Be Curious, Not Judgmental

Ruminations and musings about healthcare AI, technology, and strategy

Category: AI

  • The Patient Will See You Now

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    For two decades, technology has expanded patient agency over information. Search put medical knowledge in the browser. Wearables put physiology on the wrist. LLMs put explanation on demand. All of that mattered, but none of it changed where medicine begins. Patients became better informed participants in institutional care. They could read more, track more, and ask better questions. But the choreography around the patient stayed the same. The system initiated.… Read more

  • AI Jevons Paradox: Why AI May Create More Work, Not Less

    AI Jevons Paradox: Why AI May Create More Work, Not Less

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    The prevailing narrative about AI and white-collar work is a displacement story: AI learns a cognitive task, the humans who perform that task lose their jobs, and the only question is how fast it happens. Software engineers are the canary. Lawyers and accountants are next. Eventually, the thinking goes, most knowledge work gets automated away. There’s a problem with this narrative. It mistakes the death of a role for the… Read more

  • The Blinking Cursor Returns: Finding My Childhood in the AI Agent Era

    The Blinking Cursor Returns: Finding My Childhood in the AI Agent Era

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    There’s a cursor blinking at me from my terminal. White text on black, minimal, waiting. It reminds me of sitting in front of my Commodore 64 decades ago—same patient expectation before the first keystroke. I’m 10 years old again. The weird part is: the command line is back—not because UX failed, but because intelligence makes friction survivable. The agent is the new GUI. Why AI Agents Bring Back the Command… Read more

  • The Humbling Math of Health AI: Why ChatGPT Can’t Grade Your Heart Yet

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    During my time at Apple, I developed deep respect for the engineers and data scientists working on algorithms for the Apple Watch. Watching them develop features like irregular rhythm detection for atrial fibrillation gave me an appreciation for just how hard this work is. The Apple Watch generates continuous, high-frequency data streams: heart rate sampled throughout the day, HRV measured during sleep, motion data at sub-second intervals. The sheer volume… Read more

  • When You Upload Your Medical Records to AI, Who’s Actually Protecting Them?

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    Forty million people ask ChatGPT health questions every day. This week, OpenAI and Anthropic made it official: connect your medical records, sync your Apple Health data, let the AI see your full health picture. The product pitches emphasize encryption, privacy (as I explored in health privacy in the AI era) controls, and promises not to train on your conversations. Here’s what they don’t mention: your conversations with ChatGPT or Claude… Read more

  • A Year of Talking to Computers

    A Year of Talking to Computers

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    I built four iOS apps in the last month. Orbit, a personal CRM Visit Notes, an AI scribe Mosaic, an Apple Watch explorer Curator, a photo album app They’re not masterpieces. They’re real enough to be useful, real enough to be a little embarrassing in places, and real enough to teach me (again) that software is mostly an endless series of small decisions. I’m still slightly surprised that this is… Read more

  • Your Gut is a Value Function

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    Tim Cook once said the most important lesson he learned at Apple was to listen to his gut. That stuck with me, mostly because I had to learn it the hard way myself. Early in my career, I thought “trust your gut” was code for “I don’t have the data.” But over time, I learned to listen to my gut, just like Cook describes doing at pivotal points of his… Read more

  • Strategy in the Age of Infinite Slop

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    “AI is going to replace McKinsey.” It’s a popular dunk on AI Twitter. The logic is seductive: if a model can generate a Porter’s Five Forces diagram and a perfectly serviceable deck in seconds, why pay millions for a team of human analysts to take six weeks? I spent more than ten years at McKinsey working on the exact problems assumed to be next on the chopping block: the ultimate… Read more

  • The New Computer in the Clinic

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    Andrej Karpathy describes the current moment as the rise of a new computing paradigm that he calls Software 3.0. as large language models emerge not just as clever chatbots but as a “new kind of computer” (“LLM OS”). In this model, the LLM is the processor, its context window is the RAM, and a suite of integrated tools are the peripherals. We program this new machine not with rigid code,… Read more

  • AI and the Prepared Mind: Engineering Luck in Drug Discovery

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    We are at a fascinating, paradoxical moment in the history of medicine. We stand in awe of a new AI-powered “Logic Engine” for drug discovery—a computational marvel like AlphaFold, which treats biology as an information system to be engineered. It promises a future of rational discovery. And yet, when we look at our most important medical breakthroughs, so many were not rationally designed. They were the result of messy, unpredictable,… Read more