by Kyle Munkittrick
During covid, amid the maelstrom that was American healthcare, a miracle happened. State medical boards suspended their cross-state licensure restrictions.
No special legislation required, no political capital spent. Overnight, every state declared they would recognize medical licenses from any other state. One day you needed 50 licenses to practice nationwide—an expensive, tedious, slow process. The next day, you needed only the license you already had. The nation’s entire health system stayed this way for nearly two years.
As a patient, this was an incredible boon. If you had a primary care doctor you liked in New York and moved to Vermont, Texas, or anywhere in the US, you could keep seeing them over Zoom.
Moving did not mean losing your doctor. You could keep seeing someone you knew and trusted, even across state lines. Telehealth boomed. Whole new ways to deliver and build healthcare businesses emerged.
And then, at the end of the pandemic, all that freedom was quietly destroyed. Why? Because State Medical Boards don’t trust each other. Read more »




There has long been a temptation in science to imagine one system that can explain everything. For a while, that dream belonged to physics, whose practitioners, armed with a handful of equations, could describe the orbits of planets and the spin of electrons. In recent years, the torch has been seized by artificial intelligence. With enough data, we are told, the machine will learn the world. If this sounds like a passing of the crown, it has also become, in a curious way, a rivalry. Like the cinematic conflict between vampires and werewolves in the Underworld franchise, AI and physics have been cast as two immortal powers fighting for dominion over knowledge. AI enthusiasts claim that the laws of nature will simply fall out of sufficiently large data sets. Physicists counter that data without principle is merely glorified curve-fitting.
The smallest spider I’ve ever seen is slowly descending from the little metal lampshade above my computer. She’s so tiny, a millimeter wide at most, I have to look twice to make sure she isn’t just a speck of dust. The only reason I can be certain that she’s not is that she’s dropping straight down instead of floating at random.
Naotaka Hiro. Untitled (Tide), 2024.
In a previous essay, 
Isn’t it time we talk about you?


To be alive is to maintain a coherent structure in a variable environment. Entropy favors the dispersal of energy, like heat diffusing into the surroundings. Cells, like fridges, resist this drift only by expending energy. At the base of the food chain, energy is harvested from the sun; at the next layer, it is consumed and transferred, and so begins the game of predation. Yet predation need not always be aggressive or zero-sum. Mutualistic interactions abound. Species collaborate when it conserves energy. For example, whistling-thorn trees in Kenya trade food and shelter to ants for protection. Ants patrol the tree, fending off herbivores from insects to elephants. When an organism cannot provide a resource or service without risking its own survival, opportunities for cooperative exchange are limited. Beyond the cooperative, predation emerges in its more familiar, competitive form. At every level, the imperative is the same: accumulate enough energy to maintain and reproduce. How this energy is obtained, conserved, or defended produces the rich diversity of strategies observed in nature.



We humans think we’re so smart. But a
Giant Tarantulas 