I love these explainers, because it often "unlocks" other similar things I've seen to understand them in a new way.
For instance, I'm a nurse in the US and there is a similar hierarchy. As in finance, at some point the compensation and hierarchy becomes severed from the value or service it is trying to provide. I think about this all the time - if a doctor, for example, gives an order to draw blood or administer a medication but I am the one physically DOING it, why is the doctor paid so much more? And why does the CEO - who arguably actually does nothing? - make 1,000x that doctor? And the insurance exec 10x more than him? And why is the housekeeper, who is ABSOLUTELY ESSENTIAL for me to practice safely, paid 90% less?
It might be argued that it's for expertise, and yes - this is probably where it started, rewarding the longer years of study and effort - but this is no longer usually the case. Almost all medicine is algorithmic. A computer spits out a pathway or a plan based on given inputs. Those inputs come almost exclusively from nurses, techs, and medics. The nurse already knows what the doctor is going to order, and in fact changes or emphasizes different parts of her documentation to match what they know the doctor is looking for.
My theory is that Doctors (and CEOs) were actually paid this premium to accept responsibility for the outcomes under their care. They wouldn't always get it right, but the relationship was "small" enough that a patient could hear or accept that a doctor had attempted all they could, even if the outcome was poor. It would break it up into small enough units for meaningful accountability and meaningful process improvement. I think it was intended to be the same for CEOs and top finance guys - someone to blame if things go wrong, someone responsible for the training and actions of those working directly under them.
Now though, in healthcare as in finance, it all feels scrambled. Those higher up the chain have so much power that they are beyond accountability and can deflect the downside of their positions (responsibility) onto workers below them or "systems/protocols" above them. I often joke with my nursing students that we have to know every bit as much as the doctors do, and that we exist to be a moral crumple zone - to have our tiny mistakes or omissions in documentation magnified by huge teams of well paid lawyers so the doctor or CEO can avoid responsibility.
I don't know how to fix it, but yeah - it's a mess. Sorry I don't have more solutions to contribute, just more ways that this infects our interdependence and gets in the way of people doing the right thing.
I went to one of these gala events for the first time a few weeks ago....it was very uncomfortable and I couldn't understand how everyone there didn't see it!! Thanks for the article
I recently explored similar themes in two separate articles I wrote: Digital Death (I think you'd like this one) and an article about our modern day Trail of Tears wrapping it together with the history of the original Trail of Tears.
I'm astounded by the similarities in underlying key points that you and I both bring up: how we use our bodies, the hubris of the "elite," and the way in which our lives depend upon the natural world.
You give amazing illustrations and visions to the points you make. Whenever I read one of your articles, I'm impressed by the way you explain complex ideas.
Really solid breakdown of how physical elevation maps onto economic power. The pyrmaid analogy especially captures something most analysis misses: the amplification effect isn't about individual merit, its about postion in the structure. Makes me think about how AI deployment might accelerate this even further. When a hedge fund manager's click can be augmented by an LLM procesing billions of data points, the pyramid grows even taller while the actual human contribution shrinks. We might be buildng a system where human agency at the top becomes increasingly symbolic.
As a biology instructor I'm in a similar (though lower-status) tertiary position, attempting to train the next generation's doctors and nurses and scientists, rarely finding out whether I've succeeded in any individual case.
Similar in the case of writing, though with a different mechanism. Substack (or its algorithm) knows how many people read things, and routes the packets, but it's not like I spend my day tracking that.
Brett, When I read your portraits of height and distance ... I see someone tracing how abstraction severs us from the ground and one another. As I take that in, I feel both moved and heavy ... moved by your care for the people under the towers, and heavy because naming the wound, again and again, can also keep it aching. I value companionship, dignity, and ways of coordinating life that protect our capacity to feel and belong.
From a trauma lens (thinking of Levine’s emphasis on orienting and completing stuck survival energy), I also imagine how relentless exposure to “height” could leave any of us braced ..... mind brilliant, body still waiting for ground. If that’s anywhere true for you, I want your gifts of perception to have company and landing.
Would you be open to turning your lens (just as incisively) toward the next question?
What do we build when we refuse both grand delusion and resignation?
A few places I’d be excited to see you write into:
From numbers back to neighbors: What forms of companionship restore sightline and responsibility between the “apex” and the street ... without romanticizing “the ground”?
Valuing without extraction: How might we make promises visible (clear claims on real goods, services, care) so coordination doesn’t default to distant derivatives? (Think “commitments” rather than “products”.)
Limits as care: If runs and arbitrage are symptoms of panic, what gentle limit-windows (human-scale caps, pauses, alarms) keep systems metabolically honest rather than punitive?
One concrete direction that has helped me re-ground is writing about networks of “commitment pools”. Your critique could give this whole territory sharper language and better guardrails.
What I’m longing for in your voice is the same ferocity you bring to diagnosing distance, now applied to designing proximity: plain-language vouchers, auditable logs, humane caps, and routes between pools so value can move without people becoming invisible. That would feel like companionship in print.
If you have energy for a closing image without vitriol, I’d love to hear you describe one story, from you personally, that could help many of us steady our nervous systems and take the next step.
With respect for your stamina and your mind .... and with a wish for more company around you as you write,
I love these explainers, because it often "unlocks" other similar things I've seen to understand them in a new way.
For instance, I'm a nurse in the US and there is a similar hierarchy. As in finance, at some point the compensation and hierarchy becomes severed from the value or service it is trying to provide. I think about this all the time - if a doctor, for example, gives an order to draw blood or administer a medication but I am the one physically DOING it, why is the doctor paid so much more? And why does the CEO - who arguably actually does nothing? - make 1,000x that doctor? And the insurance exec 10x more than him? And why is the housekeeper, who is ABSOLUTELY ESSENTIAL for me to practice safely, paid 90% less?
It might be argued that it's for expertise, and yes - this is probably where it started, rewarding the longer years of study and effort - but this is no longer usually the case. Almost all medicine is algorithmic. A computer spits out a pathway or a plan based on given inputs. Those inputs come almost exclusively from nurses, techs, and medics. The nurse already knows what the doctor is going to order, and in fact changes or emphasizes different parts of her documentation to match what they know the doctor is looking for.
My theory is that Doctors (and CEOs) were actually paid this premium to accept responsibility for the outcomes under their care. They wouldn't always get it right, but the relationship was "small" enough that a patient could hear or accept that a doctor had attempted all they could, even if the outcome was poor. It would break it up into small enough units for meaningful accountability and meaningful process improvement. I think it was intended to be the same for CEOs and top finance guys - someone to blame if things go wrong, someone responsible for the training and actions of those working directly under them.
Now though, in healthcare as in finance, it all feels scrambled. Those higher up the chain have so much power that they are beyond accountability and can deflect the downside of their positions (responsibility) onto workers below them or "systems/protocols" above them. I often joke with my nursing students that we have to know every bit as much as the doctors do, and that we exist to be a moral crumple zone - to have our tiny mistakes or omissions in documentation magnified by huge teams of well paid lawyers so the doctor or CEO can avoid responsibility.
I don't know how to fix it, but yeah - it's a mess. Sorry I don't have more solutions to contribute, just more ways that this infects our interdependence and gets in the way of people doing the right thing.
Beautiful comment. Thank you.
You said you don't know how to fix it. Here's one well thought out suggestion, that came out of deeply grappling with this exsct question https://www.pdrboston.org/what-is-an-egalitarian-revolution and in more detail here https://www.pdrboston.org/faq-how-to-have-no-rich-no-poor
I went to one of these gala events for the first time a few weeks ago....it was very uncomfortable and I couldn't understand how everyone there didn't see it!! Thanks for the article
Brett - this article is fantastic!
I recently explored similar themes in two separate articles I wrote: Digital Death (I think you'd like this one) and an article about our modern day Trail of Tears wrapping it together with the history of the original Trail of Tears.
I'm astounded by the similarities in underlying key points that you and I both bring up: how we use our bodies, the hubris of the "elite," and the way in which our lives depend upon the natural world.
You give amazing illustrations and visions to the points you make. Whenever I read one of your articles, I'm impressed by the way you explain complex ideas.
That's all for now. Wishing you a great day!
Agree, this is very well written. Curious about the articles you mentioned on your account. Will look for them.
Really solid breakdown of how physical elevation maps onto economic power. The pyrmaid analogy especially captures something most analysis misses: the amplification effect isn't about individual merit, its about postion in the structure. Makes me think about how AI deployment might accelerate this even further. When a hedge fund manager's click can be augmented by an LLM procesing billions of data points, the pyramid grows even taller while the actual human contribution shrinks. We might be buildng a system where human agency at the top becomes increasingly symbolic.
As a biology instructor I'm in a similar (though lower-status) tertiary position, attempting to train the next generation's doctors and nurses and scientists, rarely finding out whether I've succeeded in any individual case.
Similar in the case of writing, though with a different mechanism. Substack (or its algorithm) knows how many people read things, and routes the packets, but it's not like I spend my day tracking that.
Brett, When I read your portraits of height and distance ... I see someone tracing how abstraction severs us from the ground and one another. As I take that in, I feel both moved and heavy ... moved by your care for the people under the towers, and heavy because naming the wound, again and again, can also keep it aching. I value companionship, dignity, and ways of coordinating life that protect our capacity to feel and belong.
From a trauma lens (thinking of Levine’s emphasis on orienting and completing stuck survival energy), I also imagine how relentless exposure to “height” could leave any of us braced ..... mind brilliant, body still waiting for ground. If that’s anywhere true for you, I want your gifts of perception to have company and landing.
Would you be open to turning your lens (just as incisively) toward the next question?
What do we build when we refuse both grand delusion and resignation?
A few places I’d be excited to see you write into:
From numbers back to neighbors: What forms of companionship restore sightline and responsibility between the “apex” and the street ... without romanticizing “the ground”?
Valuing without extraction: How might we make promises visible (clear claims on real goods, services, care) so coordination doesn’t default to distant derivatives? (Think “commitments” rather than “products”.)
Limits as care: If runs and arbitrage are symptoms of panic, what gentle limit-windows (human-scale caps, pauses, alarms) keep systems metabolically honest rather than punitive?
One concrete direction that has helped me re-ground is writing about networks of “commitment pools”. Your critique could give this whole territory sharper language and better guardrails.
What I’m longing for in your voice is the same ferocity you bring to diagnosing distance, now applied to designing proximity: plain-language vouchers, auditable logs, humane caps, and routes between pools so value can move without people becoming invisible. That would feel like companionship in print.
If you have energy for a closing image without vitriol, I’d love to hear you describe one story, from you personally, that could help many of us steady our nervous systems and take the next step.
With respect for your stamina and your mind .... and with a wish for more company around you as you write,
Great insight!