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To Those Whom Much Is Given…

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96. everything is power-law distributed

97. everything is power-law distributed

When someone writes about 137 life hacks and two of them are a) identical and b) something you have never heard of, you can’t help but dive down that rabbit hole… 

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So, what is a power-law distribution? 

A power-law distribution is the statistical description of change that is proportional to the power of the change, in other words, change that is logarithmic, not linear. One of the classic examples of a power-law distribution curve is how income is distributed in society. 

Although there are many uses for this principle in the world of finance and economics, power-law distribution can also serve as a mental model to help us understand ourselves, each other, and the world we live in.

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For those who are healers, or who are studying to be healers, there are three uses of this mental model that I think are particularly relevant: 

1) Hacking your studying

2) Investing in your future

3) Understanding inequities 

Hacking Your Studying

I unknowingly wrote about power-law distribution when I explained the “forgetting curve” in this post: “How to Ace the NBME Shelf Exams, In-Training Exams and Your Boards”. I recommend you read the entire post, but the take home message is this: Cramming never works if your goal is learning how to heal. What works? Repeating information you want to learn at least five times in gradually increasing intervals (ok, you type A folks… get out the spreadsheet).

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The best time to plant a tree was last year. The second best time is today.

The power-law distribution also helps you understand why you need to start investing for your future – today.  The chart below is what happens if you invest $100 a month starting as a new grad and keep doing it for 35 years (assuming a 6% return on your investment) 

p.s. Here’s the website to do this calculation with different variables-  investor.gov calculator

This kind of “investment strategy” also works for exercise. Wow, do you gain strength and fitness fast at the beginning… and how sad that it only takes about six weeks to lose most of what you previously gained if you stop (both are examples of power-law distribution). Like financial investment, investing in your body with small “doses” of consistent exercise is the best strategy. For most of us who work in a hospital, the amount of walking we do at work is close to the recommended minimum for fitness (#GoodNews). Just accumulate a few more minutes at a higher heart rate (take the stairs, speed walk to the next consult, etc), add some body weight strength exercises like pushups, and you are good! 

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Understanding Inequities

Investing for the future and how to hack your studying are important, but there is an even more important use for this mental model… It can help us better understanding the inequities in our society and in our work. 

It’s easier to accumulate resources if you start with more. This principle is why young faculty members with limited mentorship or disproportionate service at home or at work end up not advancing. It’s why marginalized youth without resources to obtain education or connections struggle to break free from the cycle of violence and poverty. It’s why those who “have” (money, education, privilege) end up with disproportionate success (or access to care) when compared to those who started with less. Yes, there are exceptions, but they are just that… exceptions to the powerful force of power-law distribution. 

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There are hundreds of examples of power-law distribution including the beauty of fractals like the pattern in this beautiful head of romanesco broccoli or the curve of a beautiful seashell. (It’s worth looking at the list… some of them are fun!)

Maybe Alexey Guzey is right…

96. everything is power-law distributed

97. everything is power-law distributed

You’ll never buy stock again

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This may be one of the easiest kitchen tricks I’ve learned in the last few years.  I haven’t bought any stock since I figured this out. It saves money, but more importantly, this stock tastes MUCH better than anything you can buy.

Step 1:  As you peel, chop, and otherwise use any vegetables for recipes or salads, save all the pieces you would normally throw away.

The vegetables that help the most with umami (and make your stock great) are the classic mirepox (carrots, celery and onion), garlic bits, and mushrooms.  There are a few vegetables you should avoid using for stock. Some vegetables will make the stock bitter or impart a strong, very specific taste that may not work in some recipes (e.g eggplant, turnips, cilantro, ginger). If you happen to be someone who buys Parmesan cheese with a rind, those rinds are wonderful in stocks. If you use fresh herbs when you cook, make sure you throw the stems in the stock. 

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Step 2:  Keep a big ziplock bag in the freezer and toss the washed bits you saved into the bag.  When you drain beans, tomatoes or other vegetables from cans, put the juice in the bag, too.

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Step 3:  When the bag is full, put the frozen vegetable bits in a big pot with water to cover them, bring to a boil and then simmer for about an hour.

 

If you have an Instant Pot, you can make stock in less time.  I don’t add salt while making the stock because it lets me season the dishes I make to taste.

 

 Step 4:  Freeze the stock you don’t use in a day or two.

 I usually freeze my stock in 1-2 cup plastic containers.  Alternatively, use freezer bags if you want to take up less space in your freezer (Push the air out of the bags and lay them flat on a cookie sheet to freeze).  Another trick is to freeze the stock in ice cube trays or muffin tins and then put the frozen stock in freezer bags.

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In addition to recipes, use this stock instead of water when you make rice or grains. Thaw your stock in the refrigerator (if you remember) or in the microwave (if you don’t).

We eat a mainly plant based diet, so I only make vegetable stock.  If you eat meat, you can save the bits from the meat or fish you cook – or ask your butcher for stock worthy bones and add them to the vegetables to make great chicken, beef or seafood stock.  If you want perfect chicken or beef stock, you may have a bit more work to do… 🙂

Enjoy!

 

 

Economics and Choosing Your Specialty – a guest post by Floyd S. Brandt, DBA, retired professor of Management

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There will be about 16 million college graduates this spring in addition to several million high school graduates who will not enroll in college, many of whom will find themselves in the midst of millions of unemployed workers where there are about five or six or more unemployed applying for every job vacancy. Several times during my 40 plus years of teaching, my graduates encountered the same problem for the first time.  During good times and bad, I polled my students with two questions: (1) What is your view of economic conditions in the immediate future? and (2) What are your personal prospects for the future? Thank God, in good times and bad they were almost unanimous that the general economic future was getting more difficult but their individual prospects were better. Had it been otherwise, their aging professors and society would have found little comfort in their responses 

Professor Diane Dreher, an English Professor at Santa Clara University, made the observation that there is an inclination for students during good-time labor markets to make hasty decisions, jumping into the highest paid or most prestigious job without much consideration of their own strengths and values. Too much incongruence between the job and one’s values and strengths can in time lead to the question, “What the hell am I doing in this job?” Yes, you need a job to eat in the mean time, but that can also be a time to build a strategy for how to define your values and the job that will help you sustain them. I am sure that I don’t fully comprehend the concerns of this generation because  I entered the work world at a different time, so in a sense I was never the age of today’s graduates. The baby crop eight decades ago was one of the smallest ever birthed in this country, which translates into a lot less competition in the years that followed. Still I had students in front of me for half of that time and have heard their concerns, written countless numbers of letters of recommendation for them and talked with them about their job hunting successes and failures.

Advice from old guys is often not welcome, but here goes.  Be of good cheer, this too will pass. Economics is the “dismal science”– economists have forecast nineteen of the last three recessions. Keep thinking and planning beyond tomorrow and never stop learning. People and organizations who plan usually do better than those who do not, but in all truth, they seldom follow their plans. Remember, frustration usually arises not from actual obstacles or barriers but from unrealized potential. Life and careers are more marathons than dashes, so stay in training mentally, ethically and spiritually for the much longer race. Thereafter, each passing time will sing to you that what you have been through is not as serious as you thought at the time.

Managing Money as a Medical Student and Resident

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Financial issues are a source of intense stress for most students and residents.  It costs a lot to become a doctor and is costing more each year.   The goal is to finish your training without being handicapped by financial issues.    Doctors (including me) are not experts in financial issues (even if they think they are).   There are financial counselors at every medical school, or they will at least be able to refer you to someone.  It’s a really good idea to learn about this early.  Make an appointment and go talk to them about they best way for you to approach your own financial challenges.   There are some basic principles that will help get you started:

  • Limit your debt.  Pay off credit cards every month.  There is really no exception to this rule.  The interest on credit card debt is obscene.  You have to avoid it at all costs.  You have to make a conscious effort to live within your means.  It may be you have to have a car, apartment or clothes that aren’t what you would consider ideal.  But, in the long run, not running up the debt is far more important.  Make a budget, keep track and monitor your spending.    This is a really good resource from the AAMC to help you understand how to manage your money in medical school, including how to budget:  http://aamc.financialliteracy101.org/welcome.cfm

 

  • Your credit report is important.  Let me repeat that… Your credit report is important.  It doesn’t take much to have the score slide (a few late payments, missing a payment) and it will follow you a long time!  It takes about 7 years of perfect credit to get the score up to a level where you can buy a car or a house.   It is really easy to not pay attention to this during your training… and then pay the consequences after you finish.  http://aamc.financialliteracy101.org/graphics/factsheets/creditscore.pdf

 

  • Before you worry about investing, you should worry about protecting what you have (even if it’s not very much).   You should automatically have life insurance and disability insurance from your institution, but you need to check.  Unfortunately, if you are a resident, the “MD” behind your name makes you more vulnerable than the general public – and lawsuits can be against future earnings, not just current salary.  Many attorneys recommend that you spend the relatively small amount it costs to obtain an “umbrella” personal liability policy to help prevent a large lawsuit from someone if you are involved in an automobile accident or someone trips on your front porch.  When you are in training, these kinds of insurance policies seem like a waste of money.  But – they aren’t that expensive when you consider that all your money can be wiped out with a single disabling injury or personal lawsuit.  When you go to meet with the financial experts, this would be a good question to ask.

 

  • Once your insurance is covered, and you start having a salary (i.e. when you start your residency) invest a little on a regular basis through payroll deduction.  Having the money taken out before you see the check is key.  This is a habit that you want to start early.  This can be for a retirement account (pretax money) or another kind of investment account.  Again, talk to the financial counselors to learn about these options and decide which is best for you.  The pretax dollars are important….  If, for example you earn $1000, you will be taxed roughly 30% on that money i.e. $300, leaving you $700.  If you invest $100 dollars into your retirement fund, you will only be taxed on $900.  That means you will pay the government $270 instead of $300.  You will now have $630 to spend, instead of $700.  But – the $100 will compound incredibly.   Try it out.. http://www.econedlink.org/interactives/interest.html