Escort girl chat, healthcare jobs hole, a glimpse of Glasgow
I chat with Aella on escort girl economics and her life. I contemplate healthcare jobs. I glimpse Glasgow.
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This week:
Escort girl economics, losing faith and rationality.
Re-inventing Trainers: Chatham House event Dec 2
Glimpses of Glasgow and a meet-up
Links: Climate, property, austim, theatre audiences
This week I’ve mostly been deep in contemplating healthcare investing. It’s virtually impossible today to think about investing without being aware of inflation, the great quitting, and supply chain challenges along with many of the other underlying structural shifts and debates (china, netzero, digital). Within the global context the trials and tribulations of the UK are still moderately minor which is a reflection I have from time to time.
In healthcare, innovation continues at a really fast pace. Arguably, it has been a little slower than some inventions in tech and digital (consider Nvdia - graphics/metaverse - Microsoft and the like) but, in my view, not that much slower. The development cycles in healthcare are longer and the results are less flashy to show off in the immediate term. Losing 5 kgs of weight via a pill over 12 weeks not as immediate vs a metaverse video.
Still, I am pretty certain those innovations in healthcare are coming and some of them are here.
Healthcare is not immune to the great quitting. I hear employee turnover is running at 20% for a typical homehealth and hospice company. They are losing 1 in 5 employees…. This is the same trend hitting theatre especially in the low wage parts of theatre that I’ve been commenting on. Macroeconomists are confused, but if you talk to people it seems obvious to me. People don’t want crap jobs and the pandemic has allowed them to reconsider. Not everyone will have an option to change but quite a few of them will.
This is what Ed Yong writes in the Atlantic about the US. In the UK, there are 39,000 vacancies and eg one in 10 nursing posts unfilled on acute wards in London and one in five nursing posts empty on mental health wards in the south-east.
Why Health-Care Workers are Quitting in Droves:
Health-care workers, under any circumstances, live in the thick of death, stress, and trauma. “You go in knowing those are the things you’ll see,” Cassandra Werry, an ICU nurse currently working in Idaho, told me. “Not everyone pulls through, but at the end of the day, the point is to get people better. You strive for those wins.” COVID-19 has upset that balance, confronting even experienced people with the worst conditions they have ever faced and turning difficult jobs into unbearable ones.
In the spring of 2020, “I’d walk past an ice truck of dead bodies, and pictures on the wall of cleaning staff and nurses who’d died, into a room with more dead bodies,” Lindsay Fox, a former emergency-medicine doctor from Newark, New Jersey, told me. At the same time, Artec Durham, an ICU nurse from Flagstaff, Arizona, was watching his hospital fill with patients from the Navajo Nation. “Nearly every one of them died, and there was nothing we could do,” he said. “We ran out of body bags.”
...Many health-care workers imagined that such traumas were behind them once the vaccines arrived. But plateauing vaccination rates, premature lifts on masking, and the ascendant Delta variant undid those hopes. This summer, many hospitals clogged up again. As patients waited to be admitted into ICUs, they filled emergency rooms, and then waiting rooms and hallways. That unrealized promise of “some sort of normalcy has made the feelings of exhaustion and frustration worse,” Bettencourt told me.
Health-care workers want to help their patients, and their inability to do so properly is hollowing them out. “Especially now, with Delta, not many people get better and go home,” Werry told me. People have asked her if she would have gone to nursing school had she known the circumstances she would encounter, and for her, “it’s a resounding no,” she said. (Werry quit her job in an Arizona hospital last December and plans on leaving medicine once she pays off her student debts.)
...Many have told me that they’re bone-weary, depressed, irritable, and (unusually for them) unable to hide any of that. Nurses excel at “feeling their feelings in a supply closet or bathroom, and then putting their game face back on and jumping into the ring,” Werry said. But she and others are now constantly on the verge of tears, or prone to snapping at colleagues and patients. Some call this burnout, but Gerard Brogan, the director of nursing practice at National Nurses United, dislikes the term because “it implies a lack of character,” he told me. He prefers moral distress—the anguish of being unable to take the course of action that you know is right.
Health-care workers aren't quitting because they can’t handle their jobs. They’re quitting because they can’t handle being unable to do their jobs.
A few questions and thoughts to throw out to you:
I’m chatting to the head of sustainability of AstraZeneca soon. If you had a question for her, let me know and I can try and weave it into the conversation.
Similarly, if you had a question for the CEO of Pfizer, what would it be? (Note most of their business is not COVID related).
I’m contemplating an Unconference on longtermism. I’ve not socialised the idea yet, but if this is intriguing, let me know.
I had a glimpse of Glasgow. Some observations: compared to London, the culture of mask wearing is much more dominant. Notices and nudges are everywhere and people comply.
Even post COP26, most hotels are full or near full. The Glasgow youth seem to be out, unsure how close to normal but the high heels and skimpy dresses, and the drunken boys on a Saturday night seem fairly normal.
I had this conversation with my Uber driver.
“Are you from Glasgow?”
(Subtext: Where are you from, you don’t look local)
“I’m from London”
(I know what you are asking)
“My father was from Malaysia. My mother from Singapore”
“Ah. Yes. That explains…” gestures.
“Did you grow up here?” (Of course, you didn’t but what’s your story).
“I was born Pakistan. I came here to architect school. 20 over years ago. “
“You are doing design now ?”
“I couldn’t get a job. I was qualified. But the language was hard. Their accent. My accent. So I needed a job. I trained again. I became a chef.”
“You still a chef? You speak Urdu?
“I speak Urdu. Punjabi. But, nah. After 20 years. I argued with the owner. I stopped being chef. I now drive taxi.”
“Is it good for you?”
“It’s better than a restaurant.”
“You are in control. Better money?”
“Acha. Acha”
“You miss Pakistan?”
“Pakistan too much corruption. Too many say they are good Muslims. But not good Muslims. Corrupt. Here is your stop.”
“Be well.”
My reflection - I don’t know the full story but it seems to me…what a waste of human potential.
In Glasgow, I heard about the role of cities in meeting environmental and social challenges. Cities can lead where national goverments are struggling and the majority of the world is living in cities now.
How most Scots now have an opinion on independence. And a second failed vote would put off voting for along time (cf. Quebec).
I heard about the lived experience of racism and so many variations of its expression. How David Hume was racist and that transmission via Kant had an impact on western thinking.
How we can’t change history, but we can change its consequences.
The challenge of the aspirational US working class. How if they turn from aspiration to desperation, it’s hard.
How Anthony Scaramucci may have done only one major act of public service and that is remove Steve Bannon from a position of power.
I learned about nano-satellites. Efforts on Scottish industrial policy.
How a restaurant business might be more sustainable.
How a large mix of people have found their pandemic year. Sorrows and sadness but resilience and connections too.
I heard opinions on how COP26 has moved the climate agenda on.
Hello any BAPers. The greatest of meet-ups change you. Then you go on to change the world.
Occasionally, a snowflake falls on the mountainside and an avalanche occurs.
The best meet-ups are an avalanche of ideas and a meeting of minds.
Again, I’ve been challenged by the observation that life is messy. Yet what unites and binds us as humans still remains greater than our divisions.
For all the polarization in the world, there are still places to meet. Respect. Life. Chaos. Arguments. Hugs.
Remote is important. There’s still the joy of random mass meet ups.
Glasgow in the sunlight and blue sky is quite beautiful.
Two pieces of art, I dwelt on.
And, Frank Auerbach.
I think Glasgow is well worth a visit.
Podcast this week. I cannot exactly articulate for you all the reasons why I’m doing podcasts. Podcasts help me learn deeply. If I’m going to chat with a philosopher about their work, I’m going to study their work fairly thoroughly.
Much of my life is based around communication and in particular asking good questions and having productive conversations. In my investing life this concentrates on CEOs but across my creative life, it’s everyone. Podcasts are superb training for holding better conversations and listening.
Podcasts in today’s world allow you to speak with people you would never otherwise speak to and hear lived experience you might otherwise wouldn’t.
My chat with Aella was one of those conversations.
Aella grew up homeschooled as a fundamental Christian. She lost her faith. Left home at 17. Some days during that period, she went hungry not having enough to eat. She gained a job working at a factory as a low wage worker. She managed to find another better job in photography, but could not hold on to it partly as she could not fit in culturally. She started escort work.
I’ve never had faith. Listening to Aella speak about having a worldview completely upended has stayed me with me a long while. Partly, faith can explain why humans do some extraordinary things. Losing faith can explain why humans can find radical uncertainty and then question everything. Thinking about that can also make sense of why we cleave to faith and culture and our tribes and the like, the social creatures that we are.
I had a conversation I simply could not contemplate having. Covering a little of escort economics but more on concepts or practices I’ve not come across or not explored much including circling, taking a lot of psychedelics and why despite being homeschooled as a fundamental Christian she is passionate about homeschool and against public school.
Listen here or video/transcript. Also below.
Aella is perhaps most famous on twitter for shining a light on the life and economics of Camgirls and escorts; and asking challenging questions. But her independent research is larger than that and has encompassed reporting on LSD and psychedelics use, circling, the nature of faith, and enlightenment. She grew up homeschooled in a fundamental Christian household before leaving home at 17.
The transcript and conversation includes adult themes and mild profanity from Aella and is recommended 18+.
We discuss what is most misunderstood about escort work and the additional needs of men such as emotional intimacy. How Aella thinks of her own compartmentalisation.
What you should say about male anatomy size. How insecurity can go both ways on male thinking on size.
What Aella thinks about Twitter and making questions and polls.
What it was like to have ideas you took for granted completely turned on their head. For instance, what she was taught to think of gays.
We chatted about her interest in psychedelics, speaking to people who think they are enlightened and spirituality. And what that intersection with rationality is for her.
She discusses several viewpoints of the Rationalist community and her views on Effective Altruism. Her thoughts on archaeology and thinking about moral arguments in their place in time.
Why she feels to strongly about home school.
Her thoughts on losing faith.
What it was like working in a factory, and what the point of secret messages she scratched at her work were.
How she has struggled with cultural norms.
How she answers some of her own questions:
You're in a room with 10,000 people. You get to ask three binary questions. Yes or no. For each question, the people who answer the question according to the way you want, they stay and the people who don't leave the room. What do you ask?
We play underrated / overrated on these topics:
Accordion
Ballroom Dancing
Pronouns
Abalone
Sweating on command
This week links:
Invite to Chatham House event on Dec 2.
Improbable looking for an exec director:
On mini Nukes
Gg
On autism
On how the elites made theatre audiences go quiet:
More on COP26 after thoughts
On US property (but seems similar to much in the UK).