Almost ten years ago, I wrote a thesis for a Master’s degree at Georgetown. It was about the artistic representation of the machine in human form. I was curious about the human drive to create cyborgs and robots and machines that look and behave like us, and what it means for us to also have the fear that seems to crop up in so many movies and books: The fear that the cyborgs and robots and machines that look like us are going to turn around and destroy us. I looked at a couple of texts, and I considered the Prometheus myth and, of course, Frankenstein’s monster. Naturally, I called the thesis “Doomsday or Desire: Do Androids Dream of Robotic Lovers?” (Download it here.)
It never occurred to me that a decade later I’d be considering a very similar question, albeit in a completely different industry and from a different angle (and without all the critical theory).
The other day, there was a big media flurry about a pretty cool and exciting announcement. You may have heard about it: The Qualcomm Tricorder X Prize. It’s a competition with a $10 million prize for the first group to design a Star Trek Tricorder: A device that can monitor a set of health metrics and diagnose 15 diseases. It’s pretty cool, right? Absolutely. Talk about potential!
But something was nagging at me. So I got to thinking. I got to thinking about a self-scanner and diagnoser. I got to thinking about the rise of self-tracking apps and health technology in general. I especially got to thinking after I read Vinod Khosla’s piece on TechCrunch, with the unfortunately polarizing title Do We Need Doctors or Algorithms? (NB: He addresses some of my concerns at the very end.)
Here’s what’s been bugging me: There’s a particular strain of thought, or maybe even of person, that says, “I have a set of constructs that solve these particular problems. Hey, you know what? I bet I can use them over here to solve this totally different problem!” Now, I’m not talking about using a theory from one sphere to help understand something in a totally different sphere. I’m talking about the applied version of my favorite aphorism: Running around looking for nails while wielding a really big hammer.
There are a lot of amazing ideas and possible solutions to big problems coming out of the health tech sphere right now. But there’s also what I see as a lot of this hammer/nail-ness too, this “I’ve figured out how to reengineer this over here, so I’m pretty sure I can reengineer this as well” - even though the bigger problems behind and connected to “this” haven’t really been explored. I see “my best guess” and “I’m going to assume here” more than I see “patients want to self-diagnose these types of ailments, but they want specific types of physician support in these medical cases.”
Let me explain. As I mentioned, I think the idea of a self-scanner could be great. Empowering patients is really important. But once a patient is empowered, what then? How do we work with physicians and nurse practitioners to give up some of the control they may (or may not) want to have over their professional knowledge? How do we get them to work with patients and use this technology in a mutually beneficial way? How do we educate patients so they can use this technology to have better healthcare experiences and make healthier choices? How do we go rebuild the system to train and create better doctors, period, so labor isn’t being duplicated and patients can get the best out of doctors and doctors can focus on necessary clinical tasks and the personal aspects of patient care?
Just creating the technology isn’t enough. Like I’ve said before, sometimes we look at technology as this silver bullet. Ah ha! This - this one - this is what will fix this problem. We’ll get rid of crummy doctors, right? But isn’t that treating the ecosystem of healthcare the way many of us treat our own bodies? Rather than engage in some preventative care and understand the root cause of some our problems, we allow it to get bashed around and then hope technology will save it. Technology can help it, most surely, but we have to fix the whole system. Including the human parts of it.
More than that though, if we see doctors as replaceable by algorithms, what does that mean? Yes, I know, part of being a doctor already is using an algorithm, so why not just let a computer do it since computers are more powerful. I’m not arguing against that. What I’m saying is: If we take much of the diagnosing and clinical decision-making away from doctors, and then the surgical duties, what’s left? Yes, there’s personal connection. But so far no one’s offered a solution for making sure that personal connection is good, for helping both clinicians and patients be better at making and sustaining it. We’re focused on building the technology but we need to also dig into in medical schools to make sure we’re creating a system that can support these technologies in positive ways. I’ve seen some people argue it’s just an expensive placebo. I disagree, because medicine isn’t just a quantifiable science. With the best doctors, it’s also an art, based on observation, an ability to synthesize knowledge and experience, an understanding of people as well as science and medicine.
Think about what would happen if we took away diagnosing entirely from clinicians. Think about what would be left - for clinicians to be the janitors of health? If we gave the creative part of your job to a computer - because it’ll be entirely possible to do that in almost any field - what would be left for you? What would your value be?
So let’s not make it an either or. Let’s build powerful algorithms and more powerful doctors and more powerful patients. Let’s create a better system.
By the way, sitting in that Porsche felt right. I’ve always told my wife that my mid-life crisis is gonna be a refurbished 1974 Toyota Land Cruiser but now I’m thinking I might shoot for something with a little more ejaculation potential.
I went to the North American Auto Show tonight. It was awesome. It had all of those concepts and hot “previews” that you always see featured on CNN. Plus, checking out the displays and the “show quality” was equally as fun — touch-screens and immersive presentations and modern furniture and hands-on simulators. It was kid-in-a-candy-shop stuff for design and technology, even for someone like me who’s only minimally into cars and probably only because I’m a heterosexual male and it’s in my DNA.
Guess what I learned? People in the auto industry are not dummies, in spite of their recent problems — they know that it’s primarily dudes who like cars and they know that dudes who like cars tend to like women, too.
Listen, I’m about to get a little sexist, but please trust that it’s in the spirit of the show. Nobody’s mistaking me for Sylvester Stallone or even Russell Brand. But I do have a penis and testicles, and they do get tingly when I see a pretty woman standing next to a shiny car with, ahem, sexy curves.
I’ve been to plenty of trade shows. I get it. Men are dumb, weak creatures. But what happens in Detroit every January is not crass. It is art. Truly, the idea is not just to envision yourself in the car, but to envision yourself ejaculating into a beautiful woman in the car.
Every company had their own carefully crafted “message” in their choice of spokesmodels, but they each ultimately said that same thing: If you like this car behind me, I will have sex with you.
Now that we’re clear, here’s how each of them would have sex with you:
Ford - My break’s in 45 minutes. Meet me behind the Pepsi machines.
Chevy - OK, but a video of it better not end up online.
Chrysler/Dodge - Honey, you can’t handle this goodness.
Hyundai - My roommate will be home soon so you can’t spend the night.
VW - Let’s take some pills and dance and twirl and let the music lead us where we need to go.
Volvo - You’ve got protection, right?
Honda - OK, just don’t tell my husband.
Subaru - Just say that you love me. Even if you don’t mean it.
Cadillac - A pair of Tiffany earrings in my champagne flute? You shouldn’t have!
Fiat - You’re not going to call me, are you?
Maserati - I will be the best, most passionate lover you’ve ever had — worth every penny you will lose in the paternity suit.
Kia and Scion - OMG we’re gonna do it LOL!
Tesla - Yeah I’m a dude. So what? Don’t knock until you try it!
Coda - Let’s take a blanket and a joint down under the pier.
Hey intelligent peoples, I’m troubleshooting my iMac and could use your brainthings. It’s an oldish iMac (2006, 2.4 Ghz Intel Core 2 Duo, OS 10.6.8), so I’m open to the idea that it’s just finally kicked the bucket but want to see what can be done.
It’s basically running incredibly slowly, like the delay between click and load is 10 seconds or more (but, strangely, the home screen loads fine when I reboot it). I have repaired disk permissions and the disk itself through Disk Utility, but that didn’t speed anything up.
Any ideas, suggestions, last rites? Thank you in advance, supernerds.
(P.S. it’s past my bedtime so I’m checking answers in the morning.)
He seems to have gotten stuck on cynical arrogance. But there’s more to it than that. It’s mechanical, if something so incontrovertibly human as cynicism can be mechanical. He sees the world not as shapes and colors, not as happiness and sadness. He sees it as inputs and outputs, emotional metadata that could unlock a puzzle or, more likely, could speak to the shallowness of others — those gifted with emotionalism but denied intellect. His wrath is against those who would stoop to the mundane, to commiserate with others through simple acts that he uses as well, albeit to a higher purpose than the Emotionals. He must point out your flaws. In that way, it’s not cynicism so much as it’s programming. I would say that secretly he loves his own mind so much that he hates himself, if I thought he could feel such pedestrian feelings.
1.1 million: The number of jobs gained under President George W. Bush.
That would be *eight years* of George W. Bush.
I’m all for a good Bush bash but 1) presidents don’t have nearly the influence on jobs that they are credited with/blamed for having and 2) most reliable accounts put job losses for 2008-2010 at 5-7 million, so even if you want to size up Bush and Obama the latter doesn’t look so great.
My wife has taken to saying something along the lines of “are you talking to your girlfriend?” every time she sees me on my phone or laptop, which, as I don’t need to tell the people reading this (including my wife), is a lot of the time. Contrary to it becoming our own inside-joke, it seems to have stalled in this weird zone where I’m half-convinced that she really does think I have an online girlfriend. Not only that, but she seems a little bummed that she can’t find any incriminating evidence. It’s like an affair is the spice that we’re lacking and I can’t even throw her one measly bone of adultery to save our marriage. I’m a terrible husband.
It was full. I don’t know any other way to describe it. At certain times I think of the bad things that happened, most of which I haven’t shared, and I wonder how this year could possibly be worse. Other times I think of all the good that happened — primarily my children — and I wonder how they could make me any prouder or happier than they did last year.
When a family friend asked me what I’ve been doing I told him it’s been all work and family, to which he responded that that’s the way it’s supposed to be in your mid-30’s. I guess that’s right. Not more good than bad. Not more bad than good. Just full.