I recently blogged about Shepard Siegel‘s idea that heroin “overdose” deaths — such as Philip Seymour Hoffman’s — are often due to a failure of conditioned tolerance. In the 1970s and 80s, Siegel proposed that taking a drug in Situation X causes learning of a situation-drug association. Due to this association, Situation X alone (no drug) will cause an internal response opposite to the drug effect. For example, coffee wakes us up. If you repeatedly drink coffee in Situation X, exposure to Situation X without coffee will make you sleepy. As the learned response opposing the drug effect grows, larger amounts of the drug can be tolerated and the user needs larger amounts of the drug to get the same overall (apparent) effect — the same high, for example. Trying to get the same high, users take larger and larger amounts. But if you take a really large amount of the drug and don’t simultaneously evoke the opposing response, you may die. What is called “overdose” death may be due to a failure to evoke the conditioned response in the opposite direction.

Siegel’s Science paper about this — a demonstration with rats — appeared in 1982. Since then, plenty of evidence suggests the idea is important.

First, “overdose” death has become more common. A Washington Post article prompted by Hoffman’s death says that death due to “overdosing” on drugs — usually opiate drugs — has doubled in the last ten years and is now “the leading cause of accidental death in the United States, accounting for more deaths than traffic fatalities or gun homicides and suicides.”

Second, new data has supported Siegel’s explanation. Alex Schull linked to a 2005 case report that says: “K.J. did not return home with the heroin purchased as he did on other occasions but went to the public toilet in the pedestrian underpass at the Népliget Metro station where he injected the same quantity (0.5 gram) that he had taken the previous day in the accustomed place, at home with his wife.” The report cites other supporting evidence.

Third, new data has contradicted other explanations.The Post article includes an interview with an addiction expert named Keith Humphreys, a Stanford professor of psychiatry. Humphreys said, “Toxicology results after a fatal overdose usually indicate that the victim has consumed either their normal dosage level or a dose slightly lower than their normal level.” He also said, “Toxicology studies of overdosed people very rarely find that impurities played an important role.”

Yet Humphreys appears unaware of Siegel’s idea, even as he provides supporting evidence:

Typically overdose occurs because they’ve had a loss of tolerance. This loss of tolerance often arises because they haven’t used for a while. Maybe they had a voluntary period of abstinence. Maybe they were in jail, and their body can no longer handle the same dose.

The other leading cause of loss of tolerance is consumption of other substances. This is particularly true of alcohol, which seems to lower the body’s ability to tolerate opiates (so do benzodiazepines). Most of what we call “opiate overdoses” are really polydrug overdoses: alcohol and heroin, alcohol and oxycontin, benzodiazepine, alcohol and Vicodin, combinations like that. [This is consistent with Siegel’s explanation. The second drug makes the situation less familiar, reducing the conditioned opposing process. — Seth]

Siegel’s idea was recently mentioned in the New York Times:

A change in where a person uses his or her drug of choice can increase the likelihood of an overdose, studies suggest. “If you habitually use in your car, for example, the body prepares itself to receive the drug when it’s in that environment,” Dr. Rieckmann said. “It’s called conditioned tolerance. When people using are in an unfamiliar places, the body is less physically prepared.”

This was the first mainstream mention I’d ever seen. I told Siegel about it and he said it was the first mainstream mention he’d seen, too. He added, however, that he had come across the idea in a crime novel:

A Scottish constable, Hamish Macbeth, appears in a series of books by M. C. Beaton. In one 1999 book in the series, “Death of an Addict,” Macbeth has a conversation with a Dr. Sinclair, a pathologist on the scene of an apparent heroin overdose: “Dr. Sinclair leaned his cadaverous body against his car and settled down to give a lecture. ‘The reason for tolerance to heroin is partially conditioned by the environment where the drug was normally administered. If the drug is administered in a new setting, much of the conditioned tolerance will disappear and the addict will be more likely to overdose’” (Beaton, M. C. Death of an addict. New York: Warner Books, 1999, p. 23). M. C. Beaton is the pen name of Marion Chesney, and I wrote to her asking how she knew this. She couldn’t recall, but thought that it likely was due to a conversation she had with a Scottish police officer.

There are several similarities between Siegel’s idea and the Shangri-La Diet, which I will point out later.

A recent study in the BMJ concluded that the massive breast cancer “prevention” program — having women get annual mammograms — had done more harm than good. Women were randomly assigned to get mammograms plus self-exam or self-exam alone. The death rate from breast cancer was the same in the two groups. However, women in the mammogram group were told they had cancer and received very painful and expensive treatment far more often than women in the other group. This being modern medicine, the true situation is even worse than what you read in any article about the (very negative) study. One critic has said that the randomization was not done properly. If true, this means that medical researchers, even when told exactly what to do, don’t do it, in ways that make a multi-million dollar study useless. In spite of billions of dollars and billions of hours spent on mammograms and billions of pink ribbons, we still know practically nothing about the environmental causes of breast cancer. (I suspect bad sleep is a major cause. Shift work is associated with breast cancer.)

A new book (to be published in March), titled The Great Prostate Hoax: How the PSA Test was Hijacked by Big Medicine and Caused a Public Health Disaster says that prostate cancer screening is no better. The book is by Richard Ablin, who discovered the prostate-specific protein used in the screening test. The trouble with the PSA test is simple. First, the reading is often high for reasons that have nothing to do with cancer. Second, prostate cancer is common (cancer increases as the fourth power of age) and usually benign.

In an interview, Ablin made some good points:

The US Food and Drug Administration failed in its duty to the public: its advisers warned that routine PSA screening would cause a public health disaster, but it was approved under pressure from advocacy groups and drug companies. . . . The unfortunate reality is that no current data show that men who undergo PSA screening live longer than men who decide against it.

A few years ago Ablin wrote an op-ed about this.

On this blog, Peter commented:

Lactobacillus brevis also is found in pickled turnips. I’ve used it for weeks and noticed a difference. It seems to clear my lungs [emphasis added] (I probably have a low level infection that once cleared by taking intravenous antibiotics). I buy the Japanese style fermented turnips.

At Mr. Heisenbug, libfree commented:

I’ve taking the probiotic for just this week (twice a day plus some kimchi when I can + I started eating Kimchi at the beginning of last week) and I’ve seen some dramatic improvements. My feet have always had dry, itchy skin which has just disappeared. I have a cronic bunionette, a bunion on the outside edge of the foot, that has softened dramatically. My Rosacea hasn’t changed at all. Sinuses seem better but I’m still holding off on weather this intervention is helping. The most dramatic change has been in my lower respiratory area. My lungs are nearly free of mucus. I don’t remember a time that they were this clear. [emphasis added]

Lungs: canary in the coal mine of modern life?

I have long said that good health begins with good sleep. I came to this conclusion when I improved my sleep a great deal and at exactly the same time stopped getting obvious colds. I concluded that better sleep made my immune system work better. At the 2012 Ancestral Health Symposium, in Los Angeles, Rob Wolf said something similar about the centrality of sleep: “If a person sleeps well, you can’t kill them. If they sleep badly, you can’t keep them alive.”

Mainstream health researchers, on the other hand, haven’t figured this out. James Watson, the co-discoverer of the structure of DNA, in a recent paper about how to fight cancer, wrote this:

Long known has been PERIOD 2 (PER2) involvement as a clock protein at the heart of the circadian rhythms of higher animal cells. Later, quite unexpectedly [emphasis added], PER2 was found to function as a tumour suppressor, with the absence of both its copies causing the rate of radiation-induced cancers to rise.

When PER2 is absent, circadian rhythms disappear and sleep becomes very fragmented, spread out over the whole day. When you sleep better (which usually means more deeply), your immune system works better band does a better job of suppressing tumors. There is plenty of other supporting evidence. For example, in 2012 two studies found sleep apnea associated with higher cancer rates. The PER2 evidence is especially good at establishing cause and effect.

An article about DIY medical devices — devices created outside of big companies — does illustrate the predatory nature of our health care system:

It can still be difficult for inventors to break into the medical-device market. Amy Baxter, a pediatrician specializing in pain management, found this out firsthand. When her four-year-old son developed a fear of needles, Baxter set up shop in her basement and created Buzzy, a vibrating ice pack shaped like a bee that numbs the sting of injections. . . She says, “I decided to use my solution as a mother to be a better — more globally impactful — doctor.” Baxter held randomized controlled trials comparing the device to ethyl chloride spray and published the results. But when she launched the product in 2009, she found it nearly impossible to get her product into hospitals.

“It’s the nature of the system marketing to hospitals to pad prices and make items disposable to ensure repeat sales,” she says. Medical sales reps paid on commission will only take the time to push a new product if it is very expensive, with a high profit margin, or if it’s a cheap item that has to be reordered often, she says. “A reusable, low-cost product doesn’t work.”

On the other end, she says, hospitals’ complex budgetary processes often disconnect the physicians who order products — and pass the price on to patients and insurance companies — from their true cost. “Decisions to buy aren’t as straightforward as looking at a catalog,” she says. “There is no easy way to comparison shop, and less incentive in the medical environment.”

The result of all this inefficiency [which curiously works only in one direction — to make things worse for consumers and better for health care professionals], Baxter says, is not only notoriously inflated hospital prices — like $36.78 for a $0.50 Tylenol with codeine pill and $154 for a $19.99 neck brace — but also a high barrier to entry for devices like Buzzy, which is currently available only online, with no marketing beyond word of mouth.

A predatory relationship is one where one side is much more powerful than the other side and uses that power to take from the other side.

The article says nothing about science — better understanding of the connection between environment and health. Science is so poorly understood by so many people that even a doctor, such as Baxter, fails to understand that it exists:

The more people become involved in medical making, says Baxter, the less the human body will seem like a mysterious black box whose problems and solutions are only within the realm of experts. [Not true. Making is not science. There is still a great need for science — Seth] “The truth is,” she says, “the place where the body interfaces with the rest of the world is just engineering.”

No, it isn’t just engineering. There is a vast amount we don’t know about the world’s effect on the body. Even a small improvement in understanding how environment (including food) controls health (e.g., how to sleep better) can easily be worth billions of dollars per year, more than all DIY medical devices put together. And knowledge (and the associated benefits) spreads at no cost at all, in contrast to medical devices.

Engineers assume people will get sick. Scientists do not.

Thanks to Alex Chernavsky.

The Good Jobs Strategy by Zeynep Ton, published in January, argues that retailers should change low-level jobs in four ways:

1. Offer fewer choices — fewer versions of each product.
2. Standardize common tasks and empower employees to handle unusual situations.
3. Cross-train employees so that each employee can do several jobs.
4. Operate with slack, that is, hire more employees than seemingly necessary.

The brilliance of this book is that it addresses a major problem (bad jobs), includes substantial evidence and persuasive argument, is practical, and is exceedingly non-obvious (judging by how many retailers already follow her recommendations). Ton is an MIT business school professor whose area of expertise is operations.

I interviewed her by email.

ROBERTS How did you get into studying this? My impression is that the details of how employees are treated is not what operations professors usually study.

TON Early in my career I studied pervasive operational problems at retail stores that hurt supply chain and financial performance. My doctoral thesis was on misplaced products and the resulting phantom stockouts. I found that even retailers that were great at managing the backend of their supply chain, by getting the right products to the right stores at the right time, were pretty bad at managing the last ten yards of their supply chain. Once the products made it to the store, they would stay in the backroom or in the wrong place and often not meet the customer that wanted to buy them.

Problems like misplaced products were common, frequent, and had a huge impact on customer service, sales, and profits. When I studied what drove these problems I found that stores that had more workload for employees, lower training, and more employee turnover had worse performance.

Things really clicked for me several years ago when I was presenting my research to a group of retail managers and executives. I showed them my findings from analyzing a lot of data from Borders that showed that if stores increased the amount of people they would make more money. This finding just didn’t make sense—why would managers staff their stores with too few people even though having more would increase profits? When I asked people in the audience to raise their hands if I would find a similar result if I analyzed data from their chain, almost all raised their hands.

What I saw was that a lot of retailers were operating in what I call a vicious cycle. Low investment in employees caused operational problems, which reduced customer service, sales, and profits. When stores had low sales and profits, they had low labor budgets, which further reduced their investment in employees.

Everybody suffers from this vicious cycle. Employees have bad jobs, customer get bad service, and investors are worse off because there is a lot of money left at the table. I thought there have to be some companies that operate much better. That’s how I started looking at firms that follow the good jobs strategy.

ROBERTS How have your ideas on this subject changed over the years?

TON There was a period when I wasn’t sure if excellence was possible in low-cost retail. All the examples around me were of retailers that offered bad jobs and had poor operational performance. When I went to Spain to study Mercadona I realized that I finally had found the “Toyota Production System” of retailing. What really excited me was studying QuikTrip after Mercadona. Here were two completely different companies—the largest supermarket chain in Spain and a convenience store chain with gas stations based in Tulsa, Oklahoma. Yet they were both beating their competitors by offering much better jobs than their competitors. At the same time they were both offering low prices and great service to their customers.

When I looked into what allowed them to deliver value to their employees, customers, and investors at the same time, I saw that they were both excellent operators. They were both making a set of operational choices that reduced costs, increased employee productivity, and allowed employees to have a big role in driving profits. When I looked at Costco and Trader Joe’s, I saw they were making the same choices. In my book I highlight the four choices I observed [shared by these four companies].

ROBERTS When you present these ideas to retailers, what is their reaction? Of course there is a range of reactions, but which reactions surprised you the most? Which reactions did you learn the most from?

TON The reaction that I learned most from is the following. When Marshall Fisher, a Wharton professor and a thought leader in operations management, presented his finding that retailers could make more money by increasing staffing levels, a CEO said, “I spend my days saying no to a long line of people suggesting ways to spend money, including adding more staff. I don’t need a couple of Ivy League professors with their fancy statistical analysis giving them more ammunition!”

This really shows how retailers view their labor — as a cost to be minimized.

ROBERTS What do you think about how Amazon treats employees? Do you have any suggestions for them? [The book is published by Amazon.]

TON I have not studied Amazon.

ROBERTS Your book lacked a chapter called “What Happens When…” about what happens when companies try to implement the changes you suggest — I mean, make changes based on your research. Can you say anything about that?

TON Of the four model retailers that follow the good jobs strategy, only one went through a dramatic change. Mercadona started as a company that operated just like most companies operate right now, but had to change in order to compete against much larger companies. I hope that my book will encourage more companies to adopt a good jobs strategy. If I can observe some of these changes, I will be in a better position to offer suggestions for implementation.

ROBERTS It seems to me the underlying theme of your book is “Look, your employees have brains. The more you take advantage of those brains, the better off everyone — you, them, owners, customers — will be.” Is that a fair summary?

TON One could say that the book is about designing the work that employees do to leverage committed, motivated, and capable employees. It’s also about making smart operational choices that benefit employees, customers, and investors at the same time.

ROBERTS Do you have a theory — is there a theory — that ties your four suggestions (“operational choices”) together? Is there an underlying principle from which all four of them can be deduced?”

TON The four choices I observed are choices that operationally excellent companies have been making for decades and they could be traced to lean manufacturing. Overall, the good jobs strategy—the combination of the four choices and investment in people—is a blueprint for operational excellence.

ROBERTS Why has it been hard to learn to make the choices you describe?

TON Unfortunately, the dominant view in business is that paying employees as little as possible and treating them as a cost to be minimized is the best and perhaps only way to run a profitable business, especially in industries with low profit margins.

As I show in my book, that’s not the only way and that’s not even the best way.

But companies can make bad choices just like people can make bad choices. We know exercising is great for our health but regular exercise requires commitment, discipline, hard work and a long-term view. The good jobs strategy is good for companies’ health but that too requires commitment, discipline, hard work, and long-term view.

Excellence is always harder to achieve than mediocrity. And right now we have too many companies stuck in mediocrity.

ROBERTS You say “the dominant view in business is that paying employees as little as possible and treating them as a cost to be minimized is the best and perhaps only way to run a profitable business, especially in industries with low profit margins.” That is a common-sense view that Adam Smith might have expounded. Why has such a wrong view persisted so long? On the face of it, I would think that how to treat employees would be one of the central questions that business professors (and CEOs) try to answer and nobody would be satisfied with repeating ideas of several hundred years ago. It’s one thing for a third grade teacher to tell students “the earth is flat” — yes, it looks vaguely flat. But for sophisticated university professors and captains of industry to say “the earth is flat” for hundreds of years when there is a vast amount of money to be made from realizing it isn’t flat, that is puzzling.

TON But it’s not just ignorance. Perhaps I should have worded it differently. Following the good jobs strategy is not easy. You have to get many things right. It requires excellence.

POSTSCRIPT This is what Ton said in the book — that the good jobs strategy is difficult. I wasn’t persuaded. CEOs of major retailers have done many things that are not easy. Why has this difficult thing been out of reach?

I suspect an examination of why the 4 retailers Ton study broke from the pack and treated their employees differently would not find that the people in charge were more capable of excellence than the leaders of other companies. Maybe their personalities were different, maybe their cultures (internal company culture or external society culture) were different, I have no idea.

I am unsurprised that business profs had failed to figure out what Ton figured out (although her conclusions are supported by the work of other professors). Other disciplines have enormous blind spots — epidemiologists never study the immune system, for example. The more things you can take for granted, such as the idea that labor is a cost to be minimized, the easier it is to publish papers. In academia what is rewarded and selected for is not solving real problems, it is publishing papers in prestigious journals, which is quite different.

Caltech has a serious problem with undergraduates cheating on academic work, which Caltech administrators appear to be ignoring. A few years ago, one alumnus considered the problem so bad that he urged other alumni to stop donating. I attended Tech (that’s what we called it) for a year and a half in the 1970s. I didn’t think cheating was a problem then. Now it is.

A recent article in the Times Higher Education Supplement by Phil Baty praised Caltech’s “honor system”, which includes trusting students not to cheat on exams. A Caltech professor of biology named Markus Meister told Baty that “cheats simply cannot prosper in an environment that includes such small-group teaching and close collaboration with colleagues because they would rapidly be exposed.” That strikes me as naive. How convenient for Meister that there is no need to test his theory — it must be true (“cheats simply cannot prosper”).

A few years ago, a Caltech alumnus named Peter Seidel, after receiving a donation request, told his fellow alumni not to donate until the system was cleaned up. Here’s some of what he said:

I found out today that Dean of Students Jean-Paul Revel said the following to my dad on the phone while I was at Caltech (Not realizing that my dad is a former Caltech student and BOC [Board of Control] rep) “Peter has a real problem with cheating. The fact is that people cheat. Peter needs to get over it.”

I think it’s safe to say that the Caltech ‘Honor Code’ is obsolete. [= is no longer working — Seth]

There is a small and growing population of students at Caltech [who] are systematically cheating, and the Caltech administration is aware of it but refuses to do anything about it. I suspect the problem began when Caltech started advertising its ‘Honor Code’ to prospective high school students in the 90′s, which lead to self-selection of students who were willing to bend the rules.

In my personal experience, I caught students cheating red-handed while I was a student, and though I took my findings to the BOC, nothing ever came of it.

I also went to one of my professors (along with several of my classmates) and we explained that we were very concerned that there was a significant amount of cheating going on in his class. While he was very empathetic and gave us a significant amount of his time, ultimately he essentially said that his hands were tied because the school does not allow him to give proctored exams.

The Caltech exam system is set up in such a way that it is extremely easy to take extra time on an exam, open a book on a closed book exam, or search for the answers on the internet. Most exams are taken by students alone in their dorm room, with no one watching, at the time of their choosing, with the student timing themself and with both the coursebook and an internet connection in the room, with only the student’s integrity preventing them from using resources they are not allowed to use. For that matter, many quizzes and exams are turned in to unlocked boxes in empty hallways where it would be simple to take another students answered exam to copy or check answers against, and then return it when turning in one’s own exam. <

In my job in the financial industry I interview a number of Caltech seniors every year for potential jobs. And unfortunately, I have to try to answer the question ‘Is this person a cheater?’ as part of my interview process. I have seen examples of resumes where students flat out lied about their GPA.

But probably the most blatant example . . . is a student [he means graduate — Seth] that I recently interviewed [who] claimed, as his two ‘hobbies’, to be a member of the Caltech fencing team his freshman and sophomore years, and a member of the Caltech chess club all four years at Caltech. As it happened, when I was handed his resume, the coworker sitting to the left of me was a former Caltech grad student that coached the fencing team during those years, and the coworker sitting to the right of me was a former Caltech undergrad who was an avid member of the chess club as both an undergrad and an alum. Both of them also happened to be part of the group scheduled to interview this student, and received copies of his resume. I asked them what their opinion was of the candidate.

Neither of them had ever heard of him.

We decided to go ahead and give the candidate an interview, and give him a chance to explain, in case we were somehow misunderstanding the resume. The first person to interview him was the former fencing coach. The interview began normally, and then after a while they had the following exchange (I’m paraphrasing somewhat):

Former fencing coach: I see you have two years on the Caltech fencing team.

Candidate: That’s right.

Former fencing coach: Well, I was the coach at that time… and I don’t remember you.

Candidate: Well, it wasn’t actually my freshman and sophomore years; it was just my freshman year.

Former fencing coach: I was the coach both years.

Candidate: Well, I wasn’t really on the official team, I just took the PE class that taught fencing.

Former fencing coach: I taught that class.

Candidate: Well, I didn’t really take the whole class. I signed up for it, but I only went to the first week, and then I dropped it.

After the first interview, we decided we wouldn’t be making him an offer, but I decided to go in and talk to the candidate anyway. [In] the meantime, the coworker who was a Caltech chess club member asked another chess club friend of his if he knew the guy, and he didn’t. I told the candidate that we wouldn’t be offering him a job, but I wanted to talk to him about his resume. I told him I had heard about the previous interview, and that there were also a couple members of the Caltech chess club who did not know who he was. He responded ‘Well, it wasn’t a formal team, and not everyone went every time.’ I asked him what night of the week the club met, and he told me (confidently) ‘Saturday nights.’ (I knew that it was actually Friday nights.)

When people cheat and get away with it, they are more likely to cheat in the future, Seidel believes — a very plausible idea. Given the disinterest of professors and administrators in the problem, the Caltech mascot should be a monkey with its hands over its eyes.

I am learning Chinese by studying a Chinese version of The Three Little Pigs. The story contains a phrase that irritated me: “Three’s home” (in Chinese). Although I did know the Chinese for “home”, the rest of the story used the term “Three’s brick house” (in Chinese). Why couldn’t they stick with one name for it? I thought.

I knew the answer: In language, we like to use different words for the same thing. A famous archeological decipherment puzzle was solved when someone realized the stone cutter had used different words for the same thing. A little repetition is okay but extreme repetition is not. Thus the term elegant variation. Using different words for the same thing is not just confusing, it makes the language harder to learn (because it is larger), with no obvious improvement in breadth or speed of communication.

Why do we do this? Why do we dislike certain sorts of repetition, even though language is built on repetition? I think the answer is that this is built into us to help the language to expand and grow. The variation seems useless but it isn’t because (a) there is a new word and (b) the new word can shift in meaning. The old word can continue to mean what it meant.

Fashion has a similar function. Our shifting preferences in art and decoration force artists to keep inventing. They cannot merely do the same thing over and over and over. Fashion obviously increases innovation.

In her brilliant book The Good Jobs Strategy, Zeynep Ton, an MIT business professor, says that retailers should “operate with slack” — meaning hire more employees than necessary. The effect is to give employees some free time. Why should this be? Because when you give employees free time you give them to think. Giving them time to think gives them time to think of improvements.

Language (elegant variation) and material science (fashion) might be more central to human life than well-run stores (slack) but in each case there are real problems to solve — and they are solved, in part, by adding seemingly-useless elements to the system. The new elements help the system improve.

• Acne fixed with raw honey. “I ditched the antibiotics and started using raw honey on my current breakouts and under the skin pimples.”
• “Fussy critiques of science experiments” are used to discredit good science — an example being Tyrone Hayes’s work showing that atrazine is dangerous. One “fussy critique” complained about a misspelled word. Was this a secret signal that the author of the critique had a gun pointed at his head?
• once again, a drug company (Boehringer Ingelheim) hides important information
• German city emphasizes sleep
• powerful heart doctor accused of plagiarism

Thanks to John Batzel, dearieme and Adam Clemans.

After I finished The Idealist: Jeffrey Sachs and the Quest to End Poverty by Nina Munk, I thought of something a graduate student in English had told me: A little Derrida goes a long way and a lot of Derrida goes a little way. It was literally true. A few sentences by Derrida, you could think about for days, maybe productively. A whole book by him was baffling and irritating. A lot of Jeffrey Sachs goes a little way, I thought.

When it came out (2005), I thought The End of Poverty by Sachs was the ravings of a lunatic. Munk’s book shows I was right but I had to admit that George Soros giving Sachs $100 million or whatever to put his ideas into practice (to “test” them) was considerably more interesting than the activities of the other billionaires Munk had written about before Sachs. Soros had an advisory board whose reaction to Sachs’s ideas was the same as mine but Soros overruled them. Soros was right. A tiny bit was learned from spending all that money, which is better than learning nothing. Certainly I learned more than if the money had been used to buy a private jet.

As an assistant professor doing animal learning experiments, I saw over and over that it was incredibly hard to learn anything. Anything. No doubt all science professors who are honest learn this. But then I saw something that is less easy to see: If doing the “right” thing pays off worse than we expect — Sachs’s flamboyant failure in Africa is an example — then doing the “wrong” thing should pay off better. If spending an enormous amount of money we learn less than expected, then when we spend very little money we should learn more than expected. This is the upside of ignorance. The less you know, the easier it is to learn more. And we know much less than famous professors, such as Sachs, say we know.

My personal science is the polar opposite of what Sachs did. He tried to help others (poor Africans), I try to help myself. He tries to help people he knows almost nothing about, I try to help myself — and I know a lot about myself. He tried to do something big (end poverty). I try to do something small (e.g., sleep better). What he did cost millions of dollars. What I do costs nothing. I can test a new idea about how to sleep better in days. Sachs took years to test his ideas. For me, failure costs almost nothing. Sachs’s failure cost him years of his life. You have to be an extraordinary person with great talent to do what Sachs did. Whereas anyone can do personal science.