The Long Game 75: Chronic Pain, Project Blueprint, Changing Your Mind, Tech x Bio

🌐 The Wires of War, Cold Plunges, Japan, Giving a Presentation, Outliers, and Much More!

Hi there, it’s Mehdi Yacoubi, co-founder at Vital, and this is The Long Game Newsletter. To receive it in your inbox each week, subscribe here:


Greeting from Mallorca 🇪🇸 where we’re currently having our first company retreat!

📣 We are hiring at Vital, help us build the “Strava for Health.” We are now looking for:

  • Senior Backend Engineer

  • Senior Frontend Engineer (Flutter)

  • Senior Designer

Find all our openings here.

We are offering $1,000 in Bitcoin if you refer to us a candidate we end up hiring.


In this episode, we explore:

  • Chronic pain

  • Project Blueprint

  • Changing your mind

  • Spotting the outliers

  • The Wires of War

  • The coming age of Tech x Bio

Let’s dive in!


🥑 Health

🤕 A New Chronic Pain Study

I suffered three years of chronic back pain. I couldn’t go a week without having painful episodes; I struggled to find good sleeping positions, working positions. I couldn’t squat, deadlift, run. It was hell. At some point, I almost accepted that this would be for the rest of my life.

Last January, I came up with a few resolutions for 2021, and the most important one—by far— was to fix my chronic pain for good. I talked about the books I planned to read and the approach I planned to take. Thankfully, my friend Ivan saved me a lot of time and recommended Healing Back Pain: The Mind-Body Connection by Dr. Sarno. I will be eternally grateful to him.

Seven weeks after reading the book, I was entirely cured. No more back pain, running every other day, lifting heavier than ever. This has been one of the most significant experiences in my life. I planned to write a long-form post about this but haven’t got the time recently. I still plan to do it because it always saddens me to see people waste their time and money on things that won’t give them long-term relief.

The idea in the book of Dr. Sarno is that pain originates in the mind and comes from repressed anger and anxiety. I know that said like that, you immediately want to call it BS, but just read the Amazon reviews and watch the thousands of Youtube videos of people who fixed their decade-long chronic pain this way.

Thankfully, a very well-conducted study has been published recently in JAMA, and I hope it will push the skeptics to reconsider their stance.

Here’s the abstract:

Question  Can a psychological treatment based on the reappraisal of primary chronic back pain as due to nondangerous central nervous system processes provide substantial and durable pain relief?

Findings  In this randomized clinical trial, 33 of 50 participants (66%) randomized to 4 weeks of pain reprocessing therapy were pain-free or nearly pain-free at posttreatment, compared with 10 of 51 participants (20%) randomized to placebo and 5 of 50 participants (10%) randomized to usual care, with gains largely maintained through 1-year follow-up. Treatment effects on pain were mediated by reduced beliefs that pain indicates tissue damage, and longitudinal functional magnetic resonance imaging showed reduced prefrontal responses to evoked back pain and increased resting prefrontal-somatosensory connectivity in patients randomized to treatment relative to patients randomized to placebo or usual care.

Meaning  Psychological treatment focused on changing beliefs about the causes and threat value of primary chronic back pain may provide substantial and durable pain relief.

Side note: more than ten people (subscribers of TLG and friends) told me they fixed their back pain thanks to the book, so if you currently have chronic pain, read the book—with an open mind.


🌱 Wellness

🧬♾ Project Blueprint

Bryan Johnson, the founder of Kernel that I already mentioned in the newsletter many times, came up with a fantastic initiative called Project Blueprint.

In short, here’s what it’s about:

Project Blueprint aims to measure all 70+ organs of my body and then maximally reverse the quantified biological age of each.

This started last year when I fired Evening Bryan from being authorized to make decisions about what and how much to eat. No more late night binges. No more second servings. No more just-this-once rationalizations. Evening Bryan was making life miserable for all Bryans. Enough. What started as play and tinkering has evolved into something methodical and rigorous. 

A community of Bryans made this consequential decision.  Now, my body generates the grocery shopping list, communicating their needs through the regular measurement of hundreds of biomarkers. This has given my heart, liver, kidneys and all other organs and biological processes of my body an independent voice whose authority surpasses my conscious mind. It’s my Autonomous Self.  Demoting my conscious mind while elevating other essential parts of self has unquestionably been one of the most positive developments of my life. Never has the collective of Bryans been more healthy and happy.

The idea of ‘community + health optimization’ is dear to us at Vital, and we firmly believe that quantified communities are the future of health.

We look forward to seeing where Bryan brings this project and enable people to do this together on Vital one day.


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🧠 Better Thinking

🔃 Changing Your Mind

“What’s the last thing you changed your mind about?” is one of my favorite interview questions. It can tell you a lot about someone.


⚡️ Startup Stuff

👽 Spotting The Outliers

Two weeks ago, we talked about dream teams, how important they are and how hard they are to build.

Rohit from Strange Loop Canon had a great piece on this concept. Here’s the TL;DR:

In a world of plenty, selection is hard. In a world where selection is hard, we resort to ever more stringent measurement. If measurement is too strict, we lose out on variance. If we lose out on variance, we miss out on what actually impacts outcomes. If we miss what actually impacts outcomes, we think we're in a rut. But we might not be. Once you've weeded out the clear "no"s, then it's better to bet on variance rather than trying to ascertain the true mean through imprecise means.

Unrelated to hiring outliers, but still in the ‘startup stuff’:

I found this tweet very interesting and mirroring a feeling I’ve had for a few months. Instagram has started its slow decline the same way Facebook did a few years ago. The question is, what comes next? Well, we believe it will be the era of verticalized social networks. Public, Strava, Matter, Saturn, and soon Vital for health.


📚 What I Read

🇺🇸🇨🇳 The Wires of War

This is the most important book I’ve read this year. It won’t explain something you’ll be pleased to hear, but it will clarify something we all need to hear. China is on the verge of reaching world domination, and the consequences of this would be disastrous.

I've been waiting all year for this book to come out, and it did not disappoint. The technology war with China is perhaps the most pressing and underrated issue of our time. We waste time on useless topics while the global infrastructure of information and control is at stake. The author does an excellent job of explaining the nuances of the issues at stake. I will try to review the book in the next few weeks.

For more: this thread debunks all of the classic arguments predicting a Chinese decline (demographics, Evergrande, underestimating China, etc.)

🧬 The Coming Age for Tech x Bio: The ‘Industrial Bio Complex’

A new age is coming:

We’ve now seen multiple trends come to fruition at the intersection of bio and technology over the past decade: A Moore’s Law for bio, thanks to computation; machine learning and AI transforming many areas of bio pharma and healthcare; the ability to not just “read”, but “write”, to bio, including CRISPR (even in just a decade). We’re also seeing the rapid unbundling of care delivery as well now, driven by “the great unlock” — which includes the unbundling of the hospital (into decentralized communities, virtually, and more) and the movement towards value- or outcome-based care. 

Driving this revolution has been a new breed and wave of founders and startups that merge the worlds of technology and bio — importantly, not just the old world of biotech (or a narrow definition of tech in bio as only “digital health”), but something much broader, bigger, and blending both worlds. In short, biology — enabled by technology — is eating the world. This has not only changed how we diagnose, treat, and manage disease, but has been changing the way we access, pay for, and deliver care in the healthcare system. It is now entering into manufacturing, food, and several other industries as well. Bio is becoming a part of everything. 


🎙 Podcast Episodes of the Week

This week in podcasts:

  • Michael Shellenberger

    • Michael Shellenberger is a very interesting person. The fact that he changed his mind on many things (nuclear, drug control, etc.) is worth noting and listening to.

  • The Potential of Blockchain Technology with Chris Dixon

    • The episode covers Chris's overall thesis for investing in the cryptocurrency space, the opportunities and limitations of blockchain applications, and why this is the most interesting area for investing and building over the next ten years.


🍭 Brain Food

🌍👶 The Planet and Having Children

I saw this headline last week, and I couldn’t believe what I was reading.

Thankfully, Slate Star Codex came up with Please Don't Give Up On Having Kids Because Of Climate Change to explain why the initial idea doesn’t make sense.

The people profiled in these articles make two arguments. First, climate change will be so destructive that it would be wrong to bring children into such a bad world. Second, the more people there are, the more carbon they produce, so having more children will make climate change worse.

I disagree with both arguments. Starting with the first:

The current scientific consensus, as per leading scientific organizations like the United Nations’ Intergovernmental Panel on Climate Change, is that climate change will be very bad, but not world-endingly bad.

Climate change will cause worse hurricanes, fires, and other disasters. It will lead to increased spread of invasive species and diseases. It will hit subsistence farmers in poor agricultural countries very hard, and some of them will starve or become refugees. But it won’t cause the collapse of civilization. It won’t kill everyone. Life in the First World will continue, with worse weather and maybe a weaker economy, but more or less the same as always. The people who say otherwise are going against the majority of climatologists, climate models, and international bodies.

One way to think of this is to notice that we’ve already gotten about 25-30% of the global warming we’re likely to see by 2100.

Who is going to overcome the challenges of humanity if we stop having children?

What this made me realize is the power of narratives. Unfortunately, the Green/Degrowth people did such a great job that many kids are depressed and think the world will collapse soon. They feel they have no agency and can’t do anything about it. That is absolutely wrong. They can become nuclear scientists, work on carbon capture, and other ways to produce energy in a clean way, or become nuclear influencers.

There is no going back to the forest and living in trees. We need to show the younger generations that they can have a lot of impact in the world and not scare them to the point of depression and not wanting to have kids.

To conclude this environmental part, here’s a great article and a thread:


🎥 What I’m Watching

🇯🇵 Why Japan Isn’t Ready for War

Learn why Japan isn’t ready for war while still having a correct defense budget.

📈 How to Give a Presentation

A great video from Vinod Khosla showing how to give a great presentation.


🔧 The Tool of the Week

🥶 The Cold Plunge

All the resources you need to get into cold water plunges. Winter is coming back, now is the time to challenge yourself with the cold! Morning cold showers never get easier, but that’s the point.


🪐 Quote I’m Pondering

Novak Djokovic said in an interview with the Financial Times that "I can carry on playing at this level because I like hitting the tennis ball." The interviewer replied in surprise: "Are there really players who don't like hitting the ball?" Djokovic answered, "Oh yes. There are people out there who don't have the right motivation. You don't need to talk to them. I can see it."If you can find the thing you do for its own sake, the compulsive piece of your process, and dial that up and up, beyond the imaginary ceiling for that activity you may be creating, my experience is the world comes to you for that thing and you massively outperform the others who don't actually like hitting that particular ball. I think the rest of career advice is commentary on this essential truth.

Graham Duncan


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👋 EndNote

Thanks for reading!

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Feel free to email me or find me on Twitter if you have any feedback or questions.

Until next week,

Mehdi Yacoubi

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