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“My first and biggest wish is that we had known early that Covid-19 was airborne,”

, “Once you’ve realized that, it informs an entirely different strategy for protection.” Masking, ventilation and air cleaning become key, as well as avoiding high-risk encounters with strangers, he says.

Instead of washing our produce and wearing hand-sewn cloth masks, we could have made sure to avoid superspreader events and worn more-effective N95 masks or their equivalent. “We could have made more of an effort to develop and distribute N95s to everyone,” says Dr. Volckens. “We could have had an Operation Warp Speed for masks.”

We didn’t realize how important clear, straight talk would be to maintaining public trust. If we had, we could have explained the biological nature of a virus and warned that Covid-19 would change in unpredictable ways.  

We didn’t know how difficult it would be to get the basic data needed to make good public-health and medical decisions. If we’d had the data, we could have more effectively allocated scarce resources

In the face of a pandemic, he says, the public needs an early basic and blunt lesson in virology

and mutates, and since we’ve never seen this particular virus before, we will need to take unprecedented actions and we will make mistakes, he says.

Since the public wasn’t prepared, “people weren’t able to pivot when the knowledge changed,”

By the time the vaccines became available, public trust had been eroded by myriad contradictory messages—about the usefulness of masks, the ways in which the virus could be spread, and whether the virus would have an end date.

, the absence of a single, trusted source of clear information meant that many people gave up on trying to stay current or dismissed the different points of advice as partisan and untrustworthy.

“The science is really important, but if you don’t get the trust and communication right, it can only take you so far,”

Doctors didn’t know what medicines worked. Governors and mayors didn’t have the information they needed to know whether to require masks. School officials lacked the information needed to know whether it was safe to open schools.

people didn’t know whether it was OK to visit elderly relatives or go to a dinner party.

Had we known that even a mild case of Covid-19 could result in long Covid and other serious chronic health problems, we might have calculated our own personal risk differently and taken more care.

just months before the outbreak of the pandemic, the Council of State and Territorial Epidemiologists released a white paper detailing the urgent need to modernize the nation’s public-health system still reliant on manual data collection methods—paper records, phone calls, spreadsheets and faxes.

While the U.K. and Israel were collecting and disseminating Covid case data promptly, in the U.S. the CDC couldn’t. It didn’t have a centralized health-data collection system like those countries did, but rather relied on voluntary reporting by underfunded state and local public-health systems and hospitals.

doctors and scientists say they had to depend on information from Israel, the U.K. and South Africa to understand the nature of new variants and the effectiveness of treatments and vaccines. They relied heavily on private data collection efforts such as a dashboard at Johns Hopkins University’s Coronavirus Resource Center that tallied cases, deaths and vaccine rates globally.

With good data, Dr. Ranney says, she could have better managed staffing and taken steps to alleviate the strain on doctors and nurses by arranging child care for them.

To solve the data problem, Dr. Ranney says, we need to build a public-health system that can collect and disseminate data and acts like an electrical grid. The power company sees a storm coming and lines up repair crews.

If we’d known how damaging lockdowns would be to mental health, physical health and the economy, we could have taken a more strategic approach to closing businesses and keeping people at home.

t many doctors say they were crucial at the start of the pandemic to give doctors and hospitals a chance to figure out how to accommodate and treat the avalanche of very sick patients.

The measures reduced deaths, according to many studies—but at a steep cost.

The lockdowns didn’t have to be so harmful, some scientists say. They could have been more carefully tailored to protect the most vulnerable, such as those in nursing homes and retirement communities, and to minimize widespread disruption.

Lockdowns could, during Covid-19 surges, close places such as bars and restaurants where the virus is most likely to spread, while allowing other businesses to stay open with safety precautions like masking and ventilation in place.  

The key isn’t to have the lockdowns last a long time, but that they are deployed earlier,

If England’s March 23, 2020, lockdown had begun one week earlier, the measure would have nearly halved the estimated 48,600 deaths in the first wave of England’s pandemic

If the lockdown had begun a week later, deaths in the same period would have more than doubled

It is possible to avoid lockdowns altogether. Taiwan, South Korea and Hong Kong—all countries experienced at handling disease outbreaks such as SARS in 2003 and MERS—avoided lockdowns by widespread masking, tracking the spread of the virus through testing and contact tracing and quarantining infected individuals.

For much of the pandemic, doctors, epidemiologists, and state and local governments had no way to find out in real time how many people were contracting Covid-19, getting hospitalized and dying

Early in the pandemic, public-health officials were clear: The people at increased risk for severe Covid-19 illness were older, immunocompromised, had chronic kidney disease, Type 2 diabetes or serious heart conditions

t had the unfortunate effect of giving a false sense of security to people who weren’t in those high-risk categories. Once case rates dropped, vaccines became available and fear of the virus wore off, many people let their guard down, ditching masks, spending time in crowded indoor places.

it has become clear that even people with mild cases of Covid-19 can develop long-term serious and debilitating diseases. Long Covid, whose symptoms include months of persistent fatigue, shortness of breath, muscle aches and brain fog, hasn’t been the virus’s only nasty surprise

In February 2022, a study found that, for at least a year, people who had Covid-19 had a substantially increased risk of heart disease—even people who were younger and had not been hospitalized

respiratory conditions.

Some scientists now suspect that Covid-19 might be capable of affecting nearly every organ system in the body. It may play a role in the activation of dormant viruses and latent autoimmune conditions people didn’t know they had

 A blood test, he says, would tell people if they are at higher risk of long Covid and whether they should have antivirals on hand to take right away should they contract Covid-19.

If the risks of long Covid had been known, would people have reacted differently, especially given the confusion over masks and lockdowns and variants? Perhaps. At the least, many people might not have assumed they were out of the woods just because they didn’t have any of the risk factors.

In the summer of 2020, “public-health experts” decided that racism is a public-health crisis comparable to the coronavirus pandemic. It was therefore, they claimed, within their purview to express public support for the Black Lives Matter protests following the murder of George Floyd and to argue that the benefits of such protests outweighed the increased risk of spreading the disease. Those supposed experts actually knew nothing about the likely effects of the protests. They made no concrete predictions about whether they would in any way ameliorate racism in America, just as Nature can make no concrete predictions about whether its political endorsements will actually help a preferred candidate without jeopardizing its other important goals. The political action was expressive, not evidence-based...

as is often the case, a debate which appears to be about the neutrality of institutions is not really about neutrality at all... Rather, it is about whether there is any room left for soberly weighing our goals and values and thinking in a measured way about the consequences of our actions rather than simply reacting to situations in an impulsive and expressive manner, broadcasting our views to the world so that people know where we stand.

Our goals and values might not be “neutral” at all, but they might still be best served by procedures, institutions, and even individuals that follow neutral principles.

Making friends can be hard—but there may be more opportunities than we think. Doing these interviews has taught me that connection can come from anywhere, at any time, if both parties are open to it.

“You have to look for friendship in places you would never expect it.”

Paying attention goes a long way when forging these unexpected friendships—noticing when you click with someone, being open to chance encounters.

as much as we may feel like our social networks are set and settled, it’s never too late to meet someone who will be important to you for the rest of your life. I spoke with more than one group who was surprised and grateful to have found one another in middle age, a period when work and family responsibilities tend to peak and keeping up with friends is not always easy.

I’m inspired by the people I’ve spoken with who imagined something different for themselves: the friends who bought a house together, who went to therapy together, who have raised their children together, who committed to an “arranged friendship,” whose friendship has fueled their fight for justice.

they won’t grow without intention. This is the hardest part of friendship. It takes energy and thought, and our mental and physical resources are often spread thin. In other words, friendships take work. But I have never liked framing our friendships as labor. Showing up for our friends takes effort, yes, but it shouldn’t be drudgery. It should be a joy.

One thing that seems to make keeping up with friends easier is ritual. I personally find that the effort of coordinating hangs (or even phone calls) is the biggest barrier to seeing my friends. It’s much easier when something is baked into my schedule, and all I have to do is show up.

Some have organized a book club, a monthly hike, or a regular dinner party. Others have committed to a group chat that runs all day every day, or a Dungeons & Dragons campaign that’s lasted for 30 years. In addition to keeping groups close, these traditions can fuel a friendship and give it a shared culture.

Imagination

Society has a place for friendships, and it’s on the sidelines. They’re supposed to play a supporting role to work, family, and romance. It takes imagination not to default to this norm, and to design your life so that friendship plays the role you really want it to.

Attention only gets you so far without action. When opportunity arises, you have to put yourself out there, and that requires courage, vulnerability, and a willingness to let things be awkward.

The man who gave his friend a kidney and the woman who gave birth to her best friend’s quadruplets remind me that there are friends who choose to love each other radically every day. Their love does not stand on the sidelines.

The beauty and the challenge of friendship is its diversity. A friendship can be whatever you want it to. Each one is a canvas whose only limit is our imagination.

Grace

All of the forces I’ve mentioned so far—accumulation, attention, intention, ritual, and imagination—are ideals. They’re impossible to fully live up to. Life often gets in the way.

I do love the concept of grace, of a gift so profound that it could never be earned or deserved. And so when I cite grace here as the final and most important force in friendships, I mean it in two ways. One is the forgiveness that we offer each other when we fall short. The other is the space that creates for connections—and reconnections—that feel nothing short of miraculous.

Many of the people I spoke with—who, in many cases, love each other so much that they nominated themselves to be interviewed about their friendship—told me that they don’t see each other that often, or that they don’t talk as much as they would like. I’ve come to believe that friendship doesn’t always have to be about presence; it can also be about love that can weather absence.

But absence doesn’t have to last forever. “The Friendship Files” includes many stories of second chances and rekindlings.

Sometimes, people have assumed that I must be a really great friend, given how much time I’ve spent thinking about this. And I’m not. I try to be, but I tend to retreat too much into myself and my romantic relationship and don’t prioritize my friends as much as I’d like to.

Accumulation

Attention

Intention

Ritual

onic constipation, a functional bowel disorder, affects approximately 14% of adults worldwide [1]. Slow transit constipation (STC) is the major cause of chronic constipation which is characterized by markedly prolonged colonic transit time as a result of the colonic motility function disorde

Usually, patients with STC suffer from a common sense of abdominal pain, nausea, depression and sickness, which seriously influence their social ability and health-related quality of life [4–6

Current clinical treatments include cathartics, prokinetics and aggressive surgery which can increase bowel movement frequency to a certain degree.

However, pharmacological interventions is prone to drug dependency and relapse after drug withdrawal [3]

Surgical treatments such as subtotal colectomy and total colectomy in STC patients may adversely affect the quality of life due to the risk of postoperative diarrhea or incontinence, and result in a heavy healthcare burden

The enteric nervous system (ENS), located in the intestinal wall, regulates various functions including contraction of intestine, homeostasis and blood flow [10]. As the ‘second brain’, the ENS contains large amounts of neurons working independently from the central nervous system [11]. Researches have identified that STCs are mostly caused by disorders of the relevant nerves, especially the ENS [12,13].

McCallum et al. [35] found that gastric electrical stimulation in combination with pharmacological treatment could also enhance emptying in patients with gastroparesis. Especially, gastric electrical stimulation has been approved as a clinical therapy method for gastroparesis and obesity in European and American countries [36].

we employed pulse train stimulation and implanted electrodes at the proximal colon in dogs.

After CES treatment, we observed the colonic transit time of the sham treatment group was longer than that of CES treatment and control groups, and electrical stimulation significantly enhanced the colonic electromyogram (EMG) signal.

histopathology and TEM analysis showed increased ganglia and synaptic vesicles existing in the colon myenteric plexus of the CES treatment group as compared with that of the sham CES group

Our results suggested that CES might reduce the degeneration of the myenteric plexus neurons, thereby contributing to the therapeutic effect on STC beagles.

the defecating frequency and the feces characteristics of STC beagles returned to normal after CES treatment. The result indicated that CES could improve the symptoms of STC.

The colonic EMG signal was strongly promoted by CES

Especially, the colonic EMG signal of the beagles with STC was remarkably enhanced by CES (Figure 3), indicating that CES could not only improve the colonic content emptying, but also enhance the EMG signal to promote colonic motility.

Colonic electrical stimulation (CES), a valuable alternative for the treatment of STC, was reported to improve the colon motility by adjusting the bioelectrical activity in animal models or patients with STC [17]. However, little report focuses on the underlying nervous mechanism to normalize the delayed colonic emptying and relieve symptoms. We hypothesized that CES may also repair the disorders of the relevant nerves and then improve the colonic motility.

The first study regarding the CES to modulate colonic motility was performed by Hughes et al. [37]. Since then, many researchers employed short-pulse CES in canine descending colon or pig cecum [20,21,38]. Researchers also applied long-pulse CES to stimulate the colon of human or animals [39]

Recently, studies showed that the prokinetic effect of pulse train CES is better than that of short-pulse CES or long-pulse CES [25]

Our study indicated that CES could enhance the colonic motility, and then accelerate the colonic content emptying. Thereafter, we investigated the underlying mechanism and presumed that CES might improve the STC symptom through the repairment of the ENS.

The neuropathy in ENS is considered to be responsible for various kinds of disordered motility including STC and the related pathophysiologic symptoms [40]. In agreement with this view, our study discovered the decreased number of ganglia in the myenteric plexus, as well as the destruction of the enteric nerve axon terminals and synaptic vesicles in the sham CES group beagles

The present study proves that CES with pulse trains has curative effects on the colonic motility and content emptying in STC beagles. The up-regulation of intestinal nerve related proteins such as SYP, PGP9.5, CAD and S-100B in the colonic myenteric plexus suggests that CES might reduce the degeneration of the myenteric plexus neurons, thereby producing the therapeutic effect on STC beagles. Further investigation for the underlying mechanism of nerve regeneration is necessary to better understand how CES promotes the recovery of delayed colonic motility induced by STC.

The word for ‘philosophy’ in Korean is 철학, pronounced ch’ŏrhak. It literally means the ‘study of wisdom’ or, perhaps better, ‘how to become wise’, which reflects its more dynamic and proactive implications

At night, in the darkness of the cave, he drank water from a perfectly useful ‘bowl’. But when he could see properly, he found that there was no ‘bowl’ at all, only a disgusting human skull.

Our lives and minds are affected by others (and their actions), as others (and their minds) are affected by our actions. This is particularly true in the Korean application of Confucian and Buddhist ideas.

Wŏnhyo understood that how we think about things shapes their very existence – and in turn our own existence, which is constructed according to our thoughts.

In the Korean tradition of philosophy, human beings are social beings, therefore knowing how to interact with others is an essential part of living a good life – indeed, living well with others is our real contribution to human life

he realised that there isn’t a difference between the ‘bowl’ and the skull: the only difference lies with us and our perceptions. We interpret our lives through a continual stream of thoughts, and so we become what we think, or rather how we think

As our daily lives are shaped by our thoughts, so our experience of this reality is good or bad – depending on our thoughts – which make things ‘appear’ good or bad because, in ‘reality’, things in and of themselves are devoid of their own independent nature

We can take from Wŏnhyo the idea that, if you change the patterns that have become engrained in how you think, you will begin to live differently. To do this, you need to change your mental habits, which is why meditation and mindful awareness can help. And this needs to be practised every day

Wŏnhyo’s most important work is titled Awaken your Mind and Practice (in Korean, Palsim suhaeng-jang). It is an explicit call to younger adherents to put Buddhist ideas into practice, and an indirect warning not to get lost in contemplation or in the study of text

While Wŏnhyo had emphasised the mind and the need to ‘practise’ Buddhism, a later Korean monk, Chinul (1158-1210), spearheaded Sŏn, the meditational tradition in Korea that espoused the idea of ‘sudden enlightenment’ that alerts the mind, accompanied by ‘gradual cultivation’

we still need to practise meditation, for if not we can easily fall into our old ways even if our minds have been awakened

his greatest contribution to Sŏn is Secrets on Cultivating the Mind (Susim kyŏl). This text outlines in detail his teachings on sudden awakening followed by the need for gradual cultivation

hinul’s approach recognises the mind as the ‘essence’ of one’s Buddha nature (contained in the mind, which is inherently good), while continual practice and cultivation aids in refining its ‘function’ – this is the origin of the ‘essence-function’ concept that has since become central to Korean philosophy.

These ideas also influenced the reformed view of Confucianism that became linked with the mind and other metaphysical ideas, finally becoming known as Neo-Confucianism.

During the Chosŏn dynasty (1392-1910), the longest lasting in East Asian history, Neo-Confucianism became integrated into society at all levels through rituals for marriage, funerals and ancestors

Neo-Confucianism recognises that we as individuals exist through plural relationships with responsibilities to others (as a child, brother/sister, lover, husband/wife, parent, teacher/student and so on), an idea nicely captured in 2000 by the French philosopher Jean-Luc Nancy when he described our ‘being’ as ‘singular plural’

Corrupt interpretations of Confucianism by heteronormative men have historically championed these ideas in terms of vertical relationships rather than as a reciprocal set of benevolent social interactions, meaning that women have suffered greatly as a result.

Setting aside these sexist and self-serving interpretations, Confucianism emphasises that society works as an interconnected set of complementary reciprocal relationships that should be beneficial to all parties within a social system

Confucian relationships have the potential to offer us an example of effective citizenship, similar to that outlined by Cicero, where the good of the republic or state is at the centre of being a good citizen

There is a general consensus in Korean philosophy that we have an innate sociability and therefore should have a sense of duty to each other and to practise virtue.

The main virtue of Confucianism is the idea of ‘humanity’, coming from the Chinese character 仁, often left untranslated and written as ren and pronounced in Korean as in.

It is a combination of the character for a human being and the number two. In other words, it signifies what (inter)connects two people, or rather how they should interact in a humane or benevolent manner to each other. This character therefore highlights the link between people while emphasising that the most basic thing that makes us ‘human’ is our interaction with others.

Neo-Confucianism adopted a turn towards a more mind-centred view in the writings of the Korean scholar Yi Hwang, known by his pen name T’oegye (1501-70), who appears on the 1,000-won note. He greatly influenced Neo-Confucianism in Japan through his formidable text, Ten Diagrams on Sage Learning (Sŏnghak sipto), composed in 1568, which was one of the most-reproduced texts of the entire Chosŏn dynasty and represents the synthesis of Neo-Confucian thought in Korea

with commentaries that elucidate the moral principles of Confucianism, related to the cardinal relationships and education. It also embodies T’oegye’s own development of moral psychology through his focus on the mind, and illuminates the importance of teaching and the practice of self-cultivation.

He writes that we ourselves can transform the unrestrained mind and its desires, and achieve sagehood, if we take the arduous, gradual path of self-cultivation centred on the mind.

Confucians had generally accepted the Mencian idea that human nature was embodied in the unaroused state of the mind, before it was shaped by its environment. The mind in its unaroused state was taken to be theoretically good. However, this inborn tendency for goodness is always in danger of being reduced to passivity, unless you cultivate yourself as a person of ‘humanity’ (in the Confucian sense mentioned above).

You should constantly try to activate your humanity to allow the unhampered operation of the original mind to manifest itself through socially responsible and moral character in action

Humanity is the realisation of what I describe as our ‘optimum level of perfection’ that exists in an inherent stage of potentiality due our innate good nature

This, in a sense, is like the Buddha nature of the Buddhists, which suggests we are already enlightened and just need to recover our innate mental state. Both philosophies are hopeful: humans are born good with the potential to correct their own flaws and failures

this could hardly contrast any more greatly with the Christian doctrine of original sin

The seventh diagram in T’oegye’s text is entitled ‘The Diagram of the Explanation of Humanity’ (Insŏl-to). Here he warns how one’s good inborn nature may become impaired, hampering the operation of the original mind and negatively impacting our character in action. Humanity embodies the gradual realisation of our optimum level of perfection that already exists in our mind but that depends on how we think about things and how we relate that to others in a social context

For T’oegye, the key to maintaining our capacity to remain level-headed, and to control our impulses and emotions, was kyŏng. This term is often translated as ‘seriousness’, occasionally ‘mindfulness’, and it identifies the serious need for constant effort to control one’s mind in order to go about one’s life in a healthy manner

For T’oegye, mindfulness is as serious as meditation is for the Buddhists. In fact, the Neo-Confucians had their own meditational practice of ‘quiet-sitting’ (chŏngjwa), which focused on recovering the calm and not agitated ‘original mind’, before putting our daily plans into action

These diagrams reinforce this need for a daily practice of Confucian mindfulness, because practice leads to the ‘good habit’ of creating (and maintaining) routines. There is no short-cut provided, no weekend intro to this practice: it is life-long, and that is what makes it transformative, leading us to become better versions of who were in the beginning. This is consolation of Korean philosophy.

Seeing the world as it is can steer us away from making unnecessary mistakes, while highlighting what is good and how to maintain that good while also reducing anxiety from an agitated mind and harmful desires. This is why Korean philosophy can provide us with consolation; it recognises the bad, but prioritises the good, providing several moral pathways that are referred to in the East Asian traditions (Confucianism, Buddhism and Daoism) as modes of ‘self-cultivation’

As social beings, we penetrate the consciousness of others, and so humans are linked externally through conduct but also internally through thought. Humanity is a unifying approach that holds the potential to solve human problems, internally and externally, as well as help people realise the perfection that is innately theirs

The corporate gig, as a social media director for a tech platform, was a revelation. “I could just show up to work and do work,” Ms. Tilghman said. After she was done, she could leave. She didn’t have to be a brand. There’s no comments section at an office job.

In 2019, a Morning Consult report found that 54 percent of Gen Z and millennial Americans were interested in becoming influencers. (Eighty-six percent said they would be willing to post sponsored content for money.)

If social media has made audiences anxious, it’s driving creators to the brink. In 2021, the TikTok breakout star Charli D’Amelio said she had “lost the passion” for posting videos. A few months later, Erin Kern announced to her 600,000 Instagram followers that she would be deactivating her account @cottonstem; she had been losing her hair, and her doctors blamed work-induced stress

Other influencers faded without fanfare — teens whose mental health had taken too much of a hit and amateur influencers who stopped posting after an algorithm tweak tanked their metrics. Some had been at this for a decade or more, starting at 12 or 14 or 19.

She posted less, testing out new identities that she hoped wouldn’t touch off the same spiral that wellness had. There were dancing videos, dog photos, interior design. None of it stuck. (“You can change the niche, but you’re still going to be performing your life for content,” she explained over lunch.)

Ms. Tilghman’s problem — as the interest in the workshop, which she decided to cap at 15, demonstrated — is that she has an undeniable knack for this. In 2022, she started a Substack to continue writing, thinking of it as a calling card while she applied to editorial jobs; it soon amassed 20,000 subscribers. It once had a different name, but now it’s called “Offline Time.” The paid tier costs $5 a month.

Casey Lewis, who helms the After School newsletter about Gen Z consumer trends, predicts more pivots and exits. TikTok has elevated creators faster than other platforms and burned them out quicker, she said.

Ms. Lewis expects a swell of former influencers taking jobs with P.R. agencies, marketing firms and product development conglomerates. She pointed out that creators have experience not just in video and photo editing, but in image management, crisis communication and rapid response. “Those skills do transfer,” she said.

a 2022 Reuters investigation found that some American clinics were quite aggressive with treatment: None of the 18 U.S. clinics that Reuters looked at performed long assessments on their patients, and some prescribed puberty blockers on the first visit.

As Cass writes in her report, “The toxicity of the debate is exceptional.” She continues, “There are few other areas of health care where professionals are so afraid to openly discuss their views, where people are vilified on social media and where name-calling echoes the worst bullying behavior.”

The report’s greatest strength is its epistemic humility. Cass is continually asking, “What do we really know?” She is carefully examining the various studies — which are high quality, which are not. She is down in the academic weeds.

he notes that the quality of the research in this field is poor. The current treatments are “built on shaky foundations,” she writes in The BMJ. Practitioners have raced ahead with therapies when we don’t know what the effects will be. As Cass tells The BMJ, “I can’t think of another area of pediatric care where we give young people a potentially irreversible treatment and have no idea what happens to them in adulthood.”

She writes in her report, “The option to provide masculinizing/feminizing hormones from age 16 is available, but the review would recommend extreme caution.

her core conclusion is this: “For most young people, a medical pathway will not be the best way to manage their gender-related distress.” She realizes that this conclusion will not please many of the young people she has come to know, but this is where the evidence has taken her.

In 1877 a British philosopher and mathematician named William Kingdon Clifford published an essay called “The Ethics of Belief.” In it he argued that if a shipowner ignored evidence that his craft had problems and sent the ship to sea having convinced himself it was safe, then of course we would blame him if the ship went down and all aboard were lost. To have a belief is to bear responsibility, and one thus has a moral responsibility to dig arduously into the evidence, avoid ideological thinking and take into account self-serving biases.

“It is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence,” Clifford wrote

A belief, he continued, is a public possession. If too many people believe things without evidence, “the danger to society is not merely that it should believe wrong things, though that is great enough; but that it should become credulous, and lose the habit of testing things and inquiring into them; for then it must sink back into savagery.”

Since the Trump years, this habit of not consulting the evidence has become the underlying crisis in so many realms. People segregate into intellectually cohesive teams, which are always dumber than intellectually diverse teams. Issues are settled by intimidation, not evidence

Our natural human tendency is to be too confident in our knowledge, too quick to ignore contrary evidence. But these days it has become acceptable to luxuriate in those epistemic shortcomings, not to struggle against them. See, for example, the modern Republican Party.

Writing, especially the kind of writing that I do, brings together narrative, science, sometimes history, and an appreciation for the person who might be at the center of the narrative.

The greatest influence on me was Oliver Sacks, because he could capture people as people, and he always integrated serious science into his pieces.

The two subjects that were most prominent for him, as I once wrote for you, were identity and adaptation: Who is this person, despite their illness? How does that illness interface with their behavior and their decisions, how do people perceive them from the outside, and how do they try to find meaning and adapt to what looks like a disability, but sometimes—not always, but sometimes—gives them hidden strength?

I’ve gone from witnessing the depths of disability and death, like with AIDS: I saw some of the first people with AIDS in California, in 1982 or so. The average lifespan was six months. They were mostly young gay men, and it was devastating, the infections they got, the cancers they got. Now, with all the new drugs that have been developed, someone who gets HIV is projected to have a normal lifespan. From six months to fifty years: it’s miraculous

that’s part of what keeps you going: the belief that things can advance in a meaningful way.

Are there any major or interesting medical stories that the public doesn’t know enough about? 

The idea of genetic treatments. Often when people hear the words “genetics” or “DNA” or “RNA,” they shut down. The challenge is how to make it accessible.

There’s a wonderful line in the Talmud that says, “Whoever saves a single life saves the whole world.” There might be only a few hundred people in the whole country who have a particular genetic disorder. I

That’s because real people — and yes, even professional economists — tend to process the parallel rise of prices and wages in quite different ways.

In brief, researchers have found that we tend to internalize the gains due to inflation and externalize the losses. These different processes yield different emotional responses.

Let’s start with higher prices. Sticker shock hurts. Even as someone who closely studies the inflation statistics, I’m still often surprised by higher prices. They feel unfair. They undermine my spending power, and my sense of control and order.

in reality, higher prices are only the first act of the inflationary play. It’s a play that economists have seen before. In episode after episode, surges in prices have led to — or been preceded by — a proportional surge in wages.

Even though wages tend to rise hand-in-hand with prices, we tell ourselves a different story, in which the wage rises we get have nothing to do with price rises that cause them.

But then my economist brain took over, and slowly it sunk in that my raise wasn’t a reward for hard work, but rather a cost-of-living adjustment

Internalizing the gain and externalizing the cost of inflation protects you from this deflating realization. But it also distorts your sense of reality.

The reason so many Americans feel that inflation is stealing their purchasing power is that they give themselves unearned credit for the offsetting wage rises that actually restore it.

younger folks — anyone under 60 — had never experienced sustained inflation rates greater than 5 percent in their adult lives. And I think this explains why they’re so angry about today’s inflation.

While older Americans understood that the pain of inflation is transitory, younger folks aren’t so sure. Inflation is a lot scarier when you fear that today’s price rises will permanently undermine your ability to make ends meet.

Perhaps this explains why the recent moderate burst of inflation has created seemingly more anxiety than previous inflationary episodes.

More generally, being an economist makes me an optimist. Social media is awash with (false) claims that we’re in a “silent depression,” and those who want to make American great again are certain it was once so much better.

in reality, our economy this year is larger, more productive and will yield higher average incomes than in any prior year on record in American history

And because the United States is the world’s richest major economy, we can now say that we are almost certainly part of the richest large society in its richest year in the history of humanity.

The income of the average American will double approximately every 39 years. And so when my kids are my age, average income will be roughly double what it is today. Far from being fearful for my kids, I’m envious of the extraordinary riches their generation will enjoy.

Psychologists describe anxiety disorders as occurring when the panic you feel is out of proportion to the danger you face. By this definition, we’re in the midst of a macroeconomic anxiety attack.

The human problem-solvers — 609 high school students from 108 countries — won 58 gold medals, 123 silver and 145 bronze. The A.I. performed at the level of a silver medalist, solving four out of six problems for a total of 28 points. It was the first time that A.I. has achieved a medal-worthy performance on an Olympiad’s problems.

Nonetheless, Dr. Kohli described the result as a “phase transition” — a transformative change — “in the use of A.I. in mathematics and the ability of A.I. systems to do mathematics.”

Dr. Gowers added in an email: “I was definitely impressed.” The lab had discussed its Olympiad ambitions with him a couple of weeks beforehand, so “my expectations were quite high,” he said. “But the program met them, and in one or two instances significantly surpassed them.” The program found the “magic keys” that unlocked the problems, he said.

Haojia Shi, a student from China, ranked No. 1 and was the only competitor to earn a perfect score — 42 points for six problems; each problem is worth seven points for a full solution. The U.S. team won first place with 192 points; China placed second with 190.

The Google system earned its 28 points for fully solving four problems — two in algebra, one in geometry and one in number theory. (It flopped at two combinatorics problems.) The system was allowed unlimited time; for some problems it took up to three days. The students were allotted only 4.5 hours per exam.

“The fact that we’ve reached this threshold, where it’s even possible to tackle these problems at all, is what represents a step-change in the history of mathematics,” he added. “And hopefully it’s not just a step-change in the I.M.O., but also represents the point at which we went from computers only being able to prove very, very simple things toward computers being able to prove things that humans can’t.”

“Mathematics requires this interesting combination of abstract, precise and creative reasoning,” Dr. Davies said. In part, he noted, this repertoire of abilities is what makes math a good litmus test for the ultimate goal: reaching so-called artificial general intelligence, or A.G.I., a system with capabilities ranging from emerging to competent to virtuoso to superhuman

In January, a Google DeepMind system named AlphaGeometry solved a sampling of Olympiad geometry problems at nearly the level of a human gold medalist. “AlphaGeometry 2 has now surpassed the gold medalists in solving I.M.O. problems,” Thang Luong, the principal investigator, said in an email.

Dr. Hubert’s team developed a new model that is comparable but more generalized. Named AlphaProof, it is designed to engage with a broad range of mathematical subjects. All told, AlphaGeometry and AlphaProof made use of a number of different A.I. technologies.

One approach was an informal reasoning system, expressed in natural language. This system leveraged Gemini, Google’s large language model. It used the English corpus of published problems and proofs and the like as training data.

The informal system excels at identifying patterns and suggesting what comes next; it is creative and talks about ideas in an understandable way. Of course, large language models are inclined to make things up — which may (or may not) fly for poetry and definitely not for math. But in this context, the L.L.M. seems to have displayed restraint; it wasn’t immune to hallucination, but the frequency was reduced.

Another approach was a formal reasoning system, based on logic and expressed in code. It used theorem prover and proof-assistant software called Lean, which guarantees that if the system says a proof is correct, then it is indeed correct. “We can exactly check that the proof is correct or not,” Dr. Hubert said. “Every step is guaranteed to be logically sound.”

Another crucial component was a reinforcement learning algorithm in the AlphaGo and AlphaZero lineage. This type of A.I. learns by itself and can scale indefinitely, said Dr. Silver, who is Google DeepMind’s vice-president of reinforcement learning. Since the algorithm doesn’t require a human teacher, it can “learn and keep learning and keep learning until ultimately it can solve the hardest problems that humans can solve,” he said. “And then maybe even one day go beyond those.”

Dr. Hubert added, “The system can rediscover knowledge for itself.” That’s what happened with AlphaZero: It started with zero knowledge, Dr. Hubert said, “and by just playing games, and seeing who wins and who loses, it could rediscover all the knowledge of chess. It took us less than a day to rediscover all the knowledge of chess, and about a week to rediscover all the knowledge of Go. So we thought, Let’s apply this to mathematics.”

Dr. Gowers doesn’t worry — too much — about the long-term consequences. “It is possible to imagine a state of affairs where mathematicians are basically left with nothing to do,” he said. “That would be the case if computers became better, and far faster, at everything that mathematicians currently do.”

“There still seems to be quite a long way to go before computers will be able to do research-level mathematics,” he added. “It’s a fairly safe bet that if Google DeepMind can solve at least some hard I.M.O. problems, then a useful research tool can’t be all that far away.”

A really adept tool might make mathematics accessible to more people, speed up the research process, nudge mathematicians outside the box. Eventually it might even pose novel ideas that resonate.

A clinical diagnosis of narcissistic personality disorder can occur when those symptoms become fixed and persistent — they do not come and go. In addition, the disorder causes distress or interferes with relationships, work or other domains.

the higher the levels of narcissism, the more people became “desperate, deluded, paranoid, angry, abusive and isolated.”

This makes it harder for the narcissist to “charm and impress others,” she said, which then makes it difficult for that person to elicit admiration.

Agentic narcissism is what most people think of when they imagine a narcissist. Those who score highly in this dimension are focused on status, power and success.“They see themselves as superior to others, crave admiration and have an inflated sense of self-importance,” Dr. Orth said. “They are typically very confident, assertive and want to be in leadership positions.”

Neurotic narcissism is characterized by hypersensitivity. Those who score highly in this dimension “constantly need validation and are very sensitive to criticism and rejection,” Dr. Orth said. “They often experience significant shame, anxiety, emotional instability, insecurity and self-doubt.”

Those with antagonistic narcissism often view others as rivals. They tend to be competitive, hostile toward others and willing to put them down to feel superior, Dr. Orth said. They also lack empathy and are exploitative.

It is “the core of pathological narcissism,” Dr. Malkin said. “These are bullies.”

It’s unclear why narcissism would reduce over time, but Sara Konrath, the director of the Interdisciplinary Program for Empathy and Altruism Research at Indiana University, has found in her own research that empathy increases as we grow older.

“Unfortunately, managing a difficult relationship is the best someone intimately involved with most narcissists can hope for,” said Elinor Greenberg, the author of “Borderline, Narcissistic and Schizoid Adaptations: The Pursuit of Love, Admiration and Safety.”