having a ripe avocado to eat relatively soon) and minimize distress (buying an overripe one accidentally, buying an underripe one that needs time…i.e. cannot be eaten when the buyer wants)? I believe M+S has solved this. The optimum number is exactly 2, but one must be ‘ready to eat’ and the other slightly unripe. Why?  Let us assume that most people who buy avocados imagine themselves eating it later that day (guac, snack) or the following morning (avocado toast, huevos rancheros). That leaves a window of 8-12 hours for pleasant consumption.  Let’s also assume that most people who buy avocados dont like to go shopping for them daily. We rarely buy apples one at a time, right? But apples are not avocados (forget oranges)…more on that later. 

Ok so now we have a person who wants to buy an avocado for imminent consumption but *also* has planned to eat another one within the next few days. Placing household size aside for a moment (but we would multiply the stable answer by the number in a household), the stable answer is 2: one ripe, one unripe (preferably not in the wasteful/plastic package as above, but individually).  So why do grocery stories sell them as 5-7 in that green netting? Everytime I’ve given in to ‘buy more to save more’ idea, with avocados only (not apples!) I’ve regretted it. Why? Because avocados ripen more or less at the same time when they are sold like that — it’s the ethylene gas they give off to one another. So while we *think* buying more is better, the net outcome is roughly 3 edible avocados, with 3-4 going to waste. (again: not the same for apples, oranges, etc…avocados are among the most temperamental and unforgiving of fruits!).

Now you might be wondering…what does this have to do with a newsletter about well-being and health? Everything! Because so much of our well-being deals with *how* we make decisions. Not the *what* (outcome isn’t relevant here) but the process. Good decisions heighten our well-being (regardless of the outcome) because we minimize regret around the counterfactual. Bad decisions: the opposite. We weigh a variety of factors differently when we make decisions, and there’s also an element of chance (read anything by Annie Duke, like this or this, to get more insight into this — her work has shifted my perspective immensely over the last 18 months).  Apples, you’ll recall, are not avocados. Apples are one of the most forgiving and stable of fruits — the time window to consume them is relatively long (a week or more) as opposed to short (avocados: hours !). That’s why buying apples in bulk makes sense: you can trust there’s one available for immediate consumption, and one (or many) for later. It doesn’t become a frantic exercise in planning and calculating….as it does for avocados. When we make decisions: about picking the right professional opportunity, business/romantic partner, etc, we weigh some of these same factors. And a big one, beyond compatibility around values etc is *timing*. The problem is that we often presume that these opportunities are like apples: ready when we are, and if we aren’t ready they will still be around when we are; as humans we tend to over-emphasize our own sense of timing and time more generally. This is, obviously, wrong.

Most things (opportunities, people we may want to partner with) are like avocados: If we’re ready (timing wise), we ‘match’ to the right opportunity that might be ready (ripe) as well, except that there’s also the element of uncertainty and chance: that ripe opportunity may not be all it that it seems (the ripe opportunity may end up being overripe/rotten when we finally dig in…which we perhaps didn’t judge well beforehand) OR, since we dont function in isolation but with other people, others may jump at that ripe opportunity before us. As such, the most stable solution is to pursue the ‘ripe’ one, but have a somewhat ‘unripe’ one in the wings. Note: this isn’t the same as having a backup plan: a backup plan is effectively like lining up two ripe things one after another — having something in the wings that isn’t totally ‘ripe’ (either the opportunity is still in flux, or you are still somewhat unsure), but could be sorted out over a period of time is better (this means that we also avoid the competition element). 

Thanks M&S Simply Food for sponsoring this not-so-simple digression (kidding). And yes, I know avocados are not the most sustainable fruit…but let’s park that for now, for the sake of this thought experiment. 

6.Best tweets of the month goes to…
Adam Grant on prestige and jobs
Sahil Bloom on following your curiosity 
Maria Popova on living just the one life
Amy Edmondson on…cookies 🙂

7.Products/Services that have made a meaningful difference during the pandemic:
This newsletter is not sponsored, but I love sharing products that have made a meaningful difference in my day to day (increased productivity, more joy, etc).  This month I’m sharing my absolute favorite tea: Marco Polo by Mariage Freres.

I discovered it at a friend’s house in 2016, in Cabbagetown Toronto — the teabags are just sublime and a bit over the top (think: linen). I managed to find the loose tea version at Pottery Barn of all places, but paid a visit to the Covent Garden location recently and picked up some more teabags, and have made a few cups for friends here. It’s a black tea with a fruity essence, and is simply delicious with or without honey/milk — perfect post dinner, pre conversation tincture 😍 

In My Own Words…

I just completed my reporting for a longform piece I’m working on for Wired (now the writing begins), and gave keynote talk for the National Partnership for Hospital and Hospice Innovation (their Summit is underway), on the topic of burnout and healthcare revolutions (I’ll share the video next month). Funny enough, my mother sent me a photo from London (where I am for another 10 days) from the late 1980s — my first ever keynote! Thankfully my audience was slightly larger this time around, and I found a nicer bookshelf.😜

I also had a chance to visit my old house (where I lived from about 2 to 6 years old), a duplex in Welling, Kent: 24 Clifton Road. It was really fun to chat with one of the neighbours and get all caught up on the neighbourhood happenings over the last couple of decades! I also retraced my walk to primary school — I’m a bit dumbfounded at how long it was (about 20 min for an adult, so 35 min for a 6 year old?)  

Have a healthy, joyful, and safe November,

Amitha Kalaichandran, M.D., M.H.S.

Written by Amitha