Revolutions, whistleblowers and the parable of the big fish

Posted: January 17, 2015 in Crisis in Nutrition, Evidence Based Medicine
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In  The World Turned Upside Down. The Second Low-Carbohydrate Revolution, I added my voice to the critiques of the low-fat hypothesis and the sorry state of nutritional science. I also provided specific strategies on how to analyze reports in the literature to find out whether the main point of the paper is valid or not. The deconstructions of traditional nutrition, the “also bought” of my book on the Amazon page, are numerous and continuing to proliferate as more and more people become aware of how bad things are. To me, the “surprise” in Nina Teicholz’s “Big Fat Surprise” is that, after all the previous exposés and my own research, there were deceptive practices and poor science that even I didn’t know about.

Even establishment voices are beginning to perceive how bad things are. So, with all these smoking guns why doesn’t anybody do anything? Why doesn’t somebody blow the whistle on them? It’s not like we are dealing with military intelligence.  What are they going to do? Not fund my grant? Not publish my paper? Ha.

Whistleblowing

“When you go to work today, imagine having a tape recorder attached to your body, a second one in your briefcase, and a third one in a special notebook, knowing that you will be secretly taping your supervisors, coworkers, and in some cases, your friends.” These are the opening lines of Mark Whitacre’s remarkable confession/essay/exposé (later a movie with Matt Damon) describing his blowing the whistle on Archer Daniels Midland (ADM) one of the largest food companies in the world; their motto at the time “ADM. Supermarket to the world.”

informant_lMatt Damon in The Informant!

It turned out that ADM had been colluding with its competitors to fix prices, in particular on the amino acid, lysine. Whitacre’s story is fascinating in detail.  Although relatively young, he was high up in the company, a division manager (“I lived in a huge home, which had an eight car garage filled with eight cars, and indoor horse-riding stables for my children”). He travelled around the world to big corporate meetings. At some point, encouraged by his wife whose ethical standards were quite a bit higher than his own, he became an FBI informant. Accompanying him in his business trips was a green lamp, housing a video feed. ”It is a good thing that all of the co- conspirators were men. A woman would have immediately noticed that this green lamp did not match the five star décor of some of the finest hotels, such as the Four Seasons in Chicago.” Ultimately, the lysine trial resulted in fines and three-year prison sentences for three of the executives of ADM as well as criminal fine for foreign companies worth $105 million, a record at the time. At the trial, things really went down-hill for the company when Whitacre produced a tape recording of the President of ADM telling executives that the company’s competitors were their friends and their customers were the enemy. Wits at the time suggested a new motto “ADM. Super mark-up to the world.” In the end, in a remarkable twist in the story, Whitacre’s whistle-blowing was compromised by the fact that he was on the take himself.

“I concluded that I would steal my own severance pay, and decided upon $9.5 million, which amounted to several years of my total compensation. …And I also considered what would happen if ADM learned of this theft. If they accused me, I thought that I had the perfect answer. How can you prosecute me for stealing $9.5 million when you are stealing hundreds of millions of dollars each year in the price fixing scheme? …. I decided to submit several bogus invoices to ADM, until I accumulated $9.5 million, which was meant to be my family’s financial security when I would be fired at a future date for being a whistleblower.”

As it turned out, a number of food and beverage companies, who had won hundreds of millions in settlements against ADM  were the ones who actually provided financial security for his family while Mark Whitacre spent nine years in prison.

Whistle blowing and imperial deshabillement

If it is not hidden, is it whistle-blowing? Did the kid “blow the whistle on the emperor’s new clothes?” If it is right out in the open, what is the scandal?  Well, there is open and there is open. Leaving out information may be a sign of a cover-up. I described, in my book, the case of the paper by Foster, et al., the conclusion of which was that “neither dietary fat nor carbohydrate intake influenced weight loss.”  I admitted, in the book, that:

“I had not read Foster’s paper very carefully before making the pronouncement that it was not very good. I was upbraided by a student for such a rush to judgment. I explained that that is what I do for a living. I explained that I usually don’t have to spend a lot of time on a paper to see the general drift…. but I was probably not totally convincing. So I read the paper, which is quite a bit longer than usual. The main thing that I was looking for was information on the nutrients that were actually consumed since it was their lack of effect that was the main point of the paper.…

In a diet experiment, the food consumed should be right up front but I couldn’t find it at all…. The data weren’t there. I was going to write to the authors when I found out…that this paper had been covered in a story in the Los Angeles Times. As reported by Bob Kaplan: ‘Of the 307 participants enrolled in the study, not one had their food intake recorded or analyzed by investigators. The authors did not monitor, chronicle or report any of the subjects’ diets. No meals were administered by the authors; no meals were eaten in front of investigators. There were no self‑reports, no questionnaires. The lead authors, Gary Foster and James Hill, explained in separate e-mails that self‑reported data are unreliable and therefore they didn’t collect or analyze any.’

I confess to feeling a bit shocked. I don’t like getting scientific information from the LA Times.  How can you say “neither dietary fat nor carbohydrate intake influenced weight loss” if you haven’t measured fat or carbohydrate? …. in fact, the whole nutrition field runs on self‑reported data. Is all that stuff from the Harvard School of Public Health, all those epidemiology studies that rely on food records, to be chucked out?”

So was this a breach of research integrity? It might be considered simply an error of omission. If you didn’t measure food consumed, you might think that you don’t necessarily have to put it in the methods. Was it just dumb not to realize that if you write a study of a diet comparison, you can’t leave out what people ate or at least admit that you didn’t measure what they ate. So can you blow the whistle on them for not telling the whole truth?  The authors were all well-known researchers, if party-liners.

The Office of Research Integrity is set up to police serious infractions in federally funded grants but it usually has to be clear cut and, sometimes, there is a whistle-blower. The Baltimore case is one of the better known if somewhat embarrassing cases for the agency — there was nothing to the whistle-blower’s allegations. In any case, there is a big gray area. If you falsify your data on a government research grant, you can go to jail.  If you make a dumb interpretation, however, if you say the data mean X when they show not-X, well, research is about unknowns, and you may have slipped up. Even Einstein admitted to the need to offer “sacrifices at the altar of Stupidity.” The NIH is supposed to not fund stuff like that. Editors and reviewers are supposed to see through the omission. What if they fell down on the job too? What if you have a field like nutrition where the NIH study sections are on the same wavelength as the researchers. There is, however, the question of the total impact. A lot of stuff is never cited and never does any harm. I enquired with the ORI, in a general way, about Foster’s paper. They said that if it is widely quoted, it could be an infraction. It has, in fact, been cited as evidence against low-carb diets. So am I going to be a whistle-blower? I don’t think so.

The problem is that only an insider can blow the whistle and although cooperation and collegiality remain very weak in the nutrition field, it is still our own nest and whistle-blowing makes everybody look bad. The “long blue line” does not form because the police think that corruption is okay. The problem is not just that there can be retribution, as in Serpico, but that it makes everybody look bad. It is simply that it reflects poorly on the whole police force. And while it is probable that, as Mark Whitacre said, “almost all of their 30,000 employees went to work each day doing the right thing morally and ethically,” the statement that “ADM was not a bad company” does not ring true. If we call attention to what is tolerated in medical nutrition, we are all looking like fools. And, of course, Foster’s paper is one of the more egregious but there is a lot of competition for worst. And it reflects badly on all of us in the field. “Is that what you do when you go to work?”

The parable of the big fish

I received an email from a physician in England. He has had consistently good results with low-carbohydrate diets.

“There is never a day when I don’t see the deleterious effects of too many carbs on those with the metabolic syndrome. And yet most doctors carry on as if it doesn’t exist !! …

Only yesterday I saw a man I have known for over 15 years. His GGT [gamma-glutamyl transferase; marker for liver disease] had always been about double normal. Embarrassingly I had assumed that he was a drinker, despite repeated denial, thinking his big belly was evidence!  He chose low carb on March 2013 and never looked back. Liver function normal now and an easy 7 Kg weight loss.”

He said that the information had been used in the production of the ABC Catalyst TV documentary from Australia, but:

“I am a very, very small fish! As smaller fish we GPs specialise in getting ideas across to ordinary folk. The Internet is democratising medicine faster than some big fish realise. I wrote my practical diabetes piece partly for the educated general public and insisted on open access.

Big fish will scoff at my small numbers (70) and lack of double blindness anyway.”

I assured him that he was making an impact, that n = 70 was fine and not to worry about the big fish. I related a story told to me by one of my colleagues in graduate school: he had gone fishing in the Gulf of Mexico and they had caught a very big fish (I no longer remember the kind) which was thrashing around on the deck and they could not contain it. There happened to be a rifle on board and somebody shot the fish. The bullet went through the bottom of the boat which sank.

Comments
  1. Alex Smith says:

    I enjoy your writing, welcome back after your very busy year. Low carb changed my life and I will never by convinced to go back to the dark side no matter how many so-called experts insist that I must have my grains for good health

  2. Richard–It’s good to see you back in the saddle again. Since you have been absent we have definitely suffered from a curmudgeon deficiency!

    Today I admitted a 43 year old male into the hospital. He suffered from an acute MI and although he had no history of major medical problems his blood sugar was 300 and his triglycerides were over a thousand. His diet was horrible yet the advice he got from the folks at our hospital was even worse–count carbohydrates and adjust your medications or insulin accordingly. Can anyone say “dog chasing tail”?

    • rdfeinman says:

      Only his lawyer. That’s why the health agencies are slouching toward low carb and, as in a comment on a previous post, they are saying “we use to believe fat was bad” as if they had not recommend it. It’s America. The lawyers will solve the problem for us (although that usually involves new problems) but your patient may get better. Thanks for the comments but one man’s curudgeon is the next man’s visionary prophet. Ha.

      • docww says:

        I think we should form a group called “Curmudgeons anonymous” (CA). My youngest son just got his PhD in kinesiology and nutritional science rome the University of Minnesota, yet they teach none of this in academia. Very sad indeed.

        Of course the U. of M. is the home of the infamous Ancel Keys. Nuf said.

      • rdfeinman says:

        Curmudgeons are pretty much by definition not big on anonymity. Curmudgeons United I will join. Your son is not alone.

  3. Nick Ainly says:

    Richard please read the opening summary in Diabetic Diet Wikipedia ; it will make you laugh or cry! Actually my initial response was anger but now it just makes me question everything .

    • rdfeinman says:

      I don’t understand. Wikipedia is what the literature should be like. YOu can jump in and put in the stuff that you know. If the liophobes can answer what you write, then you will be challenged to make a better case. Wiki allows you to bring out the truth. I will jump into this article and so should you. We are offered the opportunity we need on Wiki. Go for it.

  4. Mich says:

    Not wholly on the topic of whistleblowers but certainly on diet…. I’d love to know people’s thoughts. There is a show in australia called ‘save your life tonight’ and the most recent on heart disease was of course all about heart disease. They did the usual ‘have low cholesterol and the dangers of fat’ etc but they did this very strange thing. It was not an experiment, as such, and I have seen this trotted out on tv I think even on dr oz etc. They get someone to eat a ‘high fat meal’ which is meant to be typical and reflect the reason we all die of heart disease (those pub meals) which consist of chips and steak and so forth. Then they take the participants blood and spin it and then come back to the audience and hold it up and say ‘there look at that cloudily liquid, that’s the FAT!’ that is what causes heart disease!’…

    Chips are not cooked in saturated fat but canola oil anyhow, so they should be talking ‘all fats’ but they go on about saturated… but I felt they should have done maybe three meals, for example, just the salad, just the chips, just the steak and sausages or whatever the ‘fatty meat bit’ was, there was no control. There was no mention of carbs.

    Is this a valid way of showing fat in blood or should the carb/tryglycerides have got a mention?

    Or they could separate the chips separate, and then possibly get someone to eat that much potato and drink the oil in two separate studies. (I could go crazy thinking this over), but the point is, to show if potato raises triglyerices… no one is questioning this, it’s just head nodding and blind acceptance as to blood lipids but the serve of chips is huge, the carb has to add something to the blood profile.

    Is this a good and valid way to show how a high fat meal ‘clogs arteries?’

    Ironically the guy on the show they brought out who had a heart attack was young AND he had low cholesterol! They ignored the his low cholesterol though and their Message? don’t be eating fatty meals now!

    Would a high carb meal get fat into your blood by way of tryglycerides within the two hours BTW and be reflected in that spun blood in which the top layer was ‘lipid filled plasma?’

    • rdfeinman says:

      Is this a valid way of showing fat in blood or should the carb/tryglycerides have got a mention?

      Would a high carb meal get fat into your blood by way of tryglycerides within the two hours BTW and be reflected in that spun blood in which the top layer was ‘lipid filled plasma?’

      Dietary fat enters the circulation by being packaged into particles called chylomicrons and they contribute the cloudy look of blood after a meal with fat in it. The effect, however, may be somewhat different depending on conditions — A few weeks on a low carbohydrate diet and the chylomicron production is much slower although I don’t know if the plasma would be different to the naked eye. Volek showed that. So, yes, carb/triglycerides have an effect. Overall, the ingested fat will appear as chylomicrons but if you think that the level at any time is important, then low carb comes out better.

      Is this a good and valid way to show how a high fat meal ‘clogs arteries?

      No. If you eat fat it will be absorbed and appear as chylomicrons but that is not the point. The triglycerides (fat) are cleared by enzymes on the surface of cells and the fatty acids are absorbed into peripheral cells. The question in diet is what happens to the fatty acids that are picked up from chylomicrons? They can be oxidized, stored as fat, repackaged into other particles, LDL, HDL which are the likely source of “clogged arteries.” Mayo clinic, AHA, ADA are now scrambling to find a way to save face and admit that what happens to ingested fat depends on the amount of carbohydrate in the diet.

      I suspect that Australian TV has the same high intellectual standards as American TV but I haven’t seen the program you mention. I probably wouldn’t understand it anyway since I don’t speak Strine.

      • Cristi Vlad says:

        That program made a hype over the internet a couple of months ago when it was launched. It’s simple enough to be understood by the average folk…there are many recent documentaries on low carb diets (carb-loaded, cereal killers, fat head movie, etc) and I personally think they do increase awareness…I’m not sure on the power of government regulators as the power of internet plays a big role in changing the paradigm of health…if they wanna save face, the clock is ticking ever faster…

      • rdfeinman says:

        It is a war of sorts. And the war is over. Of course, wars are over at a certain point but people keep on killing each other for few years. WWII was over at the Battle of Stalingrad. The American Civil War was over in Battle of New Orleans and/or Battle of Vicksburg but killing went on for another three years. That’s how it will be here. But you just can’t resist science for ever.

      • Mich says:

        Thanks for your answer… I had suspected, having seen this elsewhere on American and British TV shows on ‘health’ that it was a little too simplistic to prove fat equals heart disease.

      • rdfeinman says:

        If it equaled heart disease they would have found heart disease. God knows they’ve been looking for it.

  5. Mrs.K says:

    Welcome back! I purchased your book as soon as I heard of it. Loved it.

    I wanted to comment on the chylomicrons. I am a biochemistry lab technologist. I analyze chemistry panels (what is carried in the blood) day in and day out.

    Rule one when evaluating blood lipids (and glucose BTW) is that the patient should be FASTING. The reference values that are used in medical labs for this purpose are calculated from people that are fasting. This is because what people eat, and how much of it is a huge variable that you can’t standardize. Notice how, when you are asked to do a fasting blood test, they don’t say it’s OK to eat low fat or no fat, it is EAT NOTHING. The chylomicron layer (admittedly to varying degrees, some are more obvious than others) is expected in people who are not fasting. It is physiological, not pathological.

    It is disingenuous to compare a sample from a patient who is not fasting against the reference values of the pool of patients who were fasting. In our hospital, when blood is drawn, the patient is asked if they are fasting. If not, the test is either cancelled by the lab, or a comment is added to the result alerting the doctor viewing the results that the patient was not fasting.

    • rdfeinman says:

      Thanks for supporting the book and for you comments on chylomicrons. You are quite right. I think the comments that started this were not seriously interested in anything but Akins-bashing but the control of chylomicron synthesis is important for itself. In fact, though, understanding the difference between high fat in the presence of high carbohydrate and high fat with low carbohydrate is one of the serious problem

    • chris c says:

      Strangely, presumably to try to find a reason to stop me low carbing, my GP ordered a non-fasting lipid panel. The results were so similar to the fasting panels I can no longer remember which one it was. In retrospect it would have been interesting to see if there was a difference between fasting and non-fasting when I was on the dietician-approved low fat diet – like most people, dropping the excess carbs doubled my HDL, cut my trigs to 1/10 of what they used to be, and barely changed my LDL, in addition to normalising my blood glucose, reducing my BP and causing me to lose the 15 kg the dietician made me gain. Maybe the difference – and the visual difference in the blood – results from adding fat to a high carb diet?

      • rdfeinman says:

        What did the GP say?

      • chris c says:

        The original GP told me she couldn’t *recommend* what I was doing but to keep doing it anyway. A more recent GP told me there had never been anything wrong with me in the first place . . . (sigh)

  6. coberylRobert Coberly says:

    MUCH gratitude to you and all other contributors for the review article. Stunning job of exposition.

    It’s sad and infuriating to visit the American Diabetes Association and read, “A place to start is at about 45-60 grams of carbohydrate at a meal. You may need more or less carbohydrate at meals depending on how you manage your diabetes. ….Finding the right amount of carbohydrate depends on many things including how active you are and what, if any, medicines you take.” Right. Take your medicines as a given, and base the “right” amount of CHO on that. Be sure to allow time for the management of the peripheral vascular disease and the nephropathy, too…

    You’ll be presenting at the N&M conference? IAny of the co-authors? I visted the Bariatric Physicians website after reading this post; right now there is no speaker schedule or planned content to be found on the conference pages. So I called the Association and was told this information should be available online in about a week. My wife and I are psychiatrists, but in any case we would consider attending (from Albuquerque, not hard) to support the promulgation of this information.
    Rob Coberly

    • rdfeinman says:

      We are highly critical of ADA and I assume that the are simply afraid of admitting mistakes and being sued. The nutritonal committee is strictly their second-stringers. I have harsh words for them in my book. Thanks for your support but I am afraid it may be a longroad.

      • Marilyn says:

        A long road for sure. Even if by some miracle the medical establishment embraced low-carbohydrate nutrition, there would still be the millions out there who have learned their “fat kills” lessons well. Earlier today, a friend of a friend on Facebook wrote, “Don’t do Atkins! I did Atkins, and I had to have a triple bypass!”

      • rdfeinman says:

        I think Ash Simmonds answered that one.

      • Marilyn says:

        If by some miracle, the medical establishment embraced low-carbohydrate nutrition, there would still be the millions who have learned their “fat kills” lessons well. Earlier today, a Friend of a Friend on Facebook wrote, “Don’t do Atkins! I did Atkins, and I had to have a triple bypass.

      • Ash Simmonds says:

        When I did Atkins I had to have a Triple Cheeseburger minus the buns.

      • rdfeinman says:

        Me too. I see a trend here.

  7. Marilyn says:

    Congratulations! I’m delighted you’ll be blogging again.

    Two questions:

    Did you do the art work on the cover of The World Turned Upside Down?

    When will The World Turned Upside Down be available in book form?

    Thanks.

  8. Ash Simmonds says:

    Ridiculous Fishing is a pretty fun timewaster.

  9. Garry Lee says:

    I’ve been on LCHF (very successfully and effortlessly) for a year. Weight nailed at ideal level for 8 months. I’m a retired histopathologist and I’ve just read the book, one of many of this type I’ve read in the past couple of years. These include Atkins, Volek & Phinney, TIm Noakes, Nina Teicholz, Gary Taubes etc.
    Your book is brilliant, but the illustrations are a disaster in Kindle. Do not have enough resolution. I particularly liked your dismantling of some of the papers from the idiots in Harvard etc. I love your wry sense of humour. It reminds me of the kind of speech which is normal in my native Cork (Ireland).
    I’ll have to get the printed copy now to make sense of the illustrations!
    Garry Lee
    Cork.

    • rdfeinman says:

      Thanks for the comments. I am sorry about the illustrations. I think that you can get a refund from Amazon. Turns out that it is not always easy to get things into Kindle.

  10. Ieva McDonald says:

    I am currently enjoying your book but finding the illustrations impossible to read, particularly data tables, on kindle. in fact I have just got to chapter 16 where you emphasize looking at the figures’ ‘Presentation in graphic form usually means the author wants to explain things to you, rather than snow you’ . As someone who last read a biochemistry textbook over 30 years ago, I was keen on your book because of its strong biochemical content but feel blinkered by an inability to read the illustrations. A hard copy of your book doesn’t seem to be available in the UK so the Kindle version is sadly my only option.

  11. […] Al contrario. Aunque todavía no me han llegado, yo mismo acabo de comprar un par de libros (éste y éste). Escribir un libro y venderlo no es nada negativo en sí mismo. Si el libro es bueno, es […]

  12. Marilyn says:

    In your book, you note that the AHA had quietly dropped their proscription against total fat — some fifteen years ago. Now it looks like another nutrient has been quietly been given the green light: “Cholesterol is not considered a nutrient of concern for overconsumption.” I stumbled onto this on Ann M. Childers “Life Balance Northwest” blog for 13 February 2015: http://annchilders.blogspot.com/

    I don’t expect this to make headlines, either. But there it is.

  13. Michael Gallagher says:

    Hello Dr. Feinman,

    I recently read your book, The World Turned Upside Down, and I thoroughly enjoyed it – thank you. I noticed a couple of things that you may or may not be aware of. In chapter 10 (page 186), you refer to Figure 10-5 (data from Yancy, et al. [68]), but the figure is not there (at least not in my copy of the book). I guess I could just look up Yancy’s study… And in chapter 14 (page 235), you refer to Figure 14-5 (shows the theoretical fluctuations of fat within a fat cell), but the figure is missing. I think I know the figure, as Gary Taubes used such a figure in one of his lectures, plus I have Frayn’s Metabolic Regulation: A Human Perspective which shows what you describe. On page 234, you also have a Figure 14-5 about Hess’s Law. I just thought you should be aware of these omissions. I don’t know if anything can be done about it. At any rate, keep up the whistle blowing! My low-carb journey began back in 1999, and I’ve never looked back (lost 60 pounds). My primary care doc is convinced I am still overweight and at risk for a heart attack. I gained five pounds of muscle doing slow burn (you also mentioned slow burn in your book), and my doc is saying I’m “gaining weight” and wants me to lose some. Meanwhile he’s gained about 40 pounds of fat around his middle over the last decade, but apparently hasn’t noticed and continues to preach the low-fat message. It’s amazing how this low-fat dogma is still entrenched, even though it has been a dismal failure. I’m currently reading Nina Teicholz’ book after you mentioned it, and it is great read. Thanks again,

    Mike

    Michael Gallagher | Senior School Biology Teacher
    Sewickley Academy | 315 Academy Ave. Sewickley, PA 15143
    [phone] 412.741.2230 ext. 3313 [fax] 412.741.9234
    web | blog | facebook | twitter | pinterest

    [cid:image003.jpg@01D0580C.7FA3AFB0]

    • rdfeinman says:

      Thanks for your comments. There are a few embarrassing typos and one real screw-up which you identified

      “In chapter 10 (page 186), you refer to Figure 10-5 (data from Yancy, et al. [68]), but the figure is not there (at least not in my copy of the book).”

      The good news is that the figure is there, but meant to be 10-5, it is the top figure in Figure 10-3(page 185). The legend got displaced and is under the legend for Figure 10-4. The bad news in terms of author frustration is that I fixed that but some glitches are like fly-paper (remember fly-paper?)

      Summary: current top figure Figure 10-3 is actually Figure 10-5 should there are two legends under Figure 10-4, the second is legend for Figure 10-5
      The final figure in Chapter 10 should be labeled Figure 10-6

      “in chapter 14 (page 235), you refer to Figure 14-5 (shows the theoretical fluctuations of fat within a fat cell), but the figure is missing.”

      The figure is there but the reference in the text should have been to “figure 14-6.” It is correctly referred to on page 236. I would be surprised if Gary Taubes, or even Frayn referred to something like that. I would be interested in the reference because we think it is an important idea that has rarely been voiced. Figure 14-5 is, in fact, the Hess’s law figure.

      “My low-carb journey began back in 1999, and I’ve never looked back (lost 60 pounds). My primary care doc is convinced I am still overweight and at risk for a heart attack. I gained five pounds of muscle doing slow burn (you also mentioned slow burn in your book), and my doc is saying I’m “gaining weight” and wants me to lose some. Meanwhile he’s gained about 40 pounds of fat around his middle over the last decade, but apparently hasn’t noticed and continues to preach the low-fat message.”

      Congratulations on good results and make sure that you have a backup doctor since your current one may be at risk for a heart attack.

      Thanks again. It is very embarrassing and frustrating and my friends keep saying “all books have typos” which is remarkably un-comforting.

  14. bill says:

    I also finished reading your book. Even with typos,
    the signal to noise ratio is exceptionally high.

    I look forward to hearing more from you at your
    NMS presentation next month in Denver.

  15. Michael Trumper says:

    Unfortunately, it appears the kindle version isn’t available at the present time.

    • rdfeinman says:

      Up at last. It was a problem in formatting. Kindle is essentially an HTML document and conversions can easily go awry. As far as I know, though, it is sort of a subscription so improvements appear on your Kindle even if you brought the old version.

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