YC Bio (opens in new tab)

My observation during this dot-com boom is that a lot of the people who did well last round are now part of the VC infrastructure, like our own Paul Graham. My impression is that this time around, money is a lot more competent because of this.

Because this made such a huge impact on my life, I kinda want to extend it: perhaps the first round of any new technology is going to be littered with bad ideas. Perhaps that is necessary. Then perhaps those with experience can look backwards and do better next time.

I personally still think we are headed towards a second dot-com bust, but I've been saying that so long that at this point, I'm just wrong. Unquestionably, the business and money people did their jobs much more skillfully this time around than they did in the '90s.

YC's "move to the bay area" requirement makes sense for software startups, but less so for bio (at least for most of the good ideas).

What could be better than glowing monkey grass leading up to your house? But as always, devil is in the details.

The current mental model is that people with CF overproduce mucus and are drowning in their own mucus. I believe this to be incorrect. We underproduce mucus. Giving the body what it needs to produce enough mucus makes a big difference. Inadequate mucus production is one of the ways the body's immune system is compromised and fixing that is entirely about proper nutrition.

I am well aware of the increase in life expectancy thanks to better drugs. I also used to take about 8 or 9 maintenance drugs and they made life not worth living. I was in constant excruciating pain for 3.5 years. No amount of pain medication really stopped it and my sleep quality was atrocious. I got better in part because I wanted to hurt less and I did not care if that accidentally killed me.

I had a life before my diagnosis. After my diagnosis, all I had was drugs staving off death. I frankly can't comprehend why more people with CF don't commit suicide. It's a horrible way to live.

All the drugs have a six page handout listing side effects. They trade short term gains for long term costs, take credit for the benefits and blame your genes for long term negative impacts.

I am not against drugs. I was thrilled to get a diagnosis and be able to ask for Zithromax up front. But there are things very, very wrong with our current approach. If anyone but a doctor did such terrible things to someone, they would be charged with a crime.

I think I was unwelcome on CF lists in part because people who had literally tortured themselves or their child balked at hearing that maybe you don't have to be tortured. I think accepting the torture and making their peace with it was a necessary psychological survival mechanism and they probably could not even name their objection to what I was saying.

I don't hate physicians either. I'm having a terrible, terrible day and speaking to these issues on HN is basically evidence that I have finally snapped. I don't like hurting other people. But trying to not hurt other people is essentially killing me. These are things I cannot discuss anywhere. It isn't socially acceptable. And that is part of the problem. Other people not only can't speak of it, many seem incapable of even thinking about it. It isn't acceptable for someone with CF to want a life. Just not dying yet is supposed to be all we aspire to and that's it. And I am incapable of swallowing that.

Today we have more leisure time than ever before in human history (well ... maybe not the HN crowd) but we're spending that time in increasingly sedentary hobbies/interests.

As a physician, does the idea that manufacturing and robotics will completely eliminate our need to work scare you at all? If the trend continues, will we truly be the space-faring humans in Wall-E - tied to our mechanical chairs and handicapped by our girth while life-spans decrease due to obesity-related diseases?

I quit taking the flu vax years ago and have done better since. In the eyes of some people, this makes me a nutcase antivaxxer even though flu vaccines are not required.

When I was growing up, anyone getting vaccinated was a success. People who didn't weren't all that uncommon. Now we are shooting for 100% of the population being vaccinated and you need to justify not getting it.

The further we go down this road, the more those options narrow rather than expand. I am some nutter who "lives in a bubble" for preferring to limit my exposure to germs as effective prevention rather than live on prophylactic antibiotics all the time, never mind that one of the outcomes of putting people with CF on antibiotics constantly is a high incidence of C-dif infections which are then treated by surgically removing your colon. Limiting my exposure to other people and their germs is not viewed as a reasonable choice for avoiding that outcome.

I am not seeing similar amounts of muscle put into policy changes that are more family friendly, people friendly etc. Saying there is nothing wrong with developing this stuff ignores the context in which this is occurring. If all of the above were equally accepted answers, I would not get so much ugly and threatening push back for talking about the choices I have made. I should not need to defend the idea that I would just rather not be sick, thanks, and I am willing to limit my social life to have that. But I get outright attacked for that.

So you would be wise to be a tad more skeptical about where such things lead. They tend to lead to promoting one path over another, at the expense of the other, rather than a broadening of options.

Failing flat, i.e., not making people healthier but not making them sicker either, is not a problem. Failing down, i.e. trying to make people healthier but making them sicker instead, is and has been a huge problem with modern medicine, even when done with the best of intentions.

Yes, the past century has seen great progress in neutralizing infectious disease (though it is likely that the HIV epidemic itself was an "own goal" of basically iatrogenic origin [1]), but nearly everything else, including cancer, is a wash.

Unfortunately, a sober analysis of the benefits and harms of actors in the medical space cannot afford to give much credit for effort or good intentions.

[1] http://science.sciencemag.org/content/346/6205/21

He also survived colon cancer in his late 60s for the same reason and I flew out and took care of my sister after her first mastectomy with her first round of cancer. The doctors attributed my father's survival after they wrote him off for dead to my mother's care. They interviewed her on tape and changed the practices at their clinic based on what she had to say. From what I gather, two different cancer clinics began offering patients German Penaten cream to help their surgical scars heal because that was why my father's 16 inch surgical scar did so well.

I have zero reason to believe you are correct. There are some differences between different diseases. But my life's experience suggests that a) getting fed right b) getting proper care from someone who actually cares about you and c) adequate control over your environment are pretty universal beneficial, regardless of your exact diagnosis.

(But I'm just a woman, so not likely to be listened to. Yes, I'm feeling pretty bitter about that at the moment.)

We are seeing a huge rise in problem pregnancies, birth defects, etc. There are likely a number of contributing factors to that reality. It isn't PC to wonder if maybe the rise of female careers is at related. That is viewed as antifeminist and so on.

Women routinely take time off work to care for relatives, whether their own children or other relatives. They get no credit for this vital work and how it impacts the health of people.

My experience suggests there isn't any point in trying to prove it. It won't get taken seriously anyway.

It is common knowledge that small kids in daycare have more health issues. My sister, who has a career and works for the CDC, used to quote studies at me about that. She managed to stay home with her only child for the first few years.

But, of course, in searching for info to support the idea that small kids in daycare get sick more, one of the most prominent pieces I can find is a PC piece assuring parents that the increased negative health effects of early daycare "has a protective effect later." Meanwhile, the study completely excludes data on, for example, hospital stays. Looks nicely spun to me.

Other pieces outright admit that staying home is simply not an option for many women and go on to talk about how best to protect your child from germs at daycare rather than exploring statistics. Yet the fact that you can google the question and there are pieces trying to address it at all suggests it is a real issue and parents ask about the problem a lot. But society can't fix it, so it isn't really comfortable to admit that it is a real issue.

Home cooked meals are also generally healthier than takeout, microwave meals, etc. Two career couples tend to not do a lot of cooking from scratch. Diet significantly impacts health.