Technical books aren't like novels. We need a new approach to technical texts. I've spent years looking for a decent reading method. I tried numerous ways before finding one that worked. This post explains how I read technical books efficiently.

What Do I Mean When I Say Effective?

Effectiveness depends on the book. Effective implies I know where to find answers after reading a reference book. Effective implies I learned the book's knowledge after reading it.

I use reference books as tools in my toolkit. I won't carry all my tools; I'll merely need them. Non-reference books teach me techniques. I never have to make an effort to use them since I always have them.

Reference books I like:

• Design Patterns: Elements of Reusable Object-Oriented Software

• Refactoring: Improving the Design of Existing Code 
  You can also check My Top Takeaways from Refactoring here.

• Practical Object-Oriented Design in Ruby: An Agile Primer

Non-reference books I like:

• The Pragmatic Programmer: your journey to mastery

• Clean Code: A Handbook of Agile Software Craftsmans

The Approach

Technical books might be overwhelming to read in one sitting. Especially when you have no idea what is coming next as you read. When you don't know how deep the rabbit hole goes, you feel lost as you read. This is my years-long method for overcoming this difficulty.

Whether you follow the step-by-step guide or not, remember these:

• Understand the terminology. Make sure you get the meaning of any terms you come across more than once. The likelihood that a term will be significant increases as you encounter it more frequently.

• Know when to stop. I've always believed that in order to truly comprehend something, I must delve as deeply as possible into it. That, however, is not usually very effective. There are moments when you have to draw the line and start putting theory into practice (if applicable).

• Look over your notes. When reading technical books or documents, taking notes is a crucial habit to develop. Additionally, you must regularly examine your notes if you want to get the most out of them. This will assist you in internalizing the lessons you acquired from the book. And you'll see that the urge to review reduces with time.

Let's talk about how I read a technical book step by step.

0. Read the Foreword/Preface

These sections are crucial in technical books. They answer Who should read it, What each chapter discusses, and sometimes How to Read? This is helpful before reading the book. Who could know the ideal way to read the book better than the author, right?

1. Scanning

I scan the chapter. Fast scanning is needed.

• I review the headings.

• I scan the pictures quickly.

• I assess the chapter's length to determine whether I might divide it into more manageable sections.

2. Skimming

Skimming is faster than reading but slower than scanning.

• I focus more on the captions and subtitles for the photographs.

• I read each paragraph's opening and closing sentences.

• I examined the code samples.

• I attempt to grasp each section's basic points without getting bogged down in the specifics.

• Throughout the entire reading period, I make an effort to make mental notes of what may require additional attention and what may not. Because I don't want to spend time taking physical notes, kindly notice that I am using the term "mental" here. It is much simpler to recall. You may think that this is more significant than typing or writing “Pay attention to X.”

• I move on quickly. This is something I considered crucial because, when trying to skim, it is simple to start reading the entire thing.

3. Complete reading

Previous steps pay off.

• I finished reading the chapter.

• I concentrate on the passages that I mentally underlined when skimming.

• I put the book away and make my own notes. It is typically more difficult than it seems for me. But it's important to speak in your own words. You must choose the right words to adequately summarize what you have read. How do those words make you feel? Additionally, you must be able to summarize your notes while you are taking them. Sometimes as I'm writing my notes, I realize I have no words to convey what I'm thinking or, even worse, I start to doubt what I'm writing down. This is a good indication that I haven't internalized that idea thoroughly enough.

• I jot my inquiries down. Normally, I read on while compiling my questions in the hopes that I will learn the answers as I read. I'll explore those issues more if I wasn't able to find the answers to my inquiries while reading the book.

Bonus!

Best part: If you take lovely notes like I do, you can publish them as a blog post with a few tweaks.

Conclusion

This is my learning journey. I wanted to show you. This post may help someone with a similar learning style. You can alter the principles above for any technical material.

Unlimited everything for $19 monthly!?

Even with pretty words, no one wants to read an ugly email.

• Not Gen Z

• Not Millennials

• Not Gen X

• Not Boomers

I am a minimalist.

I like Mozart. I like avos. I love Apple.

When I hear seamlessly, effortlessly, or Apple's new adverb fluidly, my toes curl.

No email marketing tool gave me that feeling.

As a marketing consultant helping high-growth brands create marketing that doesn't feel like marketing, I've worked with every email marketing platform imaginable, including that naughty monkey and the expensive platform whose sales teams don't stop calling.

Most email marketing platforms are flawed.

1. They are overpriced.

2. They use dreadful templates.

3. They employ a poor visual designer.

4. The user experience there is awful.

5. Too many useless buttons are present. (Similar to the TV remote!)

I may have finally found the perfect email marketing tool. It creates strong flows. It helps me focus on storytelling.

It’s called Flodesk.

It’s effortless. It’s seamless. It’s fluid.

Here’s why it excites me.

Unlimited everything for $19 per month

Sends unlimited. Emails unlimited. Signups unlimited.

Most email platforms penalize success.

Pay for performance?

• $87 for 10k contacts

• $605 for 100K contacts

• $1,300+ for 200K contacts

In the 1990s, this made sense, but not now. It reminds me of when ISPs capped internet usage at 5 GB per month.

Flodesk made unlimited email for a low price a reality. Affordable, attractive email marketing isn't just for big companies.

Flodesk doesn't penalize you for growing your list. Price stays the same as lists grow.

Flodesk plans cost $38 per month, but I'll give you a 30-day trial for $19.

Amazingly strong flows

Foster different people's flows.

Email marketing isn't one-size-fits-all.

Different times require different emails.

People don't open emails because they're irrelevant, in my experience. A colder audience needs a nurturing sequence.

Flodesk automates your email funnels so top-funnel prospects fall in love with your brand and values before mid- and bottom-funnel email flows nudge them to take action.

I wish I could save more custom audience fields to further customize the experience.

Dynamic editor

Easy. Effortless.

Flodesk's editor is Apple-like.

You understand how it works almost instantly.

Like many Apple products, it's intentionally limited. No distractions. You can focus on emotional email writing.

Flodesk's inability to add inline HTML to emails is my biggest issue with larger projects. I wish I could upload HTML emails.

Simple sign-up procedures

Dream up joining.

I like how easy it is to create conversion-focused landing pages. Linkly lets you easily create 5 landing pages and A/B test messaging.

I like that you can use signup forms to ask people what they're interested in so they get relevant emails instead of mindless mass emails nobody opens.

I love how easy it is to embed in-line on a website.

Wonderful designer templates

Beautiful, connecting emails.

Flodesk has calm email templates. My designer's eye felt at rest when I received plain text emails with big impacts.

As a typography nerd, I love Flodesk's handpicked designer fonts. It gives emails a designer feel that is hard to replicate on other platforms without coding and custom font licenses.

Small adjustments can have a big impact

Details matter.

Flodesk remembers your brand colors. Flodesk automatically adds your logo and social handles to emails after signup.

Flodesk uses Zapier. This lets you send emails based on a user's action.

A bad live chat can trigger a series of emails to win back a customer.

Flodesk isn't for everyone.

Flodesk is great for Apple users like me.

I use a conceptual and practical system I developed decades ago as an example.

Since childhood, I've been interested in the brain-mind connection, so I developed a system using scientific breakthroughs, experiments, and the experiences of successful people in my circles.

This story provides a high-level overview of a custom system to inform and inspire readers. Creating a mind gym was one of my best personal and professional investments.

Such a complex system may not be possible for everyone or appear luxurious at first. However, the process and approach may help you find more accessible and viable solutions.

Visualizing the brain as a muscle, I learned to stimulate it with physical and mental exercises, applying a new mindset and behavioral changes.

My methods and practices may not work for others because we're all different. I focus on the approach's principles and highlights so you can create your own program.

Some create a conceptual and practical system intuitively, and others intellectually. Both worked. I see intellect and intuition as higher selves.

The mental tools I introduce are based on lifestyle changes and can be personalized by anyone, barring physical constraints or underlying health conditions.

Some people can't meditate despite wanting to due to mental constraints. This story lacks exceptions.

People's systems may vary. Many have used my tools successfully. All have scientific backing because their benefits attracted scientists. None are unethical or controversial.

My focus is cognition, which is the neocortex's ability. These practices and tools can affect the limbic and reptilian brain regions.

A previous article discussed brain health's biological aspects. This article focuses on psychology.

Thinking, learning, and remembering are cognitive abilities. Cognitive abilities determine our health and performance.

Cognitive health is the ability to think, concentrate, learn, and remember. Cognitive performance boosting involves various tools and processes. My system and protocols address cognitive health and performance.

As a biological organ, the brain's abilities decline with age, especially if not used regularly. Older people have more neurodegenerative disorders like dementia.

As aging is inevitable, I focus on creating cognitive reserves to remain mentally functional as we age and face mental decline or cognitive impairment.

My protocols focus on neurogenesis, or brain growth and maintenance. Neurons and connections can grow at any age.

Metacognition refers to knowing our cognitive abilities, like thinking about thinking and learning how to learn.

In the following sections, I provide an overview of my system, mental tools, and protocols.

This system summarizes my 50-year career. Some may find it too abstract, so I give examples.

First, explain the system. Section 2 introduces activities. Third, how to measure and maintain mental growth.

1 — Developed a practical mental gym.

The mental gym is a metaphor for the physical fitness gym to improve our mental muscles.

This concept covers brain and mind functionality. Integrated biological and psychological components.

I'll describe my mental gym so my other points make sense. My mental gym has physical and mental tools.

Mindfulness, meditation, visualization, self-conversations, breathing exercises, expressive writing, working in a flow state, reading, music, dance, isometric training, barefoot walking, cold/heat exposure, CBT, and social engagements are regular tools.

Dancing, walking, and thermogenesis are body-related tools. As the brain is part of the body and houses the mind, these tools can affect mental abilities such as attention, focus, memory, task switching, and problem-solving.

Different people may like different tools. I chose these tools based on my needs, goals, and lifestyle. They're just examples. You can choose tools that fit your goals and personality.

2 — Performed tasks regularly.

These tools gave me clarity. They became daily hobbies. Some I did alone, others with others.

Some examples: I meditate daily. Even though my overactive mind made daily meditation difficult at first, I now enjoy it. Meditation three times a day sharpens my mind.

Self-talk is used for self-therapy and creativity. Self-talk was initially difficult, but neurogenesis rewired my brain to make it a habit.

Cold showers, warm baths with Epsom salts, fasting, barefoot walks on the beach or grass, dancing, calisthenics, trampoline hopping, and breathing exercises increase my mental clarity, creativity, and productivity.

These exercises can increase BDNF, which promotes nervous system growth. They improve mental capacity and performance by increasing blood flow and brain oxygenation.

I use weekly and occasional activities like dry saunas, talking with others, and community activities.

These activities stimulate the brain and mind, improving performance and cognitive capacity.

3 — Measured progress, set growth goals.

Measuring progress helps us stay on track. Without data, it's hard to stay motivated. When we face inevitable setbacks, we may abandon our dreams.

I created a daily checklist for a spreadsheet with macros. I tracked how often and long I did each activity.

I measured my progress objectively and subjectively. In the progress spreadsheet, I noted my meditation hours and subjective feelings.

In another column, I used good, moderate, and excellent to get qualitative data. It took time and effort. Later, I started benefiting from this automated structure.

Creating a page for each activity, such as meditation, self-talk, cold showers, walking, expressive writing, personal interactions, etc., gave me empirical data I could analyze, modify, and graph to show progress.

Colored charts showed each area's strengths and weaknesses.

Strengths motivate me to continue them. Identifying weaknesses helped me improve them.

As the system matured, data recording became a habit and took less time. I saw the result immediately because I automated the charts when I entered daily data. Early time investment paid off later.

Mind Gym Benefits, Effective Use, and Progress Measuring

This concept helped me move from comfort to risk. I accept things as they are.

Turnarounds were made. I stopped feeling "Fight-Flight-Freeze" and maintained self-control.

I tamed my overactive amygdala by strengthening my brain. Stress and anxiety decreased. With these shifts, I accepted criticism and turned envy into admiration. Clarity improved.

When the cognitive part of the brain became stronger and the primitive part was tamed, managing thoughts and emotions became easier. My AQ increased. I learned to tolerate people, physical, mental, and emotional obstacles.

Accessing vast information sources in my subconscious mind through an improved RAS allowed me to easily tap into my higher self and recognize flaws in my lower self.

Summary

The brain loves patterns and routines, so habits help. Observing, developing, and monitoring habits mindfully can be beneficial. Mindfulness helps us achieve this goal systematically.

As body and mind are connected, we must consider both when building habits. Consistent and joyful practices can strengthen neurons and neural connections.

Habits help us accomplish more with less effort. Regularly using mental tools and processes can improve our cognitive health and performance as we age.

Creating daily habits to improve cognitive abilities can sharpen our minds and boost our well-being.

Some apps monitor our activities and behavior to help build habits. If you can't replicate my system, try these apps. Some smartwatches and fitness devices include them.

Set aside time each day for mental activities you enjoy. Regular scheduling and practice can strengthen brain regions and form habits. Once you form habits, tasks become easy.

Improving our minds is a lifelong journey. It's easier and more sustainable to increase our efforts daily, weekly, monthly, or annually.

Despite life's ups and downs, many want to remain calm and cheerful.

This valuable skill is unrelated to wealth or fame. It's about our mindset, fueled by our biological and psychological needs.

Here are some lessons I've learned about staying calm and composed despite challenges and setbacks.

1 — Tranquillity starts with observing thoughts and feelings.

2 — Clear the mental clutter and emotional entanglements with conscious breathing and gentle movements.

3 — Accept situations and events as they are with no resistance.

4 — Self-love can lead to loving others and increasing compassion.

5 — Count your blessings and cultivate gratitude.

Clear thinking can bring joy and satisfaction. It's a privilege to wake up with a healthy body and clear mind, ready to connect with others and serve them.

Thank you for reading my perspectives. I wish you a healthy and happy life.

I recently wrote about getting VCs excited about Marketplace start-ups. SaaS founders became envious!

Understanding how people wire tens of millions is the only Series A hack I recommend.

Few people understand the intellectual process behind investing.

VC is risk management.

Series A-focused VCs must cover two risks.

1. Market risk

You need a large market to cross a threshold beyond which you can build defensibilities. Series A VCs underwrite market risk.

They must see you have reached product-market fit (PMF) in a large total addressable market (TAM).

2. Execution risk

When evaluating your growth engine's blitzscaling ability, execution risk arises.

When investors remove operational uncertainty, they profit.

Series A VCs like businesses with derisked revenue streams. Don't raise unless you have a predictable model, pipeline, and growth.

Please beat these 3 metrics before Series A:

Achieve $1.5m ARR in 12-24 months (Market risk)

Above 100% Net Dollar Retention. (Market danger)

Lead Velocity Rate supporting $10m ARR in 2–4 years (Execution risk)

Hit the 3 and you'll raise $10M in 4 months. Discussing 2/3 may take 6–7 months.

If none, don't bother raising and focus on becoming a capital-efficient business (Topics for other posts).

Let's examine these 3 metrics for the brave ones.

1. Lead Velocity Rate supporting €$10m ARR in 2 to 4 years

Last because it's the least discussed. LVR is the most reliable data when evaluating a growth engine, in my opinion.

SaaS allows you to see the future.

Monthly Sales and Sales Pipelines, two predictive KPIs, have poor data quality. Both are lagging indicators, and minor changes can cause huge modeling differences.

Analysts and Associates will trash your forecasts if they're based only on Monthly Sales and Sales Pipeline.

LVR, defined as month-over-month growth in qualified leads, is rock-solid. There's no lag. You can See The Future if you use Qualified Leads and a consistent formula and process to qualify them.

With this metric in your hand, scaling your company turns into an execution play on which VCs are able to perform calculations risk.

2. Above-100% Net Dollar Retention.

Net Dollar Retention is a better-known SaaS health metric than LVR.

Net Dollar Retention measures a SaaS company's ability to retain and upsell customers. Ask what $1 of net new customer spend will be worth in years n+1, n+2, etc.

Depending on the business model, SaaS businesses can increase their share of customers' wallets by increasing users, selling them more products in SaaS-enabled marketplaces, other add-ons, and renewing them at higher price tiers.

If a SaaS company's annualized Net Dollar Retention is less than 75%, there's a problem with the business.

Slack's ARR chart (below) shows how powerful Net Retention is. Layer chart shows how existing customer revenue grows. Slack's S1 shows 171% Net Dollar Retention for 2017–2019.

Slack S-1

3. $1.5m ARR in the last 12-24 months.

According to Point 9, $0.5m-4m in ARR is needed to raise a $5–12m Series A round.

Target at least what you raised in Pre-Seed/Seed. If you've raised $1.5m since launch, don't raise before $1.5m ARR.

Capital efficiency has returned since Covid19. After raising $2m since inception, it's harder to raise $1m in ARR.

P9's 2016-2021 SaaS Funding Napkin

In summary, less than 1% of companies VCs meet get funded. These metrics can help you win.

If there’s demand for it, I’ll do one on direct-to-consumer.

Cheers!

I’m a permaculture farmer. I want to create food-producing ecosystems. My hope is a world with easy access to a cuisine that nourishes consumers, supports producers, and leaves the Earth joyously habitable.

Permaculturists, natural farmers, plantsmen, and foodies share this ambition. I believe this group of green thumbs, stock-folk, and food champions is falling to tribalism, forgetting that rescuing the globe requires saving all of its inhabitants, even those who adore cheap burgers and Coke. We're digging foxholes and turning folks who disagree with us or don't understand into monsters.

Take Dr. Daphne Miller's comments at the end of her Slow Money Journal interview:

“Americans are going to fall into two camps when all is said and done: People who buy cheap goods, regardless of quality, versus people who are willing and able to pay for things that are made with integrity. We are seeing the limits of the “buying cheap crap” approach.”

This is one of the most judgmental things I've read outside the Bible. Consequences:

• People who purchase inexpensive things (food) are ignorant buffoons who prefer to choose fair trade coffee over fuel as long as the price is correct.

• It all depends on your WILL to buy quality or cheaply. Both those who are WILLING and those who ARE NOT exist. And able, too.

• People who are unwilling and unable are purchasing garbage. You're giving your kids bad food. Both the Earth and you are being destroyed by your actions. Your camp is the wrong one. You’re garbage! Disgrace to you.

Dr. Miller didn't say it, but words are worthless until interpreted. This interpretation depends on the interpreter's economic, racial, political, religious, family, and personal history. Complementary language insults another. Imagine how that Brown/Harvard M.D.'s comment sounds to a low-income household with no savings.

Dr. Miller's comment reflects the echo chamber into which nearly all clean food advocates speak. It asks easy questions and accepts non-solutions like raising food prices and eating less meat. People like me have cultivated an insular world unencumbered by challenges beyond the margins. We may disagree about technical details in rotationally-grazing livestock, but we short circuit when asked how our system could supply half the global beef demand. Most people have never seriously considered this question. We're so loved and affirmed that challenging ourselves doesn't seem necessary. Were generals insisting we don't need to study the terrain because God is on our side?

“Yes, the $8/lb ground beef is produced the way it should be. Yes, it’s good for my body. Yes it’s good for the Earth. But it’s eight freaking dollars, and my kid needs braces and protein. Bye Felicia, we’re going to McDonald’s.”

-Bobby Q. Homemaker

Funny clean foodies. People don't pay enough for food; they should value it more. Turn the concept of buying food with integrity into a wedge and drive it into the heart of America, dividing the willing and unwilling.

We go apeshit if you call our products high-end.

I've heard all sorts of gaslighting to defend a $10/lb pork chop as accessible (things I’ve definitely said in the past):

• At Whole Foods, it costs more.

• The steak at the supermarket is overly affordable.

• Pay me immediately or the doctor gets paid later.

I spoke with Timbercreek Market and Local Food Hub in front of 60 people. We were asked about local food availability.

They came to me last, after my co-panelists gave the same responses I would have given two years before.

I grumbled, "Our food is inaccessible." Nope. It's beyond the wallets of nearly everyone, and it's the biggest problem with sustainable food systems. We're criminally unserious about being leaders in sustainability until we propose solutions beyond economic relativism, wishful thinking, and insisting that vulnerable, distracted people do all the heavy lifting of finding a way to afford our food. And until we talk about solutions, all this preserve the world? False.

The room fell silent as if I'd revealed a terrible secret. Long, thunderous applause followed my other remarks. But I’m probably not getting invited back to any VNRLI events.

I make pricey cuisine. It’s high-end. I have customers who really have to stretch to get it, and they let me know it. They're forgoing other creature comforts to help me make a living and keep the Earth of my grandmothers alive, and they're doing it as an act of love. They believe in us and our work.

I remember it when I'm up to my shoulders in frigid water, when my vehicle stinks of four types of shit, when I come home covered in blood and mud, when I'm hauling water in 100-degree heat, when I'm herding pigs in a rainstorm and dodging lightning bolts to close the chickens. I'm reminded I'm not alone. Their enthusiasm is worth more than money; it helps me make a life and a living. I won't label that gift less than it is to make my meal seem more accessible.

Not everyone can sacrifice.

Let's not pretend we want to go back to peasant fare, despite our nostalgia. Industrial food has leveled what rich and poor eat. How food is cooked will be the largest difference between what you and a billionaire eat. Rich and poor have access to chicken, pork, and beef. You might be shocked how recently that wasn't the case. This abundance, particularly of animal protein, has helped vulnerable individuals.

Industrial food causes environmental damage, chronic disease, and distribution inequities. Clean food promotes non-industrial, artisan farming. This creates a higher-quality, more expensive product than the competition; we respond with aggressive marketing and the "people need to value food more" shtick geared at consumers who can spend the extra money.

The guy who is NOT able is rendered invisible by clean food's elitist marketing, which is bizarre given a.) clean food insists it's trying to save the world, yet b.) MOST PEOPLE IN THE WORLD ARE THAT GUY. No one can help him except feel-good charities. That's crazy.

Also wrong: a foodie telling a kid he can't eat a 99-cent fast food hamburger because it lacks integrity. Telling him how easy it is to save his ducketts and maybe have a grass-fed house burger at the end of the month as a reward, but in the meantime get your protein from canned beans you can't bake because you don't have a stove and, even if you did, your mom works two jobs and moonlights as an Uber driver so she doesn't have time to heat that shitup anyway.

A wealthy person's attitude toward the poor is indecent. It's 18th-century Versailles.

Human rights include access to nutritious food without social or environmental costs. As a food-forest-loving permaculture farmer, I no longer balk at the concept of cultured beef and hydroponics. My food is out of reach for many people, but access to decent food shouldn't be. Cultures and hydroponics could scale to meet the clean food affordability gap without externalities. If technology can deliver great, affordable beef without environmental negative effects, I can't reject it because it's new, unusual, or might endanger my business.

Why is your farm needed if cultured beef and hydroponics can feed the world? Permaculture food forests with trees, perennial plants, and animals are crucial to economically successful environmental protection. No matter how advanced technology gets, we still need clean air, water, soil, greenspace, and food.

Clean Food cultivated in/on live soil, minimally processed, and eaten close to harvest is part of the answer, not THE solution. Clean food advocates must recognize the conflicts at the intersection of environmental, social, and economic sustainability, the disproportionate effects of those conflicts on the poor and lower-middle classes, and the immorality and impracticality of insisting vulnerable people address those conflicts on their own and judging them if they don't.

Our clients, relatives, friends, and communities need an honest assessment of our role in a sustainable future. If we're serious about preserving the world, we owe honesty to non-customers. We owe our goal and sanity to honesty. Future health and happiness of the world left to the average person's pocketbook and long-term moral considerations is a dismal proposition with few parallels.

Let's make soil and grow food. Let the lab folks do their thing. We're all interdependent.

or, how I spread monkeypox and got it myself.

This story contains nsfw (not safe for wife) stuff and shouldn't be read if you're under 18 or think I'm a newborn angel. After the opening, it's broken into three sections: a chronological explanation of my disease course, my ideas, and what I plan to do next.

Your journey awaits.

As early as mid-may, I was waltzing around the lab talking about monkeypox, a rare tropical disease with an inaccurate name. Monkeys are not its primary animal reservoir. It caused an outbreak among men who have sex with men across Europe, with unprecedented levels of person-to-person transmission. European health authorities speculated that the virus spread at raves and parties and was easily transferred through intimate, mainly sexual, contact. I had already read the nejm article about the first confirmed monkeypox patient in the u.s. and shared the photos on social media so people knew what to look for. The cdc information page only included 4 photographs of monkeypox lesions that looked like they were captured on a motorola razr.

I warned my ex-boyfriend about monkeypox. Monkeypox? responded.

Mom, I'm afraid about monkeypox. What's monkeypox?

My therapist is scared about monkeypox. What's monkeypox?

Was I alone? A few science gays on Twitter didn't make me feel overreacting.

This information got my gay head turning. The incubation period for the sickness is weeks. Many of my social media contacts are traveling to Europe this summer. What is pride? Travel, parties, and sex. Many people may become infected before attending these activities. Monkeypox will affect the lgbtq+ community.

Being right always stinks. My young scientist brain was right, though. Someone who saw this coming is one of the early victims. I'll talk about my feelings publicly, and trust me, I have many concerning what's occurring.

Part 1 is the specifics.

Wednesday nights are never smart but always entertaining. I didn't wake up until noon on june 23 and saw gay twitter blazing. Without warning, the nyc department of health announced a pop-up monkeypox immunization station in chelsea. Some days would be 11am-7pm. Walk-ins were welcome, however appointments were preferred. I tried to arrange an appointment after rubbing my eyes, but they were all taken. I got out of bed, washed my face, brushed my teeth, and put on short shorts because I wanted to get a walk-in dose and show off my legs. I got a 20-oz. cold brew on the way to the train and texted a chelsea-based acquaintance for help.

Clinic closed at 2pm. No more doses. Hundreds queued up. The government initially gave them only 1,000 dosages. For a city with 500,000 LGBT people, c'mon. What more could I do? I was upset by how things were handled. The evidence speaks for itself.

I decided to seek an appointment when additional doses were available and continued my weekend. I was celebrating nyc pride with pals. Fun! sex! * ‍

On tuesday after that, I felt a little burn. This wasn't surprising because I'd been sexually active throughout the weekend, so I got a sti panel the next day. I expected to get results in a few days, take antibiotics, and move on.

Emerging germs had other intentions. Wednesday night, I felt sore, and thursday morning, I had a blazing temperature and had sweat through my bedding. I had fever, chills, and body-wide aches and pains for three days. I reached 102 degrees. I believed I had covid over pride weekend, but I tested negative for three days straight.

STDs don't induce fevers or other systemic symptoms. If lymphogranuloma venereum advances, it can cause flu-like symptoms and swollen lymph nodes. I was suspicious and desperate for answers, so I researched monkeypox on the cdc website (for healthcare professionals). Much of what I saw on screen about monkeypox prodrome matched my symptoms. Multiple-day fever, headache, muscle aches, chills, tiredness, enlarged lymph nodes. Pox were lacking.

I told my doctor my concerns pre-medically. I'm occasionally annoying.

On saturday night, my fever broke and I felt better. Still burning, I was optimistic till sunday, when I woke up with five red splotches on my arms and fingertips.

As spots formed, burning became pain. I observed as spots developed on my body throughout the day. I had more than a dozen by the end of the day, and the early spots were pustular. I had monkeypox, as feared.

Fourth of July weekend limited my options. I'm well-connected in my school's infectious disease academic community, so I texted a coworker for advice. He agreed it was likely monkeypox and scheduled me for testing on tuesday.

nyc health could only perform 10 monkeypox tests every day. Before doctors could take swabs and send them in, each test had to be approved by the department. Some commercial labs can now perform monkeypox testing, but the backlog is huge. I still don't have a positive orthopoxvirus test five days after my test. *My 12-day-old case may not be included in the official monkeypox tally. This outbreak is far wider than we first thought, therefore I'm attempting to spread the information and help contain it.

*Update, 7/11: I have orthopoxvirus.

I spent all day in the bathtub because of the agony. Warm lavender epsom salts helped me feel better. I can't stand lavender anymore. I brought my laptop into the bathroom and viewed everything everywhere at once (2022). If my ex and I hadn't recently broken up, I wouldn't have monkeypox. All of these things made me cry, and I sat in the bathtub on the 4th of July sobbing. I thought, Is this it? I felt like Bridesmaids' Kristen Wiig (2011). I'm a flop. From here, things can only improve.

Later that night, I wore a mask and went to my roof to see the fireworks. Even though I don't like fireworks, there was something wonderful about them this year: the colors, how they illuminated the black surfaces around me, and their transient beauty. Joyful moments rarely linger long in our life. We must enjoy them now.

Several roofs away, my neighbors gathered. Happy 4th! I heard a woman yell. Why is this godforsaken country so happy? Instead of being rude, I replied. I didn't tell them I had monkeypox. I thought that would kill the mood.

By the time I went to the hospital the next day to get my lesions swabbed, wearing long sleeves, pants, and a mask, they looked like this:

I had 30 lesions on my arms, hands, stomach, back, legs, buttcheeks, face, scalp, and right eyebrow. I had some in my mouth, gums, and throat. Current medical thought is that lesions on mucous membranes cause discomfort in sensitive places. Internal lesions are a new feature of this outbreak of monkeypox. Despite being unattractive, the other sores weren't unpleasant or bothersome.

I had a bacterial sti with the pox. Who knows if that would've created symptoms (often it doesn't), but different infections can happen at once. My care team remembered that having a sti doesn't exclude out monkeypox. doxycycline rocks!

The coworker who introduced me to testing also offered me his home. We share a restroom, and monkeypox can be spread through surfaces. (Being a dna virus gives it environmental hardiness that rna viruses like sars-cov-2 lack.) I disinfected our bathroom after every usage, but I was apprehensive. My friend's place has a guest room and second bathroom, so no cross-contamination. It was the ideal monkeypox isolation environment, so I accepted his offer and am writing this piece there. I don't know what I would have done without his hospitality and attention.

The next day, I started tecovirimat, or tpoxx, for 14 days. Smallpox has been eradicated worldwide since the 1980s but remains a bioterrorism concern. Tecovirimat has a unique, orthopoxvirus-specific method of action, which reduces side effects to headache and nausea. It hasn't been used in many people, therefore the cdc is encouraging patients who take it for monkeypox to track their disease and symptoms.

Tpoxx's oral absorption requires a fatty meal. The hospital ordered me to take the medication after a 600-calorie, 25-gram-fat meal every 12 hours. The coordinator joked, "Don't diet for the next two weeks." I wanted to get peanut butter delivered, but jif is recalling their supply due to salmonella. Please give pathogens a break. I got almond butter.

Tpoxx study enrollment was documented. After signing consent documents, my lesions were photographed and measured during a complete physical exam. I got bloodwork to assess my health. My medication delivery was precise; every step must be accounted for. I got a two-week supply and started taking it that night. I rewarded myself with McDonald's. I'd been hungry for a week. I was also prescribed ketorolac (aka toradol), a stronger ibuprofen, for my discomfort.

I thought tpoxx was a wonder medicine by day two of treatment. Early lesions looked like this.

however, They vanished. The three largest lesions on my back flattened and practically disappeared into my skin. Some pustular lesions were diminishing. Tpoxx+toradol has helped me sleep, focus, and feel human again. I'm down to twice-daily baths and feeling hungrier than ever in this illness. On day five of tpoxx, some of the lesions look like this:

I have a ways to go. We must believe I'll be contagious until the last of my patches scabs over, falls off, and sprouts new skin. There's no way to tell. After a week and a half of tremendous pain and psychological stress, any news is good news. I'm grateful for my slow but steady development.

Part 2 of the rant.

Being close to yet not in the medical world is interesting. It lets me know a lot about it without being persuaded by my involvement. Doctors identify and treat patients using a tool called differential diagnosis.

A doctor interviews a patient to learn about them and their symptoms. More is better. Doctors may ask, "Have you traveled recently?" sex life? Have pets? preferred streaming service? (No, really. (Hbomax is right.) After the inquisition, the doctor will complete a body exam ranging from looking in your eyes, ears, and throat to a thorough physical.

After collecting data, the doctor makes a mental (or physical) inventory of all the conceivable illnesses that could cause or explain the patient's symptoms. Differential diagnosis list. After establishing the differential, the clinician can eliminate options. The doctor will usually conduct nucleic acid tests on swab samples or bloodwork to learn more. This helps eliminate conditions from the differential or boosts a condition's likelihood. In an ideal circumstance, the doctor can eliminate all but one reason of your symptoms, leaving your formal diagnosis. Once diagnosed, treatment can begin. yay! Love medicine.

My symptoms two weeks ago did not suggest monkeypox. Fever, pains, weariness, and swollen lymph nodes are caused by several things. My scandalous symptoms weren't linked to common ones. My instance shows the importance of diversity and representation in healthcare. My doctor isn't gay, but he provides culturally sensitive care. I'd heard about monkeypox as a gay man in New York. I was hyper-aware of it and had heard of friends of friends who had contracted it the week before, even though the official case count in the US was 40. My physicians weren't concerned, but I was. How would it appear on his mental differential if it wasn't on his radar? Mental differential rhymes! I'll trademark it to prevent theft. differential!

I was in a rare position to recognize my condition and advocate for myself. I study infections. I'd spent months researching monkeypox. I work at a university where I rub shoulders with some of the country's greatest doctors. I'm a gay dude who follows nyc queer social networks online. All of these variables positioned me to think, "Maybe this is monkeypox," and to explain why.

This outbreak is another example of privilege at work. The brokenness of our healthcare system is once again exposed by the inequities produced by the vaccination rollout and the existence of people like myself who can pull strings owing to their line of work. I can't cure this situation on my own, but I can be a strong voice demanding the government do a better job addressing the outbreak and giving resources and advice to everyone I can.

lgbtqia+ community members' support has always impressed me in new york. The queer community has watched out for me and supported me in ways I never dreamed were possible.

Queer individuals are there for each other when societal structures fail. People went to the internet on the first day of the vaccine rollout to share appointment information and the vaccine clinic's message. Twitter timelines were more effective than marketing campaigns. Contrary to widespread anti-vaccine sentiment, the LGBT community was eager to protect themselves. Smallpox vaccination? sure. gimme. whether I'm safe. I credit the community's sex positivity. Many people are used to talking about STDs, so there's a reduced barrier to saying, "I think I have something, you should be on the watch too," and taking steps to protect our health.

Once I got monkeypox, I posted on Twitter and Instagram. Besides fueling my main character syndrome, I felt like I wasn't alone. My dc-based friend had monkeypox within hours. He told me about his experience and gave me ideas for managing the discomfort. I can't imagine life without him.

My buddy and colleague organized my medical care and let me remain in his home. His and his husband's friendliness and attention made a world of difference in my recovery. All of my friends and family who helped me, whether by venmo, doordash, or moral support, made me feel cared about. I don't deserve the amazing people in my life.

Finally, I think of everyone who commented on my social media posts regarding my trip. Friends from all sectors of my life and all sexualities have written me well wishes and complimented me for my vulnerability, but I feel the most gravitas from fellow lgbtq+ persons. They're learning to spot. They're learning where to go ill. They're learning self-advocacy. I'm another link in our network of caretaking. I've been cared for, therefore I want to do the same. Community and knowledge are powerful.

You're probably wondering where the diatribe is. You may believe he's gushing about his loved ones, and you'd be right. I say that just because the queer community can take care of itself doesn't mean we should.

Even when caused by the same pathogen, comparing health crises is risky. Aids is unlike covid-19 or monkeypox, yet all were caused by poorly understood viruses. The lgbtq+ community has a history of self-medicating. Queer people (and their supporters) have led the charge to protect themselves throughout history when the government refused. Surreal to experience this in real time.

First, vaccination access is a government failure. The strategic national stockpile contains tens of thousands of doses of jynneos, the newest fda-approved smallpox vaccine, and millions of doses of acam2000, an older vaccine for immunocompetent populations. Despite being a monkeypox hotspot and international crossroads, new york has only received 7,000 doses of the jynneos vaccine. Vaccine appointments are booked within minutes. It's showing Hunger Games, which bothers me.

Second, I think the government failed to recognize the severity of the european monkeypox outbreak. We saw abroad reports in may, but the first vaccines weren't available until june. Why was I a 26-year-old pharmacology grad student, able to see a monkeypox problem in europe but not the u.s. public health agency? Or was there too much bureaucracy and politicking, delaying action?

Lack of testing infrastructure for a known virus with vaccinations and therapies is appalling. More testing would have helped understand the problem's breadth. Many homosexual guys, including myself, didn't behave like monkeypox was a significant threat because there were only a dozen instances across the country. Our underestimating of the issue, spurred by a story of few infections, was huge.

Public health officials' response to infectious diseases frustrates me. A wait-and-see approach to infectious diseases is unsatisfactory. Before a sick person is recognized, they've exposed and maybe contaminated numerous others. Vaccinating susceptible populations before a disease becomes entrenched prevents disease. CDC might operate this way. When it was easier, they didn't control or prevent monkeypox. We'll learn when. Sometimes I fear never. Emerging viral infections are a menace in the era of climate change and globalization, and I fear our government will repeat the same mistakes. I don't work at the cdc, thus I have no idea what they do. As a scientist, a homosexual guy, and a citizen of this country, I feel confident declaring that the cdc has not done enough about monkeypox. Will they do enough about monkeypox? The strategic national stockpile can respond to a bioterrorism disaster in 12 hours. I'm skeptical following this outbreak.

It's simple to criticize the cdc, but they're not to blame. Underfunding public health services, especially the cdc, is another way our government fails to safeguard its citizens. I may gripe about the vaccination rollout all I want, but local health departments are doing their best with limited resources. They may not have enough workers to keep up with demand and run a contact-tracing program. Since my orthopoxvirus test is still negative, the doh hasn't asked about my close contacts. By then, my illness will be two weeks old, too long to do anything productive. Not their fault. They're functioning in a broken system that's underfunded for the work it does.

*Update, 7/11: I have orthopoxvirus.

Monkeypox is slow, so i've had time to contemplate. Now that I'm better, I'm angry. furious and sad I want to help. I wish to spare others my pain. This was preventable and solvable, I hope. HOW?

Third, the duty.

Family, especially selected family, helps each other. So many people have helped me throughout this difficult time. How can I give back? I have ideas.

1. Education. I've already started doing this by writing incredibly detailed posts on Instagram about my physical sickness and my thoughts on the entire scandal. via tweets. by producing this essay. I'll keep doing it even if people start to resent me! It's crucial! On my Instagram profile (@kyleplanckton), you may discover a story highlight with links to all of my bizarre yet educational posts.

2. Resources. I've forwarded the contact information for my institution's infectious diseases clinic to several folks who will hopefully be able to get tpoxx under the expanded use policy. Through my social networks, I've learned of similar institutions. I've also shared crowdsourced resources about symptom relief and vaccine appointment availability on social media. DM me or see my Instagram highlight for more.

3. Community action. During my illness, my friends' willingness to aid me has meant the most. It was nice to know I had folks on my side. One of my pals (thanks, kenny) snagged me a mcgriddle this morning when seamless canceled my order. This scenario has me thinking about methods to help people with monkeypox isolation. A two-week isolation period is financially damaging for many hourly workers. Certain governments required paid sick leave for covid-19 to allow employees to recover and prevent spread. No comparable program exists for monkeypox, and none seems to be planned shortly.

I want to aid monkeypox patients in severe financial conditions. I'm willing to pick up and bring groceries or fund meals/expenses for sick neighbors. I've seen several GoFundMe accounts, but I wish there was a centralized mechanism to link those in need with those who can help. Please contact me if you have expertise with mutual aid organizations. I hope we can start this shortly.

4. lobbying. Personal narratives are powerful. My narrative is only one, but I think it's compelling. Over the next day or so, i'll write to local, state, and federal officials about monkeypox. I wanted a vaccine but couldn't acquire one, and I feel tpoxx helped my disease. As a pharmacologist-in-training, I believe collecting data on a novel medicine is important, and there are ethical problems when making a drug with limited patient data broadly available. Many folks I know can't receive tpoxx due of red tape and a lack of contacts. People shouldn't have to go to an ivy league hospital to obtain the greatest care. Based on my experience and other people's tales, I believe tpoxx can drastically lessen monkeypox patients' pain and potentially curb transmission chains if administered early enough. This outbreak is manageable. It's not too late if we use all the instruments we have (diagnostic, vaccine, treatment).

*UPDATE 7/15: I submitted the following letter to Chuck Schumer and Kirsten Gillibrand. I've addressed identical letters to local, state, and federal officials, including the CDC and HHS.

I hope to join RESPND-MI, an LGBTQ+ community-led assessment of monkeypox symptoms and networks in NYC. Visit their website to learn more and give to this community-based charity.

How I got monkeypox is a mystery. I received it through a pride physical interaction, but i'm not sure which one. This outbreak will expand unless leaders act quickly. Until then, I'll keep educating and connecting people to care in my neighborhood.

Despite my misgivings, I see some optimism. Health department social media efforts are underway. During the outbreak, the CDC provided nonjudgmental suggestions for safer social and sexual activity. There's additional information regarding the disease course online, including how to request tpoxx for sufferers. These materials can help people advocate for themselves if they're sick. Importantly, homosexual guys are listening when they discuss about monkeypox online and irl. Learners They're serious.

The government has a terrible track record with lgtbq+ health issues, and they're not off to a good start this time. I hope this time will be better. If I can aid even one individual, I'll do so.

Thanks for reading, supporting me, and spreading awareness about the 2022 monkeypox outbreak. My dms are accessible if you want info, resources, queries, or to chat.

y'all well

kyle