Nutrition

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I recently embarked on a mission to learn more about nutrition. I found at least 3 different schools of thought:

Across the books and articles I read, most agreed on a few basics. Avoid refined sugars (corn syrup, added sugar, etc.), refined carbohydrates (white bread, “whole wheat” bread with added gluten, etc.), and vegetable oils high in polyunsaturated fat (canola, soy, and vegetable). Most also suggest avoiding processed foods (with Soylent as a notable exception).

My personal opinion is that:

  • The Michael Pollen approach is healthy and reasonable.
  • Soylent is better than most fast food options, and may represent the future of food, but there have not been enough long-term studies.
  • The Ketogenic diet may have short-term benefits for some people, and sensible in certain health contexts (such as epilepsy, Alzheimer’s, Parkinson’s, or cancer), but the long-term impact of the diet on healthy people is still unclear, and the diet is difficult to maintain.

My current food approach includes:

  • Soylent and fruit in the morning while commuting to work (eggs or oatmeal, and milk on weekends)
  • Lunch at LinkedIn – mostly salad, rice or noodles, side of a meat
  • Afternoon snack of fruit (apple, banana), nuts, cheese, and pumpkin seeds
  • Dinner – sweet potatoes, salads, black bean pasta, or other meals prepared by Jenny
  • Between 1.5 and 2 liters of water / day
  • No sugary drinks, coffee, or tea, and minimal desserts

At some point, I may experiment with the Ketogenic diet, but it does not seem sustainable to me. I also experimented with a 3-day water fast, which was not fun.

Your comments and feedback are welcome.

Now onto the book summaries. Enjoy!

Book Summaries

In Defense of Food by Michael Pollan [1]

  • Eat food. Not too much. Mostly plants.
    • Don’t eat anything your great grandmother wouldn’t recognize as food. Don’t eat anything incapable of rotting.
    • Avoid food products that contain more than 5 ingredients, unpronounceable ingredients, or include high fructose corn syrup.
    • Shop the peripheries – dairy, produce, meat, and fish – and avoid the middle of the supermarket
  • Native populations that do not eat the western diet have strikingly low incidence of heart disease, hypertension, diabetes, and stroke, no appendicitis, varicose veins, or tooth decay,
  • Eating less stifles production of free radicals, curbs inflammation, and reduces risks associated with western diets

Keto Clarity by Jimmy Moore [2]

  • Ketosis allows natural appetite control, weight loss, mental clarity, restful sleep, normalized metabolic function, stabilized blood sugar, lower inflammation, higher happiness, increased good cholesterol (hdl), reduced triglycerides, reduced hdl, improved immune system, slowed down aging, and reduced acne
  • Underlying formula: eliminate sugars and starch, 2-3 oz of protein per meal, as much natural fat and fibrous vegetables to satiate
  • Ketogenic approach is single most effective dietary treatment for cancer

Low Carb Myth by Ari Whitten [3]

  • Food reward – palatability is the single most significant and important factor related to whether food makes us fat. Modern processed industrial food products with refined sugars and fats mixed with artificial flavoring are the most rewarding and palatable
  • If you choose to adopt a ketogenic diet, you are essentially acting as a Guinea pig for which science does not have long term evidence and goes against the “blue zones” or longest living populations on earth.
    • Although, occasional bouts of ketosis in the form of intermittent fasting may have profound health benefits
  • Basic diet rule: eat whole food sources of carbohydrates (fruit, starchy veggies, pure grains, legumes). Recommend heavy serving of fruits and vegetables every time you eat
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Waking Up by Sam Harris Book Summary

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Waking Up: A Guide to Spirituality Without Religion

  • Our minds are all we have – every experience and relationship is because of our minds
  • The expected result of every goal (paint the house, learn a language) is to relax and enjoy the present
    • Each of us is looking for a path to the present
  • How we pay attention to present determining our experience and quality of our lives
    • Ecstasy helped him feel boundless love, not love because….
    • Spiritual, but not religious
  • Spiritual is best term about bringing mind to present and induce non ordinary states of consciousness
  • There is direct connection between spiritual wisdom and scientific facts
  • Meditation helps confirm well established truths:
  • 1) Conventional sense of self is illusion
  • 2) Positive emotions are teachable
  • 3) The way we think influences our experience
  • A rational approach to spirituality is missing from secularism
  • His experience in meditation suggests it is possible to stand free of the juggernaut of self
  • Meditating for weeks (or months) allows people to have experiences that are generally unavailable to others
  • True spiritual practitioner is someone who can be at ease for no reason
    • Western religions must accept set of implausible things whereas Eastern (Buddhism, hinduism) is possible to begin practicing
    • Western learning of Eastern religions began recently – late 1800s
    • Buddhism is not faith-based and central teachings are empirical
  • Buddhism has literature on nature of mind with no peer in western religion or science
    • Buddhism teaches being at peace in difficult circumstances and connection between spiritual and ethical
  • How one uses one’s attention – moment by moment – determining what kind of person we become
    • It is always now. Forgetting this causes us to be far less content than we ought to be
    • Vipassana can be taught in completely secular way
  • Vipassana teaches mindfulness, which reduces pain, anxiety, depression, and improves cognitive function
    • The Satipatthana is a rigorously empirical guide to free mind of suffering
    • 4 foundations
      • 1) Body – breathing, posture, activity
      • 2) feelings – pleasantness, unpleasant, neutrality
      • 3) Mind – moods and attitudes
      • 4) Objects of mind – senses and mental state
    • Mindfulness is undistracted, accepting, and non-conceptual
  • Mindfulness is vivid awareness of mind and body without grasping for pleasant or recoiling from unpleasant
    • Enemy of mindfulness is distracted thought
    • Joseph Goldstein is one of finest vipassana teachers
  • Most of us spend every waking moment lost in the theater of our lives
  • Life is unsatisfactoriness
    • Distraction is normal condition of mind
  • How to meditate
  • 1) Sit comfortably with spine erect
  • 2) Close your eyes and notice sensations
  • 3) Pay attention to breath
      • 4) Rest in sensation of breathing
  • 5) Any time mind wanders, gently return to breath
      • 6) Observe sounds, sensations, and emotions, and return to breath
      • 7) Observe thoughts, gently return to breath
      • 8) continue until you can observe, and let them pass away
  • Life is difficult even for extraordinarily lucky people because we are prisoners of our thoughts
  • Meditation allows one to lose one’s self in boundless, open awareness – to feel one with the cosmos
    • Traditional goal of meditation is to arrive at a state of imperturbable
    • Purpose of meditation is to recognize you already have that mind
    • The near term goal is to have an increasingly healthy mind
    • A spiritual master no longer feels identical to thoughts
    • Given that your mind is basis of every experience, it makes sense to train it
    • Perhaps consciousness is incomprehensible in human terms
  • If consciousness can only know itself through self-experience, then spirituality, or rigorous introspection, is the only way to understand it
    • There are two systems – conscious and unconscious
    • Ethics, morals are based on experience of conscious creatives
    • Maximizing well being doesn’t solve mystery of being itself
    • There is intrinsic selflessness of consciousness
    • Purpose of meditation is to cut through illusion of self
  • We all have problems that cannot be solved by more conceptual knowledge
    • Teleporting to Mars and destroying original body? Psychological continuity with past self is normal pattern of survival
    • There is no stable self from one moment to next
    • The only thing that exists is consciousness and its contents
    • We perceive scarcely a scintilla of all that exists
    • The self is illusory
    • We must build our own telescopes to judge empirical claim of contemplatives
  • Every moment offers an opportunity to be relaxed and responsive or to suffer unnecessarily
    • One way to manufacture gratitude is to contemplate all the terrible things that have not happened
    • Consciously practicing gratitude increases well-being, motivation, and positive outlook
    • Meditation can help you learn to not stay angry for long
  • Suddenly paying attention to something that doesn’t support your current emotional state can change your mental state
  • You can pay close attention to negative states, how it feels – what it is – without judgment or resistance, and it can vanish by itself
  • Per Buddhism, being distracted by thought is the root of human suffering
  • For a contemplative, thoughts are being asleep – because you are not present
  • Meditation is method of breaking the spell of thought
    • P. 107 – vision trumps preconception (awareness of position of body)
  • Movies and TV allows us to observe others without being observed. It is voyeurism of a transcendental kind.
  • Self conscious: conscious of others being conscious of us
  • Human mind is wandering mind and wandering mind is unhappy mind
  • Long-term meditation associated with structural changes in brain, larger corpus callosum and hippocampus, increased cortical folding, and could protect from age-related thinning of the cortex
    • P. 126 – Expert meditators respond differently to pain than others
    • One study – 8 week mindfulness reduces stress and decreases volume of right basolateral amygdala
  • 5 mins / day for 5 weeks increased left-sided baseline activity in frontal cortex and positive emotions
  • Mindfulness fosters physical and mental health, immune function, blood pressure, cortisol levels, reduces anxiety, reduces depression, and emotional reactivity
  • There is enormous difference to being hostage to one’s thoughts and feelings and non-judgmentally aware of life in present
    • Deepest goal of spirituality is freedom from illusions of self – but paradox is in seeking freedom
    • Reality is simply the lack of ego
  • Destroy ego by seeking its identity
  • Look closely at what you call, “I.” The feeling of being a separate self will disappear – all that will remain is experience – field of consciousness – free, undivided, and every-changing
    • being free of self is start of spiritual journey
    • Dzogchen practice requires intrinsic selflessness in every moment
    • His journey started with Vipassana and then Dzogchen → not vague or paradoxical
  • Advice: Don’t be satisfied until you are certain you understand practice
    • Recognize non-dual awareness
    • Thoughts and emotions that arise in consciousness are like images in a mirror
    • The mirror is not beautiful – it’s just a reflection
    • Consciousness itself is free no matter what arises
    • Meditation is practice of finding freedom directly by breaking identification with thought and allowing continuum of experience to be what it is – between pleasant and unpleasant
    • Deeper purpose of meditation is to recognize that which is common to all states of emotion
    • Book: On Having no Head
    • Exercise: look out to the world as if you have no head
    • Paradox of acceptance – acceptance is not path to happiness
    • Embracing consciousness is powerful way of training yourself to respond differently to adversity
  • Must accept unpleasant sensations as truly transitory (rather than hoping they go away)
  • P. 149 Must both refuse to be who we have been in past (eg. grow) while also relaxing, and accepting things in present, as we strive to change ourselves
  • One learning in meditation is nothing is internally boring – only a lack of attention
    • Eye contact meditation – gaze into your partner’s eyes without speaking. Ignore laughter.
    • Spirituality also creates the perfect condition for self-deception and exploited trust
    • Drugs are an inadequate term.
  • LSD poses no apparent risk and are physically well tolerated
    • Everything we do is to alter consciousness and drugs are another means toward the end
  • LSD has been proven useful to treat depression, OCD, alcohol addiction, and porn
    • The brain excludes a huge amount of information and psychadelics open the gates
    • Psychedelics can reveal the wondrous of human possibilities and normal consciousness does not offer a glimmer
  • Spirituality in rational terms is missing from secularism, humanism, rationalism, and atheism
  • Self-transcendence is possible. The conventional self is transitory and disappearing when looked for

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High Output Managemeny by Andy Grove Book Summary

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High Output Management

    • Result of globalization? Everyone competes with everyone else.

 

  • High managerial productivity depends on choosing high leverage activities.

 

    • Output of manager is output of organization under his or her control or influence
    • Fundamental tenet of intelligent management is one-on-one meeting
    • Managing your own career? Must continually dedicate to maintaining your own competitive advantage.

 

  • As manager, every minute should be spent increasing value and output of your people.

 

    • Making breakfast, training salesforce, building compiler are all operations:
      • Process – boiling egg
      • Assembly – put egg, coffee, bread together
      • Test – check
    • Common rule: detect and fix problems of lowest-value stage (raw egg, cooked egg, breakfast)
      • Better to fix raw egg
    • To run operation well, you need indicators as measurements
    • 5 metrics
      • Sales forecast and variance
      • Raw material inventory
      • Equipment
      • Manpower
      • Quality

 

  • Pairing metrics works well

 

      • Inventory AND shortage
    • Good measurements measures OUTPUT, not activity
    • Any measurement is better than none
    • For janitor, pairing quality with # of square feet cleaned
    • Leading indicator
    • Variable inspection
      • Randomly digging deep into specific activities
    • High leverage activities generate high levels of output
    • Manager’s output is not:
      • Decisions, judgment, budgets, etc.

 

  • Manager’s output = output of organization and output of neighboring organizations under his or her influence

 

    • P. 45-46 – typical Andy Grove day
    • Manager should invest time where he or she has max leverage
    • P. 48: Information most useful comes from quick, casual conversations
    • Visiting somewhere and observing is underutilized management tool
    • 2 kinds of decisions
      • forward looking
      • Respond to developing problem or crisis
        • Technical
        • or People
    • Decisionmaking depends on comprehending facts
    • This makes information gathering so important
    • Other activities (conveying, decisionmaking, role modeling) governed by base of information you have
    • Information gathering is basis of all other management work
    • Nudging happens 10X more than decisions
      • comments
      • advocating
      • suggestions
    • We are role models for subordinates, peers, and supervisors
    • P. 53 – how you manage time is single most important aspect of being a leader

 

  • 2/3 of Grove’s time is in meetings
  • Which activities could be outside a meeting?
  • Information gathering. Information giving. Decision making. Nudging. Being a role model…
  • High Leverage Activities
  • Many people affected by one manager
  • A single person is impacted over a long period of time

 

      • Large group affected by individual supplying key knowledge
    • Management output = output of org = L(1) * A(1) + L(2) * A(2) … where A = Activity manager does and L extend to which output is increased by leverage
    • P. 34 – Example – Man pushing gear – no leverage … Man pushing 2 gears – leverage
    • Management productivity = output of manager per unit of time is increased in 3 ways
      • Rate of work
      • Increase leverage of existing
      • Shift from lower leverage to higher leverage
    • When?
      • Large meeting? Prepare in advance.
      • Employee quit? immediate.
    • P. 55 Therefore, timelines is incredibly important

 

  • Negative leverage?
  • Example: key participant arrives at meeting unprepared

 

        • 1) Wastes time of people in meeting
        • 2) Lose opportunity for people to do something else

 

  • 2 hours of orientation
  • High leverage on communicating general way of doing things, when people are most impressionable

 

    • Another leverage
      • Manager taking short time, but impacting person’s performance over long time – example:
        • Performance reviews
    • Waffling (putting off a decision that impacts others) is negative leverage

 

  • Managerial meddling is negative leverage (eg. manager assuming command instead of allowing subordinates to work out)

 

    • Another high leverage management activity – applying unique skills and knowledge

 

  • Art of management? Select from many activities of seemingly comparable significant the 1 or 2 or 3 that provide leverage beyond others and concentrate on them

 

      • For him: customer complaints
    • Delegation as leverage
      • Delegater and delegatee must have common information base and set of operational ideas
    • Delegation without follow through is abdication. You can never wash your hands of a task.
    • Mastering delegated task is only practical way to ensure a result
    • mastering results of delegation resembles monitoring in QA…monitor lowest value stage (eg. rough drafts)
    • Frequency of checking? Variable

 

  • Time management?
  • Identify “limiting” steps
  • Batch work – (because processes have set up time)

 

    • Difference between job shop (anyone cna walk in) and factory is work can be forecast

 

  • Most management work can be forecast
  • Medium of forecast? Calendar

 

    • Managers should not use calendars to take orders

 

  • Managers should use calendar for production planning

 

    • 2 calendar management ideas
      • Fill non-critical, but essential work

 

  • say no at outset for work beyond your capacity
  • Another production principle: allow slack or looseness in schedule
  • Manager should carry raw material “inventory” of projects

 

      • (not to be confused with WIP inventory)
    • Managers where work is supervision should have 6-8 subordinates
      • 3-4 — too few → meddling
    • Manager should allocate 1/2 day / week per subordinate
    • Coordinating/consulting/committee = subordinate time
    • Another production concept → Regularity

 

  • Our management work should take characteristics of factory, not job shop

 

    • We should do everything possible to stop little stops and starts throughout the day
    • Most common problem at Intel? uncontrolled interruptions
    • Most interruptions – come from outside organization where work is impacted
    • 2 concepts to handle interruptions
      • standard responses to problem categories
      • batching → Can batch questions and problems at standard times

 

  • Point is to impose a pattern

 

    • Fundamental production principle: make something regular that was once irregular
    • 2 meeting types
      • process oriented – knowledge shared and information exchanged on regular basis
      • mission oriented – ad hoc and cannot be scheduled in advance

 

  • 3 kinds of process meetings at Intel
  • 1:1s
  • staff meetings
  • operations review
  • 1:1 between supervisor “subordinate” and principal way to maintain business relationship
  • Purpose? teaching and exchange of information

 

      • Q: How often 1:1s? job-task-relevant maturity of subordinates

 

  • 1:1 should last a minimum of an hour
  • Anything less on subordinate only brings up simple things that can be resolved quickly

 

      • 1:1 is subordinate’s meeting
      • Q: What’s covered?
        • Performance figures
        • Current hiring/people problems
        • Future plans
        • Potential problems
      • Supervisor role?
        • Learn and coach
    • Grove: principle of didactic management: Ask 1 more question

 

  • Take notes in all circumstances

 

    • Heart to heart issues
    • Leverage of 1:1 example?
      • 90 minute investment every other week
      • Influence 80 hours of work and help manager to learn
      • 1:1s work in personal life

 

  • Staff meeting

 

      • Interactions and decision making as peers – not easy

 

  • better understand issues by watching 2 opposing views interact rather than 1 view

 

      • Q: What to discuss? Anything that impacts > 2 people
      • Combination of mostly prepared and some open time
      • Supervisors most important role = moderator and facilitator

 

  • Operations Review
  • Managers describe work to other managers

 

      • Keep teaching and learning across organization
    • Mission Oriented Meeting
      • A lot up to chairperson

 

  • “It is criminal to allow people to be late and waste everyone’s time”

 

    • Decision making

 

  • Free discussion → Clear decision → full Support (if wrong, then start over)

 

      • organization doesn’t live by all members agreeing all the time …. instead it lives by supporting the decision
      • decisionmaking needs mix of managers and senior with everyone acting as equals in meeting
      • Things that withhold people sharing their views?
        • subordinate – fear of being overruled
        • manager – fear of sounding dumb

 

  • don’t push for decision prematurely … hear real issues

 

      • Once everyone has shared views – push for decision
      • decisionmaking out? == decisions
    • 6 decisions questions
      • what decision to be made? when? who/ Who needs to be consulted? who will ratify or veto? Who to confirm?
    • Key method for controlling output is forecasting demand and building a forecast
      • Determine demand
      • determine what factory will produce
      • reconcile by adjusting production schedule
    • Look at your own group as a company with customers, competitors, etc.
    • Determine customer expectations and perception of your performance
    • Forecast –
      • what do customers want now?
      • what do they want 1 year from now?
    • Will every project be completed?
      • NO – in manufacturing, 80% of materials get finished. OK to factor “loss” in management work

 

  • MBO – Management by Objectives
  • Where do I want to go? (Objectives)
  • How will I pace myself to see if I am getting there? (Key Metrics)

 

    • Manager’s Objectives tied to supervising objectives
    • Team of teams
      • Organizations come in 2 extreme forms
        • mission oriented (BU1, BU2, BU3, etc.)
        • Functional (Merchandising, personnel, real estate, etc.)
      • giving branch manager autonomy leads to mission-oriented organization
      • Take advantage of economy of scale → functional organization and leverage expertise
      • Good management is reconciling centralization and decentralization
      • Hybrid?
        • business divising mission
        • functional group?  internal subcontractors
      • Only advantage of mission oriented? Individual units can stay in touch with needs of business and initiate change rapidly
      • hybrid is only approach
      • coordinating groups are a way for “know how” managers to increase their leverage
      • P. 141 operating task and planning are two planes – different organizational charts
      • Subordinate / supervisory relationship could be reversed in different planes (eg. president reports to chairman of planning committee, controller.)

 

  • Multi-plane organization allows participation without being in charge of everything

 

      • “transitory teams” can solve problems
    • Work behavior goverened by:
      • free market forces
      • contractual obligations
      • cultural values
    • If person is not doing their job, either
      • he or she does not want to do it (motivation)
      • he or she can’t do it (skills)
    • Job of manager is to elicit peak performance from subordinates
    • Two methods:
      • Training
      • Motivation
    • Manager cannot motivate a subordinate because motivation comes from within
    • Manager can help create environment where motivated people flourish
    • Some people are competence driven, others are achievment driven
    • Achievers stretch themselves to test limits
    • MBOs should be 50% achieved
    • To create achievement oriented motivation, create environment that values output

 

  • Once in self-actualization mode, person needs to gauge progress and achievement
  • Most important measure? Feedback on performance

 

    • Grove suggest endowing work with characteristics of competitive sports (eg. maintenance competition.)
    • Task-relevant maturity?

 

  • Best management style dependent on Task-Relevant Maturity OR education, training, skills, experience of person in task

 

    • The presence of monitoring subordinate’s task is difference between abdication and delegation

 

TRM Effective Management Style

Low Structured, task oriented

Medium Individual oriented, 2-way communications support

High Minimal management involvement | Establish objectives and monitor

 

      • As supervisor, should try raising TRM as quickly as possible
    • Giving performance reviews is single most important of task-relevant feedback

 

  • Performance reviews are one of manager’s highest leverage activities

 

      • Purpose of review is to improve subordinate’s performance
      • Review process is most formal type of institutional leadership
      • If performance matters to your organization, performance reviews are necessary
      • One pitfall to avoid is always assess performance, and not potential
      • No action communicates values more clearly than who gets promoted
      • 3 Ls when delivering review
        • Level – be frank
        • Listen – remember more complex the issue, the more prone to communication being lost
        • Leave yourself out

 

  • To make things work, people don’t need to agree with you. They only need to commit to decided course.

 

      • Example: Andy made subordinate write a more thoughtful review of his subordinate, even if the person didn’t want to.

 

  • Supervisors tend to invest more time in improving performance of low perofrmers, but this may be reversed. Investing time in mproving performance of high performers leads to more leverage because high performers do more work

 

    • preparing and delivering performance assessment is one of manager’s hardest tasks.

 

  • Each year, Grove reads and comments on 100 reviews

 

    • Interview purpose?
      • select a good performer
      • Educate candidate on you and company
      • Determine if mutual match exists
      • Sell candidate on job
    • P. 205 Sample questions
      • Describe a highly regarded project
      • Weaknesses? how are you eliminating?
      • Why should we have you?
      • Most significant failure?
    • When someone valued is quitting, your initial reaction is critical
      • Likely they are quitting because you did not appreciate
      • Ask why – don’t argue
    • As supervisor, need to be sensitive to money needs of subordinates
    • Insufficiently trained employees create inefficiencies, excess cost, unhappy customers, etc.
      • Most managers feel training should be left to others
      • Grove believes strongly managers should do their own training

 

  • Manager job = increase output of team
  • How?
  • increase motivation
  • Increase capability → Training
  • Training is one of highest leverage activities a manager can perform
  • for training to be effective, needs to be reliable and consistent – not solving problems in the moment

 

    • At Intel – 2-4% of time is classroom training
    • 2 training tasks
      • About company
      • Ideas, principles, skills, etc.
    • Steps?
      • 1) list things subordinate should be trianed on
      • 2) Take inventory of instruction and materials
      • 3) Prioritize
      • 1st time you teach – throwaway
      • after that – ask for anonymous feedback

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Being Mortal by Atul Gawande Book Summary

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Being Mortal: Medicine and What Matters in the End

    • Scientific processes have turned the process of aging and dining to medical experiments
  • As of 1945 most deaths happened at home. Now only 17%
    • Historically, elders were respected and taken care of by the family and maintained their roles as head of household
    • Process of aging. Tooth loss. vessels and joints hardening and gaining calcium. Muscle loss. Brain shrinks.
    • 40% have dementia by 85
    • Scientists have discovered that all during a single gene can double the lifespan of certain animals such as worms
  • Up until last hundred years, lifespan was ~30… Death was risk in every age
    • Genetics only describes 3% of lifespan variance. Identical twins die 15% apart
    • There is no singular cellular cause of aging – multiple micro issues
  • One of the biggest risks of the elderly is falling so geriatrician would closely examine feet
    • The key treatment for a geriatrician is quality of life
    • There was a study comparing the results of geriatrics and regular physicians. The geriatrics achieved 20% less depression and 40% less home services even though the death rate was the same
    • The geriatricians focused on simplifying medicine regimes, trimming toenails and good meals
    • Scores of the medical centers across the country have shrunk or closed their geriatric Centers
  • There is no way to train enough geriatricians
    • One proposal is to have current geriatricians train primary care physicians. 97% of doctors do not take a single class in geriatrics
    • 1910  – pour houses. Where old people, drunks, and invalids would go
    • People in the past would balk at us complaining about nursery homes
    • Modern old age homes were more about the children’s comfort and improving the elderly’s lives
    • In the 20th century, hospitals ushered in unprecedented results
    • Eventually, the elderly would go to hospitals for their care
    • In 1954, the hospitals lobbied Congress for nursing homes so that the elderly would not be filling up all their beds
    • The modern era did not make nursing homes to assist the elderly with long-term care, but rather it was a way to help the hospitals
    • Nursing homes are like prisons. Their definition of care is safety. But that is not living.
  • The elderly feel that nursing homes are more like hospitals than homes.
    • Rigid schedules of the institution
  • How do we make life worth living for those who are weak and frail?
    • Independent living, then assisted living, then nursing home
    • Home was the key question. The place needed to feel like home
  • In 1983, Park Place, the first assisted living center opened. It had locks on the door. Private apartments. And gave the elderly the freedom. At the same time, they had 24 hour nursing and assistance with food and daily routines
    • As people get older, they prefer to spend time with family more than friends. The opposite is true if you are younger
    • Older people are happier than younger people
    • Carson, Stanford psychologist, thought this had to do with perspective. Knowledge of your own mortality.
  • How we spend time depends on how much time we think we have
    • When future ahead of you is finite and uncertain, your focus shifts to the here and now, Every day pleasures, and the people closest to you
    • Socio emotional selectivity theory – perspective matters
    • Study on those with aids – chose similar to old
    • The simple service of companionship and and provide everyday comforts is what the elderly need
    • Suddenly, assisted living grew rapidly. Then, people not true to the vision started using that name
  • Harvard doctor (bill Thomas) from upstate New York thought the way to improve nursing homes is to introduce life. Plants, children, and animals
  • Boredom, loneliness, and helplessness are the three plagues of nursing homes
    • People started coming to life with all the animals around
    • Death rates fell. The theory is that the animals gave them a reason to live
  • Medical professionals focus on repair of health. Not sustenance of the soul.
  • The paradox is that we’ve decided that medical professionals should decide how we live in our waning days
    • We’ve decided that aging and mortality is a medical concern
  • Safety and protection is not all that we seek in life
  • Autonomy is being the writer of your own story
    • Bill Thomas decided to start a nursing home from the ground up, the greenhouse
    • Each unit had no more than 12 people staying in them
    • Each caregiver would help them get ready, cook, and administer medicines so that they developed more personal companion relationships
    • As people age it becomes more important to curb our medical judgment
  • In the US, 25% of Medicare spending is in the final year of their life. Often when there is no potential benefit
  • The priorities of people with serious illness include: avoid suffering, strengthen relationship w family and friends, not burdening others, and feeling like life is complete
    • Dying in an icu does not provide any of this
  • Hospice care is where you go if you’re willing to sign a form that says that your condition is terminal
  • The goal of hospice is not to extend the life, but to make your current life comfortable
  • 40% of oncologist give treatment that they know will not work
    • Most doctors overestimate how long patients have to live
    • Health insurance company delayed treatment for one breast cancer patient, and even though the treatment would not have worked, jury awarded family 89m. So now insurance companies will continue to fund end of life treatments.
  • People who had a discussion about their end-of-life care were more likely to die at peace, Live longer, and their family was less likely to become depressed
    • Lacrosse, Wisconsin life expectancy over one year longer. In 1881, lacrosse began open campaign discussing end of life care
    • Do you want breathing tube? Antibiotics? Etc.
    • Discussion had brought lacrosse end of care price down 50%
    • The best process for informing a patient and their family that they are dying is to take your time
    • Sometimes, it is easier for doctors to just prescribe chemotherapy. But then, the last months can be miserable
    • Palliative care professionals three magic words were “I am worried” another set of magic words is “what do you want to know?”
  • Technological society has forgotten the dying roll people want to pass on memories, pass on wisdom, complete their legacy and then sure that those they left behind will be okay

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5 Love Languages by Gary Chapman Book Summary

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The 5 Love Languages: The Secret to Love that Lasts

  •  The 5 Love Languages are:

o Words of Affirmation

o Acts of Service

o Quality Time

o Gifts

o Physical Touch

  •  Languages of Love depend on how you were raised.

o Most people were raised with one or two languages, and then marry someone who has other languages.

o This can cause confusion. People think they’re being great to their partner, but they’re often only doing what they’d want done to/for themselves- instead of really thinking about what their partner’s needs are

  •  The key is to know your language of love, communicate it, and be aware of your partner’s language of love.
  •  Then, speak in your partner’s language of love on an ongoing basis for a long period of time (eg. > 6 months) with no expectation in return.
  •  The problem with the “in love experience” is that it is totally unrealistic.

o When you are falling in love, everything is about serving your partner. You allow your world to revolve around your partner- often at the expense of your other responsibilities and relationships. Average in-love experience lasts around 2 years.

o It is excessive and unrealistic.

  •  You need to learn the languages of love to survive a relationship in the real world.
  •  1) words of appreciation.

o Try noticing and complimenting things that your partner does, even if those things are already expected and within their responsibility.

o Encourage and be positive to people for doing what they should be doing anyway.

o Ideas:

  • Compliments
  •  Compliment your spouse daily without any expectation of anything in return
  • Encouragement
  • Kindness
  •  Kindness is the way you say things.
  •  You can even express disappointment in an honest and kind away. “I am disappointed that you didn’t help me this evening.”

o Babbling brook (someone who talks a lot) and Dead Sea (someone who only listens).

  • Advice…track feelings and limit to 3 things…
  •  2) Quality time

o Talking to each other…and doing activities together. Focused, uninterrupted.

o Engage in the other person’s interests

  •  3) Acts of service.

o changing diapers, taking out garbage, cooking, etc

o Even if it is already expected and within their responsibility, it’s still an act of love and service

  •  4) Receiving gifts.

o Gift giving transcends cultures

o Note: You can’t make demands and love. You can only make requests.

o It should always be a request and not a demand.

  • With criticism and demands- when people finally do things, it will not be out of love- just acquiescence and avoidance for more nagging.
  • Make requests out of love.
  • Criticism is an ineffective way of describing what is emotionally important to you in the realm of love
  •  5) Physical touch

o Physical affection of any kind- holding hands, hand on a shoulder, ruffling hair, hugs, kisses, etc.

  •  Ways to discover your love language are to

o See when you criticize what love language are you seeking

o Picture the ideal mate and to see what’s most prominent in your mind about that person- what do they do/say?  

  •  Check your spouse’s “love tank” three times a week to gauge how loved they’re feeling and how well you’re communicating in their love language.

o Have them rate it from 0- empty to 10- full.

o If your spouse is at 10 every day then you know that you’re doing good job.

  •  Try different love languages each week and see which gets the most response from your partner

·  The expression of love in your spouse’s love language unconditionally over the long term is the key to success

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The Hard Thing about Hard Things by Ben Horowitz Book Summary

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The Hard Thing About Hard Things: Building a Business When There Are No Easy Answers

  •         Don’t judge by their surface
  •         Colin Powell: Leadership is to get someone to follow you even just out of curiosity
  •         Diverse perspective
    • Football and Math
  •         Facts vs. alternative narrative explanations
  •         2 types of friends
    • Excited for you
    • Go to with big problems
  •         Stanford Business Schools grads gave presentation and he asked, “Did I ask for this?” = War Time CEO
  •         He took responsibility for success of company
  •         Michael Orvitz
    • “I believe in artificial deadlines.”
    • “I believe in playing 1 against another.”
  •         To get shit done, Ben called a daily meeting to remove obstacles
  •        Figuring out the right product is the innovator’s job – not the customer’s
  •        Sometimes, only the founder has the courage to ignore the data
  •        All decisions are objective until 1st line of code….Then all decisions are emotional
  •        Conventional wisdom DOES NOT equal truth
  •        Efficient market hypothesis is deceptive
  •        Market efficiently converge on solution – often the wrong one
  •        Bushido Warrior keeps death in mind and lives each day like it is his last
  •        CEO should tell it like it is –
    • Ben’s biggest improvement – stopped being so positive
  •        1) Trust
  •        2) More brains working on problem
  •        Once deciding to lay off
    • Execute quickly
  •        Bad advice…hire someone “bigger” than required. Hire the right person for your company context over next 12-18 months.
  •        Q: How to demote a friend?
    • A: Move to another part of company
    • Use appropriate language, “I decided”
    • Acknowledge contributions
    • Admit reality
    • You could couple demotion with salary increase…
  •        Best way to deal with emotions is to leave emotion out of ity
  •        Take care of:
    • People
    • Product
    • Profits (in that order)
  •        2 most important positions in software
    • VP of Engineering
    • VP of Sales
  •        Training is the manager’s job
    • Andy Grove – high output management
    • Training is highest leverage work a manager can do
  •        P. 132 – measuring cost acquisition – OK … cust retention – not good
  •        Companies execute well when
    • Everyone is on same page
    • Everyone is constantly improving
  •        If an executive is complaining about performance of another executive, the situation has gone too far
  •        Tech startups are in furious race against time
  •        Q: outside vs. internal promotion?
    • What do you value more?
    • Outside knowledge or inside knowledge?
  •        One way to raise your standard is interview experts in field and ask, “What do yo look for?”
  •        P. 176-177 – one on one meetings – employee meetings
    • Stuff that doesn’t fit in status report
  •        Primary thing a startup must do is build something 10x better than what is out there
  •        #2 take the market
    • Cultures do not make the company
  •        Culture
    • Distinguish from competition
    • Ensure operating values
  •  Delight customers
  •  Make beautiful products
    • Identify employees that fit mission
    • P. 182 – $10 / minute
  •        CEO Job
    • Knowing what to do
    • Getting the company to do it
  •        Things cause no problems when small become big problems when you grow
    • Communication
    • Common knowledge
    • Decision making
  •        Scale techniques
    • Specialization (build, test, ops)
    • Org design
  •        Rule of org design
    • All are bad tradeoffs in communication
  •        Org design
    • Communication architecture of company
  •        Further away in org  = less communication
  •        Steps
    • 1. Figure what to communicate
    • 2. What decision
    • 3. Communication and decision paths – do we want engineers thinking of customers?
    • 4. Who runs group?
    • 5. Identify paths not optimized
    • 6. Build plan to mitigate
  •        Process
    • Purpose is communication
    • When communication spans boundaries – process
  •        Q: Process design?
    • What are process outcomes/goals? (eg. Interview process = great employees)
    • How do you know if you are success of each step?
  •  Enough candidates?
  •  Right candidates?
  •  Right …?
  •  Accept
  •  Product
  •  Retain?
    • Accountability
  •        Good to anticipate growth … bad to over-anticipate growth
  •        No such thing as great executive – only great exec for specific company at a specific time
  •        Make judgment of executive relative (eg. For this company at this point in time, is there better executive I can hire?)
  •        Predicting if executive can scale corrupts ability to manage
  •        Herb Allen invested in:
    • Courage
    • Determination
  •        2 CEO mistakes
    • Taking things personally
    • Not personal enough
  •        Ideal:
    • Urgent, but not insane
  •        2 key characteristics
    • Brilliance
    • Courage – much harder
  •        CEOs possess different data, knowledge, and perspective
  •        If smart people take other side, on 54-46% decision, very hard tst of CEO courage
  •        P. 212 – expected social reward for crowd-influenced decision si high
  •        Hard, correct decisions = courage
  •        Wrong, easy decisions= not
  •        Succession planning – internal candidates > external because of knowledge
  •        Ones – set direction
  •        Twos – get company to perform at highest level
  •        CEOs must be Ones and Twos
  •        Twos act as Ones for their function
  •        Most oerganizations run by Ones with functional Twos
  •        Define leader
    • Quantity, quality, and diversity of people who want to follow
  •        1) Activate vision
  •        2) Right ambition
  •        3) Achieve vision
  •        Truly great leaders create environment where employees feel leader cares mor about employees than herself
  •        Peacetime CEO – steadily growing market – building on strength
  •        Wartime CEO – facing an existential threat
  •        Most management books describe peacetime, not wartime
  •        Classic peacetime – never publicly humiliate employees
  •        P. 230 – Feedback
    • Constantly giving feedback is precisely what a CEO must do
    • As CEO, have an opinion on everything
  •        Does CEO know what to do?
  •        Can CEO get company to do what she knows?
  •        Did CEO achieve results against appropriate objectives?
  •        Personal, financing, product strategy goals, selling, marketing – In good companies….Story = strategy
  •        CEO creates context – why work here? Why buy?
  •        Clear story = clear context
  •        CEO doesn’t have to create story or vision – but keep it
  •        2) Decisionmaking
    • Speed and quality of decisions
    • Elite mix of intelligence, logic, and courage
  •        Most difficult decisions are often not popular with constituencies – employees, board, customers
  •        Never enough time to gather all information
  •        Must systematically gather information on ongoing basis
    • Competitors
    • Technically possible in what time frame
    • True organizational capability
    • Financial
    • Product architecture
    • Employee sentiment
  •        To executive braod set of decisions
    • 1) Capacity (right people)
    • 2) employees have context, motivation to accomplish them
  •        Great CEOs constantly assess whether they are building the best team
  •        How easy is it for contributor to get job done?
  •        The first task in measuring results is setting objectives correctly
  •        CEO shold be evaluated on company opportunity
  •        Accountability vs. creativity paradox
    • Accountability for effort – check
    • Accountability for results
    • Reply to e-mail = easy
  •        Engineering schedule depending on solving hard CS problem = harder
  •        1) Sr. People should forecast more accurately
  •        2) Degree of difficulty
    • Sales #s with inferior product = hard
  •        3) amount of stupid risk
  •        Difference between mediocre + magic is difference between taking creative risk and holding team too tightly accountable
  •        Accountability = important, but not only thing
  •        Freaky Friday management – 2 warring roles – change functions
  •        As CEO, you do little employee development that happens at functions below you
  •        #1 reason executives fail – continuing to do old job instead of new one
  •        Loyalty must go to employees
  •        If you are early in a large market, that has a chance to be #1 , then remain standalone
  •        Andreeson Horowitz
    • Tech founders or innovator running the business
    • Skill gap between tech and professional CEO
  •  CEO skillset
  •  Network
    • Network
  •  Large companies
  •  Executives
  •  Engineers
  •  Press and analysts
  •  Investors and acquirers
    • Marx quote: “life is struggle.” … embrace the struggle
    • Embrace your weirdness, background, and instinct

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Purpose of this site

My name is Nitin Julka and I share book notes and summaries on an email newsletter each month.

I usually copy and paste the book notes and summaries into a single Google doc, but I noticed that the doc was becoming unwieldy and difficult to search.Therefore, I am going to also use this site to store each of my book notes and summaries.

If you like what you see, feel free to sign up for my email newsletter where I share these summary book notes each month.