<script data-pm-proxy="intercept"></script><?xml version="1.0" encoding="UTF-8"?><rss xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:atom="http://www.w3.org/2005/Atom" version="2.0" xmlns:itunes="http://www.itunes.com/dtds/podcast-1.0.dtd" xmlns:googleplay="http://www.google.com/schemas/play-podcasts/1.0"><channel><title><![CDATA[Nassim Nicholas Taleb]]></title><description><![CDATA[Probability, applications and inferential rigor.]]></description><link>https://nntaleb.substack.com</link><image><url>https://substackcdn.com/image/fetch/$s_!a8dV!,w_256,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3391b634-83e6-4241-8216-3396ea92d12e_144x144.png</url><title>Nassim Nicholas Taleb</title><link>https://nntaleb.substack.com</link></image><generator>Substack</generator><lastBuildDate>Tue, 01 Sep 2026 10:46:59 GMT</lastBuildDate><atom:link href="/__u/nntaleb.substack.com/feed" rel="self" type="application/rss+xml"/><copyright><![CDATA[Nassim Nicholas Taleb]]></copyright><language><![CDATA[en]]></language><webMaster><![CDATA[nntaleb@substack.com]]></webMaster><itunes:owner><itunes:email><![CDATA[nntaleb@substack.com]]></itunes:email><itunes:name><![CDATA[Nassim Nicholas Taleb]]></itunes:name></itunes:owner><itunes:author><![CDATA[Nassim Nicholas Taleb]]></itunes:author><googleplay:owner><![CDATA[nntaleb@substack.com]]></googleplay:owner><googleplay:email><![CDATA[nntaleb@substack.com]]></googleplay:email><googleplay:author><![CDATA[Nassim Nicholas Taleb]]></googleplay:author><itunes:block><![CDATA[Yes]]></itunes:block><item><title><![CDATA[Have Another Drink!]]></title><description><![CDATA[Government sponsored study on alcohol doesn't stand up to scrutiny.]]></description><link>https://nntaleb.substack.com/p/have-another-drink</link><guid isPermaLink="false">https://nntaleb.substack.com/p/have-another-drink</guid><dc:creator><![CDATA[Nassim Nicholas Taleb]]></dc:creator><pubDate>Sat, 15 Aug 2026 21:50:58 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!eKIZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>I have been finding flaws in studies critical of alcohol consumption in low to moderate doses.  The one I will examine is the following one used as &#8220;definitive&#8221; argument in the medical discussions.</p><p>George S, Naimi TS, Keyes K, Martinez-Matyszczyk P, et al. (including Shield KD). &#8220;Alcohol Intake and Health Study: No Protective Effect at Low Levels, With Mortality Increasing to 1 in 25 at 14 Drinks Per Week.&#8221; <em>Journal of Studies on Alcohol and Drugs,</em> 2026 (Vol. 87, Issue 4; DOI: 10.15288/jsad.25-00435). This analysis was commissioned by the US goverment. It has a deceiving title and a deceiving summary conclusion:  &#8220;At low levels of consumption, no protective net effect of alcohol consumption on health was observed.<em>&#8221;</em>. Their claim is that lifetime alcohol-attributable mortality risk were &gt;1 in 1,000 at around 7 drinks per week and reached  ~1 in 25 (4%) at 14 drinks/week (the established upper guideline limit). It offers a guidance of no more than 1 drink per day (or less).</p><p>Table 1 in the paper shows data that doesn&#8217;t fit the narrative (there are obvious gains from alcohol at low levels, and high standard errors) and, worse, some methodology that is obscure enough to be suspicious.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!eKIZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!eKIZ!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, 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/__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!eKIZ!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png" width="1345" height="611" 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/__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png 424w, /__u/substackcdn.com/image/fetch/$s_!eKIZ!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png 848w, /__u/substackcdn.com/image/fetch/$s_!eKIZ!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png 1272w, /__u/substackcdn.com/image/fetch/$s_!eKIZ!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F3fc5669f-e464-483c-a998-cbb3470c3346_1345x611.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">The central result.</figcaption></figure></div><p>Primo, they use mysterious asymmetric CIs (confidence intervals). The risk for 7 drinks for &gt;70, here &#8722;5.47, is not halfway in [&#8722;28.59  14.57] (should be &#8722;7.01).  Nothing appears to fit a standard probability distribution. The lognormal must be ruled out since there are negative risk numbers. Monte Carlo (MC)? needs an explanation. The supplemental material is highly amateurish and silent on calculation.</p><p>Secundo, the total risk is an exact unweighted sum of all age segments. However the CI are <em>not</em> added.  The total interval is tighter than the sums of subparts. Naive summation gives 35.81, quadrature (independence) gives 22.42, and TABLE 1 reports 31.86, much nearer to dependence. This is a  MC propagating the uncertainty using correlated draws for every age bracket.</p><p>This is sloppy. We have no idea about the correlation structure. Their baby equations in the text and their supplementary bloviation do not explain it.</p><p>Terso, one age bracket dominates the study &#8212;the one where standard error is maximal, where cause of death is almost never isolated. For males consuming 21 drinks, the &gt;70  contributes 27.30 of 68.92 , [5.58, 48.33]. So the entire claim rest on the most stochastic segment: mortality is highest, exposure is recalled and subjected to survivor-filtering, the cause-of-death attribution is almost never unique. The underlying subjects are frail. There is no sensitivity analysis excluding it/bootstrapping, etc.</p><p>For a paper claiming to overturn decades of alcohol drinking recommendations, the statistical foundation is underdocumented and, to be mild, statistically strange. There is nothing definitive there.</p>]]></content:encoded></item><item><title><![CDATA[The Book is a Book, not Disembodied Information]]></title><description><![CDATA[Believing that the book is just abstract information that can be merely held on a stick is an error we will call dimension overtrucation.]]></description><link>https://nntaleb.substack.com/p/the-book-is-a-book-not-disembodied</link><guid isPermaLink="false">https://nntaleb.substack.com/p/the-book-is-a-book-not-disembodied</guid><dc:creator><![CDATA[Nassim Nicholas Taleb]]></dc:creator><pubDate>Tue, 11 Aug 2026 18:53:11 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!U9wZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p></p><p style="text-align: justify;">Believing that the book is just abstract information that can be merely held on a stick is an error we will call dimension overtrucation.</p><blockquote><p style="text-align: justify;"><em><strong><span>Definition:</span></strong><span> Dimension overtruncation is a Procrustean-bed in which the simplification of an object, phenomenon, or process proceeds beyond the level that can be justified without material loss. It applies to situations when the focus is confined to easily observable dimensions while less visible ones &#8211;while central &#8211;are ignored. Thus, an item may be assumed to be used for a stated purpose while its survival and persistence are attributable to other, unrecognized dimensions.</span></em></p></blockquote><p style="text-align: justify;">I read Victor Hugo&#8217;s <em>Les mis&#233;rables</em> when I was thirteen. The book remained in our family library in Lebanon for years, then somehow strayed from it, as books tend to do, serially running away with each borrower. A few years ago, I found it again on the shelves of a relative. It was the Pl&#233;iade edition, printed in dense type on thin, Bible-like paper, and had survived for nearly half a century. I held it in my hands and did not need to open it to recover, in a flash, the gripping experience of reading it&#8212;particularly the passage in which Cosette suddenly felt the bucket she had been struggling to carry become light: Jean Valjean had taken hold of it and was helping her carry it.</p><p style="text-align: justify;">I smelled the book: it was a period smell for printing techniques, at the time, used different materials. I won&#8217;t do a Proustian <em>madeleine</em> tirade here about the potency of the olfactory dimension; just note an inseparability here. I will never know whether it was holding the book or smelling it that brought the episode back.</p><p style="text-align: justify;">The physicality of the book &#8211;more than its content &#8211;is what makes it real. I saw then that one cannot effectively separate the physical presence from the reading experience.</p><p style="text-align: justify;">Not long afterwards, there was some excitement about the arrival of the Kindle, a hand held device for reading electronic books. It was roughly the size of a standard book hence claimed to emulate the conventional format. The main reason I heard of it was because<em> The Black Swan</em> was the book used by Jeff Bezos during the launch press conference as he was making annotations on the virtual pages during the demonstration. I was horrified; I like books, and by books I mean that inconvenient thing you hold in your hand, pick up from a table, and carry in your backpack. Every book must be a separate item &#8211;a single book with different contents induces a loss in differentiation.</p><p style="text-align: justify;">Things got worse when I met Daniel Kahneman on the following day and he was singing the praises of the Kindle. I tried to explain to him that reading virtual formats miss a fundamental dimension. I had just read the story by the Russian scientist A.R. Luria about some kind of memory genius whose ploy consisted in associating phrases with physical objects, applying the mnemonic trick ancient Greeks call the method of the <em>loci</em>. Each locus has to be spacially separed. Furthermore I had discovered quite early on that things you read online are hard to remember. Kahneman wavered between the excitement of neomania and the convenience of academic research on one hand and, on the other, a compelling psychological argument coming from his discipline. He agreed half heartedly. You could carry an entire library on that device and pick what you want on your next trip to Chicago, that type of thing, was his argument.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!U9wZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!U9wZ!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!U9wZ!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!U9wZ!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!U9wZ!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, 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/__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!U9wZ!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!U9wZ!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!U9wZ!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa017ddaa-d991-4bd7-bbe0-c58edefe6114_2338x1630.jpeg 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Every time I glance at a book it is like rereading it.</figcaption></figure></div><p style="text-align: justify;">This is the classical Procrustean bed type of reduction in dimensionality. You think you are reading abstract content but we are not abstract beings and the physical book recruits more channels than you can intellectually perceive.</p><p style="text-align: justify;">I keep notes on the front page of my books, referring to the corresponding page. I often consult them while looking for references &#8211;like just now. I realized that all I have to do is find the book in my library, pull it out of the shelves, and the idea referenced in it would come to me in a flash. It is practically impossible for me to work entirely from electronic formats. As to more complicated subjects, say mathematical material, only the physical works &#8211;I could tell that complicated stuff required physical paper from seeing my students printing out the assigned reading and taking notes on them.</p><p style="text-align: justify;">This inseparability of the content and its embodiment is the reason I&#8217;ve decided to keep every book I&#8217;ve read in the original format in which I have read it. This is not for any functional or pragmatic reason. This is not for any reason other than existential: once you&#8217;ve read a book, you are effectively rereading it every time you take a glance at it.</p>]]></content:encoded></item><item><title><![CDATA[A Lebanese Technology Transfer]]></title><description><![CDATA[Notes on a blowup]]></description><link>https://nntaleb.substack.com/p/a-lebanese-technology-transfer</link><guid isPermaLink="false">https://nntaleb.substack.com/p/a-lebanese-technology-transfer</guid><dc:creator><![CDATA[Nassim Nicholas Taleb]]></dc:creator><pubDate>Fri, 07 Aug 2026 15:19:26 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!bXwC!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><span data-color="#ff0000" style="color: rgb(255, 0, 0);">Postface to Abi-Rached and El-Richani&#8217;s </span><em><a href="https://www.hurstpublishers.com/book/lebanon-3/"><span data-color="#ff0000" style="color: rgb(255, 0, 0);">Lebanon: Anatomy of a Collapse</span></a></em><a href="https://www.hurstpublishers.com/book/lebanon-3/"><span data-color="#ff0000" style="color: rgb(255, 0, 0);"> </span></a></p><p>I would like to repeat an aphorism that Lebanon has twice the qualities found in the Mediterranean world, but twice the flaws. This can generalize beyond the Mediterranean: Lebanon can be a place to study both societal functioning and its maladies.</p><p style="text-align: justify;">For the Lebanese crisis under discussion in this volume appears to be a rare confluence of three ailments hitting a country as if by some conspiracy of providence. And by some divine coincidence, the solution is also found in Lebanese (more generally North Levantine) history.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!bXwC!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!bXwC!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg" width="378" height="529" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:529,&quot;width&quot;:378,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:null,&quot;alt&quot;:&quot;Figurines from the Temple of Obelisks at Byblos, Lebanon.Gilded  bronze,7th-8th BCE.National Archaeological Museum, Beirut, Lebanon.&quot;,&quot;title&quot;:null,&quot;type&quot;:null,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Figurines from the Temple of Obelisks at Byblos, Lebanon.Gilded  bronze,7th-8th BCE.National Archaeological Museum, Beirut, Lebanon." title="Figurines from the Temple of Obelisks at Byblos, Lebanon.Gilded  bronze,7th-8th BCE.National Archaeological Museum, Beirut, Lebanon." srcset="/__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!bXwC!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F47c38113-6632-400a-a533-d27dfaf6956b_378x529.jpeg 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p style="text-align: justify;">This author, who grew up in Lebanon (and never really left it socially and intellectually), happens to specialize (in both academic research and business activities) in these exact three major ailments &#8211;though applied to Western societies and financial markets. By a curious technology transfer, yours truly generalized from Lebanon and applied overseas.</p><p style="text-align: justify;">Primo, there is what one can call <strong>the carry trade</strong> (or the active concealment of risk under the rug); secondo, there is the risk transfer between agents (<strong>skin in the game</strong>); and, tertio, there is the fragilization of an economy by stifling the market signals and dampening its natural intellectual and business fertility. And what is the remedy? The building of a system along the lines found in Lebanese history, something called <em>antifragility</em>.</p><p style="text-align: justify;">The &#8220;carry trade&#8221; is as follows. Start producing steady returns while hiding some tail risk in the corners. People will invest. Keep going. Then they will invest more. At some point, some will give you all their savings. Then the greediest (and risk-blind) will blow up and nobody will hear of them. Owing to the survivorship bias, their losses will be both absent from the collective consciousness and, worse, from much of the salient record. Losers don&#8217;t write books (if they did nobody would publish them) and, as every financial statistician would confirm, dead entities are not listed in phone books, dead stocks are not easily found on Bloomberg lists, and the wisdom and the experience of bankrupt people isn&#8217;t found on the shelves of your local bookstore.</p><p style="text-align: justify;">There are accounting and psychological explanations for the appeal of the carry trade as well as an inordinate amount of hidden moral hazard.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!3hpV!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 424w, /__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 848w, /__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 1272w, /__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!3hpV!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png" width="1328" height="968" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:968,&quot;width&quot;:1328,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:208205,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://nntaleb.substack.com/i/210227528?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="/__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 424w, /__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 848w, /__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 1272w, /__u/substackcdn.com/image/fetch/$s_!3hpV!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4a7ff2ec-8d50-4afd-8a1c-793ec62667a4_1328x968.png 1456w" sizes="100vw"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p style="text-align: justify;">First, let us start with the way investors and depositors like to fool themselves with hidden risks that blow up on the occasion. Kahneman and Tversky showed empirically (see this author&#8217;s many interpretations<a href="#sdfootnote1sym"><sup>1</sup></a>) that the value function (the equivalent to the conventional utilility in their framework) is concave in the gain domain and convex in the loss domain. This means that, hedonically, making small gains repeatedly and losing the bulk (and more) suddenly brings more psychological satisfaction than the reverse, that is, losing (or underperforming) continuously and gaining abruptly. This invites the selling of tail events for pennies.</p><p style="text-align: justify;">Second, the moral hazard, the &#8220;crooks of randomness&#8221; effect, or the Robert Rubin Trade, covered in <em>Skin in the Game</em>. Robert Rubin, when he was the vice-chairperson of Citi, made close to a hundred million dollars in bonuses over a decade for a trading strategy that sells the tails and hence benefits from absence of volatility. When Citi lost everything and more from such fragile betting on the tails, all he had to do was invoke an unexpected event nobody foresaw, a &#8220;Black Swan after a (very) stubborn Lebanese author-trader&#8221;. And he kept his 100 million dollars and his Fifth Avenue apartment while the taxpayer had to directly and indirectly bail out Citi.</p><p style="text-align: justify;">Recall that U.S. money center banks (including the very same Citi) lost every penny they ever made in their history on a single event, in the summer of 1982, from emerging market loans that defaulted collectively, something that convincingly shows that the Robert Rubin Trade is going to be repeated at some point in the future. Furthermore, the entire analytical apparatus of the financial economics establishment, based on the Gaussian distribution, deemed these strategies &#8220;safe&#8221;. A couple of &#8220;Nobel&#8221; laureates in economics (that is the Medal in honor of Alfred Nobel) were fooled by it as they blew up and lost their own fortunes, particularly in 1998 with the bankruptcy of Long-Term Capital Management. Likewise another &#8220;Nobel&#8221;, Joseph Stiglitz, deemed the tail risks of FNMA (which ended up with a blowup of 600 billion) as non-existent. For the economics establishment, the tails were deemed expensive, hence irrational to not sell &#8211;a belief that mysteriously lingered without any empirical backing.</p><p style="text-align: justify;">Now something similar happened in Lebanon, <em>couleur locale</em>. Depositors were making steady income from the carry trade and fooled by it &#8211;it is remarkable how fooled investors like to theorize to justify their strategy (Nobel or no Nobel). The central bank delivered to them the ideal Ponzi: it created fake local U.S. dollars that yielded more than the real U.S. dollar, and that at a time when U.S. rates went to literally zero (as a consequence of the generalized bailout of the system after the blow-up of the Robert Rubin Trade). The differential was, in their eyes, compelling. This attracted every carry hog in Lebanon and even among Lebanese expatriates.</p><p style="text-align: justify;">The problem with the carry trade is that it came with the necessary artificial stabilization of the Lebanese Lira, in order to give the impression of a &#8220;dollarization&#8221; of the local economy. Yet nothing fragilizes more than artificial stability. People liquidated their businesses, workshops, and legit activities just to invest in a supposedly &#8220;risk-free&#8221; deposit yielding 7%. Many people retired prematurely. The Central Bank ended up sucking away all funds from the economy for that stabilization business.</p><p style="text-align: justify;">This was particularly painful to this author. For my personal strategy is as follows. Find anything that produces steady returns, take the other side, and wait for the blowup. Then wait again for new suckers to enter the market &#8211;often the same suckers return for more; engaging in a certain class of trades is imprinted in some people&#8217;s genetic makup<a href="#sdfootnote2sym"><sup>2</sup></a>. I gave a talk sponsored by the Lebanese Central Bank at AUB in 1998 called &#8220;unsafe at any speed&#8221; (a Ralph Nader title), causing me to receive all manner of insults for the following twenty years from people who subsequently had to come ask me for a personal loan.</p><p style="text-align: justify;">Now let&#8217;s look at the positive. I will leave it to a commentary by one of the great living historians:</p><p style="text-align: justify;">In the revision of the seminal <em>1177: The Year Civilization Collapsed, Eric Cline </em><span>discussed this author&#8217;s </span><em>Antifragile</em><span>. He wrote about the Canaanites:</span></p><div class="pullquote"><p style="text-align: justify;">&#8220;<span>(&#8230;) They may actually have been among the most resilient of the peoples whom we are examining&#8221; (...) for they not only apparently carried on from the initial Canaanite city-states but even flourished in the vacuum created by the Collapse.</span></p><p style="text-align: justify;">Thus, we may well suggest that the Canaanite survivors in these cities, now identified by specific city (e.g., Sidon) or simply rechristened as generic &#8220;Phoenicians&#8221; by the Greeks as early as the time of the Homeric epics, were more than simply resilient in the face of the Collapse.</p><p style="text-align: justify;">They might be better referred to as &#8220;anti-fragile&#8221; to borrow a term from Nassim Nicholas Taleb. &#8220;anti-fragile&#8221; can be used to describe a situation in which an entity exhibits more than just resiliency or robustness, and actually &#8220;thrives under the right amount of stress&#8221; &#8212; taking advantage of the situation not only to survive but to flourish. Taleb describes it specifically as &#8220;things that gain from disorder&#8221;. In the case of the Phoenicians, they seem to have actively taken advantage of the chaos and, most important, of the destruction of Ugarit in northern Syria, to take over the maritime trade routes to the west, across the Aegean to Greece and thence further to Italy, Sicily, and Sardinia.</p></div><p style="text-align: justify;">So for those worried about the inevitable recurrence of the Bronze Age Collapse &#8211;the collapse of the large powerful states trapped by their overdependent structures &#8211;my answer is that there is a great chance that history will be kind, for a second time, to that hard-to-tame Canaanite strip.</p><blockquote><p style="text-align: justify;"><strong>NOTES</strong>: A more technical note on the Ponzi scheme. First it is characterized by crescendo borrowing, with debt servicing increasing in a multiplicative way. Second, governments issuing debt <em>in their own currency </em>(unlike Riad) are relatively shielded as they can transfer the effect to that sneaky think we call inflation thanks to the beastly printing press. Third, note that nobody in known history has been able to survive a Ponzi, meaning that it is <em>always</em> a matter of time and that trade is the kind of thing for suckers. Actually the unavoidability of the collapse can be easily shown mathematically. A banker engaging in a Ponzi is necessarily &#8211;as I insisted with the case of the public vilain Antoun Sehnaoui &#8211;totally incompetent.</p></blockquote><p style="text-align: justify;"><a href="#sdfootnote1anc">1</a> See Taleb, N. N. (2004). Bleed or blowup? Why do we prefer asymmetric payoffs?. <em>The Journal of Behavioral Finance</em>, 5(1), 2-7, and Taleb, N. N., and G. Martin. &#8220;How to Avoid Another Crisis.&#8221; <em>SIAS Review of International Affairs </em>(2012).</p><p style="text-align: justify;"><a href="#sdfootnote2anc">2</a> See Malcom Gladwell, 2002, &#8220;Bleed or Blowup, How Nassim Taleb turned the inevitability of disaster into an investment strategy.&#8221; <em>The New Yorker</em>.</p>]]></content:encoded></item><item><title><![CDATA[Medical Mistakes with Probability, 2]]></title><description><![CDATA[Optimal LDL Levels]]></description><link>https://nntaleb.substack.com/p/medical-mistakes-with-probability-284</link><guid isPermaLink="false">https://nntaleb.substack.com/p/medical-mistakes-with-probability-284</guid><dc:creator><![CDATA[Nassim Nicholas Taleb]]></dc:creator><pubDate>Wed, 19 Nov 2025 18:20:19 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!hzjr!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><strong>Abstract</strong>: risk factors for LDL/ApoB underestimate the risk factor for Lp(a) positive subjects and overestimate for Lp(a) negative ones, a case of base-rate fallacy.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!hzjr!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!hzjr!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!hzjr!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!hzjr!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!hzjr!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!hzjr!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg" width="1456" height="1896" 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/__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!hzjr!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!hzjr!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!hzjr!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe683f00f-f1e6-4a51-98b9-830ac1a78141_1850x2409.jpeg 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Base rate fallacy and correction of risk factors. I simplify by calling Lp(a) positive and negative those with numbers above and below the average population.</figcaption></figure></div><p>I am just using basic probabilistic logic here.</p><p>Risks factors for ASCVD from LDL (or ApoB) levels are computed for a general population which includes people with low and high Lp(a) levels. Now if having a high Lp(a) increases the cardiac risk over the baseline (up to 2-3 times!) and the proportion of subjects with high Lp(a) is between 15 and 28% of the population, then, necessarily, those with low Lp(a) will have, for a given level of LDL, a considerably lower risk and many might be treated unnecessarily.</p><p>The risk factor for nonLp(a) can be ~ 30% lower!  Statins don&#8217;t come for free. There are hidden and less hidden side effects.</p><p><strong>Note</strong>: it appears from papers (the latest, Bhatia et al, &#8220;Independence of Lipoprotein(a) and Low-Density Lipoprotein Cholesterol&#8211;Mediated Cardiovascular Risk: A Participant-Level Meta-Analysis&#8221;, <em>Circ</em>., 2025) that Lp(a) is additive (hence independent) which simplifies the computation.</p><p>I also note the possible presence of a &#8220;J curve&#8221; of LDL for primary prevention that has the optimum too far above what can be expected from guidelines, but this inference  is largely from Chinese billing data, though with an impressive sample ~4 10^5, Chang et al, &#8220;Low-Density Lipoprotein Cholesterol, Cardiovascular Disease Risk and Mortality in China&#8221;, JAMA Network Open, 2024. JAMA Network Open. doi:10.1001/jamanetworkopen.2024.22558</p><div id="youtube2-BI91CTaxTeA" class="youtube-wrap" data-attrs="{&quot;videoId&quot;:&quot;BI91CTaxTeA&quot;,&quot;startTime&quot;:&quot;54s&quot;,&quot;endTime&quot;:null}" data-component-name="Youtube2ToDOM"><div class="youtube-inner"><iframe src="https://www.youtube-nocookie.com/embed/BI91CTaxTeA?start=54s&amp;rel=0&amp;autoplay=0&amp;showinfo=0&amp;enablejsapi=0" frameborder="0" loading="lazy" gesture="media" allow="autoplay; fullscreen" allowautoplay="true" allowfullscreen="true" width="728" height="409"></iframe></div></div>]]></content:encoded></item><item><title><![CDATA[Medical Mistakes with Probability, 1]]></title><description><![CDATA[Misapplication of the law of large numbers applied to the maximum heart rate]]></description><link>https://nntaleb.substack.com/p/medical-mistakes-with-probability</link><guid isPermaLink="false">https://nntaleb.substack.com/p/medical-mistakes-with-probability</guid><dc:creator><![CDATA[Nassim Nicholas Taleb]]></dc:creator><pubDate>Tue, 07 Oct 2025 16:18:21 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!t4vb!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic" length="0" type="image/jpeg"/><content:encoded><![CDATA[<h2>Max Heart Rate</h2><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!t4vb!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!t4vb!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 424w, /__u/substackcdn.com/image/fetch/$s_!t4vb!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 848w, /__u/substackcdn.com/image/fetch/$s_!t4vb!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 1272w, /__u/substackcdn.com/image/fetch/$s_!t4vb!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!t4vb!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic" width="724.71875" height="502.22611177884613" 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/__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 424w, /__u/substackcdn.com/image/fetch/$s_!t4vb!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 848w, /__u/substackcdn.com/image/fetch/$s_!t4vb!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 1272w, /__u/substackcdn.com/image/fetch/$s_!t4vb!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F682ef6ba-0fc0-4d81-88b2-d8ae4c0ea455_2033x1409.heic 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Lach J. et al. (2021). Hr max prediction based on age, body composition, fitness level, testing modality and sex in physically active population. Frontiers in physiology, 12:695950</figcaption></figure></div><p>When you do a stress test, say the Bruce Protocol, the administering doctor relies on something called the &#8220;age predicted maximum heart rate&#8221;, usually 220 minus your age, or some formula slightly more complicated but equally unrigorous. Once you reach that point, they stop, depriving you of potent information &#8212; at low risk since they are monitoring via live ECG your cardiac strain. In fact, such an estimation based on age, no matter how complicated its computation, appears to explain <em><strong>only 20% of the variation</strong></em> between individuals. I believe that explained variations are even smaller for, clearly, in the graph above, to the right, samples above 55 are sparce and the expected maxima would be considerably higher.</p><p>I noticed this myself as I am easily able to reach the 170s without feeling strain, guessing the effective max would be in the 180s (next test, but would require some live ECG for caution).</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!0aVq!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 424w, /__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 848w, /__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 1272w, /__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!0aVq!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png" width="910" height="784" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/e3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:784,&quot;width&quot;:910,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:111407,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://nntaleb.substack.com/i/175537906?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fff41de72-08a3-45cc-aa1a-5f4da7045b2a_910x784.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="/__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 424w, /__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 848w, /__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 1272w, /__u/substackcdn.com/image/fetch/$s_!0aVq!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fe3a21ad3-2edd-4f4d-a436-5f0d18febd1b_910x784.png 1456w" sizes="100vw"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><h2>The Law of Large Numbers is not reversible</h2><p>This video tutorial explains how an average can apply in a clinical setting if and only if the variations around it are small. Otherwise it is not informational.</p><div id="youtube2-FIc5p79CxDk" class="youtube-wrap" data-attrs="{&quot;videoId&quot;:&quot;FIc5p79CxDk&quot;,&quot;startTime&quot;:null,&quot;endTime&quot;:null}" data-component-name="Youtube2ToDOM"><div class="youtube-inner"><iframe src="https://www.youtube-nocookie.com/embed/FIc5p79CxDk?rel=0&amp;autoplay=0&amp;showinfo=0&amp;enablejsapi=0" frameborder="0" loading="lazy" gesture="media" allow="autoplay; fullscreen" allowautoplay="true" allowfullscreen="true" width="728" height="409"></iframe></div></div>]]></content:encoded></item><item><title><![CDATA[The World in Which We Live]]></title><description><![CDATA[Lecture at the Annual Meeting of the Ron Paul Institute, 2025]]></description><link>https://nntaleb.substack.com/p/the-world-in-which-we-live</link><guid isPermaLink="false">https://nntaleb.substack.com/p/the-world-in-which-we-live</guid><dc:creator><![CDATA[Nassim Nicholas Taleb]]></dc:creator><pubDate>Mon, 22 Sep 2025 18:57:09 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!_6i6!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>Friends, I have seven points. Why seven? Because I&#8217;ve been reading too much Babylonian history recently.</p><h1><strong>FROM CONNECTIVITY TO TECHNOFEUDALISM</strong></h1><p>The first one is about concentration, a distinctive feature of the modern world, often tied to what I called the <em>Black Swan </em>problem. We now see winner-take-all effects everywhere, owing to connectivity. Imagine an island with many species but a high density per square meter. Compare that to a continent, where opening up space leads to fewer species per meter becausesome will eventually dominate. This mirrors cultural and economic life today.</p><p>Take books, for instance. Everyone reads the same ones &#8212; think <em>Harry Potter</em>or, for music, The Beatles. In publishing, a few authors prevail. You either sell 20 million copies or you&#8217;re working at Starbucks (unless you boycott the firm, as I do personally). This concentration applies to opera singers too. In the past, they could make a living locally because there were no audiovisual recordings. Now, a few stars capture most of the income.</p><p>This concentration isn&#8217;t inherently bad &#8212; it&#8217;s just part of market mechanisms, the way things work. The problem arises when it becomes <em>sticky</em> at the top. The road from a college dorm to dominating through Google was once short, and search engines like AltaVista could disappear in minutes, replaced by the newly universally adopted Google. But now, replacing Google is harder because dominance is entrenched, which is unhealthy. This leads to what some like Varoufakis call <em>technofeudalism</em>.</p><p>Concentration also applies to viruses. COVID spread globally in about a week, dominating the planet. Compare that to the bubonic plague, which took years to travel from what was Constantinople to Northern England and never reached the Americas due to limited connectivity. Today&#8217;s hyper-connectivity amplifies concentration, which is only pathological if we cling to an archaic, early 20th-century textbook understanding of economic, social, cultural, and biological life.</p><p>In wealth, for example, only 20% of billionaire families in the U.S. remain after 20 years, but in Europe, it&#8217;s the reverse &#8212; concentration is getting stickier, and we&#8217;re heading toward the more stultified European version globally.</p><blockquote><p><em><strong>Comment 1</strong></em></p><p><em>Capitalism works not just by allowing upward mobility, but by accelerating its downward equivalent.</em></p></blockquote><h1><strong>DYNAMICS AND MISUNDERSTANDING OF HISTORICAL PROCESSES</strong></h1><p>The second point is our difficulty in grasping dynamics, particularly in geopolitics, because historians and statisticians view history differently. My specialty is in stochastic processes (sort of), so I see history as a dynamic process, not a static textbook description.</p><blockquote><p><em><strong>Comment 2 </strong></em></p><p><em>Both GDP and its rate of growth can fool one in projecting future states; but errors from ignoring growth differentials can be monstrous owing to their compounding. When in doubt, use the rate of growth as status quo.</em></p></blockquote><p>When I published <em>The Black Swan</em> in 2007 (it became a bestseller again recently, despite warnings that my tweets on Palestine would cause my books to be sold for $1 at discount stores. Threats of cancellation keep coming, though)&#8230; In 2007, the U.S. accounted for about 20% of the world economy (using purchasing power parity, the most rational metric), Europe about the same, and China around 6%. Now, the U.S. is roughly 15% and declining, Europe is about 14% and dropping faster, while China is north of 20%. This shift happened within the lifespan of a book.</p><p>Small differences in compound growth produce massive outcome differentials over time, as Warren Buffett keeps preaching. Even if you measure GDP in real dollars, the story is similar, with the same growth but different starting bases.</p><p>Now consider military expenditures: the U.S. spends about a trillion dollars annually, while China spends roughly a third of that. But compare what they get for their money. A chair made in China might cost $1, but here, it&#8217;s far more expensive. Apply that to military production, and you see who&#8217;s becoming the real superpower. If China isn&#8217;t there yet, wait two weeks or two months &#8212; it&#8217;s happening fast. This isn&#8217;t pro- or anti-China; it&#8217;s just reality.</p><ul><li><p>China makes things cheaper in general and comparatively <em>much</em> cheaper in the military field. The U.S. has a $53,000 garbage can problem.</p></li><li><p>The U.S. weapons industry, as mentioned by Col. McGregor, is not competitive; it is one of the three areas that costs &#8220;a lot in the U.S.,&#8221; along with healthcare and education &#8212; the latter can cost two orders of magnitude more here.</p></li><li><p>China spends a third of U.S. military in nominal terms. You can figure out what is going on since they don&#8217;t have the $53,000 garbage can problem yet.</p></li><li><p>By some mental bias, people think that status quo is GDP. No; it is GDP <em>growth</em>. China pulled from 6% to more than 20% of world GDP (PPP) in 15 years. So consider what the state of geopolitics would be in 2035.</p></li></ul><p>Our projections often fail because we rely on primitive analyses of the past, ignoring second-order effects. In the future, discussions about war might need to happen in Beijing, not Washington, where overpaid officials may not grasp these evolutions.</p><h1><strong>THE S-CURVE AND ECONOMIC SATURATION</strong></h1><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!_6i6!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 424w, /__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 848w, /__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 1272w, /__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!_6i6!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png" width="760" height="456" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:456,&quot;width&quot;:760,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:null,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:null,&quot;type&quot;:null,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="/__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 424w, /__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 848w, /__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 1272w, /__u/substackcdn.com/image/fetch/$s_!_6i6!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1752b104-50d6-4bf7-8a85-fb32f4a35c3a_760x456.png 1456w" sizes="100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">GDP growth slows down necessarily when you run out of poor people. Growth follows an S curve, though more unbounded to the right. Things in biology tend to saturate or, at least, slow down. It is easier to grow very fast when you are pulling people out of poverty than to do so when you need to import your poor. The problem is that then debt burden does not allow countries the luxury of slowing down. Alas, countries &#8211;like people&#8211; tend to borrowmore when they are rich than when they are poor, that is, when they don&#8217;t need to borrow, then get into trouble with spiraling &#64257;nancial obligations</figcaption></figure></div><p>The third point is the S-curve, which I discussed in <em>Antifragile</em>. In biology and economics, entities grow in a convex way, then slow as they saturate &#8212; growth may be unbounded, but remains sub-logarithmic. Once you have a two-car garage, do you need a five-car garage? Some might, but most don&#8217;t &#8212; the incentive diminishes.</p><p>China is growing fast because many still lack basics like a car, while Europe and the U.S. have reached saturation, with little incentive for further growth.And many are discovering that lifestyle improvements, such as bicycling paths and pedestrian- and cyclist-friendly cities, may not produce economic growth.</p><p>The problem is that it is saturated economies, like the U.S. and Europe, that carry the most debt. There&#8217;s a French saying: <em>On ne pr&#234;te qu&#8217;aux riches</em> (&#8220;One only lends to the rich&#8221;). But when you&#8217;re rich and borrow heavily, you need growth to service that debt, which is harder at the top of the S-curve.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!_o7y!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 424w, /__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 848w, /__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 1272w, /__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!_o7y!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png" width="968" height="764" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/d1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:764,&quot;width&quot;:968,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:null,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:null,&quot;type&quot;:null,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="/__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 424w, /__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 848w, /__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 1272w, /__u/substackcdn.com/image/fetch/$s_!_o7y!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd1c840b9-bd47-4578-b80c-52f9dcb9eae1_968x764.png 1456w" sizes="100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>Further, policies like tariffs, as seen under the current administration, can stifle growth by forcing resources into lower-margin activities &#8212; like asking a brain surgeon to do some gardening two days a week to avoid being &#8220;ripped off&#8221; by professional gardeners. This shift from higher added value to lower added value depresses GDP, a point orthodox economists agree on &#8212; and this, at the time when we need growth the most.</p><p>Our metastatic government and irresponsible fiscal policies exacerbate this.Soon, most U.S. expenditure will go to servicing debt, and we lack the political mechanisms to correct this. Worse, we now depend on foreigners or local retirees to buy our debt. Former President Biden&#8217;s policies, like freezing assets in U.S. dollars, discouraged investment in U.S.-denominated assets. If your assets can be frozen because you once met someone who had lunch with the brother-in-law of a banker connected to Putin, why take the risk of holding dollars (or Euros since the U.S. bullied Europe into following suit)?</p><p>Central banks are shifting to gold, which has rallied significantly, as BRICS countries move away from dollar reserves.</p><h2><strong>IMMIGRATION</strong></h2><p>There has never been a society that welcomed immigration for its own sake, for reasons beyond its economic utility. The West grew wealthy, then ran out of people willing to clean bathrooms, fix roofs, babysit noisy spoiled brats, and mow lawns. It would be prohibitively costly to ask a dentist to spend two days a week gardening for balance. Nor do many youngsters in the middle class dream of growing up to be janitors. So the poor must be imported &#8212; reluctantly.</p><blockquote><p><em><strong>Comment 3</strong></em></p><p><em>Immigration in small doses is socially benign; immigration in large doses threatens the museum-state perception of the locals as a discontinuity from past history and feels like an invasion, even if it is not.</em></p></blockquote><p>The United States and Europe became structurally addicted to cheap immigrant labor, building oversized houses with expansive lawns and labor-intensive upkeep. A sharp reduction in this supply would trigger hyperinflation, owing to the nonlinear effects of such squeezes. Remember 2022.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="/__u/substackcdn.com/image/fetch/$s_!YKkZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="/__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_webp, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 1456w" sizes="100vw"><img src="/__u/substackcdn.com/image/fetch/$s_!YKkZ!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg" width="1070" height="714" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:714,&quot;width&quot;:1070,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:null,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:null,&quot;type&quot;:null,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="/__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_424, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 424w, /__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_848, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 848w, /__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_1272, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 1272w, /__u/substackcdn.com/image/fetch/$s_!YKkZ!, /__u/nntaleb.substack.com/w_1456, /__u/nntaleb.substack.com/c_limit, /__u/nntaleb.substack.com/f_auto, /__u/nntaleb.substack.com/q_auto:good, /__u/nntaleb.substack.com/fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8724962c-1116-42e3-a7d7-8b51fe466bfc_1070x714.jpeg 1456w" sizes="100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">The illusion that immigration benefits ONLY immigrants. Most of people holding such beliefs end up relying on immigrants for their own &#8220;better life&#8221;, unless their definition of &#8220;better life&#8221; has nothing materialistic in it. [LOOKING FOR CREDIT]</figcaption></figure></div><p>Every Western political party that won office on an anti-immigration platform has ended its term with more immigrants than before. Giorgia Meloni is a recent example.</p><p>In that light, recent moves to deport immigrants appear largely symbolic &#8212; gestures aimed at winning elections. Some are simply vicious, driven by the urge to humiliate immigrants for its own sake.</p><p>Can the West dispense with immigrants? Not without crushing its own global GDP &#8212; an option unaffordable to economies already burdened with accumulated deficits. It may be a rational choice in theory but, in practice, almost no one is willing to pay that price.</p><p>Note again, I have nothing against closed xenophobic ethnostates <em>per se</em> (so long as they don&#8217;t invade others and mind their own business); but under modern conditions one cannot have both such a state and accumulated debt requiring economic growth.</p><p>We end up in the strange situation of xenophobic people importing labor for their own purposes while voting against immigration &#8212; a sort of tragedy of the commons.</p><blockquote><p><em><strong>Comment 4</strong><br>The perception of the number of immigrants tends to be biased considerably higher than reality, perhaps because of salient differences and their visibility from their concentration in dense central areas (a saliency bias).</em></p><p><em>The proportion of Muslims in Europe tends to be under 1/20, ranging between 1/10 and 1/100 in most countries &#8212; yet casual perceptions tend to be almost one order of magnitude higher.</em></p></blockquote><p><strong>Note on Highly Skilled Immigration</strong>There is a marked difference between Europe and the United States in terms of reverse brain drain &#8212; the inflow of highly skilled immigrants &#8212; which explains the growth differential between the two environments. The U.S., with its more generous (though less equalitarian) academic compensation packages and fewer restrictions on retirement, has consistently drawn Europe&#8217;s most aggressive and productive scientists.</p><p>At the Tandon School of Engineering of NYU, where I spent more than fifteen years, the near-totality of both faculty and graduate students were foreign-born.</p><blockquote><p><em><strong>Comment 5</strong></em></p><p><em>Reversing the direction of brain drain (via visa restrictions) may in fact help the countries of origin by keeping talent locally.</em></p></blockquote><h1><strong>THE LIBERATING EFFECT OF SOCIAL MEDIA</strong></h1><p>The next point is an optimistic one: social media has transformed information flow. Historically, people traded information at the barber shop or fish market, acting as both conveyors and recipients. Big media disrupted this, turning us into passive consumers of TV lectures by the state and a bowdlerized press. Now, platforms like TikTok and X allow us to both share and receive information, returning to a natural model.</p><p>Social media is hard to control, even with censorship, and AI makes it even harder to manipulate without producing incoherent outcomes. For example, an ethnic cleansing in Gaza might have been covered up by traditional media in 1995, but in 2025, social media exposes it. The media only matters to politicians or those out of touch &#8212; anyone under 30 doesn&#8217;t care about ABC News.</p><p>So this is good; someone was talking to me about the &#8220;media cycle&#8221; in Washington and I told him the only people who care about the media are people who are either in a wheelchair or in politics. I&#8217;m here because of Facebook (initially) and X/Twitter, not traditional channels, and I&#8217;ve refused the media tour for my last couple of books.</p><blockquote><p><em><strong>Comment 6</strong><br>One effect of the breaking of traditional, centralized media&#8217;s grip on Western citizens is the inability of the Israeli propaganda to frame their ethnic cleansing and Apartheid as a defense of Western values against fundamentalist Islam.</em></p></blockquote><h1><strong>THE GROWING ROLE OF GOVERNMENT</strong></h1><p>The sixth point is the creeping growth of government invalidating cross-temporal comparisons. In history books, we read about kings like Louis XIV and centralizers like Colbert, but today&#8217;s governments are far, far larger and more intrusive.</p><p>In Europe, governments account for 40&#8211;50% of GDP (higher in France particularly if you include education). In the U.S., it&#8217;s higher than reported when you include local government and recent interventions. A century ago, governments were under 15% of GDP, often less than 5%.</p><blockquote><p><em><strong>Comment 7</strong><br>Government size is period dependent, invalidating cross-temporal comparisons. At no point have governments been more effectively intrusive, thanks to technology.</em></p></blockquote><p>Even in economies driven by Adam Smith&#8217;s principles, government has grown substantially. In 1500, a dictatorial government couldn&#8217;t control much because it was a smaller share of the economy. Today&#8217;s governments have far more reach, and this is proving to be unstoppable. A limited-government conservative today is dreaming of what a centralizer was hoping for only a few decades ago.</p><h1><strong>SCALE IS SIGNIFICANT</strong></h1><p>The final point is that scale matters when it comes to governance. I have an aphorism phrased by friends as follows: <em>I&#8217;m a libertarian at the national level, a Republican at the state level, a Democrat at the municipal level, and a communist at the family level.</em></p><p>The point is, governance depends on scale. Country clubs have rules and enforcement &#8212; effectively a government &#8212; but nobody complains of country club dictatorships.</p><p>Historically, successful models like Venice, Dubai, or Singapore were small city-states. Scale enables effective governance, but as the U.S. economy grows in size and complexity, governance becomes harder. We need even more localism than we had 50 or 100 years ago, but our systems haven&#8217;t adapted to this reality.</p>]]></content:encoded></item></channel></rss>