#this is totally practice for using excel in my econ class
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Excel has a random function (RAND)
Excel also has a random btwn two entered numbers function (RANDBETWEEN)
Rolling set dice combinations (for like healing potions) have set minimum and maximum values.
This means I could theoretically make excel roll stuff for me if I made it right and also have the worksheet double as an easy reference for what dice to roll
#Isa babble#this is totally practice for using excel in my econ class#and totally not avoiding studying for a math test#and having fun making everything reference everything else#so that changing one thing changes so much more#bc that's fun#also important to know how to do right for my econ class
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for the halloween prompts - "strangers who hooked up at a party while in costume but tbh i might be in love with you so i’m gonna walk this earth looking for the right woodland nymph" pre-serum steve as the teeny tiny woodland nymph?
“But Natasha, I love him,” Bucky says, laying with his head on Natasha’s lap. They’re sitting in their apartment on the chaise lounge Bucky bought from a professor in exchange for shoveling their sidewalk this winter. Bucky thinks he got a pretty good deal out of it; it’s the most comfortable thing he’s ever owned.
“You’re very dramatic,” Natasha says.
“It’s been three weeks since the toga party and I can’t find him,” Bucky says. He lets his hand drape over his eyes to add to the overall vibe he’s trying to give off. “I’ll never find him again. I’ll never see his beautiful face or perfect—”
“Don’t finish that sentence,” Natasha interrupts.
“See, this is what happens when I go out. One Alpha Delta Phi party and here I am, pining over the nymph of my dreams.”
The guy was beautiful. Small with elven features, thin but not delicate. He was beautiful as he looked at Bucky from across the room, a mischievous gleam in his eye as he raised an eyebrow at Bucky. And later that night, when they were in bed together, he was perfect. He was fun and giving, and his smile when they were finished was enough to make Bucky’s heart start beating fast. If he hadn’t gotten an SOS text from Sam that he was needed to help a drunk friend get home, he would’ve tried to stay all night.
“If he was really the nymph of your dreams, you would’ve gotten his name.”
“I was a little busy, Natasha,” Bucky says, moving his hand so he can frown at her with full effect.
“Even if you had his dick in your mouth, you could pause and ask for his number,” she says.
Bucky rolls his eyes, flopping back on the couch for good measure. “That’s not what happened and you know it.” He pauses, sighs. “He’s my soulmate and I’ll never see him again.”
“Well, if he’s got such a good nymph costume, maybe he’ll be going out for Halloween next week.”
Bucky pulls himself up. “You’re a genius!” he says. Then realization dawns on him and he flops back down. “Natasha,” he says.
“Yes?” she asks, voice restrained but long-suffering.
“There are hundreds of parties on Halloween,” he says. “How am I supposed to know which one he’ll be at?”
“That’s up to you,” Natasha says, folding the book she’s been pretending to read closed and standing up. “I have to go to ballet practice and you have your econ class in fifteen minutes.”
“My AP classes never prepared me for this,” Bucky says as she zips up her backpack.
“They didn’t prepare you for college, either, but somehow you’ve made it to senior year. You can make it through Halloween.”
“From your mouth to God’s ears,” Bucky says. “I’m gonna need a miracle.”
“I think, in this case, you may have more luck pleading to Beelzebub,” she adds before leaving Bucky alone in their apartment.
— —
“Four hundred and sixty eight parties,” Bucky says, looking over the Excel spreadsheet he’s compiled over the past three days.
“And those are only the ones you could find,” Sam says, scratching the back of his head. “I know this is obvious, but there’s no way you can go to four hundred and sixty eight parties.”
“I’ve narrowed it down. There are at least fifty that are pretty much grad student-exclusive, and I didn’t think this guy was headed towards his PhD.”
“There we go,” Natasha says. “That’s some progress.”
“Another eighty are really small, ten people or less on Facebook. Even if he’s at one of those, I couldn’t just roll up. Besides, he said that he likes big parties. It’s easier to find someone to hook up with there, and he’s out on Halloween for a reason, just like everyone else.”
“To troll for seed?” Clint asks.
“Jesus,” Bucky says. “To have a good time. Hell, maybe he’d be out to look for me.”
“Fat chance,” Natasha mutters under her breath and Bucky shoots her a glare. She rolls her eyes. “What do we have to do?”
“I’ve narrowed it down to twenty likely parties. I have five people, including the three of us. That’s only four parties per person. Are you in?”
“Of course we are,” Sam says. “I don’t love it, but of course we are. Let’s go get your nymph.”
— —
Group text
Sam: house no 2……. nothing. someone did ask if I wanted to be a human sacrifice, so my night’s going great.
Clint: nothing here except for pizza.
Bucky: Stay on mission!!!
Clint: I can be on the mission and also eat some pizza.
— —
Bucky types an angry response to Clint as he walks to his next party. They’re all on a schedule, and should be switching by now, so Clint is putting them behind, and—
“HEY,” someone yells from behind him. Bucky ignores it, trying to focus on the task at hand. “Caesar, hey, HEY.”
And then there’s someone tackling him.
“Aurghahaaaa,” Bucky says, swinging his arm around and nearly dropping his phone.
“Hey, I’ve been looking for you!” says whoever is on his back as he slips down. His voice is low and hot and it’s—
“Holy shit, it’s you!” Bucky says, grinning as he looks nymph guy up and down. He’s not dressed as a nymph tonight; instead, he’s Andy Warhol. “I was looking for you, too.” He can’t stop himself from smiling. He’d half-believed that he’d been dreaming this guy up, but here he is, wearing a bad wig and a black turtleneck.
“Really?” the guy asks.
“Yeah, I really was.” He pauses. “I’m Bucky,” he says. “Bucky Barnes. In case you wanted to know. You don’t have to call me Caesar.”
“Hi Bucky,” he says.
“Do you have a name? I’d like to call you something other than nymph guy.”
“Maybe I like that,” the guy says.
“Please?” Bucky asks, taking a step closer to the guy and wrapping an arm around him.
“Steve,” he says. “Steve Rogers. But if you take me home, you can still call me a nymph.”
“I’d love that,” Bucky says, leaning down for a kiss.
— —
“So you’re telling me that I went to six different house parties for nothing?” Sam yells into the phone the next morning. Bucky totally deserves it, but the criticism goes a bit over his head. It’s hard to pay attention to what Sam is saying when Steve is waking up next to him, looking beautiful and ethereal and perfect on November 1st.
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homestay in a beach town, what could be better! > Da Nang, Vietnam
Please forgive me! This is soooo delayed! Turns out school can really catch up to you sometimes :)
Look out for a post on Hoi An and Ho Chi Minh City coming real soon (I am currently in the latter). But for now, let’s dive into the second stop of my time in Vietnam as well as my homestay experience!
I really cannot express enough of the love and joy I experienced living in my homestay. My sweet mother Hoai took excellent care of the 4 of us that she welcomed in with open arms - as well as our dad, our grandma (from here on referred to as Gma) and our two little siblings, Ngoc (12 yo) and Tu (6 yo). We lived in a quieter part of Da Nang, which is the 6th biggest city in the country and is situated on the Central Coast. We lived about a 5 minute walk from the beach, and needless to say I was totally spoiled.
A typical day in the homestay would entail waking up before 7am to have breakfast with my mom and Gma. We’d eat noodles, rice, soup, morning glory greens, and a little meat, as well as very strong coffee and lots of fresh fruit. Ngoc’s favorite fruit is dragonfruit, and lucky us, we had it every morning! From there I’d hug them goodbye and leave Gma watching the news on the couch with the barely one month old puppy they acquired in the middle of our time there. I’d then hop on the back of a motorbike to school! There is a service in VN called Grab, which is essentially Uber (but better for its drivers) and is for both cars and motorbikes, which is the predominant form of transportation in the country. The streets of Da Nang are bustling with motorbikes and cars and trucks alike at all times of day, but I especially always enjoyed my morning commute. Being whisked through the city around corners and over edges of sidewalks and across the famous Dragon Bridge every morning certainly woke me up, no need for coffee!
Then we’d have class in a room at Duy Tan University, a busy school in another, you guessed it, busy part of town. Our incredible guest lecturers included everything from scientific perspectives on the climate types in the Central areas of Vietnam to how meditating with groups of very different people can lead to communities solving grassroots problems and how the hydropower dam has increasingly negative effects on populations and ecosystems all across the country. All of the different perspectives we got; from people closely affiliated with the government to organic farmers to ecologists gave us the once in a lifetime chance to really hear what it is like in Vietnam with climate change affecting them every day. I wrote my research proposal for my big paper this semester in Da Nang, as well as my first essay for Econ on climate change in a capitalistic world and how I’d propose to change our political system in order to better address our environmental problems globally. Not an easy prompt, but certainly one I had fun messing around with.
I’d Grab bike home back across the river and to our neighborhood after school, and do homework or readings on the beach or at a cafe and then go home and play with my little brother, Tu, for hours! I’d also help my little sister practice English, and we’d talk about how her day was and what she is learning in school. With Tu we’d mostly just run around together until we exhausted each other. Being in a homestay with little siblings gave me endless amounts of joy. I wish everywhere I lived was like that! Just running around and playing with Tu and his friends made me feel so grounded and centered amongst everything else going on. Dinner with the fam was always SOOO delicious and tons of fun! Dad would come home from work and we would all gather around the table and eat tons of rice, tofu, eggs, morning glory greens, meat, and fruit. We’d always finish off the meal with peanuts that Gma had roasted and grown herself.
Living in Da Nang was like a little slice of paradise. I got so comfortable in the city life, and the people were so unbelievably generous to me and all my friends. Between going on walks with my mom, doing my homework listening to the waves crash and throwing my little brother up in the air and catching him, I lived the dream!
Vietnam is incredible and surprises me more every day with giving me joy, love, and teaching me new things all the time. Next post will come to you very soon, as I am actually leaving for Morocco tomorrow night! But for now, enjoy some snapshots of my time in the homestay and on the Central Coast.
agapé, hugs as always,
jessie

my little brother Tu and me :)

the reservoir of the Dak Mi 4 hydropower dam in Quang Nam province - displaced whole communities of ethnic groups and is also having incredibly drastic negative effects on the geomorphology of VN. in some surveys, hydropower is not considered sustainable renewable energy in VN because of many of its wildly horrible effects on the land and the people.

dinner w the homestay fam! mom took the pic, but here’s me, my 3 buddies from my program (Summer in front on the left and Emily in the back on the left with Emma next to me) and Gma at the head of the table and the wonderful studious Ngoc right up front on the left!

the picturesque beach of Da Nang around 5.45pm. perfect reading spot :)

me and the little man up to our usual after dinner antics!

Gma and me enjoying some pink dragonfruit! She can’t speak any English and I am still working on my Vietnamese, so we mostly communicate through laughter and smiles and sometimes she blows me a kiss across the dinner table.

all of us with mom before we said a teary goodbye! Hoai is a true superwoman. we just adore her :)
#vietnam#da nang#sit#sit study abroad#study abroad#ihp#international honors program#classes#photos#homestay
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2017 Audi A4 2.0T Quattro Long-Term Verdict: Excellence Versus Soul
The Audi A4 never shouts—it quietly works its magic until you start questioning choices other automakers make with their compact luxury sport sedans. After a year with our long-term 2017 Audi A4, living with the car solidified our feeling from last year’s Big Test comparison that it’s one of the best cars in its class.
Of course, when you spend that much time with a car, you also notice what doesn’t work well. The A4’s seatbelt chime is too loud, the rear defroster quits too early, I don’t like the upward-tilting exterior door handles, and the twin-clutch automatic transmission could be smoother in low-speed driving. Those are relatively minor issues when you realize that every car you’re considering has something you won’t like.
With the A4, you must decide how much soul you’re willing to give up for all-around everyday excellence. The Audi isn’t as fun to drive as the Alfa Romeo Giulia, our 2018 Car of the Year and the car that won the comparison in which the A4 placed second. Some feel the Alfa is more fun to look at, too, but I disagree. The Alfa is attractive, but the Audi’s sharp, understated looks will age well.
So the impressively capable Audi isn’t as entertaining as the Giulia, but you’re in for a great commute. Because let’s face it: That’s where you’ll drive this car most of the time. A number of smart details occasionally made me nod my head in appreciation. The A4’s 8.3-inch infotainment screen is ideally placed at the very top of the dash and is canted toward the driver. Then there’s the superb 12.3-inch Virtual Cockpit digital instrument cluster, which is distinguished from other similar systems not by its use of Google Earth—which is cool, but pricey after the trial period ends. Instead, I like the interface and how easily you can switch views using steering wheel controls. Whether you want a full-screen map view or a more traditional display of a tachometer and speedometer with music or drive info in the middle, the Audi gets most details right. Three suggestions: I wish the car could show album covers when I’m using Apple CarPlay; I want a tire pressure monitoring system that displays PSI at each tire; and it’d be cool if I could change the color of the “A4” that appears in one of the full-screen display modes.
The process of accessing some settings menus isn’t intuitive at first, but the system and MMI control knob are easy to use after a little practice.
Other interior pluses include an ambient lighting system that offers multiple colors and allows you to color part of the interior in one color and the rest of the car’s interior lighting in another complementing hue. Unfortunately, though, the illuminated white line at the bottom of the front doors doesn’t play along. Also, the A4 has one of the best turn-up-the-volume controls in the industry, with a roller-type control on the steering wheel and an easy-to-find volume knob at the base of the center console between the driver and front passenger. Over time, I even came to appreciate the engine auto start/stop system, but not for its smoothness. In fact, the engine awakens with a noticeable and unfortunate shake. I kept the feature on because under the right conditions, the car can turn the engine off for over a minute—perfect for making the most of our long-termer’s 19-speaker 755-watt sound system at long red lights in the silence to which EV owners have become accustomed.
Were I ordering an A4, I wouldn’t pick the Atlas Beige interior color of our long-termer, and not just because our Big Test comparison tester’s Nougat Brown looked great. The beige seats on our A4 don’t hide dirt well, and the standard seats on our car don’t provide as much side bolstering as I’d like. I would get the available sport seats, after making sure that the sport suspension with which they’re bundled isn’t too uncomfortable.
During our 19,419 miles with the A4, we had a few issues. The biggest one was when the car couldn’t reliably recognize phones that were compatible with Apple CarPlay. A total of $2,839.99 of warranty cost later, the control module that connects with the phone through the USB outlets was replaced to fix the system. The back of the center console armrest—which has a lid that adjusts up and down, and front to back—started to warp, and that was replaced with a warranty cost of $103. We also replaced all four tires before we would have liked. Right before a trip up the coast of California, we noticed one tire had a bubble on the sidewall, so two tires were replaced. Just a couple weeks later, a nail in another tire caused enough damage that we had to replace that one (and we again decided to replace a second tire to keep wear levels even).
I’m going to miss the A4’s adaptive cruise control—in use and customizability, it’s one of the best systems I’ve experienced so far.
Audi throws in the first scheduled maintenance, but the second regularly scheduled service visit cost $561.36. For comparison, our $46,140 2015 Mercedes-Benz CLA 250 cost $181.18 over 18,525 miles. Our $36,420 2015 Acura TLX 2.4 required $235.40 of services over 18,915 miles. As you compare prices of various cars you’re considering, keep in mind that some automakers (BMW, Jaguar, Genesis, Volvo) include additional complimentary service visits. As for the car’s retained value, IntelliChoice estimates our A4 would be worth an impressive 67 percent of its original $52,325 MSRP after three years and 42,000 miles, holding its value better than the less expensive Acura and Mercedes, and also slightly above our 2017 BMW 530i long-termer.
My own A4 would be a top Prestige-trimmed all-wheel-drive model. I didn’t find the less powerful, front-drive A4 Ultra’s responses at low speeds to be smooth, and our all-wheel-drive A4 is already so quick I would have trouble justifying the more powerful S4. As for the Prestige trim—like the mid-level Premium Plus trim, it includes chrome exterior trim that accentuates the arched side-window shape that has defined Audi sedans for over two decades. The top trim also includes Audi’s great adaptive cruise control. After turning off the lane keeping assist system that doesn’t center the car in its lane at low speeds, I sometimes let the adaptive cruise ease my evening commute. Some systems are too rough as they come to a stop or take off, but Audi’s system has settings for distance and aggressiveness. I’m more prone to motion sickness than the average driver, and for me, this is the difference between usability and permanently turning off the tech.
Really, though, I wouldn’t get an A4 at all. My choice would be a beautiful A5 Sportback, the four-door hatchback that slips all of the A4’s many advantages into a sexier shape. If I’m making the emotionally charged decision of paying $50,000 to $60,000 for a car that’s more cramped inside than a Civic, I’m treating myself to the more exclusive shape. For those who aren’t interested in that hatchback variant, a year in the Audi reaffirmed our belief that, despite the car’s drawbacks, the 252-hp all-wheel-drive A4 is one of the most well-rounded and recommendable cars in its class.
Read more about our 2017 Audi A4 2.0T:
Long-Term Arrival: A Year With a Sharp 3 Series Competitor
Long-Term Update 1: Feeling Quick
Long-Term Update 2: Seeing Stars and Apple CarPlay
Long-Term Update 3: Capable vs. Fun
Long-Term Update 4: Comments From an Actual 2017 A4 Owner
Long-Term Update 5: Interior Space
Long-Term Update 6: Let Me Do That for You
Long-Term Update 7: Design – Not Far Enough or Just Right?
Long-Term Update 8: How the Interior Could Be Improved
Long-Term Update 9: The Road Trip
Long-Term Update 10: Going Ultra
My first “long-term” A4 was a 1996 model, shown here with the 2005 Acura TSX that replaced it.
Our Car SERVICE LIFE 12 mo / 19,419 mi BASE PRICE $40,350 OPTIONS Prestige package ($8,600: 18-inch wheels, Bang & Olufsen sound system, Audi advance key, LED headlights, top view camera, head-up display, Audi virtual cockpit); Driver Assistance package ($1,800: Adaptive cruise control, active lane keep assist, high-beam assist, traffic sign recognition); Adaptive damping suspension ($1,000); metallic paint ($575) PRICE AS TESTED $52,325 AVG ECON/CO2 25.1 mpg / 0.77 lb/mi PROBLEM AREAS None MAINTENANCE COST $561.36 (2-oil change, inspection) NORMAL-WEAR COST $0 3-YEAR RESIDUAL VALUE* $34,900 RECALLS None *IntelliChoice data; assumes 42,000 miles at the end of 3-years
2017 Audi A4 2.0T Quattro POWERTRAIN/CHASSIS DRIVETRAIN LAYOUT Front-engine, AWD ENGINE TYPE Turbocharged I-4, iron block/alum head VALVETRAIN DOHC, 4 valves/cyl DISPLACEMENT 121.1 cu in/1,984 cc COMPRESSION RATIO 9.6:1 POWER (SAE NET) 252 hp @ 5,000 rpm TORQUE (SAE NET) 273 lb-ft @ 1,600 rpm REDLINE 6,750 rpm WEIGHT TO POWER 14.5 lb/hp TRANSMISSION 7-speed twin-clutch auto AXLE/FINAL-DRIVE RATIO 4.23:1/1.63:1 SUSPENSION, FRONT; REAR Multilink, coil springs, adj shocks, anti-roll bar; multilink, coil springs, adj shocks, anti-roll bar STEERING RATIO 15.9:1 TURNS LOCK-TO-LOCK 2.8 BRAKES, F; R 13.3-in vented disc; 13.0-in vented disc, ABS WHEELS 8.0 x 18 in cast aluminum TIRES 245/40R18 97H (M+S) Pirelli Cinturato P7 DIMENSIONS WHEELBASE 111.0 in TRACK, F/R 61.9/61.2 in LENGTH x WIDTH x HEIGHT 186.1 x 72.5 x 56.2 in TURNING CIRCLE 38.1 ft CURB WEIGHT 3,645 lb WEIGHT DIST, F/R 56/44% SEATING CAPACITY 5 HEADROOM, F/R 38.9/37.4 in LEGROOM, F/R 41.3/35.7 in SHOULDER ROOM, F/R 55.9/54.5 in CARGO VOLUME 13.0 cu ft TEST DATA ACCELERATION TO MPH 0-30 1.8 sec 0-40 2.7 0-50 3.9 0-60 5.2 IFTTT
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Make Me a Match (Rebroadcast)
Market-design wizard Al Roth finds solutions for the problems money alone can’t solve. (Photo, cropped: Newtown Grafitti)
Our latest Freakonomics Radio episode is called “Make Me a Match (Rebroadcast).” (You can subscribe to the podcast at Apple Podcasts or elsewhere, get the RSS feed, or listen via the media player above.)
Sure, markets generally work well. But for some transactions — like school admissions and organ transplants — money alone can’t solve the problem. That’s when you need a market-design wizard like Al Roth.
Below is a transcript of the episode, modified for your reading pleasure. For more information on the people and ideas in the episode, see the links at the bottom of this post.
* * *
Hey there, it’s Stephen Dubner. The holidays are upon us, so we’re taking the opportunity to replay what’s turned out to be one of the most influential episodes we’ve ever made. It actually helped save lives! Now, we can’t claim credit — we were just spreading the word on the good work done by people like Al Roth, whom you’ll meet in a minute. And then people who heard the episode acted on their own to perform random acts of kindness, and courage. I won’t tell you what they did — you’ll figure it out as you listen. Suffice it to say that during this season of gratitude, we’re grateful to have played a tiny role in this most excellent display of human ingenuity, and generosity. The Freakonomics Radio team has been really busy this year, producing dozens of new episodes that are sent out to you each week, free of charge. That’s they way it should be. It’s why we’re here. It’s quite possible that if you are a regular listener, you spent, in total, more than one whole day with Freakonomics Radio in 2017. It feels safe to say that we’ve earned a spot in your life. I mean, you’re here now, right? Well, you can help us bring you more Freakonomics Radio in the new year. When you do it by December 31st, you’ll set yourself up for a nice little charitable deduction on your tax return. What are you waiting for? Support Freakonomics Radio. Become a member today with your donation. Get your 2017 tax deduction before it’s too late. Just go to Freakonomics.com/donate or text the word “Freak” to 701-01. Thanks so much!
[MUSIC: Greg Ruby, “Someone Told Me Your Secret” (from The Rhythm Runners)]
Al ROTH: Okay, I’m Al Roth and I’m a professor of economics at Stanford.
For many years, Roth had taught economics at Harvard. But he and his wife, who’s a human-factors engineer, had relocated.
ROTH: We had just moved into our new apartment. We had moved to Stanford in September of 2012.
Shortly thereafter, on October 15th, something memorable happened.
ROTH: And my wife woke up around three in the morning and said, “The phone’s ringing.” And I woke up and it wasn’t ringing anymore. We only had one phone at that point and it was in her office, which was downstairs. So I said, “It’s not ringing,” and went back to sleep. And she went down and got the phone and it started ringing again. It turns out it’s a good thing they call you back, they don’t go down their list. And it was the Nobel Committee.
Roth, half-asleep, was informed that he, along with Lloyd Shapley, had won the Bank of Sweden Prize in Economic Sciences in Memory of Alfred Nobel — also known as the Nobel Prize in Economics.
DUBNER: Did you think you had a chance? Um…
ROTH: You know, it’s hard to answer that humbly. So I knew that I was on the big list of people who, if I won a Nobel Prize, it wouldn’t cause the Nobel committee to be embarrassed. The newspapers the next day would not say, “Craziness in Stockholm.” But there are many, many people in that category. So indeed, we had- we were asleep. We were not waiting for a call. And it’s an interesting call because one of the things they’re concerned about — they have a lot of experience with this — is convincing you that it’s not a prank. So the person who first spoke to me said, you know, “Congratulations. You’ve won the Nobel Prize.” And then he said, “And I’m here with six of my colleagues and two of them know you and they’re going to talk to you now.”
DUBNER: To persuade you that this is for real.
ROTH: Right.
DUBNER: Either that, or a very elaborate prank.
ROTH: Exactly. But they call you up and say, “So in half an hour this is going to happen. Get ready.” And, you know, I took a shower and got dressed, which was a good thing, because there wasn’t the opportunity to do that again all day.
DUBNER: And what was the rest of the day like then?
ROTH: Well, so at five minutes to, someone calls you back and again, they’re still I guess concerned that you shouldn’t appear confused on the phone. So what she said was, “Point your browser to the Nobel site and you will see your name being announced and then we will come on the line and have a press conference by telephone.” So by the time that happened, I was ready and then the Stanford press office, fortunately descended on our house at 4:00 am and started fielding calls from journalists, and you know they’d say, “Professor Roth is ready now. Are you ready?” And I’d get the phone and I’d get, you know, five questions from someone and I would speak to many, many people. And apparently I mostly answered them very, very seriously, but I told a joke or two that I hadn’t intended to tell. But people would say to me, “Oh, I heard you on NPR. You said something a little odd.” But—and then there was a press conference, and then at 11:00 I had a class. So people seemed a little surprised but that’s how we ended the press conference. That this was a surprise and it was a Monday and I teach on Mondays.
DUBNER: Word had travelled to your students by then, I assume?
ROTH: It had. There was Champagne in the classroom.
DUBNER: Very nice. Yeah.
So what kind of work did Al Roth do to land a Nobel Prize in Economics? Well, it’s not the kind of work that typically wins a Nobel. He has helped people who need a kidney transplant find a donor. He’s helped new doctors find their first jobs. He’s helped high-school students in New York City find the right high school – even though Roth himself, who grew up in New York City, dropped out of high school.
ROTH: I was, you know, a poor ungrateful student who didn’t appreciate what my teachers were trying to do for me. You should tell all your listeners they should complete high school.
* * *
[MUSIC: Slink Moss Explosion, “Bad Bad Blues” (from Slink Moss Explosion)]
I recently visited Palo Alto, California, home to Stanford University – and a few others things — to talk with Al Roth. He was, as you’ve heard, a high-school dropout. But don’t worry, he did go on to college – many, many years of college. Not finishing high school isn’t the only odd thing about Al Roth as a Nobel laureate. Consider this: even though he won the prize in economics, and even though he’s a professor of economics, he is not technically an economist.
ROTH: I mean, my degrees are in engineering. And, you know, I wrote a paper once, a manifesto of market design called “The Economist as Engineer,” so I think of myself as something like an engineer. I’d like to be an engineer.
“A manifesto of market design” Roth calls it. The Nobel Committee’s citation noted his “theory of stable allocations and the practice of market design.” So what is market design, and why can it win you a Nobel Prize?
ROTH: Market design is an ancient human activity. You know, when you look at a distribution of stone tools around the Middle East and Europe, you find that long before the invention of agriculture, stone tools were moving thousands of miles from where they were quarried and made. And that’s a sign that there were markets for stone tools. There were ways to meet and trade things and we don’t really know much about those markets. But the stone tools, which are very durable, are evidence that markets are older than agriculture. But the Stone Age men who traded those stone tools and weapons had to make markets somehow. They had to make them safe. They had to feel confident that they could bring the things that they would trade for those stone tools and not be robbed by guys with stone axes who would take their stuff. And that’s been a big part of market design for a long time is making markets safe. Today we think about fraud and identity theft and securing your credit card. But there was a time when kings thought about securing the roads against highwaymen so you wouldn’t be waylaid on your way to and from the market. So if I were the king of England and I wanted to have markets in England, I had to make sure that the roads were safe to get to the markets.
Al Roth has written a book – a really wonderful book, I should say – called Who Gets What — and Why: The New Economics of Matchmaking and Market Design. If market design is, as Roth says, an “ancient human activity,” why does someone like him need to get involved? After all, we’re told that markets generally organize themselves – there are sellers and buyers, supply meeting demand, with price being the glue that holds it all together. In this regard, the invention of money was a big breakthrough.
ROTH: Barter is very hard because you need a double coincidence of wants. You need to find someone who has what you want and who wants what you have.
DUBNER: Right, you happen to have salt, I happen to have wool, and we each want what the other wants, or we find a third party.
ROTH: Right. Well, so finding the third party starts getting you involved in other things. And, of course, money is a great market-design invention for helping you find third parties because you can sell what you have for money and then go look for what you want.
But there are some transactions – entire realms of transactions, really – where money cannot do what it does in a typical market. Where, for whatever reason, supply is not allowed to naturally meet demand with price as the arbiter. And that’s where someone like Al Roth comes in handy. The economist as engineer. Because these atypical markets have to be set up differently, they have to be helped along. This is called a “matching market.”
ROTH: Matching markets are markets where money, prices don’t do all the work. And some of the markets I’ve studied, we don’t let prices do any of the work. And I like to think of matching markets as markets where you can’t just choose what you want even if you can afford it, you also have to be chosen. So job markets are like that, getting into college is like that. Those things cost money, but money doesn’t decide who gets into Stanford. Stanford doesn’t raise the tuition until supply equals demand and just enough freshmen want to come to fill the seats. Stanford is expensive but it’s cheap enough that a lot of people would like to come to Stanford, and so Stanford has this whole other set of market institutions. Applications and admissions and you can’t just come to Stanford, you have to be admitted.
Or think about this problem, which Al Roth has worked on directly: what is the best way for hospitals to hire newly minted doctors, and for those doctors to find the most appropriate hospital for them to work in? The current system is called the National Resident Matching Program:
ROTH: So I got involved in helping it during a crisis in the 1990s. But you have to go back to the 1900s to understand how doctors get jobs. And the 1900s is around the time when the medical degrees as we know them, the MD degree, became the dominant medical degree. In about 1900, that’s when internships began. So instead of graduating from medical school and immediately beginning to “practice medicine,” as we say-
DUBNER: A word that’s always bothered me.
ROTH: Yes.
DUBNER: You should be good at it by now.
ROTH: The first job- the standard first job for medical graduates became what was called an internship, and is today called a residency. And that’s a job where you work at a hospital and you take care of patients under the supervision of a more experienced attending physician. And it’s a giant part of the professional education of doctors. So it’s very important to doctors where they get their internship and residency. And it’s very important to hospitals because the interns and residents are a very important part of the labor force of a hospital.
As Roth tells it, there was an arms race between hospitals for the best future doctors. They began grabbing medical students earlier and earlier – sometimes two years before graduation.
ROTH: And when you try hiring people two years in advance, it’s hard to tell who the good doctors will be. It’s also hard for the doctors to tell what kind of jobs they want.
So the medical schools intervened. In 1952, they created the National Resident Matching Program.
ROTH: They developed a marketplace that has a form that has survived ‘til today, although my colleagues and I have helped modify it since then. And what that form was…you go on interviews and you find out the salary and the working conditions of the various jobs that you might be offered and then, instead of working the phones and maybe getting an offer that says you have to take it — yes or no right now on the phone — what you do is you consider in advance which jobs you would like and you submit a rank order preference. This would be my first choice of the jobs I’ve interviewed at. Here’s my second choice. Here’s my third. And the jobs do the same thing, the hospital residency programs do the same thing. And then a match is made in a centralized clearinghouse.
By the 1990s, this system was showing strain. Some people thought the hospitals had too much leverage over the residents. Also: by now, there were a lot more female medical students, some of whom had a significant other who was also a medical student – and such a couple typically wanted to get a residency in the same hospital, or at least the same region. But the matching program couldn’t handle that kind of request. So those candidates might opt out. In 1995, Al Roth was asked to help write an algorithm that could fix these problems. The algorithm worked well and it now matches more than 20,000 applicants each year.
DUBNER: It sounds as though this works pretty well according to most people involved, yes? Most people involved in this scenario are pretty happy with how it works, correct?
ROTH: Well, labor markets are stressful for everyone. So I think you are overstating how happy people are with the labor market. But I think it works pretty well.
DUBNER: I mean in the medical residency matching particularly. Or at least an improvement over what was before?
ROTH: It’s a vast improvement.
DUBNER: But here’s my question for you really is this, broader labor markets. If we consider the medical residency matching program relatively successful to what preceded it, at least, why is it not used more widely in the labor markets?
ROTH: Well, the medical market is an easier one to coordinate than many markets because just about everyone becomes available at the same time when they graduate from medical school and they all start their jobs therefore about the same time in July. So it’s a market that can easily move people all at the same time. Whereas many markets, think about the market for journalists, they might be hired at different moments and jobs might become available and need to be filled and not be able to wait for you to consider many jobs.
DUBNER: Yeah, but you and your colleagues are pretty brilliant and you have mathematical backgrounds. I would think you could deal with rolling admissions, is that right? For all the talk about how modern labor markets have so many mismatches in them — so many people doing jobs that they don’t really want to be doing, so many corporations with all these theoretically qualified people out there not being able to find the people to fill them without going through- going to a lot of trouble. I mean, hiring practice has become more and more complicated it seems as one way to address the matching problem. But it seems as though your complicated mathematical foundation might provide, ironically, a simpler way to address that problem.
ROTH: So I’m not sure that’s true. Again, one of the special things about residency positions is, although they’re very different at different places, they’re sort of similar to each other. If you’re thinking about should you be a journalist or an airplane pilot or a chef, you are dealing with very different jobs with very different employers. And one of the things that we do in the medical match is we make all the jobs available at the same time that allows you to consider them, to have preferences over them. That’s hard to do if you’re thinking about being a chef or an auto mechanic.
DUBNER: Sure. I’m curious to know, what’s a market or scenario that you’ve looked at before that you thought, “Boy, I would love to help fix that one,” but either haven’t had a shot or maybe tried and failed?
ROTH: Well, the markets for new lawyers might fall into that category and certainly the most- the fanciest job that top graduates of elite law schools get is a lot like a medical residency. It’s a clerkship with an appellate judge. That market is presently in the kind of situation that the doctor market was around 1940, where jobs are being contracted far before law school graduation. And probably a dozen times in the last 30 years, the lawyers have tried to fix this with things like setting dates before which you shouldn’t hire and things like that, but it turns out it’s hard to make rules that judges have to follow. Judges are a law unto themselves, and they break the rules. They cheat. If you know someone who’s in law school now who wants a clerkship, they’re probably going to get an offer sometime in their second year. You know, so the middle of their second year and a half before they are ready to graduate.
DUBNER: And what would it take for you to have the authority to get in there and redo that market?
ROTH: Well the question is, is there a desire for judges to coordinate in a way that would control the market? And so far there hasn’t been.
DUBNER: So you can win all the Nobel Prizes you want and there’s a limit to your power nonetheless.
ROTH: There is.
[MUSIC: Tallboy 7, “Electro Acoustic”]
As complicated as it may seem to match future lawyers or doctors with their employers, consider an even more complicated match: a person who will die unless they can get a kidney transplant.
Ruthanne LEISHMAN: You can’t buy a kidney. You can’t pay for somebody’s college education to get a kidney. You can’t buy them a car. It’s illegal in the United States to obtain a kidney through any kind of valuable consideration.
That is Ruthanne Leishman.
LEISHMAN: I’m the program manager for the kidney-paired donation program at the United Network for Organ Sharing.
The United Network for Organ Sharing, or UNOS maintains the registry of all the people in the U.S. who need an organ transplant. According to the National Kidney Foundation, out of the roughly 123,000 people awaiting an organ transplant, more than 100,000 of them, roughly 80 percent, need a kidney.
LEISHMAN: We don’t have enough supply of kidneys available. And so the list is ever-growing, but the number of kidneys available for transplant is pretty stagnant.
It’s estimated that 12 people die each day in the U.S. while waiting for a life-saving kidney transplant. And that’s because, as Leishman says, the demand for kidneys keep rising — but the supply hasn’t risen to meet it. Why is that? Consider where most donated organs come from. They primarily come from cadavers – from people who have died but who’ve died under just the right circumstances – from a brain trauma, for instance — to allow their still-functioning organs to be harvested for transplant.
LEISHMAN: Only about 1% of the population who die are actually able to donate their organs.
So if you need a heart transplant, let’s say, you are waiting for a cadaver organ. But a kidney is different from a heart. Why’s that? Because humans are born with two kidneys – and yet we really need only one. Which means that in a country like the U.S. with a few hundred million people, there are potentially a few hundred million spare kidneys out there. When someone has kidney failure, typically both their kidneys fail, so they are left with zero healthy kidneys. Whereas the typical healthy person has a perfectly good spare. So while it might seem that there’s a massive demand for donated kidneys – remember, there are more than 100,000 people on the list – the fact is that the potential supply is really massive. Here’s Al Roth again:
ROTH: If you’re healthy enough, you can remain healthy with just one. And that means if someone you love is dying of kidney disease, you can give him a kidney and save his life.
DUBNER: If you happen to be a match.
ROTH: If you happen to be a match. And that’s where kidney exchange comes in.
[MUSIC: Scott Hallgren, “Milonga” (from Tango – Jazz (live in Studio C))]
Ah, kidney exchange. Because remember, unlike some markets, where price is allowed to let demand meet supply, organ donation is a market that doesn’t allow money. As a society, we’ve decided it isn’t right to reimburse people for donating an organ – although I should say, some economists have argued that we should rethink that. But for now at least, kidney donation is reliant on altruism. Which, judging by the backlog of kidney patients waiting for an organ, isn’t working so well. And that’s why Al Roth got involved.
ROTH: People often ask me how I got involved in kidney transplantation and I think the romantic thing that they’re hoping I’ll say is that I knew someone who was ill or that I was ill, but that isn’t the case at all. I entered through the mathematics.
Coming up on Freakonomics Radio: how Al Roth and his comrades used mathematics to save lives:
LEISHMAN: We have about 600 kidney paired donation transplants a year right now in the United States. In 2000 we had 2.
And: Al Roth’s greatest hope for his new book, Who Gets What – and Why:
ROTH: My hope is that this book will help you to see markets in new ways. So may I take you to dinner to celebrate the completion of this book?
That’s coming up. But first, a quick quick reminder that you can do something amazing that will deliver good stuff for many other people, right now. This is the time of the year when we remind you that Freakonomics Radio is made possible in no small part by the dollars given by our listeners. That means: you. You can help us bring you more Freakonomics Radio in the new year. When you do it by December 31st, it’ll deliver a charitable deduction on your next tax return. Become a member today with your donation. Get your 2017 tax deduction before it’s too late. Just go to Freakonomics.com/donate or text the word “Freak” to 701-01. Thanks so much!
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[MUSIC: Seks Bomba, “Fresh Perked” (from Somewhere in This Town)]
Al Roth – high-school dropout, Nobel laureate, author of the book Who Gets What – and Why – began working on organ donation more than 40 years ago, as it turned out.
ROTH: So in 1974, in Volume 1 Number 1 of the Journal of Mathematical Economics, Herb Scarf and Lloyd Shapley, with whom I eventually shared a Nobel Prize, wrote an article about how to trade indivisible goods when you couldn’t use money.
DUBNER: And this was a theoretical argument? Entirely, yes?
ROTH: Entirely theoretical. And sort of whimsically they said, “Let’s call the object houses.” And let’s suppose everyone has a house and people have preferences over houses and they can trade houses but they can’t use money. All you can do it barter. You can say, “I’ll trade my house for yours.” Or you can do it among three people, you know, “I’ll give you my house and you give someone your house and he gives me his house.” That’s all you can do. How would trade work? So they wrote a paper about that. And I had just gotten my Ph.D. in 1974 when this article came out and I read the article and I thought, “What an interesting problem to think about: how to trade without money.” So I wrote some articles about that too with Andy Postlewaite, and—
DUBNER: Still theoretical or did you touch-
ROTH: Entirely theoretical. We were talking about how to trade houses, and of course, no one trades houses without money. I can tell you, I’ve just bought a house in California and money played a role. But it’s, you know, the way economists learn about things, the way mathematical economists learn about things is a little bit the way children learn about things. You find toys to play with and then by playing with the toys you gain experiences that might help you with other things. So this is a toy. This toy model that allows you to think about the question of how to trade goods when you can’t use money and when you can’t divide the good. You can’t say, “You have a big house and I have a little house, so just give me half of your house for my house,” you know. You say, “Houses are indivisible, we have to trade.”
[MUSIC: Dorian Charnis, “Cubano”]
In 1982, Roth took a teaching job at the University of Pittsburgh – which happened to have an excellent medical center with a prominent organ-transplant program. Roth began thinking about kidneys from the perspective of supply and demand. Again, there’s a seemingly huge demand for donated kidneys – but in fact a much, much larger supply of potential kidneys for donation, since healthy people have two, but only need one. So let’s say that your spouse, or sibling, or parent needs a kidney transplant. You could voluntarily undergo surgery to give up one of yours – if, that is, you happen to be a biological match.
ROTH: If you aren’t a match, then you’re healthy enough to give someone a kidney but you can’t give the person you love a kidney. So there they are with an indivisible object that we had been calling houses. But now, call it a kidney. And here are these incompatible patient donor pairs and they have an indivisible object and it’s against the law to buy and sell kidneys for transplantation. So all of a sudden this toy model that we’d been playing with that didn’t make a lot of sense for houses because we use money for houses made sense for kidneys.
DUBNER: Was there a light bulb moment for you where you saw that the kidney was the, you know, concrete version of what had been discussed in this model or no?
ROTH: Again, I’d like to say that there was but there wasn’t.
DUBNER: Were you looking for something to plug in to that model?
ROTH: I was looking for a teaching tool. I was teaching the model and my students would say, “This is an interesting model, but isn’t it a little silly. We use- here in Pittsburgh, we use money for houses, professor.” And I’d say, “Yes, yes but this is a toy model. You should study it.” But there we were in Pittsburgh and we had all these transplants going on and I said, “Well, supposing it’s kidneys.” So we talked about kidney exchange without my ever thinking it would become a practical thing. I was not seeking to design kidney exchange. But in 1998, I moved to Boston to teach at Harvard and in 2000 the first kidney exchange in the United States was done in New England.
That’s an exchange between “incompatible patient-donor pairs” as Al Roth calls them – two couples, let’s say, with the healthy member of each couple agreeing to give a kidney to the needy member of the other couple. The first kidney-paired exchange ever took place in South Korea in 1991; the first U.S. exchange, that Roth mentioned, happened at Rhode Island Hospital, in Providence.
ROTH: And it was covered in the press, it was an unusual thing. And there I was, I had notes about kidney exchange. So with a former student of mine from Pittsburgh who was visiting at Harvard, Utku Ünver, I said to him, “Look at this. There’s kidney exchange. Let’s give a class-” I was teaching a market design class, “Let’s give a class on how we would do kidney exchange.” And—
DUBNER: Meaning this one had happened without your help and you looked at this and thought, “Hey, if this is happening on a small scale, we can maybe-“
ROTH: We can help organize it. We have played all these years with toy models. We know how to organize on a large scale trade among people dealing with indivisible goods when you can’t use money. We know a lot about this.
Several other economists began thinking about the problem.
ROTH: And eventually we wrote a paper about how to organize kidney exchange if you weren’t too worried about logistical problems. So we hadn’t yet talked to doctors. We hadn’t yet talked to surgeons. Although-
DUBNER: Like where the kidney needs to be at what-
ROTH: Right-
DUBNER: And what the preparation is for surgery and so on.
ROTH: And how hard it is to do big exchanges compared to little exchanges. So we sent the paper to all the surgeons we could think of and only one answered. It was Frank Delmonico.
DUBNER: Ah, that’s a good one to have answered then, as it turns out.
ROTH: Absolutely. He was the director of the New England Organ Bank and he came to lunch and he and I have been colleagues on kidney exchange and on other things for more than a decade now. But we helped him build the New England Program for Kidney Exchange.
[MUSIC: Arian Saleh, “Better in Blue” (from The Cobblestone EP)]
One person that Delmonico hired at the New England Program for Kidney Exchange, or NEPKE, was Ruthanne Leishman, who helped set up their kidney-paired donation program. Remember, the Rhode Island transplant had already happened, in 2000.
LEISHMAN: But that was just done manually looking at the blood types of the donors and the candidates. And then in 2004, we started working with Al and using his optimization program.
The idea behind using Al Roth’s algorithm was to make it so transplant centers could simply enter the medical and demographic data on potential organ donors and recipients, type in a few keystrokes, and then – voila! – it would produce a match.
LEISHMAN: It would really be impossible to do this by hand because of the number of antibodies that we’re talking about and the number of people that we’re talking about and we really need a computer to look at it. Not just to do any kind of matching, but really to optimize the matching.
DUBNER: Matching a potential kidney donor is harder than it sounds. Not only does any given person have one of four major blood types but we also each have our own stew of antibodies and antigens. We’re born with a certain amount of inherited antigens; but when our bodies encounter foreign antigens, we develop antibodies that battle them. This can happen during a blood transfusion, for instance. That’s was the case with a Minnesota woman named Julie Parke.
Julie PARKE: What really happened was I broke my leg about, I don’t know, five, eight years ago and unbeknownst to me they gave me a blood transfusion during it. And that just changed a bunch of antigens and antibodies, enough so that Ray no longer was going to be a match for me.
Ray is Julie’s husband, Ray Book. They’ve been married for 24 years.
Ray BOOK: Julie and I went to high school together, didn’t know each other, had one date when we were freshmen at the University of Minnesota. I told her I’d get back to her and at our 20-year class reunion I got back to her.
Julie and Ray have one daughter and three grandchildren. Julie has been a Type 1 diabetic since she was 8 years old.
PARKE: And it basically, you know, has caused all my medical issues over the years.
Julie got her first kidney transplant when she was 35. It came from a deceased donor.
PARKE: And it lasted me quite a while, and that was great, like 26-plus years. And then that one for whatever reason was failing. So, all of a sudden I needed another one.
Ray’s blood type is O, which means he’s a universal donor.
PARKE: We were kind of going down that road thinking he’d be able to donate to me someday.
But after that blood transfusion, Julie was told by her doctors that Ray was no longer a match. In Julie’s body, Ray’s kidney would have failed. Ruthanne Leishman is familiar with Julie’s case:
[MUSIC: Tallboy 7, “Underwater Dreamer”]
LEISHMAN: She had a lot of antibodies. 94% was her antibody level, which means basically she only matches with about 6% of the population.
So if Julie went the route that got her her first donated kidney, it likely would have taken a long time to get another one. Given her particulars, one doctor told her, she could wait five years or more – years which, as Leishman describes, are hard on anyone with kidney failure.
LEISHMAN: And then they’re waiting on dialysis and then three days a week, they go into a dialysis unit to have their blood cleared of the toxins that the kidney usually removes, or they’re at home at night doing home peritoneal dialysis, and so that’s a nightly ritual for people. And it makes it difficult to work. It makes people tired. It makes people sicker, so when they do get a transplant they may not be in the best health anymore, so it’s challenging.
But Julie had the good fortune to be enrolled in a kidney-exchange program. And her chances were greatly increased because her husband Ray was offering to donate one of his kidneys to someone – anyone – since he wasn’t a match with Julie. This is what’s known as being a “paired donor,” meaning that Ray was offering his kidney under the condition that his wife would receive a kidney donated by someone who was a match with her.
BOOK: I wanted to help my wife in any way that I could, so I went out and got tested. All the information went into the computer. We just put it out there into the network and thank god there’s a network like that and the algorithm obviously worked.
And it worked fast.
PARKE: You know, I went on dialysis November 1st. They called me around Christmas time and told me, “Looks like we got something on the schedule here, but you’ve got to heal this wound you’ve got on your foot.” So I spent the month of January in bed. So anyway, that was January and then we had the transplant February 5th. So, you know, it wasn’t- it certainly wasn’t five years or more.
The kidney-exchange landscape has changed. There have been consolidations – NEPKE, for instance, has been dissolved under a push to create a national program. And the numbers have grown. Last year, for instance, there were just over 17,000 kidney transplants in the U.S. About one-third of those came from living donors – not all from kidney-paired donation, but still: that’s a lot. As Al Roth points out, in one respect it’s even more than it sounds:
ROTH: So what that means is that in the United States, we now have more living donors than we have deceased donors because deceased donors give two kidneys and living donors only give one. So there are more living donors than deceased donors, but more deceased donor transplants than living donor transplants. But the growth possibilities would be in the living donor transplantation because everyone has two kidneys.
The growth possibilities are substantial not only because the matching algorithm is successful but, perhaps because it’s so successful, it has allowed for another kind of kidney donor to enter the program. Ray Book, you’ll remember, was a paired donor; but there’s also room for what’s called a non-directed donor. Ruthanne Leishman again:
LEISHMAN: Somebody who comes into the computer program without a recipient. They don’t know anybody who needs a kidney transplant. They just want to donate to somebody and help somebody. Well they come into the program and they match with a recipient whose donor matches with another recipient, whose donor matches with another recipient, and this can go on and on. And so instead of that nondirected donor helping just one person receive a transplant, they can help 2, 3, 5, 10, 30, 60 people receive a transplant as we go down the line in the chain.
It was one of these incredibly generous people – a non-directed donor — who wound up giving Julie Parke a new kidney.
LEISHMAN: This chain started with a woman named Jodi.
Jodi SHEAKLEY-WRIGHT: Hello. My name is Jodi Sheakley-Wright.
Jodi Sheakley-Wright is 42 years old. At the time, she was living in Charlotte, North Carolina.
SHEAKLEY-WRIGHT: In May 2012, I was working as a telephonic health coach for a company in Dallas, TX, and I worked from home in Charlotte. I had a client who needed to lose 20 pounds so that he could donate a kidney to his sister. And I knew nothing about organ donation at the time. And at first I wanted to do some Internet research to determine how his lifestyle might change after the surgery, as well as what he could expect to do pre-op in order to prepare for the procedure. In my research, I came across something called kidney-paired donation. Wasn’t really familiar with that at first, but I had also seen around the same time an episode of Grey’s Anatomy. It’s actually season 5, episode 5 if you’re interested in checking that out, but it’s about paired donation. And at first, when I had seen it on Grey’s Anatomy, I wasn’t really sure if it was a Hollywood thing or if it really existed. So I did some more research and sure enough it was a real thing and I wasn’t looking to donate, but kind of sat back and thought, “You know, I’m at a place in my life where I think that I’m healthy enough. I work out of my house. I’m financially stable, and this is something that I could do.”
She began working with the transplant center at Piedmont Hospital in Atlanta. She went through a long series of physical and psychological tests.
SHEAKLEY-WRIGHT: They wanted to know if I had considered all of the factors why I should not donate. First and foremost, I was asked to make a few minor lifestyle changes, or at least I felt like they were minor. But things like they didn’t want me to do any death-defying stunts, like ride motorcycles or jump out of airplanes. I had already jumped out of an airplane so that was okay. But with one kidney, you kind of have to take a little bit more care. So basically, you know, they wanted to make sure that I was sure about donating one of my kidneys, because I really only have one to donate. I need the other one to survive and you know, they really want you to think about things like, are you going to be okay with the decisions that your recipient makes? Meaning that once you give this kidney up, it’s not mine to direct how it’s used anymore. And I was really okay with that. That’s the recipient’s call. I’m giving a gift.
After passing her tests, Sheakley-Wright’s information was entered into the computer program used by the kidney-paired donor system, and the algorithm went to work on her data. It quickly found a match – Julie Parke, in Minnesota. Less than two months later, it was surgery day.
[MUSIC: The Mackrosoft, “The Immortality Project” (from Antonio’s Giraffe)]
SHEAKLEY-WRIGHT: My surgery was in Atlanta. First thing in the morning. And once they removed my kidney, it’s put in a styrofoam container and it’s put on a commercial flight and was flown to Minneapolis.
LEISHMAN: Her kidney is actually put on a plane and flown to Minnesota, where it is transplanted into Julie.
PARKE: I think I went in about four in the afternoon, something like that.
LEISHMAN: Julie’s husband, the same day, is having his kidney recovered at a hospital in Minnesota.
BOOK: It was a very emotional time. I told my kidney, “Go, do a good job and take care of somebody.” And I shed some tears.
SHEAKLEY-WRIGHT: So Ray’s kidney at the same time that my kidney was flying from Atlanta to Minneapolis, his was flying from Minneapolis to Atlanta for the second recipient in the chain to receive her kidney.
So Ray Book donated his kidney as a paired-donor so that his wife, Julie Parke, could get a kidney from a stranger, the non-directed donor, Jodi Sheakley-Wright. And who got Ray’s kidney?
BOOK: We did find out that it was a woman who got my kidney, so. And she was in the next room, next to the woman who was donating to Julie.
SHEAKLEY-WRIGHT: Now my recovery room in Atlanta was next door to Ray’s recipient’s recovery room. And I’m, you know, I had the respect enough not to barge in there and introduce myself; although I have to be honest, I really wanted to. All I know about her is that she’s doing well.
That recipient had also come into the kidney exchange with someone willing to give her a kidney – but she wasn’t a match.
LEISHMAN: So this person in Georgia who received Ray’s kidney, her daughter the same day went to the operating room and donated her kidney. And that kidney stayed right there in the same hospital and went to somebody on the deceased donor waitlist who didn’t have a living donor available to them.
So this one act of kindness by Jodi Sheakley-Wright…
PARKE: Who donated out of the goodness of her heart. She didn’t even have anyone she was donating for.
This one act had a multiplier effect.
LEISHMAN: So what Jodi did by entering the program without a recipient attached to her—she was able to unlock matches that otherwise wouldn’t have been possible.
It also wouldn’t have been possible without the algorithm created by Al Roth and his colleagues.
LEISHMAN: It’s saving a lot of lives. We have about 600 kidney-paired donation transplants a year right now in the United States. In 2000 we had 2. We would have stayed doing 2 or 4 or 6 a year without the algorithm.
SHEAKLEY-WRIGHT: The entire process is incredible. I don’t have that much knowledge about algorithms. It’s been a little while since high school and college so I’d have to revisit some of my math skills, but I do know that it’s amazingly complex and just to match blood types and antibodies. And especially knowing that at this time there are almost 124,000 people in need of an organ. So how somebody begins to sift through all that is beyond me.
But, thankfully, it’s not beyond everyone. Al Roth again:
ROTH: This is about exchange. It’s called kidney exchange. There’s real exchange going on. So when I started talking to surgeons they didn’t automatically think of economists as fellow members of the helping profession. But when I talk about it nowadays, I say, “exchange.” That’s what economists study. Of course this is a subject for economists. But initially many people found it odd that economists were getting involved in organizing surgeries.
DUBNER: You write in the book, or maybe hint in the book, that all this work that you and others have done to try to solve this problem, will hopefully be obviated one day not too long from now, when there’s either medical treatment, or perhaps artificial organs, yeah?
ROTH: Oh I hope so. I think that your grandchildren, and maybe mine, they’ll just be appalled. They’ll say to you, “So Grandpa, tell me again. You used to cut the organ out of a dead person and sew it into a sick person and that was modern medicine?” And we’ll have to say to them, “Yeah yeah. We were proud and lucky to be able to do that. It saved lots and lots of lives.”
DUBNER: And even more antediluvian, perhaps, would be the notion that you would have had to create this complicated way to get a living donor to match with a donor, yes?
ROTH: So my hope is that stem-cell technologies will allow you to grow a new kidney the way you grew the ones you had originally. But we’re far from that now. And while that may eventually happen, everyone who has end-stage renal disease today, will be dead by that time. So our responsibility is to try to take care of the people who are sick today, even though there will be better ways to take care of them in the future.
DUBNER: What’s it feel like to have played a role in helping redesign, I don’t know if you call this a market, it is a market, yes?
ROTH: I call it a market. I mean, it’s not a market where money plays a role, but it’s exchange and you want to get efficient exchange. You want to get as many and as good quality transplants as you can, so absolutely it’s a market.
DUBNER: So there are a bunch of people out there who are alive who would not have been alive had not you and others working with you done what you’ve done. What’s that feel like?
ROTH: Well, many others. It feels good, but economics in general does good things for people. So I think that it may be an illusion to say, “Here we are saving lives. Isn’t that great?” And it is great, but imagine all the other good things that markets do. You know, the economy has been immensely productive. We all live much, much longer than people like us lived even a hundred years ago. And this has to do with the rapidly increasing prosperity that the world experiences because of the way markets work. So the big job of economists, of market designers, is to help that process along. It’s been going along for many, many centuries without the help of economists, but it goes by trial and error and maybe we can reduce some of the errors and make some of the trials go more quickly and more fruitfully.
DUBNER: The last chapter in your book is called “Free Markets and Market Design.” Do you happen to have a copy with you?
ROTH: I don’t but I remember it.
DUBNER: I’m glad you do. I do have a copy. I’d like you to read then, if I may pass you the book, the first two, the first two paragraphs there.
ROTH: “Thinking about the design of markets gives us a new way of looking at them, noticing them, and understanding them. My hope is that this book will help you to see markets in new ways. So may I take you to dinner to celebrate the completion of this book?”
DUBNER: Okay, that’s great. So Al, you interested in continuing this conversation over a bit of dinner, then?
ROTH: That sounds like a great idea.
[MUSIC: Studio Nine Productions, “New Orleans Funky Jazz” (from Michael Nickolas and Carl Carter)
DUBNER: Okay, Al, you have any ideas for where we can go grab a bite then?
ROTH: Well, we could go to California Avenue. There’s a thick market for restaurants there.
DUBNER: We didn’t really get into that. What do you mean by a “thick market”?
ROTH: Lots of restaurants and lots of people who like to eat at them.
DUBNER: And thickness is good in a market because why?
ROTH: Well, if we didn’t have reservation—which I know that you did make…
DUBNER: Did I? Did I?
ROTH: Someone in your office made a reservation. But if we didn’t have a reservation, the advantage of thick market is we could just walk down California Avenue and open doors and say, “Do you have room for two guys at this hour?” And we’d eventually get to one.
DUBNER: Okay, let’s go.
We went to a nice place in Palo Alto, on California Avenue, called Spalti. Northern Italian.
DUBNER: Al, you interested in something to drink?
ROTH: Uh, yeah—so we’re gonna split a half bottle of the Santa Margarita.
DUBNER: We can order food as well.
ROTH: I’ll have the salmon please.
DUBNER: Chicken Marsala. Thank you very much
[MUSIC: Texas Gypsies, “Maxwell Swing” (from Café Du Swing)]
MAN: Salmon?
DUBNER: Salmon here.
MAN: Some pepper?
DUBNER: I’d love some pepper. Please. Thank you…
You wrote about something that was so fascinating to me, it was just a tiny little aside, I just wanted to ask you not about it per se, but what it’s like to do the kind of work you do and the things you learn about these fields where you’re coming from outside. So when you’re writing about organ transplantation you wrote that if let’s say a husband and wife, if a spouse needs a kidney and the other one is willing to donate and they might be physiologically, blood type, tissue type, they might be compatible, but if they’ve had children there might be a higher chance of rejection because of the proteins intermingle or something during…It sounded made up to me, but I believe you because you’re a Nobel laureate. So…
ROTH: So one of the things that could stop you from taking my kidney is that you might have antibodies, pre-formed antibodies against some of my proteins. So if you have antibodies against my proteins then your immune system is waiting to attack my proteins if they show up in my kidney, for instance. But mostly you shouldn’t have antibodies against human proteins that you don’t have. You have to be exposed to those proteins to develop antibodies. So the chance that, so if I didn’t know my blood type, the chance that you could take my kidney is somewhat over 50 percent. But the chance that my wife could take my kidney is only about 30 percent. And the reason is we’re parents, and in the course of childbirth, not pregnancy, but childbirth, my wife, my wife’s immune system might have been exposed to some of the proteins that our boys inherit from me. And if so, her immune system might have developed antibodies that would now be prepared to attack my kidney if it should appear. So for parents, husbands donating to wives is harder than other donations.
DUBNER: And I assume that is just one of many strange, interesting, fascinating things you learn in your work about realms that you knew, right, nothing coming in?
ROTH: Market design is an outward facing part of economics, which means that we’re always learning new things. Economics is about almost everything that people do, which means that the nice thing about being an economist is it means that we can learn things from almost anyone. And of course you have to learn a lot about kidney surgery to be able to help surgeons organize surgeries. You have to learn a lot about medical practice and education in order to help organize labor markets for doctors. You have to learn a lot about New York City’s schools to be able to help high schools do their admissions process.
[MUSIC: Teddy Presberg, “$4/Gal” (from Outcries From A Sea Of Red)]
And that learning is a chain of its own, like the kidney-donor chain that Al Roth and others helped create, and which is saving lives. And as Al Roth and people like him continue to learn, they pass that knowledge along to people like you and me, making all of us a bit wiser, a bit more curious, a bit better off every day.
DUBNER: Cheers!
ROTH: Cheers!
SJD NARR: Thanks for listening. Please remember: it’s a great time to make a donation to keep more Freakonomics Radio coming in the new year. And to claim your tax deduction. Just go to Freakonomics.com/donate or text the word “Freak” to 701-01. Thanks so much!
Coming up next time on Freakonomics Radio: we talk about one of the most important — and, unfortunately, elusive — components of a healthy, happy society: social trust.
David HALPERN: Social trust is an extraordinarily interesting variable and it doesn’t get anywhere near the attention it deserves. But the basic idea is trying to understand what is the kind of fabric of society that makes economies and, indeed, just people get along in general. It’s an issue that’s got long roots, but it doesn’t mean that governments had done very much about it until very recently.
How to create more social trust. That’s next time, on Freakonomics Radio.
CREDITS: FREAKONOMICS RADIO is produced by W-N-Y-C Studios and Dubner Productions. This episode was produced by Greg Rosalsky. Our staff also includes Alison Hockenberry, Merritt Jacob, Stephanie Tam, Harry Huggins, and Brian Gutierrez. You can subscribe to Freakonomics Radio on iTunes, Stitcher, or wherever you get your podcasts. You should also check out our archive, at Freakonomics.com, where you can stream or download every episode we’ve ever made – or read the transcripts, and look up the underlying research. You can also find us on Twitter, Facebook, or via e-mail at [email protected]. Thanks for listening
Here’s where you can learn more about the people and ideas in this episode:
SOURCES
Al Roth, professor of economics at Stanford University
Ruthanne Leishman, program manager for the kidney-paired donation program at the United Network for Organ Sharing
RESOURCES
“The Economist as an Engineer”; Alving E. Roth, Econometrica (2002)
“A Kidney Exchange Clearinghouse in New England”; Alvin E. Roth, Tayfun So¨nmez, And M. Utku U¨ Nver, Practical Market Design (2005)
“The Redesign of the Matching Market for American Physicians: Some Engineering Aspects of Economic Design”; Alvin E. Roth And Elliott Peranson, The American Economic Review (1999)
Who Gets What ― and Why: The New Economics of Matchmaking and Market Design by Alvin E. Roth (2017)
EXTRA
Al Roth Takes Home the Nobel Prize
The Opposite of Repugnance
The post Make Me a Match (Rebroadcast) appeared first on Freakonomics.
from Dental Care Tips http://freakonomics.com/podcast/make-match-rebroadcast/
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2017 BMW M2 Long-Term Verdict: Farewell, Wee Beastie
Well, that went fast, and the loss is palpable. Honestly, I miss this car. When it arrived, we said the 2017 M2 was “as good as it gets” among BMW’s current offerings. (I now temper that statement with the recently remastered M5.) The M2 remains a Goldilocks “just-right” benchmark, not only for the high-performance coupe segment but also for BMW itself—and the company knows it. I spoke with a BMW product planner who admitted that in the past several years, the company had taken to heart reviews about poor steering, isolated driving dynamics, and a general failure to live up to the “Ultimate Driving Machine” motto. So the M Division took the well-received, now cult favorite 1M Coupe and used the Frankenstein’s monster recipe—borrowing parts from extant M cars—to make its successor even better.
That’s not to say the M2 is flawless. My routine: fire it up, toggle to Sport mode (opening the sonorous exhaust and awakening throttle response), and nudge the shifter, once for Drive and a second time for manual mode. We liked that it was possible to decouple Sport steering from Sport mode, keeping the driveline setting. Why? Sport steering muddies the feel with unnecessary heft. And although the M DCT (double-clutch transmission) is an enormous improvement over the old single-clutch, it still isn’t to Porsche or Audi levels of sophistication in any drive mode.
I drove in full-manual all the time to better choose my up- and downshifts. It was more prudent than Sport Plus, smarter than Sport, and smoother than Comfort mode. Also, there’s very little off-pedal creep, which can necessitate a quick dab of the throttle while covering the brake pedal to roll into a parking spot. Easing away from a stoplight was a hit-or-miss experience (which grew more problematic over time). Sometimes the engine would rev with the car stationary, then the clutch would grab suddenly, especially when cold. Near the end of the year, we also began to hear mild groans from the Active M Differential. Nothing more ensued, though, and spirited driving was unchanged. And although we grew accustomed to it, not having a park button/position and merely shutting the M2 off in gear felt weird. Also, it seemed unnecessary that a driver needs to press the start/stop button once to kill the engine, and a second time to shut the entire car off.
Every staffer who drove the M2 loved the 365-hp twin-scroll turbo-six engine. Because the fuel log tells a story, we could determine who loved it more than others. In the 20,674 miles driven, the worst tankful came at the right foot of “JN” at 16 mpg (guess we know which photographer has a leaden hoof). The best, thanks to Erick Ayapana’s feather-toed road trip, was 30 mpg. The yearlong average of 21 mpg (1 mpg shy of the EPA’s combined fuel economy estimate) is impressive, as most drivers overrode the engine’s auto stop/start function. At an average of $3.45 per gallon for premium, we spent $3,414 on fuel. The most expensive tank was just shy of $50, and the Zero Club award goes (again) to Erick, who added 13.066 gallons to the 13.7-gallon tank. Incidentally, fuel prices rose from $3.20 per gallon in April 2017 to $3.95 per gallon on its last tankful.
In the time we had the M2, we took it to the drag strip twice, had it serviced once, changed out one set of tires, and lapped the Streets of Willow Springs twice. The brakes never complained or faded, but we noticed that the M2 doesn’t like the combination of hot-lapping in hot weather, making noticeably less power in the 95-degree heat. Although the suspension is an excellent match for a smooth racetrack, many drivers complained the M2 crashed over highway bumps and street seams, allowing an inordinate amount of road noise to penetrate the cabin. Several of our staff wished for multivalve or magnetorheological dampers. In our fifth update, we compared our M2 to the more sedate, less powerful M240i and found that the latter was just as quick at a significantly lower price.
Unlike a comparable Audi S5 or Mercedes-AMG C 43 (which offer prepaid scheduled maintenance, ranging from about $300 to $500 for the first year), the 2017 BMW M2 came with $0 routine maintenance for three years or 36,000 miles. For the year, we spent $10 for a single quart of oil (at 9,000 miles). Had Michelin not been so generous with a free set to test, we would’ve spent $1,110 on new Pilot Sport 4 S tires (at 11,500 miles). Our total outlay for the year was just $1,120 for normal wear ($4,534 including gas).
In terms of its projected retained value after three years, the 2017 M2 came in at an incredible 76 percent of its $57,795 as-tested price, according to our friends at IntelliChoice. Compare that to our 2015 BMW M3 (at 54 percent) and Jaguar duo 2014 F-Type S and R (both at 50 percent). The M2 is practically an investment.
For a modern turbocharged BMW M Division car to remind us of those long-gone yet beloved E36 and E46 M3s, the 2017 M2 has been a corporate, divisional, and emotional success. Like those legacy screamers, this M2 is a perfectly balanced, cohesive whole with the right size, right look, right power, right brakes, and right performance in a subtle yet assertive two-door coupe. With that in mind, we can’t wait to get our hands on the 2019 BMW M2 Competition.
More on our long-term BMW M2:
Arrival
Update 1: Break-In Miles Complete
Update 2: Taking it to the Streets
Update 3: Oil, Scheduled Maintenance, and New Shoes
Update 4: Hot Lapping our M2 on Fresh, New Tires
Update 5: Is the M2 Too Hard, Too Hot, And Too Pricey?
Update 6: Grabbing Seventh Gear
Our Car SERVICE LIFE 13 mo / 20,674 mi BASE PRICE $53,495 OPTIONS Twin-clutch auto transmission ($2,900); Executive pkg ($1,400: heated steering wheel, rear-view camera; rear parking sensors, auto high beams, collision warning with pedestrian detection and auto braking, lane-departure warning, wireless charging, Wi-Fi hotspot) PRICE AS TESTED $57,795 AVG ECON/CO2 20.9 mpg / 0.93 lb/mi PROBLEM AREAS None MAINTENANCE COST $0 NORMAL-WEAR COST $10 (1 qt oil); $1,110 (four new tires) 3-YEAR RESIDUAL VALUE* $43,700 (76%) RECALLS None *IntelliChoice data; assumes 42,000 miles at the end of 3-years
2017 BMW M2 POWERTRAIN/CHASSIS DRIVETRAIN LAYOUT Front-engine, RWD ENGINE TYPE Turbocharged I-6, alum block/head VALVETRAIN DOHC, 4 valves/cyl DISPLACEMENT 181.8 cu in/2,979 cc COMPRESSION RATIO 10.2:1 POWER (SAE NET) 365 hp @ 6,500 rpm TORQUE (SAE NET) 343 lb-ft @ 1,400 rpm* REDLINE 7,000 rpm WEIGHT TO POWER 9.6 lb/hp TRANSMISSION 7-speed twin-clutch auto AXLE/FINAL-DRIVE RATIO 3.46:1/2.32:1 SUSPENSION, FRONT; REAR Struts, coil springs, anti-roll bar; multilink, coil springs, anti-roll bar STEERING RATIO 15.0:1 TURNS LOCK-TO-LOCK 2.3 BRAKES, F; R 15.0-in vented, drilled, 2-pc disc; 14.5-in vented, drilled, 2-pc disc, ABS WHEELS, F;R 9.0 x 19-in; 10.0 x 19-in forged aluminum TIRES, F;R 245/35R19 93Y; 265/35R19 98Y Michelin Pilot Super Sport DIMENSIONS WHEELBASE 106.0 in TRACK, F/R 62.2/63.0 in LENGTH x WIDTH x HEIGHT 176.2 x 73.0 x 55.5 in TURNING CIRCLE 38.4 ft CURB WEIGHT 3,506 lb WEIGHT DIST, F/R 52/48% SEATING CAPACITY 4 HEADROOM, F/R 40.1/36.5 in LEGROOM, F/R 41.5/33.0 in SHOULDER ROOM, F/R 54.4/53.4 in CARGO VOLUME 13.8 cu ft TEST DATA ACCELERATION TO MPH 0-30 1.7 sec 0-40 2.5 0-50 3.3 0-60 4.2 0-70 5.5 0-80 7.1 0-90 8.9 0-100 11.1 0-100-0 15.2 PASSING, 45-65 MPH 2.0 QUARTER MILE 12.9 sec @ 107.1 mph BRAKING, 60-0 MPH 106 ft LATERAL ACCELERATION 0.99 g (avg) MT FIGURE EIGHT 23.9 sec @ 0.83 g (avg) 1.6-MI ROAD COURSE LAP 84.78 sec TOP-GEAR REVS @ 60 MPH 1,800 rpm CONSUMER INFO BASE PRICE $53,495 PRICE AS TESTED $57,795 STABILITY/TRACTION CONTROL Yes/Yes AIRBAGS 6: Dual front, front side, f/r head BASIC WARRANTY 4 yrs/50,000 miles POWERTRAIN WARRANTY 4 yrs/50,000 miles ROADSIDE ASSISTANCE 4 yrs/Unlimited miles FUEL CAPACITY 13.7 gal REAL MPG, CITY/HWY/COMB 18.7/29.8/22.5 mpg EPA CITY/HWY/COMB ECON 20/26/22 mpg ENERGY CONS, CITY/HWY 169/130 kW-hrs/100 miles CO2 EMISSIONS, COMB 0.87 lb/mile RECOMMENDED FUEL Unleaded premium *369 lb-ft @ 1,450 rpm in overboost
IFTTT
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