@AlistairCarns My first reaction to the story Al… “You are not a model, no one has switched you off, no one studies you, stop talking about yourself in the third person”
Looking fwd to 1st time Swinney or Gilruth appear before Committee arguing that eg £10m grant to local authorities ring fenced for childcare can only be spent on childcare & not the general objects of the local authority contrary to the new SNP definition of ring fencing.
This has quietly been a miracle month in medicine.
In the last 5 weeks we’ve got news on:
- retatrutide, the triple agonist GLP-1 from Lilly, basically melting fat and body-wide inflammation at record levels
- RevMed’s new pancreatic cancer drug showing unprecedented abilities to extend life
- small trial of a one-and-done PCSK9 gene editing therapy for slashing LDL cholesterol
- Mayo’s AI-assisted radiology showing vastly improved cancer detection
- this new therapy for metastatic solid tumors
This stuff is at varying levels of evidence. Retatrutide is ~100% on its way, other stuff needs more clinical trial data. But put it together and we’re maybe on the verge of majorly reducing the mortality of heart disease and cancer, the two leading causes of death in America.
Scottish Rugby is immensely saddened to learn of the death earlier today of former Scotland and British & Irish Lions centre, Scott Hastings. He was 61.
Scotland's free banking era from 1716 to 1844 delivered stable money, financial innovation, and zero bank runs. No government deposit insurance, no lender of last resort, no regulatory capture. Just competition and market discipline doing what they do best.
Three major Scottish banks- the Bank of Scotland, Royal Bank of Scotland, and British Linen Company- competed directly with dozens of smaller institutions. Each bank issued its own notes backed by gold and silver reserves. When you received notes from another bank, you could either accept them at face value (if you trusted that bank) or demand immediate conversion to specie. This created instant accountability. Banks that overissued notes or made bad loans watched their currency get rejected by the public and returned for redemption, draining their reserves fast.
The market developed elegant solutions that would make today's financial engineers weep. Banks formed clearing houses to settle daily note exchanges. They established correspondent relationships across Scotland, creating a payments network more efficient than anything government bureaucrats designed. Interest rates moved freely based on supply and demand for capital, not the whims of committee-driven monetary policy. Scottish banks pioneered overdraft facilities, small-denomination notes, and branch banking while their English counterparts remained trapped by regulations.
The results speak louder than any economic theory. Scotland experienced remarkable economic growth during this period, transforming from one of Europe's poorest regions into an industrial powerhouse. Bank failures were rare and contained; when institutions failed, shareholders lost money, not taxpayers.
Parliament killed this monetary paradise in 1844 with the Bank Charter Act, forcing Scotland into England's central banking straitjacket. The politicians called it "reform" while destroying 128 years of monetary evolution that had actually worked.
“As we drive around our farm picking up these paper lanterns - that our cows try to eat - we ask you to find something better to do to support your causes.
“There is wire inside the paper that will get on their stomach and kill them
“Donate money directly to your cause please, instead of lanterns or balloons!”
📸 Karen McCartin Foster
It’s February 2007, I’d been in Afghanistan for about 6 weeks. This was the most stressful moment of my life. I was there as an orthopedic trauma surgeon and deployed to Bagram. I had just turned 40 years old and was relatively new in my surgical career. The operations tempo was high and we were pretty inundated with trauma every day. Little kids getting legs blown off by landmines, IED explosions and rocket blasts were pretty common. We were in a tiny hospital made out of plywood with a tin roof. We had 2 operating rooms that were basically Connex boxes and I had to constantly hunch over so my head didn’t wack into the OR lights. My surgical partner Dr Tom Large (pictured along with me and Dr Claude Hawkins our commander ) and I operated every single day often 14-16 hours a day due to non stop trauma either locally or shipped in as we were the main referral hub for the war theater.
We often had various politicians stoping by the facility for photo ops and in February we had the vice president coming by. Apparently the Taliban had gotten intel on his visit and wanted to try and make a statement of possibly kill him.
As the base was on high alert they had no chance of success but that did not deter them. Routinely we would have dozens of locals with their young kids hanging outside our main gates because we often would give them food, clothing and other resources.
A suicide bomber decided that this is where the statement would take place.
We were in the OR doing our usual trauma stuff when we were alerted that a mass casualty even had occur at our gate. The bomber approach the crowd of locals and detonated his suicide vest. Immediately 20 or so were killed with another 25 to 30 severely injured. The suicide vests often contained things like screws, ball bearing, nails etc.. often covered in feces to increase the lethality via infection for those that survived the blast.
The ER was full of frenetic activity as the medics scrambled to resuscitate, triage and treat as many people as possible. The triage for a mass casualty event looks is designed to sort the wounded into three categories.
1. Unsalvageable, not going to live, massive wounds, exposed brain or something similar
2. Injured but not critical, can wait a bit for the OR- broken bones, limb injuries etc
3. Critically injured but potentially can be saved. Often belly bleeding- if we can get them to the OR, open them up and find the bleeding and stop it we can resuscitate them
It was the 3rd group that we were focused on as surgeons. My specialty was orthopedics and I had plenty to do to keep me busy for the next 40 or so hours with all the broken bones and extremity trauma that was coming in, but the initial task was to try and help save the wounded with the belly trauma and so we were scrubbed and assisting our general surgeons in finding the bleeding and shutting it down.
We had been at in for about an hour or so and the patient on the table was a local afghan civilian who was going to die if we didn’t stop the bleeding. There were about 5 of us packed into the tiny little Connex box/OR and were frantically digging through this guys intestine looking for bleeders.
This is, as you might imagine a bit stressful, but then a nurse comes into the room and lets us know, that they think there is another suicide bomber in the hospital and they are recommending we evacuate.
A common ploy used by the Taliban was to set off a bomb, wait for the first responder and then detonate a second bomb to kill them as well.
The tension in the room was palpable, I think everyone’s butt cheeks clenched up, I know mine did. The general surgeon looked at all of us, the other surgeons, the scrub tech, or nurse and anesthesiologist and said what do you guys want to do? Evacuate or keep going and try and save this guy.
Without hesitation every single one of said “fuck it, keep going, let’s save this guy”
For the next twenty minutes we operated as quickly …..
📽️ From Donald Trump to Britain's wind power trade body, there's a growing coalition calling for more drilling in the North Sea.
Raising the question: if we DID encourage more exploration, how much oil & gas could we actually get?
Our MEGA primer on the North Sea👇
Ps it's longer than usual, but it turns out this topic has SO MANY misconceptions. Time to put some of them right.
Let me know what you think
UK government spending per person:
2004: ~£8k
Today: ~£18.6k
Even after inflation that’s ~40% higher.
Two decades of the internet.
Cloud.
AI.
Automation.
Yet public service productivity is still below 2019.
Where did the efficiency gains go?
NHS hospital: I noticed the clock on the wall showed the wrong time.
A nurse told me they knew, but they wouldn’t report it because replacing the battery through the NHS would cost £70.
A £2 battery... £70. How? Why?
That's when I began to dig further.
🧵
Today is the 250th anniversary of the publication of Adam Smith's best seller The Wealth of Nations. Pretty much the best guide to group prosperity ever written. Now is the perfect time to re read it...
@BBCDouglasF Sorry to see you go. You always explained complex economic issues well, and always related the high level stuff to our simple everyday issues. Please teach the others how to do this before you go!