Rural Physician, Medical Educator, Medical Informaticist. Interests: Health Informatics, Clinical Research, Edtech in Health Profs & Medical Education.
Pondicherry, India
Joined August 2009
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I propose the The Racism Asymmetry Law:
"The amount of energy needed to refute racist misinformation is an order of magnitude larger than is needed to produce it."
Core Tenets
The Effort Gap: It takes mere seconds to invoke a stereotype or deny a group’s historical contribution. Conversely, it takes minutes or hours to research, cite, and present the historical evidence (like the 1,500 Indian soldiers who died at Gallipoli) required to debunk that claim.
The Burden of Proof Shift: In these digital exchanges, the racist actor often shifts the burden of proof onto the responder, forcing the "educator" to prove a minority group's right to exist or belong, while the "detractor" relies on the low-energy comfort of prejudice.
The Saturation Effect: Because it is "cheaper" (in terms of cognitive effort) to be bigoted than to be factual, a single person defending historical truth can be quickly overwhelmed by a volume of bad-faith arguments that they simply do not have the time to correct.
Inspired by: Brandolini's law (or the bullshit asymmetry principle)
The electric traction with high-rise OHE is India’s engineering innovation to the Double-stack container trains.
The long-haul formation and “Make in India” high-horsepower electric locos are significant capacity upgrades on the Dedicated Freight Corridor.
Jagan Mohan R., MD retweeted
if you're using claude to edit videos, you can give it a library of 5.2M+ audio files for $0
sound effects, ambience, music. openverse has a free api. no key needed.
give it api.openverse.org and ask:
“whenever you need sound effects search Openverse to find the best options and use them for tasteful sound design within my video”
no more using your browser to download random clips or trying to generate the audio itself
Jagan Mohan R., MD retweeted
How a civilisational nation can be destroyed without defeating its army!
Critical lesson for Indians in these times from Douglas Kruger, who uses Poland in this case study:
Jagan Mohan R., MD retweeted
I explained why almost every actor and artist ends up on the same side. Today I want to show you that none of this is an accident. It was theorized almost a hundred years ago, by an Italian communist sitting in a prison cell. His name was Antonio Gramsci. Once you understand his idea, you will see it everywhere.
Start with the problem Gramsci was trying to solve.
Karl Marx had predicted that workers in rich countries would rise up and overthrow capitalism. It never happened. Workers in Italy, France, England and America didn't want a revolution. They went to church on Sunday. They loved their country. They wanted a house, a family, a better life for their kids. The communists couldn't understand it. They had the theory, the anger, the slogans. Why wasn't anyone following them?
Gramsci, locked up by Mussolini, spent years thinking about this. And he found the answer.
His answer was this: a society isn't held together by police and soldiers. It's held together by what people believe is normal. What you learned at school. What your priest told you. What the newspaper says. What the movies show you. What your neighbors think is obvious. Gramsci called this "hegemony." Put simply, it means: whoever decides what is normal, rules.
So he drew a conclusion that changed everything. In the West, you can't win by attacking the palace. You'll lose. People will defend the system because they believe in it. You first have to change what people believe. You have to win the schools, the universities, the newspapers, the arts, the churches. Slowly. Patiently. Trench by trench. He called it a "war of position." Once the culture is yours, politics falls into your hands like ripe fruit.
Forty years later, in 1967, a German student leader named Rudi Dutschke turned this idea into a battle plan. He called it "the long march through the institutions." The idea was simple. Don't burn down the university. Become the professor. Don't attack the newspaper. Become the editor. Don't fight the courts. Become the judge. Get inside every institution, rise to the top, and change it from within.
Now watch how it works in real life, step by step.
A young activist goes to university. He stays. He becomes a professor. Now he trains thousands of students every year. Those students become teachers, journalists, lawyers, HR managers, screenwriters, civil servants. They all learned the same ideas from the same people. They hire people who think like them. After one generation, the institution has changed. After two, nobody remembers it was ever different.
Studies have found that at elite American colleges, Democrat professors outnumber Republicans by roughly ten to one, and in some departments there are almost none. That isn't a conspiracy meeting in a basement. It's what a completed march looks like.
And here is the most powerful part. Once the institutions are won, you don't need to force anyone. People absorb the ideas without noticing. A fish doesn't know it's wet. A young actor who grew up with teachers, drama coaches, screenwriters, agents and award juries who all think the same way doesn't need to read Gramsci. He just breathes the air. To him, these are not opinions. They are simply what good people believe. And anyone who disagrees isn't someone with a different view. He's a bad person.
That's the final stage of hegemony. Disagreement stops being an argument and becomes a moral stain. You don't debate the other side anymore. You cancel it.
This is why Hollywood thinks as one. This is why so many newsrooms sound identical. This is why your kids come home from college with ideas you never taught them. Nobody had to give an order. The march was already over.
Conservatives made one huge mistake for fifty years. They thought winning elections was enough. They focused on Washington while the other side took the classrooms, the studios, and the newsrooms. They won some votes and lost the culture. And as Andrew Breitbart used to say, politics is downstream of culture.
The good news is that a march can go in both directions. Buying Twitter and turning it into X was one institution taken back. There will be others. But it won't happen by complaining. It will happen when people who love freedom start teaching, writing, filming, building, and creating again.
They understood the game a hundred years ago. It's time you did too.
Ask yourself a simple question. Why is almost every celebrity on the same side?
Actors, singers, late-night hosts, award-show presenters. Thousands of people with different backgrounds, different lives, different temperaments. And somehow, on every major issue, they land on the exact same opinion, at the exact same moment, with the exact same hashtags. Free minds don't behave like that. An ecosystem does.
Now ask a second question. Elon Musk is landing rockets on their own tails. He's bringing internet to villages that never had a phone line. He's building cars that drive themselves and implants that let paralyzed people move a cursor with their thoughts. Artists are supposed to be the ones who dream about the future. Here is a man actually building it. How many of them stand next to him? A handful. Why?
Because Hollywood is not a free market of talent. It's a royal court.
A young actor doesn't make it because he's good. Hundreds are good. He makes it because someone lets him in: an agent, a casting director, a producer, a studio, an awards committee. Every step is a gate, and every gate has a keeper. When your whole career depends on a few rooms, you learn very quickly what can be said in those rooms and what can't.
This is how it works. First you stay silent. Then you nod. Then you repeat. Then you believe. Compromise never arrives all at once. It arrives one dinner, one role, one red carpet at a time. And once you've given up enough, you need the system to stay in place, because the system is the only thing that makes the sacrifice worth it.
Want to see the whole mechanism in a single story? For decades, one of the most powerful producers in Hollywood was the subject of accusations from dozens of women, and much of the industry treated it as an open secret. A host even joked about it at an Oscar nominations announcement, and the room laughed. Speaking up seriously meant losing everything. When the truth finally broke, the same industry dressed in black and applauded its own courage. Silence while it pays. Virtue once it's safe. That's the system.
And that's the real lie. Not that these people are monsters. Most aren't. The lie is calling it courage. Real courage costs you something. Saying what every room in town already applauds costs nothing. Saying the opposite is what costs. That's why so few artists stand with Elon. Not because they've studied his ideas and rejected them, but because standing there is a career risk they can't afford.
Look at what happened to him when he left the consensus. Advertisers fled. Friends disappeared. Invitations stopped. He could afford it. Almost nobody else can. That tells you exactly how free that world really is.
So wake up. Stop taking your political cues from people whose paycheck depends on agreeing. A celebrity endorsement is not an argument. It's a loyalty signal. Your vote, your convictions, your children's future: don't outsource them to people who are paid to recite lines someone else wrote.
The people who build the future rarely get applause from the people who perform it.
Think for yourself. It's the most American thing you can do.
Must read for this week
When you disagree with someone, there are two paths forward. The first is to try to engage with what they’re saying: what their reasons are, whether their position is true, what evidence could be brought to bear, and so on.
ALT When you disagree with someone, there are two paths forward. The first is to try to engage with what they’re saying: what their reasons are, whether their position is true, what evidence could be brought to bear, and so on. The second is to diagnose them: to engage with the second-order question of why they’re saying it. For instance, if you’re arguing with somebody about microservices, you could say “well, you only like microservices because you want to polish your resume”, or “you only like monoliths because you’re scared of distributed systems”. This happens a lot in online arguments. On the question “are AI models improving”, some anti-AI people will argue that people only think so because AI psychosis is rotting their brain, and the dumber they get, the smarter AI models seem in comparison. Likewise, many pro-AI people argue that people only disagree because they’re Luddites, or scared of change, and so on. None of these arguments are about the quality of AI models.
ALT It feels so good to diagnose your opponents because there’s no possible response. If you say “I think AI models are improving because these benchmark scores are rising”, somebody might point out that the AI labs are training on those benchmarks, or argue that they represent isolated skills that don’t transfer, and so on, making you feel stupid. If you say “you only disagree with me because you want to roleplay as a revolutionary”, how could you be proven wrong? The more someone protests a diagnosis, the more it sounds like it must be right. Otherwise why would they be so upset?
Masterclass in debunking and exposing propaganda.
Animated data visualisation says it all.
Watch MAGA X invent a scandal about James Talarico in real time.
For four days they teased it and built up to the big day. Paxton called him "missing." Spencer Pratt's "sources" put him in a mental health facility. Then, at 1:05 pm, Nick Sortor posted that an Ohio mental hospital "confirms" Talarico was discharged.
50 accounts pushed the claim within 20 minutes. Those posts have 9.3 million views.
The white dots are copy-pasted posts. There are 605 of them. One account posted the same text 83 times in under 2 hours.
The hospital says Talarico never received treatment there. Talarico says he's never even been to Ohio.
This story eventually even made it to MSM. This is MAGA manufacturing an alternative reality in real time.
Full breakdown with the data here:
xitter.cf/theGhostOfRiel/status/…
I pay for this data myself. If you want more of these, support links are in my bio.
@jamestalarico
@TeamTalaricoHQ
@krassenstein
Michel Foucault’s analyses of the medical gaze, the construction of the “normal” versus “pathological” body, and "biopower" provided the conceptual framework later adopted by Fat Studies to reinterpret obesity medicine.
In this reading, the classification of excess adiposity as a disease state and the promotion of weight loss - whether through lifestyle measures or pharmacologic agents such as GLP-1 receptor agonists - are understood primarily as exercises of disciplinary or biopolitical power rather than responses to measurable health risks.
The language of the 2026 Harvard Medical School panel “Against the Pathology of Unruly Bodies,” which framed medical attention to fatness as pathologization and described weight-loss drugs as tools of 'fascistic' (am not kidding) eradication, directly reflects this Foucauldian inheritance. The framework entered medical institutions via feminist and queer theory, the formalization of Fat Studies, and the embedding of medical humanities and social-medicine perspectives within clinical education.
While Foucault’s historical account of knowledge/power relations does not entail the denial of biological associations, its stronger contemporary applications treat epidemiological and randomized-trial evidence of obesity-related morbidity and the cardiovascular benefits of GLP-1 agents as secondary or ideologically suspect.
The result is a selective skepticism within certain academic and institutional settings that subordinates outcome data to critiques of medical power.
city-journal.org/article/har…
Jagan Mohan R., MD retweeted
We made a fair OCR benchmark. And we're not ranked first.
Introducing OmniParseBench - 16k tests across 90 languages with consistent, interpretable scoring.
Campbell’s Law and Deliverology: Why Targets in Education Often Distort the Thing They Measure
In education reform, two ideas frequently collide: the accreditation and ranking milieu push to set clear targets and rigorously track them, and a longstanding social-science warning about what happens when those targets become high-stakes.
Campbell’s Law, stated by psychologist and social scientist Donald T. Campbell in 1976, is:
“The more any quantitative social indicator is used for social decision-making, the more subject it will be to corruption pressures and the more apt it will be to distort and corrupt the social processes it is intended to monitor.”
The core insight is straightforward. A measure (test scores, graduation rates, attendance, crime statistics, hospital mortality rates, etc.) can be a useful indicator under ordinary conditions. Once it becomes the basis for consequential decisions - funding, rankings, promotions, bonuses, or political accountability - people and institutions face strong incentives to "improve" the number rather than the underlying reality. The result is often both a corrupted metric and a distorted process.
Campbell applied the idea directly to education as a fantastic demonstration (Thank you Campbell). He wrote that achievement tests can usefully reflect general school achievement under normal teaching aimed at broad competence. But when scores become the goal of the teaching process, they lose their value as indicators and distort instruction. Common manifestations include teaching to the test, narrowing the curriculum, coaching test-taking strategies, reclassifying students, or outright cheating (as seen in high-profile scandals such as Atlanta). Similar patterns appear in other fields: police departments under pressure to lower reported crime rates, factories meeting Soviet-style production quotas with unusable goods, or airlines lengthening scheduled flight times to boost “on-time” percentages.
Campbell’s Law is closely related to Goodhart’s Law (“When a measure becomes a target, it ceases to be a good measure”), but it places extra emphasis on the corruption of the social processes themselves, not merely the breakdown of the statistical relationship.
Deliverology is a results-driven approach to public-sector performance management developed by Sir Michael Barber. It originated in the early 2000s when Barber headed the Prime Minister’s Delivery Unit (PMDU) under Tony Blair. The small unit’s job was to ensure that a limited set of government priorities—especially in education and health—actually got delivered rather than remaining policy aspirations. A Treasury official coined the term “deliverology” as a mild joke; Barber and his team adopted it.
The method treats delivery as both a science and an art. On the science side, it calls for a small number of clear, ambitious, measurable targets; baseline data and trajectories (expected paths of improvement); regular monitoring; stock-take meetings with top leadership; and structured problem-solving when progress stalls. On the art side, it stresses political (or administrative) will, urgency, honesty about obstacles, and building a lasting culture of delivery. Barber later codified the approach in Deliverology 101: A Field Guide for Educational Leaders (2010) and applied it through roles at McKinsey, Pearson, the U.S. Education Delivery Institute, and his firm Delivery Associates. Variants have been used in education systems in the UK, various U.S. states, Ontario, and elsewhere.
Typical Deliverology practices in education include setting quantitative targets for test scores, attendance, or graduation rates and then intensively monitoring progress against them through dedicated delivery units and data routines. Proponents argue this disciplined focus forces attention onto priorities that would otherwise drift amid everyday bureaucratic noise and produces measurable short-term gains.
Where the two ideas meet is the claim that Deliverology’s heavy reliance on targets and quantitative indicators puts Campbell’s Law into action. When high-stakes consequences are attached to a narrow set of metrics, the pressures Campbell described—gaming the measure and distorting the underlying educational process—tend to appear. Academic studies of English secondary education under performance-measurement regimes influenced by this style of management have documented effects such as test-driven pedagogy, curriculum narrowing, reduced teacher autonomy, and short-termism. Critics contend that these systems can improve the numbers without equivalently improving learning, or can even undermine broader educational quality. Supporters counter that without clear targets and relentless monitoring, many education systems simply fail to deliver meaningful improvement at scale, and that careful design (multiple indicators, verification, and attention to unintended consequences) can mitigate the risks.
In short, Campbell’s Law is a cautionary principle about the predictable side-effects of turning social indicators into high-stakes decision tools. Deliverology is a practical methodology that deliberately uses ambitious targets and data to drive public-service results. In education, the tension between them is ongoing: the former warns that the latter’s tools can corrupt the very processes of teaching and learning they are meant to improve. Recognizing both helps explain why so many education reforms that look decisive on paper produce mixed or distorted results in classrooms.
Jagan Mohan R., MD retweeted
My teacher team has recently been discussing rubrics, so I wanted to check out Brookhart's oft-cited research on their quality and effectiveness. Her 2015 review of 63 studies found that rubrics improve student learning, but only when they describe the quality of thinking, not just list tasks to complete. Well-designed rubrics helped students perform better across writing, science, math, and other subjects.
The core problem Brookhart identified: many rubrics conflate different skills or measure nothing meaningful. Take "has three sources" as an example. What does this actually measure—research skills? Source evaluation? Synthesis ability? It's unclear, and that matters. If we provide sources to students, it measures only compliance. If students find sources themselves, it lumps together distinct intellectual skills without clarity. Students can't aim for a fuzzy target, and teachers can't give useful feedback when criteria blur multiple competencies together.
Effective rubrics are precise about what thinking skill they're measuring: "evaluates source credibility using relevant criteria" (research skill), "synthesizes information across multiple sources" (integration skill), or "interprets evidence to support claims" (analytical skill). This specificity helps students understand exactly what quality work looks like and helps teachers see where students actually need support. When rubrics clearly name distinct thinking skills, they guide learning. When they list vague requirements or blend skills together, they just create hoops to jump through. tandfonline.com/doi/abs/10.1…
I also attended a course at Harvard Medical School.
And a MIT-Harvard bootcamp.
You won't catch me using those as some sort of academic halo because my peers know the value of such 'executive courses' well.
Anybody who uses the 'Harvard' label is always laughed at.
Mr. Vembu, I came back after my Harvard programme wanting to build in India. I still do. But my experience has shaken my faith in the system.
I’m working in AI and healthcare. Even getting clarity on the regulatory pathway for a clinical validation study has been a struggle. In education, I’ve encountered resistance to adopting AI. My qualifications feel irrelevant when institutions won’t engage with the work. And when basic civic issues arise, police support has been difficult to secure.
Where is the conducive environment we’re asking people to return to?
Who is accountable for giving founders clear regulatory answers? How do educators evaluate new technology responsibly? Where does a citizen turn when local authorities don’t help? What recourse exists when nobody takes ownership?
You’ve built here. What concrete governance reforms would you push for and how can people like us help make them happen?
“Come back, let’s build” is a call I believe in. How do we make the system support those who answer it?
Jagan Mohan R., MD retweeted
Еще один герой в этой цепочке чудес, произошедших на рейсе из Дубая, - Шота Мусаев.
Шота - стоматолог и был единственным врачом на борту. Он стал одним из трех пассажиров, которые ворвались в кабину пилотов и остановили террориста. Вместе они связали нападавшему руки и ноги проводами от наушников.
А затем Шота остановил кровотечение у тяжелораненого капитана Смита Маччхара.
По словам саудовских врачей, если бы не действия Шоты, капитан бы умер.
Jagan Mohan R., MD retweeted
You'll be shocked after hearing what Captain Smit Machchar said to the passengers 🚨
Doctor Maya Peretz -
“Smit is truly a brave man. Everyone on that plane was brave. Everything was going normally, and I was peacefully taking a nap. Suddenly, the whole plane shook so violently that people started panicking.
After some time, some of us saw the cockpit door being opened. I was sitting in the last seats, so I couldn't clearly see what had happened. But when people started attacking the Muslim pilot, Captain Smit said, ‘Leave him. If anyone can control the plane, have a look.’
Some of us were even ready to throw that man out of the plane. But Captain Smit and few of us doctors insisted that we should not do it and let officials deal with him. I truly want my daughter to become as great a human being as him. I pray to lord that he recovers soon.”
No matter which country you belong to, everyone should aspire to be a human like Smit 🙏❤️
Jagan Mohan R., MD retweeted
Captain Smit Machchhar is a HERO.
In the face of the gravest danger and despite being seriously injured, he showed immense courage and an unwavering resolve to protect the lives of others.
His valour helped save hundreds of lives and avert a great tragedy.
India is proud of Captain Machchhar.
Praying for his speedy recovery, renewed strength and good health.
Jagan Mohan R., MD retweeted
My salute to the Indian pilot Captain Smit Machchhar for his extraordinary bravery.
Despite being stabbed and seriously injured, he fought back, resisted, opened the cockpit door, and enabled passengers and crew to overpower the attacker — preventing a catastrophic mid-air disaster.
He saved the lives of 174 people, including Israeli citizens and other nationals.
I wish Captain Machchhar a speedy and full recovery.
He is a true hero.
Actually, combining multiple of the siloed columns creates competencies.
Recall x, y and z and devise a plan, monitor and evaluate the outcomes and refine the plan till you can recognise and demonstrate that the outcomes have been achieved.
Instead of just words from the 'evaluation' column.
It's difficult to overestimate how damaging this view of teaching and learning has been for so many kids.
Virtually every teacher trained over the last 50 years was taught that knowing stuff is the least important part of thinking.
This image taken from Utica University's assessment resources for faculty:
utica.edu/academic/Assessmen…
The problem is that the Humanities people come up with various theories (postmodernism, social constructivism, radical feminism, and cultural relativism, critical race theory, subaltern something something, etc) that cannot be empirically tested, validated or experimented in safe lab conditions nor even using computational tools.
One issue is the Asymmetry of Risk. Popularised by @nntaleb in Skin in the Game, this theory posits that intellectuals and bureaucrats suffer no personal or material downside when their ideas fail in practice (unlike an engineer building a bridge) Rather the whole society suffers disastrous consequences (Chinese sparrows -> famine).
Research in Humanities is limited to Universities where these departments can devolve into self-referential citation cartels. Corporates, startups, entrepreneurs are not doing such research. Success in this ecosystem is not judged by whether a theory improves human well-being, but by peer assessment - whether it satisfies university administrators, matches dominant internal ideologies, or generates citations within a closed loop.
Some like Wendy Doniger last for decades and decades in crucial departments, growing their networks and silencing dissent leading to ideological corruption and nepotism.
If science advances one death at a time, humanities go rogue every generation in some new direction.
Other critics of contemporary humanities (such as those involved in the famous Grievance Studies Affair or "Sokal Squared" hoax) argue that certain branches of the liberal arts have systematically rejected empirical reality.
By favoring postmodern deconstruction and prioritizing "lived experience" over objective data, these fields insulate themselves from scientific refutation
When a field replaces objective metrics with linguistic and ideological conformity, it creates a monoculture where disagreement is penalized and bad ideas are shielded from rigorous critiques.
Gad Saad in the Parasitic Mind argued that in the same way that organisms (including humans) could be parasitized by physical brain worms that detrimentally alter the hosts’ behaviors to serve the neuro-parasites’ interests, human beings could be infected by another class of devastating ideological neuro-parasites that are hard to get rid of.
BTW, great article from Bhavya Pant: dailycollegian.com/2018/10/p…
This quoted post is unavailable.
Jagan Mohan R., MD retweeted
Asking everyone to fine tune github.com/NandhaKishorM/lay…
Just use any kinda agentic harness like claude code, codex etc. Change the code and use free kaggle GPUs to train your own use cases. Base model has limitations
