
Why the Fuck? - mehulkar
http://raganwald.posterous.com/why-the-fuck
======
raganwald
My fellow HNers:

It does depress me, daily, that I do not have a career in physics or chemistry
or biology or medicine where I could work on "big problems." The simple truth
is, I'm not smart enough, I don't work hard enough, and I've been napping when
opportunity knocked a few times in my life.

That being said, sometimes a man in a saloon has a few drinks and yells at the
television, telling the coach of some football team what to do next. Just
because he's drunk and in a saloon doesn't mean he's _wrong,_ just boorish.

I lamented the fact that it's easier to upload and simultaneously tweet about
a picture from my phone than it is for Scott to lead a normal life. There are
lots of reasons why this is so:

1\. The barrier for entry (education, &c) is higher in medicine and
bioinformatics.

2\. There are regulatory obstacles for businesses.

3\. The problems are harder to solve than it may seem to the man in the
saloon.

4\. Some people feel the monetary incentives are to avoid medicine.

p.s. "Hypocrisy" is one of those empty criticisms, like "Unprofessional." If
someone says to you, "smoking is bad," it doesn't matter whether he smokes.
Maybe, his advice is actually more relevant if he's an older fellow who smoked
and now regrets not making a different choice when he was your age.

~~~
ramanujan

      2. There are regulatory obstacles for businesses.
    

As someone in the biotech space, this is by far the biggest factor. When you
are dealing with humans, crashes and bugs mean deaths. Deaths mean increased
regulation, often under the mistaken assumption that more rules would prevent
engineers from making bugs. Modern testing and build systems might, but
regulators aren't keen to change their testing systems, many of which were
encoded by legislation decades ago. For example, adaptive clinical trials have
been known to be theoretically superior to the Phase I/II/III design for 15
years, yet are still in limbo[1] at the FDA; their proponents are still banned
from trying them out. Facebook does not need a Federal Software Assocation to
sign off on its new unit testing framework.

Moreover, it is just more stressful to deal with a regulatory climate where
any error is assumed to have happened because you were an evil corner-cutting
capitalist who didn't allocate enough for safety. This kind of Monday morning
quarterbacking is unfortunately usually done by people who've never shipped a
drug or device in their lives, like most politicians, journalists, or federal
regulators. Twitter, unlike Genzyme[2], is not fined millions of dollars by
the FDA when its site is down.

Finally, you have to guess what the law is. There is so much "discretion"
[3,4] afforded to regulatory agencies that the threat of fines and seizures
over bizarre interpretations of the law by a Carmen Ortiz-style ambitious
regulator is never far from your mind. Example [5]:

    
    
      [Newsweek:] What exactly would constitute a “medical   
      claim?” Would pointing people to medical research papers 
      [qualify]?
    
      [FDA]: It depends. There are rules as to how one can do   
      that … Those rules are actually worked out pretty well, 
      and they just would need to make sure they’re staying 
      within the rules.
    
      [Newsweek:] Are those rules on the Web?
    
      [FDA]: I don’t know where the policy is. I would have to 
      get it for you. It’s an agencywide policy. I would have to 
      find it for you. And it won’t be that easy for people to 
      follow it…
    

Another example [6]:

    
    
      The agency has urged hospitals to allow vendors to guide 
      them on security of sophisticated devices. But the vendors 
      sometimes tell hospitals that they cannot update FDA-
      approved systems, leaving those systems open to potential 
      attacks. In fact, the agency encourages such updates.
    
      “A lot of people are very confused about FDA’s position on 
      this,” said John Murray Jr., a software compliance expert 
      at the agency.
    

And one more [7]:

    
    
      In United States v. Park, the Supreme Court held that a 
      responsible corporate official can be convicted of a 
      misdemeanor based on his or her position of responsibility 
      and authority to prevent and correct violations of the 
      Food Drug and Cosmetic Act (FDCA). Thus, evidence that an 
      individual participated in the alleged violations or even 
      had knowledge of them is not necessary.  
    

Think about that: criminal penalties for violations of laws that "won't be
that easy for people to follow", where knowledge or participation in the
alleged violations is not necessary. And the law is not static. The FDA also
can and does write "guidances" outside of the legislative process which will
make your business model illegal overnight or vastly more expensive due to
unanticipated regulatory costs. Google does not need to guess what the DNS
protocol is or will be in 2013.

For just a taste of how all this plays out, look at the FDA's ongoing attempt
to regulate[8] mobile health apps. Who knows what the rules will be, what they
will cost, or what the fines are? Look at the FDA's attempt to deny[5] people
access to their genome without a prescription. Look at the fact that they
issued a record 10000+ 483s in 2011[9], which threaten a business with civil
or criminal penalties. Look at the fact that they used these 483s to shut down
Teva and Sandoz and Hospira and Bedford at the same time[10], causing a
massive shortage of injectables which they blamed on industry profit seeking
and used to gain[11] yet more regulation, more power, more budget.

Look, finally, how they claim in an official court filing against family farms
producing raw milk that you have "No Generalized Right to Bodily and Physical
Health" [12], where they approvingly cite the case of Cowan vs. US, where a
terminal cancer patient was denied access to experimental medication, denied
the right to opt-out of the FDA:

    
    
      There is No Generalized Right to Bodily and Physical   
      Health.
    
      Plaintiffs’ assertion of a “fundamental right to their own 
      bodily and physical health, which includes what foods they 
      do and do not choose to consume for themselves and their 
      families” is similarly unavailing because plaintiffs do 
      not have a fundamental right to obtain any food they wish. 
      In addition, courts have consistently refused to 
      extrapolate a generalized right to “bodily and physical 
      health” from the Supreme Court’s narrow substantive due 
      process precedents regarding abortion, intimate relations, 
      and the refusal of lifesaving medical treatment. 
    
      See Glucksberg, 521 U.S. at 721 (warning that the fact 
      “[t]hat many of the rights and liberties protected by the 
      Due Process Clause sound in personal autonomy does not 
      warrant the sweeping conclusion that any and all 
      important, intimate, and personal decisions are so 
      protected”); see also Cowan v. United States, 5 F. Supp. 
      2d 1235, 1242 (N.D. Okla. 1998) (rejecting a claim that 
      the plaintiff had the fundamental “right to take whatever 
      treatment he wishes due to his terminal condition 
      regardless of whether the FDA approves the treatment”).
    

I know it sounds surreal, but they are arguing here that you only control your
own body with respect to abortion, intimate relations, and euthanasia.
Everything else is controlled by the FDA, yea even unto your death from
cancer.

The only solution here is for hackers to carve out a jurisdiction in which the
FDA has no say, where patients are free to be early adopters and startups are
free to push the technological envelope. Patients in this zone will need to be
mature and understand that these are version 1.0s, and may not help or even
actually harm them. But every drug or device or surgery needs _someone_ to be
first, and a few brave risk takers could both benefit their own health and
push humanity forward. After all, we have thousands of people dying for
_futile_ risks in various foreign wars.

So, the limiting reagent is not money, or expertise, or motivation, or smarts.
raganwald, you and most of HN are plenty smart enough. It's about the freedom
for companies to innovate, for patients to take risks. We need a jurisdiction
(a seastead? Singapore? Estonia?) that enables us to push the technological
frontier. Everything else will fall into place once we can't be punished for
innovating.

[1] <http://jnci.oxfordjournals.org/content/104/18/1347.extract#>

[2] [http://www.fiercepharma.com/story/genzyme-
submits-175m-fine-...](http://www.fiercepharma.com/story/genzyme-
submits-175m-fine-fda-consent-decree/2010-05-25)

[3] [http://www.ivdtechnology.com/article/letters-labcorp-show-
fd...](http://www.ivdtechnology.com/article/letters-labcorp-show-fdarsquos-
enforcement-discretion)

[4]
[http://www.fdalawblog.net/fda_law_blog_hyman_phelps/2011/03/...](http://www.fdalawblog.net/fda_law_blog_hyman_phelps/2011/03/cost-
of-compliance-fdas-new-enforcement-discretion-1.html)

[5] [http://www.thedailybeast.com/newsweek/blogs/the-human-
condit...](http://www.thedailybeast.com/newsweek/blogs/the-human-
condition/2010/08/05/dna-dilemma-the-full-interview-with-the-fda-on-dtc-
genetic-tests.html)

[6]
[http://articles.washingtonpost.com/2012-12-25/news/36015727_...](http://articles.washingtonpost.com/2012-12-25/news/36015727_1_health-
care-medical-devices-patient-care)

[7] [http://www.gatewayfda.com/fda-regulations/under-park-
doctrin...](http://www.gatewayfda.com/fda-regulations/under-park-doctrine-fda-
can-prosecute-individuals-for-company-violations-of-fdca/)

[8] [http://m.spectrum.ieee.org/biomedical/devices/the-fda-
takes-...](http://m.spectrum.ieee.org/biomedical/devices/the-fda-takes-on-
mobile-health-apps)

[9] [http://blog.fdazilla.com/2011/11/fda-
issues-483-every-50-min...](http://blog.fdazilla.com/2011/11/fda-
issues-483-every-50-minutes-in-2011/)

[10] [http://www.forbes.com/sites/aroy/2012/06/15/how-margaret-
ham...](http://www.forbes.com/sites/aroy/2012/06/15/how-margaret-hamburgs-fda-
causes-cancer-drug-shortages/)

[11]
[http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050796....](http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050796.htm#q5)

[12]
[http://www.organicpastures.com/pdfs/FDA%20dismissal%20docume...](http://www.organicpastures.com/pdfs/FDA%20dismissal%20documents%20FTCLDF%20CFR%201240.61%20.pdf)

~~~
hackingla
This is why I think that this revolution will be led by hacker/patients and
not business men / politicians. I am not trying to be dramatic but I will
literally die for this cause because I spent my entire life sick, in bed,
shitting blood and trying what everyone else wanted me to.

3 months of doing it my way and I never knew life could be this good, so while
I agree that the regulatory climate makes this difficult; I dont care. I will
never take such a risky attitude toward others and risk their health or
wellbeing because I do not have this right but I also will not use this as an
excuse to do nothing when I know I can help.

~~~
new299
what does "doing it my way" in this context mean? What did you try and how did
you research it?

Have looked into this kind of thing myself before and am interested in how you
went about your project and if there's a community around that kind of thing.

~~~
hackingla
Their way == Prednazone, Asacol / 6MP

My Way = Macrobiotics, Stress Control, Acupuncture etc...

Yes, there are many communities; I mostly used trial and error but the
difference is how I measured what worked. I kept a food diary that allowed me
use actual nutrient stats etc... to find patterns in my trigger foods.

~~~
jhartmann
I'm very glad this worked for you. I don't have Crohn's, but I also have an
auto immune disease called Ankylosing Spondylitis. For many immune conditions
there seems to be an environmental trigger, or something that makes it worse.
There is quite abit of research that many of our conditions are caused by
interactions with the bacteria in our gut and our immune response to certain
food. I saw your other posts about working on tools to help people track these
things, I commend you. There is a large body of people who could potentially
benefit from this work. Not just people with Crohn's, but many autoimmune
conditions. Keep on trucking and I wish you luck.

------
pg
Essentially he's asking why person-hours are expended on things that make the
most money rather than things that are important, for some definition of
important.

There are several answers to that.

1\. The most obvious is that people need to make a living. People can and do
work at some discount in order to work on things they think are important, but
it rarely stretches as much as 10x. I expect most workers either don't care or
can't afford to.

2\. A lot of people do work for nonprofits (the biggest of which is the
government), but the number of such jobs is constrained by the amount of money
nonprofits can raise.

3\. The number of people employed on frivolous things seems larger than it is,
because e.g. things designed for entertainment are by their nature more
visible than infrastructure. So it is dangerous to draw conclusions based on
anecdotal evidence.

~~~
wamatt
Meta: OP is looking past the author's sentiment, generalizations and
inaccuracies to respond thoughtfully to the central point of the message.

Someone is following their own advice:

<http://www.paulgraham.com/disagree.html>

So regarding hypocrisy, while it's true in certain contexts and under certain
conditions, calling out hypocrisy, could constitute a logical fallacy, simply
stating that possibility, says very little about how to value it.

Is hypocrisy _good_ or _bad_? Perhaps the question is ill-framed. Avoiding
hypocrisy, can create a powerful resonance between the speaker's aligned
actions and words. It may be worth nothing this not a moral value judgement,
but speaks to leadership. People on average, appear more willing to follow
those with strong and bold congruency, and yet abandon them, when that
illusion shatters (aka Lance Armstrong).

That said, _my_ own view is that hypocrisy is generally inefficient, as it
appears to increase the noise in the system.* As the proverb goes "talk is
cheap" and hence it costs little to put an opinion out there, which is not bad
in and of itself, merely that it requires little effort.

Thus with a sea of opinions floating out there, and limited time to process
(if your cognition doesn't naturally operate in a frequentist manner), who can
you trust?

There does not appear to be a definitive set of answers, however the heuristic
of matching words to actions, while not perfect, combined with a test for
integrity, has personally proven useful over the years.

*cf bounded rationality, opportunity cost, SnR etc.

~~~
cko
Do you speak like this in real life? I went ahead and read your other comments
on other threads and I can't understand what you're writing until I've read
the words at least three times.

~~~
wamatt
Interesting that you should pick up on that. It usually depends on the
audience.

In general if one has a slightly more divergent worldview than that of the
company in which he/she finds themselves, it's historically been useful
(albeit frustrating at times), to be more considered and precise.

Between my best friend, a fellow coder/entrepreneur of ten years, (who has a
very different personality), we can communicate in shorthand as he understands
what I mean, irrespective of the natural imprecision, that creeps in by
wanting to be "good enough" to get the message across. Although the early days
of our friendship was somewhat.. challenging.

Some of the usernames on HN that I've noticed that have insightful content, do
not appear to reward sloppy rhetoric, and even, I suspect, use it as a
filtering signal.

Hence, it would seem rational to at least demonstrate one is willing to
embrace the norms of that group, but more importantly to avoid genuine
misunderstanding, which has plagued me since childhood.

(I know what a cliche, what a special snowflake etc etc ;) Yes I dislike how
it sounds too.

Lastly my own values dictate a personal preference for dialectic over
sophistication. But perhaps that's a debate for another time.

~~~
cryptbe
You use too many ",", and they make your writing hard to understand. Use
shorter sentences, and consider replacing "," with a full stop.

~~~
klibertp
It's not about commas, it's about "asides" (I just looked this up in a
dictionary, I hope it's a correct term in English) - end it's true that he's
using many of them, but I wouldn't necessarily recommend changing this.
Rather, I'd think about assigning priorities to those asides and grouping them
in relevant chunks, using parentheses, dashes and semicolons beside colons,
because - as we all should know (and those who do not have a chance to learn)
- this could substantially increase readability of his writing. Long sentences
can be a pleasure to read as long as their construction follows _some_
consistent plan.

Just trying to help a bit :)

------
untog
_"Reginald Braithwaite is a software developer at Leanpub, where he and his
colleagues take the friction out of writing and selling books"_

Why the _fuck_ are the greatest minds of our generation toiling away on a book
publishing platform? Oh, right, because _you_ think it's important. Guess
what- we all have different opinions. Is book publishing more important than
dating? Before you laugh, think about it- finding someone to share your life
with is very important to a lot of people. A lot more than will ever publish a
book.

It's pretty depressing to see this upvoted as far as it has been on HN. What
is it _actually_ saying? It's like one of those stupid motivational posters
(only negative)- all emotion-tugging, no depth.

Why are you making a book publishing platform and not following your own
advice?

~~~
amix
There's an old saying that applies to this: Don't throw with stones when you
live in a glasshouse. I can't really give much respect to people that don't
follow their own advice and that rant with profanity at people that make a
difference in the world to at least 1 billion people (Google and FB combined).

~~~
enraged_camel
>>I can't really give much respect to people that don't follow their own
advice

<http://en.wikipedia.org/wiki/Tu_quoque>

~~~
Karunamon
He said respect, there was no judgement as to correctness or not. I for one
also don't respect hypocrites.

------
glesica
To launch a Facebook clone you sign up for Heroku or AWS, push some Rails
code, and start promoting yourself. To launch a medical device you spend years
cutting through regulation and red tape, negotiating with and marketing to an
industry that is probably threatened by your existence and will do its best to
stop you.

Screw up at Facebook, you get yelled at on Twitter and your share price dips
for a few days. Screw up a medical device, you get sued out of existence.

This probably doesn't explain the whole thing, but it is certainly related.

~~~
pavel_lishin
> _Screw up a medical device, you get sued out of existence._

Or, you know, people die.

~~~
Ingon
The most scary moment - one of the applications we've written was used to take
life-saving medications on time. Scary stuff I'm telling you.

~~~
stingraycharles
Off-topic, but I'm curious how you handled that situation. Personally, a safe-
guard I might build in would be to audit our code by an independent third-
party. Was this at all feasible in your situation, and/or how did you handle
QA?

~~~
Ingon
Well... External QA for app which costs 2.99$ (or less at times)? No. We just
tried to make sure it worked properly - some code reviews, several unit tests
to cover some nasty edge cases and that's it. I really hope everybody is alive
and well. :)

Also it did help that the users grew confident in it over time. It was not
like these overnight success stories (not even success story) which you hear
all over the news :)

------
haberman
In my five years at Google, I am not sure I have met a single engineer who is
"trying to figure out how to get Scott Hanselman to click on ads."

I _have_ met tons of engineers who work on interesting problems like building
models of query patterns to detect spiking queries (Google Trends and Google
Hot Trends, all publicly accessible: <http://www.google.com/trends/>), Gmail,
Maps/Directions/Traffic, improving (machine) efficiency of Google Search, and
tons of systems problems/architectures like MapReduce, Dremel, etc. And people
I haven't met are working on everything from Flu Trends to Driverless Cars.

This oft-repeated claim that Google is squandering a bunch of engineer talent
building things that don't improve humanity reflects a distorted view of what
Google engineers do, one that is easily refuted even by the publicly-
accessible information about Google's engineering accomplishments.

~~~
pekk
That makes sense. And I am sure engineers working on cool problems at Facebook
and other large companies can say the same. But there has to be someone
thinking about how to get people to click on ads at these companies, because
selling ad clicks is their bread and butter. Right?

~~~
Evbn
There are ads and there are ads. Spamming you with Brand awareness billboards
so that you buy Frobulous instead Snaztacular (both produced in the same
assembly line and recipe) at the grocery store is one thing, helping you find
a good deal on a product you are searching for (even if you don't know its
name) is another

~~~
TeMPOraL
The former is done by ads. The latter by communities and volunteers.

I'm yet to see an ad that wants me to find a good (for me) deal on a product
_I_ want.

~~~
chronophilic
Part of the rationalization I have made for creating ads is that proper
targeting gives exposure of products that people would actually need/want.
When scaled up to millions of people this specialized ad delivery allows for
much greater diversity of products and solutions in the marketplace. Ideally
this should lead to less of a "winner take all" effect in a group of
competitors and would allow for more niche solutions to be catered to and
sustained.

Certainly I would never say this goal is comparable to anything in medicine,
but the domain does have ambitions beyond simply making money.

------
johnbender
It appears that Diabetes research receives over a billion in funding each year
just from the NIH [1][2]. As far as I can tell this doesn't include private
funding for cures/treatments.

Maybe I'm misinterpreting the data here, but it looks like many people and
many millions of dollars are devoted to solving real world problems like the
one Scott Hanselman has.

[1] General Disease research numbers
<http://report.nih.gov/categorical_spending.aspx>

[2] Diabetes funding by project
[http://report.nih.gov/categorical_spending_project_listing.a...](http://report.nih.gov/categorical_spending_project_listing.aspx?FY=2011&ARRA=N&DCat=Diabetes)

~~~
clivestaples
I've had Type 1 diabetes for about 20 years now; it's a little bit of pain in
the ass, but I don't get why people bellyache about it so much. Blood sugar
meters? Check. Fast-acting insulin? Check. Insulin pumps? Check.

Blindness, amputation and kidney failure are no longer guaranteed and I'm
grateful as heck for that. For now I'll count my blessings: one of which is
the fact that my wife has yet to find me laid out in a diabetic coma --
something that was very, very common less than 50 years ago.

~~~
frabcus
My dad had type 1 diabetes. He had all the problems you mention, and died when
I was 11.

Yes, died essentially because the equipment wasn't as good back then (he was
born in the late 1930s, died in the 1980s) as it is now.

He also taught me to program when I was 7 (by pairing together on a ZX
Spectrum!).

~~~
clivestaples
I'm sorry to hear. That he experienced so much pain and suffering, and that
you lost him so young, is exactly the reason I can't feel sorry for myself
(and no other diabetic should either).

Awesome that his hacker spirit lives on in you...

------
cynicalkane
Bad incentives.

Maybe smart people don't care about money all that much, but they want their
lives to not suck, their effort to not feel wasted, their identity not wrapped
up in the service of dysfunction and politics. There are not many places where
you can better humanity for a living and live the life such a person deserves,
and it is not the job of humans to sacrifice themselves for no reward. That's
why people who do so, effectively, are so rare.

Here's a guy who left the ivory tower for Google:
<http://cs.unm.edu/~terran/academic_blog/?p=113>

_I’m concerned that the US — one of the innovation powerhouses of the world —
will hurt its own future considerably if we continue to make educational
professions unappealing._

~~~
oh_sigh
Is there any indication that education needs geniuses? Does it substantially
improve innovation? When America was world dominant in innovation, were its
geniuses in academia, or industry?

~~~
SoftwareMaven
So Sweden is ranked as the "most innovative" country, with the USA coming in
seventh. Switzerland and Singapore beat the US also.

Yet I can't think of a single innovation I've seen from them. Good
governments, great fashion, cheap furniture, sure. But what is the innovation
they speak of?

Fwiw, Iceland was number one last year. Was it for their constitution?

My point is that I don't think you really have to look into history for "when
American was dominant in innovation". (And this is coming from a major cynic
of current affairs in the US!)

~~~
subsystem
"Yet I can't think of a single innovation I've seen from them."

<http://www.thelocal.se/15578/20081110/>

<http://en.wikipedia.org/wiki/List_of_Swedish_inventions>

[http://www.du.ac.in/fileadmin/DU/DUCorner/pdf/14812_IR_Examp...](http://www.du.ac.in/fileadmin/DU/DUCorner/pdf/14812_IR_Examples_Photo.pdf)

It can be noted that most people studying engineering in Sweden go on to work
for companies like ABB, Volvo, Ericsson, Scania etc.

------
shazow
Why do we play videogames? Why do we create art? Why do we eat tasty unhealthy
foods? Why do we go on hikes or climb rocks?

Why do we write posts complaining about other people not saving the world?

We do things we enjoy, things we're passionate or curious about, things we
care about or have no choice but to do them. Glamour is a factor. Money too.

Perhaps if I had diabetes, or someone very close to me was suffering from the
disease, then I would spend some time thinking about how to more efficiently
manage one's blood sugar levels. Perhaps if I were closer to the realities of
obesity, then I Move You (my former startup focused around getting healthy
through social pressure) would have worked out differently. I learned that
this isn't something I'm passionate about, but I know there are others who
are.

~~~
Draiken
But this just states what this generation lacks the most... Empathy.

I couldn't care less if Facebook didn't exist because humanity focused it's
work into solving real problems. But some people just don't care. As long as
they are living their good life... who cares about diabetes?

The biggest problem IMHO is our generation's goals. Money, money and more
money. If the world provided better ways for us to help each other instead of
distracting us, while they suck work and money out of us, until we die.
Imagine how different everything could be...

~~~
bluekeybox
As someone who left biomedical field and moved into tech, one of the biggest
reasons for my move is that I have a distaste towards relying on guilt in
order affect things (this probably goes back all the way to my childhood and
my parents' use of guilt in order to affect my own decision-making), and that
I generally dislike people who rely on it to further their causes.

I will work hard if there is an incentive. I _will not_ work hard because
someone is trying to guilt-trip me to.

------
DigitalSea
I hate to sound rude, I mean well. But why the fuck is Raganwald whining about
start-ups that aren't solving real problems instead of solving the problems
himself? That's what really irks me about today's society. People bitch and
whine about things, wanting people to change the world and yet don't do a
single things themselves to make it happen. I hate the mentality that it's up
to everyone else to solve serious problems when Raganwald is wasting his time
whining about people not solving real problems behind his computer screen
oblivious to the fact there are people out there trying to make a difference.
Curing things doesn't happen over night. After the initial study, it can take
upwards of 10 years before a new drug can come to market.

Maybe people aren't solving medical issues because it's not easy. Case in
point: a man by the name of Thomas Shaw engineered a syringe that after it's
use the tip retracts inside of the syringe to prevent people from jabbing
themselves, an obviously genius idea, right? He's worked on the design for
over 15 years and has failed to crack into the market, although accomplished
many other notable contracts and things other budding start-ups wanting to
crack into the medical market could only dream of. Other companies have copied
his device, he's had to fight even though his device has been proven to be the
best in comparison to others.

The medical industry is not only tightly regulated, it's heavily infiltrated
by super lobbyist groups. Doctors taking kickbacks for exclusively using a
particular medical supplier or company regardless of safety or price.

Having said that, what makes this guy think people aren't out there solving
problems? While diabetes is a serious medical issue, it's manageable. But I
would much prefer resources are allocated to illnesses where they're only
treatable for so long before you die, like you know cancer and leukaemia. Be
grateful you have a condition that if managed properly you can still live a
normal life unlike those who are bed ridden and slowly dying from cancer
because even though the treatments they have can cure them if caught early
they make you extremely sick in the process.

~~~
desireco42
He is just starting conversation it seems. I agree that we should do more
about things that matter and in that, most posts to this are right.

~~~
ruswick
I don't think he succeeded in starting any kind of conversation. He just sort
of screamed vehemently at the internet, eliciting what appears to be a general
backlash from HN.

Writing a blog post comprised heavily of expletives that most people
immediately reject is not really promoting a discourse.

------
bhickey
Because research pays terribly and not everyone has the luxury of martyrdom.

Want to be a grad student? 80-90% pay cut. (Unless you go to Switzerland and
then it's closer to 70%).

Want to be a university research programmer? 70% pay cut.

Removing economic considerations, would I rather be researching auto-immune
disease? Sure. But 'doing good' means compromises like buying a house at 45
instead of 35.

No one asks doctors to make these compromises.

Edit: If someone wants to deposit $2m in my bank account I'll quit my job on
Tuesday and go to grad school.

~~~
olivier1664
"buying a house at 45 instead of 35" is an economic considerations, no? ;)

In the case you had $2M: Have you consider that reasearch problem are far
longer and thus far less exciting than the ones we, programers, are used to
solve?

~~~
bhickey

        economic considerations

Erm -- look over there.

    
    
        pile of money
    

Yes. I did research as a student and as a research programmer / computational
biologist. I was just an author on a paper for work done three years ago.
There will probably be another one being written up in a year or two.

------
MatthewPhillips
Who says programmers are the greatest minds of our generation?

~~~
oh_sigh
Generally their bank accounts.

~~~
majormajor
There are pretty good ways to make a good deal more money more predictably
than working at Google or playing the startup lottery...

~~~
oh_sigh
I wasn't saying that any given programmer was the best mind of their
generation - just that many of the best minds of these recent generations have
been programmers, or involved in technology development in some manner.

And what are some of the "pretty good ways to make a good deal more money more
predictably" that you're referencing?

~~~
comicjk
Uh, finance? Maybe this isn't as obvious to a non-New Yorker, but that seems
to me like the easiest way for a smart person to make money.

~~~
oh_sigh
Except that it isn't at all easy to get into finance, and the profits are not
guaranteed in any case, as you seemed to imply.

~~~
polshaw
_> it isn't at all easy to get into finance_

so.. you are saying you need to.. be one of the best minds?

------
justsee
Elon Musk chose to do PayPal (a rather disliked company on HN) which enabled
him to work on Tesla, SolarCity, and SpaceX (which HN rather likes).

Isn't it possible that some of these people toiling away in the corporate womb
are acquiring capabilities and capital so they can be reborn to do important,
but potentially unprofitable 'change the world' projects?

~~~
whatusername
Paypal is awesome.

It's 2012 and I'm still not aware of any other company that allows me to sign
up (for free) and start taking payments straight away (for arbitrary items no
less). See also: <http://www.paulgraham.com/schlep.html>

(Note: Stripe have a schlep blindness in International Transactions. I still
can't sign up for Stripe. Last Week I was recommending a friend use paypal)

~~~
zt
I work at Stripe and we are working hard on rolling out our products
internationally. I am sorry you cannot use it yet and that you can't recommend
us to your friends yet.

It takes time to do right--it's a schlep--as we want to make sure that the
experience is as dead-simple everywhere. "Fixing payments", as PG put it in
the Schlep blindness essay, involves working with new banking partners and new
back-end infrastructures to make it as easy in every country.

------
YuriNiyazov
Because most people, Facebook programmers included, don't have the patience
and the resources to undergo the amount of schooling necessary to reach the
level of understanding to make an impact in these areas; and after they do,
the amount of bureaucracy they will need to fight to make a dent will drive
even the most resilient minds to take a job getting people to click on ads.

~~~
bhickey
Disagreed. It isn't a matter of patience, it's all about incentives.

Almost all people who are smart enough to make a difference aren't foolhardy
enough to make terrible economic decisions that will drastically reduce their
quality of life.

The existence of economics PhD students still baffles me.

~~~
shadowfox
> The existence of economics PhD students still baffles me

Interestingly, I have met many in the sciences that feel the same about
computer science.

~~~
bhickey
Perhaps we can chalk it up to the economic ignorance of CS grad students.
There's no such explanation for econ students. :)

------
jholman
Okay, wait, what? You seriously think that Google isn't making huge positive
impact on humanity? I mean, please discount the following argument based on
the admittedly-confounding fact that I have drunk the kool-aid and am on
payroll, but...

First, I claim that the improvement from searching with AltaVista etc, to
searching with Google, has made the web orders of magnitude more useful. And
Google search continues to get more effective.

Second, I claim that the web, as an information-interchange platform, is
hugely impactful to society, on the same level as curing diabetes, and more
useful to society than the kind of incremental improvement in diabetes
management that was Raganwald's case study.

Third, I claim that making hugely awesome projects profitable (or at least
sustainable) is part of making those hugely awesome projects actually have
impact. With no revenue ever, Google wouldn't be able to have all the positive
impact it has.

Fourth, Google has done and is doing lots of other shit that is also hugely
impactful. Along with, let's all explicitly admit, lots of bullshit stuff that
it's fair to mock. Google Books. Google Health (which admittedly failed).
Mother-fucking Maps and Earth (which admittedly were _founded_ outside of
Google, but were bankrolled into awesomeness by Google ads). Maps and Earth
are a big deal in solving real-world macro-scale ecological problems, even
aside from the huge convenience they provide their normal users. Google.org.
And in the sexy-so-it-must-be-bullshit department, the self-driving cars
_could_ save hojillions of lives and help reform oil dependence.

So if you want to decrease "useless busywork", and you want to increase real
solutions to real problems that affect real people, Google is doing that. And
also some bullshit stuff involving social/mobile/local whatever whatever.

------
kogir
Judging by all he's accomplished at Microsoft, I'm sure Scott could
successfully lead a team to solve his problem and bring a product to market.
But he doesn't.

I (luckily) would not have use for such a product. If he doesn't care enough
to tackle the problem, why should I?

Same goes for Obesity. Most of it could be controlled by changes in diet and
behavior. If people affected can't be bothered, why should I care?

~~~
shanselman
I didn't know my friend @raganwald was writing this post but I thank him for
his outrage.

That said, I've already put a product to market in the mid-90s. I wrote
GlucoPilot, the first portable blood sugar management software for the
original PalmPilot. I worked a lot in the diabetes and healthcare space. I'm
tired though, and I did my part for now. Now I guess I'm just complaining.

As far as obesity, I agree that's totally unrelated to Type 1 diabetes and I
share your opinion. Move more, eat less.

------
lindowe
There are a lot of interesting startups right now in the mobile health space,
but it is a significantly more difficult space to operate in. It takes years
to get FDA approval for new medical devices, the healthcare industry is
beholden to several large industry players, and the culture of medicine is
resistant to rapid innovation. I understand and echo your frustration that
silicon valley often only pays lip service to 'dangerously ambitious ideas',
but there are also real reasons why people don't operate in these difficult
business environments.

~~~
azernik
As an example, Glooko makes a mobile version of a glucose logbook that reads
data straight from a sampling device - useful, but not earthshaking. But to go
from that data to automatic reminders and advice about managing glucose levels
- what raganwald wishes existed - would require a much more stringent level of
approval from the FDA.

~~~
glennos
I used to work next to the guys from mySugr. They went through the process of
having their app certified as a medical device by the European Commission,
(the CE or Conformité Européenne mark). Not easy, but doable. I'm not sure
whether it gives explicit recommendations, but it let's you identify patterns
based on what you're eating and the activities you're doing.

<https://mysugr.com/>

~~~
f-debong
Hi glennos! Nice to meet you here!

We are now getting FDA approval too. Good fun.

Regulations are a bastard, but there for good reasons. Imagine getting a med
which wasn't tested and which is made in someones bathtub… Exaggerated but you
get what I mean?

------
Shenglong
My friend is in the process of completing his residency in emergency medicine.
When I asked him what the most difficult part of his job was, he told me,
"having to see one obese person after another, knowing what I tell them will
almost certainly have no impact."

Lots of people have already mentioned the incentive factor (well covered by
Bill Gates in his comment about baldness:
<http://www.ted.com/talks/bill_gates_unplugged.html>), so I won't speak about
that. Rather, it might be worth thinking what solving these _real problems_
involves.

Fixing obesity? Working with obese people day in and day out, trying solution
after solution with no success? It's not just that these things aren't
glorious - but they're also soul crushing. When you make a social network,
people around you get excited for you. When you make a weight-loss
application, well... not much happens.

For an industry that is already prone to depression and mental illness, it's
not entirely difficult (although it may not be right) to see why things have
developed the way they have.

------
moultano
Lots of people in the Googleplex, including my team, are working to make sure
that when Scott Hanselman types [blood sugar monitoring] into Google he gets
useful results. I'm working on this because I believe it to be the most
important thing within range of my skills and experience.

People at Facebook are working to allow Scott Hanselman to be able to find
friends of friends with diabetes to ask for advice.

~~~
shanselman
Agreed and both are truly useful and greatly appreciated.

------
chewxy
Because those who can market themselves lean to 'easier' spaces.

Think of it this way. I'm a very terrible programmer. My understanding of the
O notation is abysmal at best. If you ask me to write a distributed database,
I probably won't do a good job at it.

But you know what I can write? Webapps! Any Tom Dick and Harry can write them.
People who can market themselves well and can write the easy stuff wins. And
with that comes the compound effect of the rich getting richer.

Example: I write the next social network and I market the hell out of it. Now
I'm the cool company that people who are really good in computer science want
to join, since you know, I've scaled out to the point where data is big enough
to warrant the term 'Big Data', where information retrieval is now a problem.

Imagine instead if I were say a very very good biologist. That also typically
means my focus is very very narrow, and doesn't lend itself to marketability.
I cannot start a company saying I want to create a drug that turns off
production of the PRSS3 enzyme. No, I'd have to market it as "I am creating a
drug cure for prostate cancer". But I can't and I won't (if I am being honest
with myself), because all I know about prostate cancer is the PRSS3 enzyme.
There are other factors that causes prostate cancer.

People who are experts in their fields are generally stuck on the narrow field
they're in. A PRSS3 researcher would know everything there is to know about
the PRSS3 enzyme. He/she would probably suck at marketing it though. Same with
say, information retrieval experts. The people who don't give talks at XYZ
conference. The people who work behind the scenes, engineering everything -
they don't market themselves well.

As a result, the people who best market themselves win. The easiest things to
make are also usually quite easy to market.

tl;dr: people flock to 'easier' spaces because that's what's easy to market
to. Programmers flock to the latest SoLoMo startups, because SoLoMo is easy to
market to hackers.

wow I'm so ranty today

------
quasque
Funnily enough, this is exactly why I gave up on software development and went
to study a degree in the biosciences.

Ten years of fixing crappy websites, writing dull database interfaces,
troubleshooting bugs in shit code written by people who didn't give a damn --
and for what purpose? The paycheck was good but money is not everything. It
felt like such a colossal waste of life.

My mind is my best asset - I want to apply it to something that will actually
make a difference and help people. And it isn't going to happen in software or
IT.

Anyway, I'm well on my way to working in biomedical research as a career, so
this has really paid off. Already interned in a lab for a while and it was
amazing, just the feeling of finding out something new and real, even if it
takes months, is such a rush. The previous software experience came in very
useful too.

~~~
vacri
I've gone the other way. I started out as a medical tech. It's the same thing
every hour, every day. Usher in a patient, do a test. Usher in a patient, do a
test. There's no real scope for 'using your mind', but you are directly
helping people. At least I saw patients - some medical scientists do nothing
but pippette things all day, doing pretty much the same thing as assembly-line
factory work. I know one that got RSI of the elbow from endless pippetting.

If you want to 'use your mind' to help people, then either get a job that has
some form of diagnostics in healthcare, or build healthcare products in a
company in the industry. I moved from medical tech to support at a company
that made our equipment to R&D in the same company. You can still do IT things
and help people in a medical sense. Just because you don't see the patients
directly doesn't mean that the software you build isn't helping them.

It sounds like you've found a good place to be, but I thought I'd throw in my
2c that IT is not a sort of 'by definition not helping'.

~~~
quasque
Sorry yes I was being rather general and should clarify that I ended up down
the wrong path in my software work, didn't feel that I could change to
anything more interesting - and really just desired a fresh start.

I do appreciate that there are fields in IT where one can make more of a
difference, and I hope it works out well for you!

------
RoboTeddy
Probably because profit is only somewhat related to delivering actual utility.

~~~
hammerdr
Is profit the main driver? Should it be?

~~~
oh_sigh
Be the change you want to see in the world. Feel free to quit your job and go
bankrupt while trying and most likely failing to make the world a better
place.

------
will_brown
As it relates to developing pharmaceuticals and medical devices they generally
require FDA approval. Please watch "Burzynski Movie: Cancer is Serious
Business" it is about a Dr. who patented non-toxic cancer treatments that have
better "survivor" rates than surgery+chemo on many types of cancer and it has
even treated certain brain cancers in children that have never been
successfully treated by current treatments. The Movie documents the FDA's
continued harassment of the Dr. on behalf of big pharmaceutical companies,
including multiple criminal charges that the Dr. was always acquitted for.
Included is footage of Congressional hearing about this matter and a direct
question to the FDA Director as to why the Dr.'s applications for FDA trials
were repeatedly denied when his treatments had cured certain childhood brain
cancers, and the response was he never had and never will approve applications
unless they are from big pharmaceutical companies.

The best minds are busy preventing the best minds from taking a piece their
pie (ie. Google protecting its market share), for the best minds to be busy
making a difference (this is simultaneously why none of us have privacy on the
internet, we cannot enjoy an internet experience without a bombardment of adds
and why cure of diabetes is not the focus but rather treatment.

------
chaostheory
I feel that Jolie O'Dell had a more eloquent rant on the same subject:

"However, more and more, I am royally pissed off that so many bright
engineers, good entrepreneurs and capable venture capitalists are throwing
resources into problems that no one really has. They’re creating “bread and
circuses” in a digital format — apps that are wildly popular, infinitely
entertaining, and exactly what people want.

The only problem is that they don’t really do anybody any good. They’re not
doing what technology is intended to do: Solve problems."

[http://blog.jolieodell.com/2010/10/07/bread-and-circuses-
the...](http://blog.jolieodell.com/2010/10/07/bread-and-circuses-the-state-of-
web-app-startups/)

------
mahyarm
Seeing how pharmaceutical companies and other medical related things have a
lot of money thrown at them world wide, I think that isn't the case. Computing
isn't the only place where 'the greatest minds of our generation' reside,
there are a lot of them in the medical community.

Also there has been a recent trend of quantified self and medical start ups
starting to gain traction, such as fitbit, mybasis.com, the tricorder xprize
and so on. For quite a while it's been a software only world and just now we
are starting to see an uptick in consumer electronics start ups.

Not everybody can work on curing cancer.

------
uladzislau
The answer is well known. All challenging real world problems require deep
domain knowledge besides programming.

You need to have medical expertise to even consider providing solutions to
people with diabetes.

That's why we have 100:1 ratio of useless, solving not existing problems
projects to world changing ones.

------
crazygringo
> _Why the fuck are programers strategizing how to pivot Facebook into being a
> dating site?_

Umm... finding and getting a date with the right person can eventually lead to
marriage, incredible happiness, new children in the world... seems like a
pretty worthy goal to me.

------
maxcameron
Reginald strikes again!

But the real question is why a mind as bright as Reg is doing biz dev at a
services company in Toronto? Shouldn't he be saving the world?

------
seanduffy
I'm the Co-Founder & CEO of Omada Health (<http://omadahealth.com>), and any
engineers who are keen to help make a dent in the diabetes and obesity crisis
should please reach out. Our company has built a web-version of a landmark
clinical study called the diabetes prevention program (<http://goo.gl/shiaw>)
to help the 78 million people with prediabetes from progressing to full-blown
type 2 diabetes. Diabetes prevention is absolutely possible, and there are
technology and design solutions that can help.

sean@omadahealth.com

------
Zarkonnen
My father spent most of a decade running a company developing a non-invasive
blood sugar meter: [http://www.diabetesnet.com/diabetes-technology/meters-
monito...](http://www.diabetesnet.com/diabetes-technology/meters-
monitors/future-meters-monitors/solianis-monitoring-ag)

After many years of struggle, the company folded from a lack of investment:
medicine investors were scared off by the tech component, and tech investors
didn't understand that in medicine, you have to prove, with studies, that your
treatment or device actually works. This takes time, and frequent trips back
to the drawing board.

------
steveplace
Why the fuck do we see this complaint pop up on HN every quarter?

~~~
glesica
Maybe because it is something HN readers worry about. Seems like a pretty
reasonable explanation...

------
seehafer
If you knew the difficulty/incentive trade-off involved in making sugar
management easier relative to that involved in getting people to click on ads,
you wouldn't ask this question.

If web application developers had to jump through the same hoops that medical
device developers did we'd all still be using AltaVista.

------
sshillo
Because curing cancer and solving major issues doesn't make money right now.
It takes major investment and years of research for something that may or may
not give return.

Further, google is solving big problems. How bout better internet service,
cars that drive themselves, making computers more accessible, a universal
translater, etc.

How bout the fact that many of the top grads from schools go to work in
finance. If we could get all those people to go work at google, the world
would be a better place.

------
rickdale
The one word answer to your question is MONEY. Thats why the fuck. Also an old
proverb from urban dictionary tells you, don't hate the player player hater,
hate the game.

------
abrahamsen
Not sure about the world, but the smartest people in Denmark are likely
working within the Novo Nordisk domicile, trying to work on better ways to
manage diabetes with second-by-second efficiency.

They don't post a lot here, because honestly, this site has few stories that
matches their interests.

It is rather arrogant to believe that the greatest minds of our generation are
to be found in our field, and not e.g. in biomedicine and other fields more
relevant for diabetes treatment.

------
scottilee
Raganwald,

Have you considered asking yourself this question? You "take the friction out
of writing and selling books." You could start with yourself and helping with
Diabetes.

------
snitko
The incentives are in the wrong place. It's not that entrepreneurs don't want
to work on important things, but rather that important things are regulated by
the government. Good luck waiting 2+ years and spending millions waiting for
your blood sugar measuring device approved by the FDA. It pays to work on
Facebook-like things because government has not yet spoiled the internet with
endless expensive regulations.

------
brudgers
My son doesn't trust my recommendations in books. It's justified. He'd been
reading a fantasy series. I recommended _Sword of Shanara_. He thought it
sucked. Fair. I thought it sucked when it came out. I was the same age.

Yet, when I pulled _Hitch Hiker's Guide to the Galaxy_ off the library last
month, the title pulled him in.

"Flying is the art of throwing yourself at the ground" is a hit in middle-
school. But that's not the part Reg got me thinking about.

 _The other two-thirds, of course, stayed at home and lived full, rich, and
happy lives until they were all suddenly wiped out by a virulent disease
contracted from a dirty telephone._

I'm in agreement with Reg. To a point. He is able to share his thoughts with
me here, not because someone was seeking a cure for diabetes, but because
someone wrote software to automate the building of web storefronts.

While steely eyed missile men took us to the brink of nuclear war, a B-grade
actor, a lawyer, a playwright and a longshoreman helped bring down the iron
curtain. The idea that we should seek work which matches our nature goes back
to Plato's _Republic_. We don't know in advance phone sanitizers important.

~~~
charlieok
I assume the B-grade actor is Ronald Reagan, yes? The lawyer could be almost
any politician and I'm drawing a blank on the other two...

~~~
brudgers
Gorbachev, Havel, Walesa.

------
saurik
> even if they don't sound glamorous when writing a "Show HN" post

Is this true? I feel like "Show HN: technological solution that allows people
to forget they have diabetes" would cause a "woah, that's awesome" reaction. I
mean, for another example, imagine "Show HN: I'm 14, please check out my fool-
proof iOS dieting app"; or, at the far end of the scale, "Show HN: my weekend
project - I cured cancer". I feel like these would be pretty "glamorous";
like, sufficiently so, that I'm having a difficult time keeping a straight
face writing the titles of the posts, as they come off as the kind of thing
way too epic for a "Show HN": if I saw these headlines, I'd immediately think
"yeah, whatever, obviously total BS; maybe let's check out the comments to see
what they failed to take into account" ;P.

------
sajid
The greatest minds of our generation are not working at the googleplex. They
are at universities and research labs working on math, physics, molecular
biology, etc.

------
jerf
<http://www.glooko.com/> ?

------
mikle
Is the author of this is currently working on curing diabetes? I think the
chances are small he is. What I'm trying to say is that he is a hypocrite.

~~~
ruswick
I don't think so. In order to be a hypocrite, one needs to criticize a group
into which one fits. However, the post explicitly referenced our nations
"smart people," or whatever phrasing he used. Evidently, he doesn't consider
himself sufficiently educated or academically positioned to pursue cures for
diabetes, so it's permissible that he criticizes people who are in such a
position and choose not to cure diabetes. This is why people who are not
professional football players can still criticize a team: they are not members
of that team and do not have the capacity to improve the performance of the
team, so there is no hypocrisy.

Although this post is arguably bullshit for other reasons, it's not hypocrisy.

~~~
mikle
So you think he is talking to that department at Google full of MDs? :)

Just to make sure I got the point across - the above joke was meant to say
that people working in Google usually are also not sufficiently educated or
academically positioned to pursue cures for diabetes. Being a programmer is
not some aptitude test that means you can do anything. I'm a great programmer
but I can barely watch House MD without cringing at the sight of innards or
blood.

------
namank
Oh my god why does every god damn person, including the author, think they are
incapable of stuff?

Fucks sakes people, you don't need to learn physics or chemistry or math or
whatever. You bunch of perfectionist want to learn the science when ALL you
need to do is learn how to apply it.

EVEN if you're technically incapable, think about how you can make someone's
life better. How you can help someone feel better about themselves. Go figure
out how to solve a human problem if you can't do technical ones.

But, no matter what, do not give me excuses as to what you can't and why you
can't. That, sirs and madams, is unacceptable. All of us, within our current
skillset, have some knowledge that the world can directly benefit from. Find
it, own it, be it.

------
desireco42
Why to fuck do you think that overweight people are the real problem, I would
think endless wars and poverty and living on this planet without destroying it
would be real problems.

I agree that masses of people are working on ridiculous problems, it is like
those people in wall street working on how to squeeze out few pennies more
during a trade. In part, it is because we live in capitalism and money is only
measure of success, so if you make 40K and i make 60K, I am better then you
and 150% better to be precise :).

Plus, these other problems are really hard and if you start tackling them you
really stir up things.

I believe Elon Musk is, for example, a guy who is trying to work on real
problems.

------
thewisedude
I usually dont like to talk in sound bites. But I can't help but say this
famous quote from Gandhi.

Be the change you want to see in the world.

This article has a very judging tone. People are doing whatever they think
matters for whatever reason - Its their choice. If you think Physics/Chem/Bio
research is more important than dating, please be the guest of the world....
learn it and do it!

If you improve dating (to sufficient levels) and people are having better
marriages and in turn healthy family structure that could possibly be more
effective(in some measureable way) than say finding cure for some disease. So
I dont buy that doing a dating service is worser!

------
jiggy2011
I don't have a degree in medical sciences so I have no idea where I would
start.

~~~
ihnorton
Some suggestions:

Help build better tools for researchers. * Julia (julialang.org) is very
promising and could use talented developers to help build the ecosystem. *
Numba (<http://numba.pydata.org/>) looks amazing and should build on the
existing strength of SciPy.

Contribute to open-source projects related to medical research; a few
favorites in the imaging space: * PLUS
(<https://www.assembla.com/spaces/plus/wiki>) * OpenIGTLink
(<http://openigtlink.org>) * XTK (<http://goxtk.org>) * NiPy
(<http://nipy.sourceforge.net/nipy/>)

Contributing to an open-source project would give exposure to the problem
space while leveraging existing skills and _not_ taking a huge initial risk
(school or paycut). If you wanted to make this a full-time pursuit, such
contribution could be leveraged: many labs would love to hire a talented
programmer. However, expect a ~30-50% haircut (in hospital or university labs
you will have a hard time cracking $50k to start and $70k on the high end).

I am familiar with open-source projects in a number of other medically-
relevant research areas. If you are interested in some specific area, shoot me
an email and I'll see what I can think of.

~~~
jiggy2011
Those do indeed look like some incredible projects.

If I had more time (and judging by the docs better linear algebra skills) I
might certainly be interested in these.

I hope that some smart hackers do take you up on this.

------
studentrob
You don't need great skills to make an impact. I work in Cambodia and there
are plenty of opportunities for web developers to bring opportunities and
learning here for the local culture. Also I would compare the existing base of
developers here to what I imagine it was like in the US in the 70s. Computer
Science is just picking up steam and the folks who learn it are very bright.
Quite a cool climate to be in, in my opinion. Cost of living is dirt cheap,
you have all the western amenities, and internet is fast enough (5 Mbit down
via my phone).

------
agentultra
I suspect the rewards of an academic career are not on par with or even close
to those of a career on the commercial path. The cost of tuition is
prohibitive for most families and the rewards of a teaching/research career
are mediocre at best compared to one in on a commercial track.

As well most schools have incentives to place students in commercial careers.
It's what parents and students expect these days from an educational
institution.

Finally it's extremely easy to get started and learn enough programming to be
dangerous and difficult to learn enough to produce real innovation.

------
waterlesscloud
A year or two ago most of the responses to a blog like this were along the
lines of "But facebook/google/mystartup _is_ trying to change the world."

Now people don't even bother with that line.

That might be progress, actually.

------
nbashaw
Because it creates value, whether or not you approve or understand it. Fun and
entertainment are what most people spend most of their time seeking. Simple as
that.

------
opminion
Because the diabetes researchers use Google.

------
kolleykibber
Why is this upvoted..? HN needs a homer simpson exclaiming boorring. Let's
tell the truth. At least they're not bankers. The world is truly getting
better,

------
confluence
Simple. Ad work pays better and is less hard work. Same reason people become
radiologists and gps instead of working in the er.

Make the other shit pay better and you'll be flooded with applications. I only
live once and I don't intend to be a sacrifice on the altar of science when I
can easily live a great life pushing cat pictures to a sedentary work force.

Do I feel bad about that? Not really. I have bills to pay.

------
MisterBastahrd
Individuals are motivated by different sets of wants and needs. Financial
security just happens to be damned near at the top of the list.

------
jowiar
2 brief points:

Consider the amount of human innovation dedicated to killing other humans more
efficiently. Ads are an improvement.

Also, analysis techniques and technologies developed and funded with the goal
of selling more ads translate to other fields, making life easier for
researchers there. Just because the short term goal isn't curing cancer, that
does not mean the work does not bring us closer.

------
orangethirty
The line reached the restaurant's entrance. It was 12:00pm, people were on
lunch break. Orders came in as Confederate batallion ready to strike us down.
There I was. In the middle of everything. Knowing how the software that took
the orders worked (and how to write it), and working in that restaurant.

Why the fuck?

At that moment, it was one of the choices I had. Being smart does not give you
unlimited amount of choices. It only means that you can understand some things
better than others. It does not grant super powers. Or even connects you
socially. You are just _smart_.

Why are the smartest minds doing those jobs? Maybe they don't have a choice.
In reality, few people (percentage wise VS. general population) are equipped
to start, grow, and operate a successful business. Smart people can't just go
and get funding and cure Cancer. Shit don't work that way. There is a lot more
needed than being smart to do so.

Instead of asking why the fuck, focus on _how the fuck can I build something_
to allow this people to build the cure for Cancer.

------
a_bonobo
If you're interested in working in bioinformatics, use Google to check for
your local university and drop a mail to any of the bioinformatics groups,
interns and research assistants are always great!

We love to have someone on board who's a) motivated and b) actually knows what
he/she's doing, not many bioinformaticians know how to "properly" code, it's a
lot of dirty hackish stuff.

------
shaunxcode
I can only speak for myself: When I was younger I had nothing but the loftiest
of goals. To implement the cybernetic fantasies that had been suggested to me
either directly by my favorite authors, or by my imagination connecting the
dots of how the world I longed to live in could exist.

I got older. I realized it was going to be nigh on impossible to get a large
enough user base for anything of that sort to exist so I settled into a cycle
of keeping a straight job whilst I focussed on tool refinement as a form of
procrastination. "Once I have the perfect platform..."

I doubled down on my critical theory. Maybe once I REALLY understood what
marx, beer, derrida, lacan, mcluhan, and debord were REALLY saying my next
steps would be clear.

I became stuck. Entirely aware of the complexity and futility of the "all".
For now I wait and attempt to inspire those around me to take a deeper look
into their cybernetic heritage (past and future). Keep on refine, keep on
read, keep on eval, keep on print.

------
thechut
Well said, people need to focus on real world problems.

On the diabetes note, I'm close friends with the founders of Jerry the
Bear[1], who's primary goal is helping kids with diabetes. There are startups
out there doing real good, but they need to get more exposure.

1\. <http://www.jerrythebear.com/>

------
djt
My friend has a insulin pump similar to this

[http://www.medtronic-diabetes.co.uk/product-
information/para...](http://www.medtronic-diabetes.co.uk/product-
information/paradigm-veo/index.html)

This seems to be a solved problem, if only someone could make a way for people
to search out such things via the internet ;)

~~~
thedamon
Solved problem? Not even close.

Having an insulin pump is equivalent to doing frequent insulin injections more
easily and calculating what your dosage should be in a more complex way. Still
requires tons of attention to make sure your insulin sensitivity ratings etc
are accurate. I've heard from endocrinologists that patients on insulin pumps
tend to have hbA1C scores about the same as patients on multiple-daily-
injections. Insulin pump definitely does not 'just do everything for you'

Fun note: I have a very similar insulin pump. Up until a year ago when I
logged onto their 640x480 resolution Java Applet to upload my device readings,
it warned me that my browser was unsupported and that I should acquire
Internet Explorer 6 or higher. That's a good example as what we deal with as
far as tools to help us manage our diabetes ;)

~~~
djt
my friend has one and it is imbedded 24 hours and monitors giving top ups
throughout the day. I was commenting that the problem the author mentioned is
solved (ie measuring and injecting many times throughout the day).

Yeah that sounds horrible to deal with. Maybe chat with Fit Bit :D

Its not ideal by any stretch of the imagination but short of pancreas gene
therapy, it is an intervention rather than cure unfortunately

------
tunesmith
I don't get the sense that there's an obvious, simple solution here that is
just waiting to be implemented. I don't think it's that the only reason it
doesn't exist is just because programmers are choosing to work elsewhere.
Basically I think this question is probably built on faulty assumptions.

~~~
DanBC
I was really excited when Gates announced his foundation. Smart people, lots
of money, focussing on evidence based things that work or should work.

Even though they've done fantastic things it doesn't feel like we're much
closer to a cure for Malaria being developed.

Would the world be a better place if smart people weren't sending private
vessels to space or the deep ocean or around the world photographing every
road or onto the public roads with no human drivers? Like actors working the
lousy but well paid films to give them the cash to work on the good but low
paid films we need the cat pictures and social buttons and advertising to give
companies the funds to do exciting things.

Having said that, anyone facing burnout in the industry should really consider
some humanitarian thing because there are problems looking for solutions
there, and more smart people can't hurt.

------
levlandau
"The market will be satisfied"--Marc Andreessen

i) It's probably never right to worry about technological stagnation. ii) Tech
solutions to big problems (including diabetes) never look like solutions to
big problems at the start.

I worry about startups that complain about regulations. Want to become the
hotel industry? Start by renting out air beds. For now maybe it's just making
some hardware that tells you how many hours a day you sleep. We all know that
the answers here lie in the data. It's a mistake to try an obvious frontal
attack on this problem though.

Maybe it's some hardware made by the guys up at Mountain View that you put in
front of your eyes that eliminates the ned for a guide dog because it talks to
you.

There are numerous (smart) engineers working on very useful and tractable
problems in these spaces. They just look like toys now... that's all.

------
tubelite
If you get right down to it, the end goal of anything and everything is
absurd. Life is a runaway exploding self-catalyzing chemical reaction and its
ultimate goal is the replication of aperiodic crystals. It so happens that the
replication process involves some fiendishly complicated side effects, rube
goldberg to the goldbergth power machinations (viz. multi-cellular plant and
animal bodies) which are very very interesting indeed.

So what if the smartest minds are focussed on getting clicks? That is only an
issue if there weren't very interesting side effects, like indexing megatons
of information and making it accessible by a simple search interface.

In fact, I would encourage Google to get its smartest minds to do focus on
insulting everyone in the universe in alphabetical order. Space travel, here
we come.

------
sakopov
Since we're talking about medical industry here, we're talking about insane
regulations because human lives are at stake. I personally believe that
software professionals working in this field must be professional engineers.
Much like every other engineering discipline where you are obligated to take
the blame for your actions. Unfortunately, given the current state of our
industry, I would have to say from experience that more than 50% of devs are
either self-taught or certified without any formal education. Not to say that
all of them are terrible devs, but it sure as hell doesn't look good for us. I
don't want people "hacking" medical industry like it's some kind of mind-
numbing picture-sharing app. I want people building better medical experience.

------
Mz
Hey, dude, I will probably make money from a webcomic at some point. People
like it when I am cute and funny. No one wants my "cure"* for cystic fibrosis.
So I will likely pay the bills by making people laugh, then sereptitiously
slip the health thingy under the door while folks aren't looking.

Chill. Life is more convoluted than you seem to think. For example, fiction is
how humankind dreams up the future. We collectively write about things like
traveling to the moon long before we do them. There are no small problems. Go
watch the movie "It's a wonderful life", examine your bellybutton more
privately for a bit, get laid or drunk or loose. Come back fresh.

Happy New Year.

* Not a cure, a means to be healthy in spite of the defect. Quibbling detail which everyone misses.

~~~
illuminate
"No one wants my "cure"* for cystic fibrosis.

* Not a cure, a means to be healthy in spite of the defect. Quibbling detail which everyone misses."

Your confidence in your anecdotes and bitterness that they're not taken as
fact may be seen as offputting. Try understanding why people may listen to
your experiences and not see them as an immediate path to follow.

Regardless of whether your "methods" are sound or not, there have been and are
plenty of well-meaning and sincere quacks throughout history and certainly
today, complaining that you are entitled to respect for having these
hypotheses isn't going to swing anybody your way who doesn't already believe
as you do.

~~~
Mz
I am curious why you feel the need to hound me and repeatedly use terminology
like "quack". That is generally not socially acceptable behavior. No one else
on HN does this to me. I wish you would stop. It isn't likely to accomplish
anything constructive.

~~~
illuminate
I'm saying that a change of tact is required if you're experiencing hostility
from the communities you wish to draw readers from. Realizing and working
around these preconceptions will be essential.

I use the phrase "quack" because these people exist in large number on the
internet, and there certainly exist people who offer promises to the disabled
community that they are not capable of delivering on. There's a very large
burden of proof that many persons would wish to meet to take a hypothesis
seriously. This isn't fanfiction, this isn't diet tips to swap, this, if real,
would be a lot of promise to people. Sarcastic comments about the people who
don't believe you implicitly are unnecessary, there are very real reasons why
these barriers to belief exist.

~~~
Mz
Listen, the remark above which you are currently criticizing was not bitter
and was not a complaint about my situation. It was intended to be supportive
of raganwald. Perhaps it utterly failed. No big.

If you would really like to help me, I would appreciate if you stop trying to
give this sort of "social" feedback to me, especially publicly. It isn't going
to help me. I understand the social challenges I face far better than you do.

However, there is a type of feedback I am in desperate need of and cannot get.
If your remarks to me actually are motivated by a constructive impulse, I
could really use some feedback, probably privately, to help me start turning
some of my stubs into posts. There is a yawning chasm in that regard which I
don't know how to cross and no one can tell me how to cross. I could use a
sounding board to help me bridge it. Otherwise, please just let it go. I am
making inroads on quite a lot of things.

Thanks.

------
JustARandomGuy
_Diabetes. Overweight. These are real problems, affecting real people, that
need real solutions..._

Doing healthcare projects requires dealing with hardware, dealing with
regulatory overhead, etc. It's much, much more difficult than building out
another web app for social/ads/etc.

~~~
sjs
Facebook has dealt mainly with software till now, but look at all the projects
Google has tackled. Self-driving vehicles, fiber Internet service, blanketing
cities with wifi, Google Glass, fighting for net neutrality. Google has the
talent, bank roll, and ambition to tackle something monumental that spans
hardware, deals with regulatory overhead, involves a lot of on-the-ground
grunt work, etc. Apple has the resources to tackle such problems as well but
hasn't shown the will to do things like street view or fight for net
neutrality, which is probably why people think of Google more than Apple when
they think of such problems.

------
ok_craig
I think one obvious point is that the minds dedicated to increasing ad
clickthrough generate the revenue needed for other great minds to embark on
projects like self-driving cars, glass, and, you know, only indexing the
entire internet.

Also, not everyone on the planet is interested in becoming a doctor. People
have different interests. The ones who are not people who want to solve those
problems, instead support the economy that allows people who are doctors to do
their work and make scientific advances. To simplify, if we were all capable
of working on these things, and we all did so, it wouldn't be any better
because we'd all die from lack of food, because none of us are doing menial
things like being farmers and cashiers.

------
adventured
The speed of product innovation radically slows down when you have to
seriously concern yourself with whether you might kill the consumer with a
mistake.

There is a large class of engineering minds out there that simply don't want
to work in that field of risk.

------
dannyr
It is pretty easy to dismiss that what Google, Facebook & Twitter are not that
important.

These companies have impact that are not easily measured. Google gave people
knowledge at their fingertips while Facebook and Twitter have become tools for
democracy.

------
HunterV
Is this not unlike one yelling at a toy maker for not using his clever
engineering to create "more useful" products? I'm sure the toy maker would
tell you that making a child smile is as useful and satisfying as a product
can be.

------
bhauer
I can't do anything to help with diabetes research directly, but my own little
side project is predominantly about using charitable giving as a force to
drive local community improvements. So what I can do, if not the research
itself, is make a $50 donation to the American Diabetes Association on behalf
of a favorite city-improvement tasks of interest to me [1].

Sure, it's using charitable giving to draw some attention to something of
interest to me, and that may sound base. But what's wrong with a tiny
incentive to give to good causes such as this research?

[1] <http://btforce.com/348>

------
thetable
I've been entertaining the thought lately that all the work being done on
photosharing sites and other "unworthy" commercial projects may qualify as
basic research in the sense that the short-term benefits for society may be
hard to see.

In contrast to traditional science, today, in computing, big ideas and
inventions come from commercial applications, and then move into the public
domain where they are often used for greater causes. For example, a new
database may be invented at a hot photosharing startup, but graduates that
particular application and becomes something that _could_ be used to fight
cancer.

------
oliyoung
Well, if _you_ can't do something, support one of us who is
[http://www.kickstarter.com/projects/nialg/the-diabetic-
journ...](http://www.kickstarter.com/projects/nialg/the-diabetic-journal)

------
jisaacstone
I was thinking about this the other (past few months)

Getting into _that_ industry, I mean.

I was wondering specifically if it might be possible to get some existing
medical devices to communicate via bluetooth with a central server; to build
an adapter so everything that sent out a vital signal was logged on disc and
remotely accessible in real time.

I was in a hospital recently, and the vital signs were logged on paper, and
abnormalities were signaled by a loud alarm, to be audible at the nearby
nurses station.

But I don't know how I can 'weekend hack' this sort of thing. Perhaps I can
grab some medical surplus, a bluetooth adapter and start hacking?

~~~
ihnorton
Getting access to devices is definitely a big hurdle, but there are people
working in this area already. Maybe you could contribute to framework
engineering in collaboration with groups who can get (or reverse engineer,
more likely) communication protocols on specific devices. Here are a few links
to get started:

<http://www.mdpnp.org/>

<http://conferences.sigcomm.org/sigcomm/2012/medcomm.php> (google the speakers
and organizers)

[http://repository.upenn.edu/cgi/viewcontent.cgi?article=1525...](http://repository.upenn.edu/cgi/viewcontent.cgi?article=1525&context=cis_papers)

OpenIGTLink is working on something similar for surgical navigation
(<http://openigtlink.org>).

(See this comment for some more general suggestions:
<http://news.ycombinator.com/item?id=5089663> )

~~~
jisaacstone
fantastic! thanks

------
dinkumthinkum
Kind of a tangent by why are we wasting so much engineering trying to make
hypertext documents and HTTP do do things that could be done with other
software years ago, why are we wasting all focusing so much on limited
constraint computing when we have a lot of horsepower we could be going
interesting things with. LaTeX on a browser? Near, but we've has LaTeX for
decades. I'm not trying to call anyone specfically out. I just can't help
feeling we as an industry have gone so full barrel down the hypertext path
that innovation as a whole has potevtiallt suffered. Just my rambles.

------
timonv
Obesity isn't a problem, it's an effect. People eat crap and don't work out
and the media doesn't help.

Whether problems are 'real' is a point of perception. Obesity and the high
rate of diabetes are only a problem in ignorance of the cause. That's yours to
fill in. The same goes for the banking crisis, political scams and the facade
we call democracy (<http://plato.stanford.edu/entries/democracy/>).

I totally agree we should be addressing real issues in our society, however,
addressing effects is like duct taping a drain - temporary.

------
charlieok
Economics is about allocating resources in order to produce goods and services
that people want and need.

A lot of people are spending a lot of time using google and facebook's
products these days.

Assuming that people are spending time this way because they like what they
are getting, and presumably need or want more of it, it makes sense to
allocate resources to the upkeep and evolution of these services.

How to balance want vs need, and how to add all this up to get a useful total
score is, of course, subjective and up for debate.

The person doing the complaining is, of course, highly encouraged to offer
suggestions for improvement...

------
hawkharris
Why the fuck does everyone always throw plastic beads in the air, drink
tequila and eat catfish? Oh, wait, I'm on Bourbon St. in New Orleans.

Just saying it's easy to make generalizations based on the people, places and
industries with which you're familiar. While I agree that too much emphasis is
placed on ad-related tech careers, it's a cop out to say that engineers aren't
finding important solutions, some of which improve the lives of people with
disabilities. Other commenters mentioned Google Flu Trends and driverless
cars, which are both great examples.

------
ruswick
Why? Because people don't want to change the world. Most people want a job
that they can easily complete with minimal effort that still affords them a
large salary. Most people want a comfy couch upon which they can stare a black
rectangle on their wall for 4 hours each night. Most people want to sit on a
beach for 2 weeks every winter. Most people want to pursue a lifestyle, not a
legacy. An unremarkable life lived to achieve domestic success and hedonistic
pursuits is an attractive proposal. I don't blame people for wanting one.

------
rewind
It used to annoy me, but now I'm just amused when someone tells me what I
should think is important when he's not even putting importance on those same
things himself. HN trolling at its finest.

------
petercooper
Love the sentiment of this post. But why does water run downhill instead of
up? Up would certainly be useful.

As in physics, there seems to be a gravity that pulls people towards the
greatest rewards for the least effort.

Becoming wealthy by building a diabetes management tool is, I suspect, much
harder than drinking some of Facebook's cream for working on their ad network.
There are certainly people who relish and lean into such challenges, but it's
not the majority and never will be IMHO.

------
OafTobark
Why people gotta judge? Lead by example, or shut the fuck up (statement made
by the excessive fucks in the article). Ignore what others do and do what you
believe.

------
mangler
Because millions of others have a much more desperate need for some love and
some feeling of self worth. Even a surrogate one. There's no insulin for
that...

------
jamesaguilar
Apparently all of society needs to be devoted to fixing diabetes before we do
anything else. Meh. This article kinda sucks, as does the sentiment behind it.

------
tathastu
It actually takes a lot more to have a career in the sciences; the field is
extremely competitive. More so than getting a job at Google or Facebook. I
applied for a lot of computational biology post-docs (having a PhD in the
field), and because I wasn't from a big-name university, didn't get anything,
and wound up working for one of the so-called "WTF" companies.

------
wr1472
Wow! This post has generated a lot of debate. I wonder is it because of the
content or the delivery?

Playing devil's advocate, I would say that Raganwald has touched a raw nerve
with those that are working on the types of apps he is having a go at. There
are a lot of people who are attacking his point by name calling and responding
to tone (ie. the delivery and not the content).

------
michaelbuddy
Don't forget a ton of brilliant minds are also in finance toiling away in
fantastic paying jobs making the mega rich even more rich.

------
pbreit
Maybe I misunderstood the post but my first reaction is "I hate this
sentiment". I refuse to listen to anyone trivializing the good put forth by
Google, Apple and Facebook. They may not be perfect (no entity is) but it is
simply ridiculous to suggest these 3 companies are wasting human brilliance on
things of comparatively little import.

------
orion512
The greatest minds of today are not all specialized in diabetes. If they are
not masters of a highly specialized skill, their main focus is probably
earning money. Which is OK, because all this infrastructure being created is
going to hopefully make the life easier of those who do specialize in curing
disease.

------
cowsandmilk
Does he honestly believe the greatest minds of this generation are all working
at the googleplex?

Anyone in the biomed field knows there have been huge advances towards
artificial pancreases over the last five years. The purpose of an artificial
pancreas is to provide the "second-by-second efficiency" that raganwald
discusses.

From googling (as I am an expert in other areas of biomedical research), there
are several companies and universities going into clinical trials in hospitals
during this time and UVA entered outpatient clinical trials last year[1]. FDA
gave preliminary guidance on approval of these devices in December 2011 and
final guidance in November 2012 [2].

As one example of the extremely intelligent people working in this field, I
point to an interview with Ed Damiano[3], who describes some of the
difficulties in the control algorithms around these devices. A big one is that
the time delay within a single patient evolves with time, and this time delay
can be on the order of hours. So, you have continuous glucose monitoring on a
second-by-second basis, but if the patient doesn't respond to the insulin for
hours, you can quickly overdose the patient. A lot of control theory work is
extremely well established, but usually with a fixed time delay related to the
physical parameters of the system. (at this point, I should point out that
work on ad systems that learn over time and adapt to changes in individual
users response over time to an individual ad may be very applicable here,
meaning work on optimizing ads may someday contribute to better managing
diabetes, who knows? cross-polination in algorithms is very common, one
algorithm I have used in my biophysics research was adapted by Ephraim Katzir
from work he did for the israeli army on detecting tanks in satellite
photos....).

I don't know why raganwald believes "the greatest minds of our generation
toiling away in the Googleplex". There's lots of proof this isn't the case and
I know several people in the biotech field that are much smarter than anyone
I've seen go to work at Google. In fact, just as it is easy to jump from a
physics PhD into google or the finance industry, I've seen a ton of people do
it from the biotech field (prominent example: D.E. Shaw[4]).

At the same time, don't forget that people work to cure or manage diseases
such as diabetes so that people can lead normal lives with a vibrant social
circle. Many social apps serve a similar purpose of helping keep us connected
with loved ones. While there are specialized social networks for people with
diseases, this activity is often mirrored on nonspecialized platforms.
Additionally, while a specialized network may help you find people with a
similar disease, facebook or gmail may be what keeps someone who has to have a
specialized treatment at a hospital hundreds of miles away in touch with their
friends and facetime can allow a patient to call the spouse and kids and read
a bedtime story. When Intel comes out with a new power-efficient processor,
they may be driven by tablets and ultrabooks, but those processors may allow
new portable medical devices that save lives in the field as paramedics are
now able to apply medical technologies critical minutes earlier to a patient.
So, don't let your narrow view of technologies blind yourself to the good
actually resulting from the work done at these companies. Not everyone will
make the next vacanti mouse, but their work may save more lives.

[1] [http://www.news-medical.net/news/20120514/First-US-
outpatien...](http://www.news-medical.net/news/20120514/First-US-outpatient-
trial-of-UVA-developed-artificial-pancreas.aspx) [2]
[http://www.fda.gov/downloads/MedicalDevices/DeviceRegulation...](http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM259305.pdf)
[3] [http://www.diabetesmine.com/2011/02/behind-the-scenes-of-
the...](http://www.diabetesmine.com/2011/02/behind-the-scenes-of-the-
artificial-pancreas-human-trials.html) [4]
<http://en.wikipedia.org/wiki/D._E._Shaw_Research>

------
madiator
Thats a very myopic view. Indeed its not good if everybody work on things that
'matter'; it is essential that some people do work on things that don't
matter.

Not everybody can be doing and/or should be doing cancer research or whatever
the author seems to perceive is important.

------
noonespecial
Is it possible that one activity doesn't necessarily preclude the other?

Perhaps society is already running at its "cure diabetes hull-speed". What is
everyone else to do? Sit around and cheer them on... hey that gives me an idea
for this social app...

------
ryanjodonnell
Diabetes isn't a problem that we need technology to solve. Sure it could help,
but that's treating the symptom, when what we really need to do is use
preventative care to treat the root of the problem - corn subsidies and
education.

~~~
icebraining
There are more than one million of Type 1 diabetics in the US alone, like the
man mentioned in the post (Scott Hanselman). How would those measures improve
their life?

------
ilaksh
Because the underlying 'economic' and political institutions are fundamentally
flawed since they doesn't incorporate relevant information like human needs
and social science, ecology, physics and developments in technology, etc.

------
crockstar
All I can say is "thank you." In spite of not being one of our greatest minds
(far from it) this kick up the backside forced me to respond to an email and
get involved in a project that might actually do some good.

------
rachelbythebay
The greatest minds aren't necessarily selling ads, either. This came up in a
comment thread about 6 months ago:

<http://news.ycombinator.com/item?id=4347948>

------
tomasien
Control f'd "vulgar" and "profanity" - only one hit. Really proud of HN for
not making this about the use of the word "Fuck", which was used exquisitely
and in its most potent form (which is "to add emphasis").

------
agumonkey
Didn't Steve Yegge have the same issue ? I wish there was less layers to
important research, I always have a feeling that solutions would emerge if
some people have met but they just don't know each others.

------
Tloewald
I's the same reason, unfortunately, that leads to all (most) commercial radio
stations playing much the same music. People would rather chase a small piece
of a big pie than come up with a new pie.

Great rant though.

------
hanula
That reminds me of this terrific example
<http://www.youtube.com/watch?v=lOYCkHFMnVc> Funny/sad, but true.

------
jmadsen
How smart can the guy be if he can't even express himself without using a word
that is still considered by most people to be vulgar and unfit for public use?

"Vulgarity is no substitute for wit"

------
dotborg
"the smartest guys" didn't want to work on health problems, ok, however

Google Search is pretty much crap lately, AdWords/Facebook ads campaigns are
expensive and ineffective

maybe it's not that bad after all

------
cromwellian
Only a small fraction of Googlers work on ads optimization. The money made
from ads allows the vast majority of the rest to go work on other problems.

------
dorkitude
Well, that's certainly not what _everyone_ of consequence is doing, just the
risk-averse and as-yet-unrescued.

A lot of us work hard to rescue them :P

------
hbien
If you're looking into making a big impact: <http://80000hours.org/>

The answer is usually not clear cut.

------
roopeshv
similar to "Why should we be spending money exploring space when there are so
many problems here on Earth that we need to solve first?".

------
armored_mammal
If I new of a job where I could program for a container agriculture company or
something I would. Your comments ring true to me.

------
krickle
I bet if you pay them what they expect to get from their own companies,
they'll stop fucking around and get right on it.

------
polskibus
5 letters as the answer: money.

------
rjzzleep
you don't need a degree in physics chemistry or biology to do great things.

And you don't need to be at google, to be qualified as a great mind. But
people may not call you that then.

So what

------
saurabh
For money, obviously.

------
cynwoody
Too small; didn't read.

Raganwald needs to forget the font-size attribute.

------
elisk
Why the fuck? I'll tell you why. Because true innovation is too far and few in
between, because it took us 60,000 years to realize that we can plant our own
crops, that we can cultivate and breed our own farm animals.

Because it took us a good few thousand years to understand that there is more
to life than just bashing each other with stones and sticks.

Because coming up with something new, and having the guts to share it with
your community, and not being killed for it is still rather rare today.

Because it took us almost 1,500 to "accept" the fact that we're on a spherical
object, not being held by a bunch of turtles. Because some of us are still not
convinced that this is true.

Because most of the time we're not actually creating anything new, but instead
try to improve something that was already there, because we're afraid thinking
out of the box. Because our society loves new stuff as long as it doesn't
change their old views, and most of the truly revolutionary ideas are just
that, shattering our older views.

Because we're distrustful apes that think that their youngsters are naive or
just plain stupid. Because we think that our 5 year-old's are too young to see
the naked body of a human being.

Because our society teaches our kids how to suppress originality from the very
first days in schools and throughout their "education", which is just a pretty
word for enslavement camps that teach our population how to be obedient,
unoriginal parrots.

Because if you ask 95% of humanity who they believe more, their parents or the
scientists that tell them something different than what their parents (and
their parents parents) said or think, they'll tell you they prefer the "truth"
of their parents, ignoring facts, experiments, and their own eyes.

Because we have patent laws that do nothing but prevent true innovation.
Because a lot of the ideas that we have are already protected by some stupid
law and we can't actually do that. Because we can't experiment with human
embryonic cells because we consider them sacred and at the same time we allow
the slaughter of millions of people around the world, deny them the food that
we throw away in the garbage because we simply can't consume that much.

Because we distrust each other and we intimidate and sometimes execute those
who do something different. Because we're so arrogant that we're always sure
that we know best, and this new thing that someone just mentioned to you won't
work because of a million reasons.

But mainly, because we're lazy as fuck, and we rather complain about why we
don't have anything truly new and life improving, and replying to those rants
explaining the reasoning behind it.

Why? Because you're too squared in. Because you're too afraid to truly say
what's on your mind. Because you don't want others to think that you're crazy.
Because if you don't conform, society will reject you. And new things, are by
definition, non-conforming.

Now go and create something new. I dare you.

~~~
JohnHaugeland
I create things all the time. (shrugs)

Ain't that hard if you put more effort into the code than the soliloquy.

~~~
elisk
Doing /something/ is easy. We're talking about true innovation here, don't we?
Doing something /new/ is rare. Very, very, very rare.

------
natmaster
Audience isn't scalable.

------
kcbanner
Check out Glooko.

------
boomlinde
Capitalism?

------
andrijac
money

------
benihana
Oh goodie, another arrogant whine by raganwald where he can't understand why
the greatest minds (implying people writing code are somehow the greatest
minds) aren't doing what _he_ thinks is important.

This post makes two incorrect assumptions. First, that the things he derides
(Google automating targeted content, Facebook introducing new search features
that are tangential to their current features, Apple changing form factors)
aren't beneficial to society as a whole. Second, that problems he would like
to see solved are more important than problems other people would like to see
solved.

~~~
lukev
I would hope it's uncontroversial that saving people's lives, health and
sanity is categorically more important than making money or trivial social
interaction.

~~~
beering
And yet, if Google didn't make money, we wouldn't have such a great search
engine to use. Think about how much Google has helped scientific research,
both for academics and ordinary people.

Clicking ads is literally what supports Google.

~~~
rtpg
I think the point is that there are many people who work on the clicking ads
part, arguable moreso than the search part.

I understand that the NYT needs a paywall and ad networks to survive, I just
hope that most of the staff spends their time on the journalism, not on the ad
network.

------
wissler
I agree with Raganwald's sentiment, and I think most of the posters here at HN
lack vision and standards and are just fat dumb and happy with the status quo.
Well the status quo is not good enough, and YOU need to raise your standards
and expectations about what is possible and you need to get a clue about the
kinds of things that are holding us back, but first and foremost, it is YOUR
ATTITUDE that is holding us back.

------
dakimov
Dude, the folks doing websites aren't greatest minds. They aren't even
engineers. It's a bunch of ADHD kids rushing for cash.

All this social web bullshit is not really even programming, and programming
is not even engineering.

~~~
pyre
All of the PhDs working on machine-learning and self-driving cars at Google
are ADHD kids rushing for cash. Good to know...

~~~
dakimov
Obviously, those guys aren't, kudos to them.

------
moneypenny
The benefit is that you know which tedious people to avoid when they tell you
they work at Facebook/Google/etc.

------
LatvjuAvs
One day I killed few children, few days later I happen to kill about two
children. Week later I killed one...

And so day by day, I kill few, mostly children, of course sometimes I kill
adults too, but most targets are children.

Yet, I feel perfectly fine.

Every time when I walk past charity advertisement person.

------
CleanedStar
As Warren Beatty said in Reds:

"Profits"

------
nirvana
I can't speak to the other companies, though I know google want's "all the
worlds info at your fingertips" which is a reasonably high ideal... I can
speak to what Apple is doing as someone whose followed the company closely for
a couple decades.

Apple doesn't care whether you buy the 3.5", 4.0", 7.85", or 9.8" screen.

Apple is bringing the personal computer to the 6 billion other people who
weren't able to get in on the PC revolution.

Their slogan in the 1980s used to be "The Computer for the Rest Of Us." While
it isn't used for marketing, the mission hasn't really changed.

There were two key issues that prevented those people from participating in
the PC revolution.

The first was that you had to be trained how to use a computer. You had to be
at least literate, and you had to spend the time to overcome the significant
usability hurdle that even Mac OS X presents to the random person. (Eg: your
grandmother.)

iOS has revolutionized computer usability such that your grandmother can use
it, even if she never made it to high school (bless her heart.)

The second is price/distribution. PCs were for the relatively rich. And while
Apple never _seemed_ to compete on the lowest end, that's simply because most
people who think Apple makes expensive products think about $300 laptop as
"affordable". Instead, Apple put a $50 computer in peoples hands- the iPod
shuffle. Sure, it might not be as full featured as a laptop, but you have to
walk before you can run.

Lets also not forget that there's a big difference between a PC that draws
serious amps and thus needs a house wired for electricity... and a mobile that
runs on batteries and can be charged with solar power.

Apple is toiling away building the greatest development/ design/
manufacturing/ distribution machine in history. Of course they have some key
partners in this- foxconn and their suppliers.

That iPod shuffle has been replaced with the inexpensive iPod touch, which
really is a PC. And of course there is the iPad mini, also a new entry on the
low end pc market.

Just because they didn't choose to make zero margin crap that nobody can use
(Eg: windows running netbooks), doesn't mean they aren't working their tails
off to address this under filled market. They are coming in from the high end,
which makes sense given that they can't make the devices fast enough. Hence
scaling the company across all those axis I mentioned.

I'm sure this sounds like a radical idea, because "everyone knows" that Apple
is only interested in selling "shiny things to rich people". Just keep
thinking that!

Whether android ultimately beats them to it, or not, their mission is pretty
damn noble, as far as I'm concerned.

The post-PC era they created is going to empower a massive number of people.

~~~
polshaw
Your description of how apple is on a noble quest to bring the personal
computer to the poor of the world through the '$50 computer' that is an ipod
_shuffle_ is so far from reality in so many different ways that you are
verging on a parody of yourself.

I can't believe you seriously typed all that out and then submitted it.

~~~
nirvana
It's a shame that you chose to ignore the point I was making, and instead post
this snide, narrow minded response. Alas, this is typical of the anti-
intellectualism that pervades hacker news these days.

Of course the reason you did this is that you know what I say is true. You
just are an apple hater and can't even admit that this is what they're doing.

Also typical of hacker news: Burying comments that point out that others have
got nothing but personal attacks, while upvoting personal attacks. Everyone
who engages in this is, by definition, anti-intellectual.

So, go ahead and downvote me, it just proves to me that you are not worth
wasting time on, and that this site is full of narrow minded anti-intllectual
bigots.

Make a counter argument, and I can respect that. But you don't. Probably
because you can't, right?

~~~
polshaw
You are (thankfully!) not the sole decider of what is intellectual or not.

I attacked the frankly deluded points you made, addressing them directly, so
i'm not sure what point you _thought_ you were making. I made no counter
argument because i thought it was too obvious to bother wasting my (and
others') time when this submission wasn't even about apple anyway!, but since
you insist;

Apple are a _business_ (and a very good one, that makes great products and
lots of money) not a charity or an NGO. They do not make literally unheard of
profits and margins because they are 'struggling to find a way to address the
low end' or 'bring computing to the other 6 billion'. Sorry, that is pure
'reality distortion field' _delusion_ on your part. They have a valuable brand
that does indeed _intentionally_ place itself in the high end. Moreover, the
ipod shuffle isn't even _close_ to being the first DAP of it's kind, most of
which (specifically this product) have a similar UX and are much cheaper. We
haven't even got to the fact that this '$50 computer', that not only can't run
any custom code, but actually _requires_ another (real) computer to be able to
do anything at all! Do i really have to go on any further?!? The first device
that could be called a computer with any sanity at all would be the iPod
touch.. which coincidentally is (from) the same 'not affordable' $300 you
quoted for the actual PC. You might bring up that they sell the previous
generation from $199, but care to mention acer's $199 chromebook? Or the ipad
mini.. that pioneer.. ignoring the earlier, cheaper and equally capable nexus
7, or (much more relevantly for the 'next 6bn') the Chinese android tablets
(and phones) that sell for much less still and achieve the same.

You are (thankfully!) not the sole decider of what is intellectual or not.

I attacked the frankly deluded points you made, addressing them directly, so
i'm not sure what point you _thought_ you were making. I made no counter
argument because i thought it was too obvious to bother wasting my (and
others') time when this submission wasn't even about apple anyway!, but since
you insist;

Apple are a _business_ (and a very good one, that makes great products and
lots of money) not a charity or an NGO. They do not make literally unheard of
profits and margins because they are 'struggling to find a way to address the
low end' or 'bring computing to the other 6 billion'. Sorry, that is pure
'reality distortion field' _delusion_ on your part. They have a valuable brand
that does indeed _intentionally_ place itself in the high end. Moreover, the
ipod shuffle isn't even _close_ to being the first DAP of it's kind, most of
which (specifically this product) have a similar UX and are much cheaper. We
haven't even got to the fact that this '$50 computer', that not only can't run
any custom code, but actually _requires_ another (real) computer to be able to
do anything at all! Do i really have to go on any further?!? The first device
that could be called a computer with any sanity at all would be the iPod
touch.. which coincidentally is (from) the same 'not affordable' $300 you
quoted for the actual PC. You might bring up that they sell the previous
generation from $199, but care to mention acer's $199 chromebook? Or the ipad
mini.. that pioneer.. ignoring the earlier, cheaper and equally capable nexus
7, or (much more relevantly for the 'next 6bn') the Chinese android tablets
(and phones) that sell for much less still and achieve the same.

EDIT: I see further down you say you meant apple gained 'experience in low
cost manufacturing' from the shuffle.. this isn't really true either as; there
were many mass-market ipods before the shuffle (or even the macs themselves),
they are not designed for lowest cost (eg. they are made of aluminium, not
plastic), apple don't actually do any of the manufacturing anyway, and low
cost manufacture does not infer a low cost product (nor does an expensive
product exclude low cost manufacturing) and it is not really close in
manufacturing terms to a full computing device. Apple have had the capacity to
bring a masssss-market low cost computing device (in terms of 'low cost
manufacturing experience', in whatever form factor) since at _least_ the 2/3
gen iPod. You could argue the iPhone was relevant because it was their first
post-PC device, but in no way the shuffle IMO.

------
spuiszis
Awesome title

------
AndrewKemendo
C.R.E.A.M. my friend, it all comes back to the C.R.E.A.M.

------
kylebrown
Diabetes is just another first-world problem.

What about the millions of children dying of preventable diseases in the
third-world?

~~~
derleth
> What about the millions of children dying of preventable diseases in the
> third-world?

What about children serving as child soldiers? What about _everyone_ in the
world who gets assaulted?

There are a never-ending parade of problems in the world. Any one of them you
pick, you pick at the expense of something that someone will think is a lot
more important. That's why statements like yours are completely worthless and
always will be.

In addition to the fact you're factually incorrect.

------
derpmeister
Because nobody cares about your diabetes and obesity. Lay down that taco and
get some fricken exercise, FFS.

~~~
icebraining
What an ignorant post. How exactly does "laying down the taco" help Scott
Hanselman and the other million of US citizens who suffer from Type 1
diabetes?

~~~
derpmeister
Even if it doesn't, there's a lot more profit in advertising than insulin. The
economy would probably function better if diabetes patients were left
untreated and die, since the cost saving estimates are quite enormous.

~~~
ciupicri
Isn't the treatment paid by the patients?

~~~
derpmeister
That's only a fraction of the costs involved. For one, today’s diabetes
patients are tomorrows alzheimer patients.

~~~
derleth
> today’s diabetes patients are tomorrows alzheimer patients

... possibly. Or they could be tomorrow's cancer patients, or tomorrow's
stroke patients, or tomorrow's jack-knifed tractor trailer across three lanes
of traffic patients. All those can happen to people without diabetes, too,
though; it's part of living.

~~~
derpmeister
Sure, I get that. But diabetes and Alzheimer’s are actually related:

[http://opinionator.blogs.nytimes.com/2012/09/25/bittman-
is-a...](http://opinionator.blogs.nytimes.com/2012/09/25/bittman-is-
alzheimers-type-3-diabetes/)

