Duke Duncan MD

Interventional Radiologist at Cleveland Clinic Martin Health - Tweets do not represent my employer. @PennRadiology @PennIR @PIGILab alumnus

[Duke Duncan MD @RadDrDuke]

2023 July 13 @NEJM Clinical Decision section on Treating Intermediate Risk PE: CDT and thrombectomy not even considered. They are arguing systemic TPA versus heparin! I had to double check the date to make sure it wasn’t the 2008 issue

[Michael Dell 🇺🇸 @MichaelDell]

Robert Reich forgot the 6th and most common way:

6) Build something millions of people actually want

[Dustin @r0ck3t23]

Elon Musk just defended America better than every politician in Washington combined.

Musk: “After World War 2, the US could have basically taken over the world and any country. Like we got nukes, nobody else got nukes. We don’t even have to lose soldiers. Which country do you want?”

One nation on earth held a weapon nobody else had.

Total dominance. Zero competition. No risk of retaliation.

Every empire in history that held that kind of advantage used it.

Rome. The Mongols. The British. The Ottomans.

They conquered until they collapsed.

America had a bigger advantage than all of them combined.

And it rebuilt the countries it just defeated.

Musk: “The United States actually helped rebuild countries. So it helped rebuild Europe, it helped rebuild Japan. This is very unusual behavior, almost unprecedented.”

Almost unprecedented?

It had never happened before. Not once in 5,000 years of recorded history.

The Marshall Plan wasn’t foreign aid.

It was the most radical act of restraint any superpower ever committed.

America turned its enemies into allies. Turned rubble into economies. Turned surrender into partnership.

Germany went from ashes to the economic engine of Europe in a generation.

Japan went from unconditional surrender to the third largest economy on earth.

Three years after the war, America was flying food into Berlin.

A city in the heart of the nation that just tried to destroy it.

That’s not policy.

That’s a civilization deciding what it is at the exact moment it has the power to be anything.

You’re being told a story right now.

That America is the villain of history.

You hear it everywhere. Media. Universities. Social platforms.

Musk: “There’s always like, well America’s done bad things. Well of course America’s done bad things, but one needs to look at the whole track record.”

Every nation on earth has dark chapters. Every single one.

The difference is what a country does when nobody can stop it.

And when nobody could stop America, it fed its enemies and rebuilt their cities.

Musk: “The history of China suggests that China is not acquisitive. Meaning they’re not going to go out and invade a whole bunch of countries.”

Probably right.

China has historically built walls, not fleets.

But the real question isn’t about borders anymore.

We’re approaching a moment that mirrors 1945 in ways nobody has fully processed yet.

AI is going to give a handful of people a power advantage that makes nuclear monopoly look quaint.

If someone is going to hold that kind of power, who do you want it to be?

The country that conquered when it could? Or the one that rebuilt when it didn’t have to?

Every alliance. Every trade route. Every economy.

Billions lifted out of poverty.

All of it traces back to one act of restraint that had never been done before.

And carries no guarantee of being repeated.

The most powerful thing America ever did wasn’t building the bomb.

It was what it didn’t do after.

[Duke Duncan MD @RadDrDuke]

@IR_Doctor You love a good controversy!

[Duke Duncan MD @RadDrDuke]

@r0ck3t23 Great post

[Dustin @r0ck3t23]

Mark Cuban just described the largest wealth transfer of the AI era.

Almost nobody understood what he said.

Cuban: “There are 33 million companies in this country. Aren’t going to have AI budgets. Aren’t going to have AI experts.”

Not tech startups.

The shoe store. The regional trucking outfit. The accounting firm with 12 employees.

The businesses that actually run the physical economy.

They know AI is coming. They have no idea what to do with it.

Cuban: “You’ve got the head of Microsoft saying software is dead because everything’s going to be customized to your unique utilization.”

Software is dead.

The SaaS era ran on one rule. Build a generic product. Force millions of companies to bend their workflows around it. Charge rent forever.

AI ends the contract.

The business stops bending to the software. The intelligence bends to the business.

But customized by whom.

The third-generation manufacturer cannot tell Claude from Gemini. The county hospital is staring at a reactor asking where the light switch is.

Cuban: “Who’s going to do it for them?”

That question is worth more than the frontier models themselves.

Hundreds of billions are being burned to build the foundation. The smartest engineers alive are locked in a bloodbath over who owns the base layer.

Let them fight.

Let them burn the capital. Let them drive the cost of raw intelligence toward zero.

Because the wealth does not collect where the brain is built.

It collects where the brain meets the business.

Every ambitious kid in college right now thinks survival means a seat at OpenAI or Anthropic.

Cuban is staring at the other 99 percent of the economy.

Learn the models. Then learn the messy, unglamorous reality of how a 50-person company actually operates.

Walk through the door. Understand their problems. Wire the intelligence directly into their revenue.

That is not a job title. That is an entire economic class being born.

You do not need to build the brain. You need to build the nervous system.

The biggest winners of the electricity era were not the engineers who built the generators. They were the ones who walked into dark factories and showed the owners where to plug in.

33 million companies are standing in the dark right now.

Silicon Valley is racing to build the god. The fortunes will belong to whoever teaches him a trade.

[Duke Duncan MD @RadDrDuke]

@SenWarren This is not correct unfortunately.

[Duke Duncan MD @RadDrDuke]

@digijordan Because they have nuclear weapons already.

[Duke Duncan MD @RadDrDuke]

@david_parker It’s a very bizarre combination

[Duke Duncan MD @RadDrDuke]

@Rajatsoni Because a rental property is tax-free income and often times has appreciation on the equity. STRC has capped upside and unlimited downside. Google “what are the risks of investing in STRC” and you will find out immediately

[Duke Duncan MD @RadDrDuke]

@buckethatbtc @Strategy Hey @grok what are the risks of investing in STRC

[Duke Duncan MD @RadDrDuke]

@compliantvc Typical leased car is $500 month. And driving in your own car is often preferable to taking public transit for most people.

[Duke Duncan MD @RadDrDuke]

@cryptopunk7213 Tuition is same as an elite school, this if an elite school just with a different curriculum

[Duke Duncan MD @RadDrDuke]

This is unbelievable, huge change is coming to media in the next three years.

[The Dor Brothers @thedorbrothers]

We just made a $200,000,000 AI movie in just one day.

Yes, this is 100% AI.

[Duke Duncan MD @RadDrDuke]

@trentjhughes Takes more than one full day is the problem. We had our garage organized by someone who does this full-time and it took almost a week.

[Austin Bourgeois @AustinBourgeois]

Geniculate artery embolization for knee pain in an otherwise healthy 60's year old looking to delay knee replacement.

Prior to treatment, was unable to exercise more than 15 mins with 7/10 pain. Now pain free at 6 months. #iRad #GAE

[Duke Duncan MD @RadDrDuke]

@YunTaTsai1 @elonmusk Significantly reduces the subliminal stress of driving, especially for trips over an hour

[Sloan Rachmuth @SloanRachmuth]

Features of the bill.

[Duke Duncan MD @RadDrDuke]

@ChengaziMD Good save, reasonable approach to start, do you think using different coil type would have helped?

[Duke Duncan MD @RadDrDuke]

@IRKhalsa @SIRspecialists @SIRRFS @SIR_ECS @_backtable @SDhandMD @TheRealDoctorOs @thegestgroup CARTO with gel foam slurry

[Duke Duncan MD @RadDrDuke]

@allenanalysis I picked these from my backyard in Florida this morning