Questioning "Innovation?" Is that even allowed?

From one of my favorite requisite daily hangs.

The commentariat is every bit the equal of the topical authors. Better bring your A-Game if you're gonna participate; they do not suffer fools gladly. ("Yves Smith" is the blog owner.)

Questioning Innovation
Posted on December 5, 2019 by Yves Smith

I haven’t quite worked through my reaction to some recent pieces in the Financial Times that seem to merit comment, so forgive me for picking out a just a couple of tidbits that still might serve as grist for discussion.

One thing that has long bothered me is the worship of innovation. Relatively early in my career, I had a consulting gig with a venture capital firm where my job was to look at oddball deals. I learned that quite a few bona fide inventions and technology improvements, even though they might seem cool and engineers would get excited about them, didn’t add up to a business opportunity. The most common failing was they didn’t represent a big enough improvement over the status quo to justify customers making the needed behavior changes to adopt them.

And an even earlier lesson came in college, when I majored in the history and literature of the modern era, which meant the Industrial Revolution to World War II. The first generation, and arguably even two, of the Industrial Revolution led to a decline in worker incomes in England. The revolutions of 1848 were mass pushback against the dislocations of the rise of factory work. So while industrialization eventually increased living standards, the transition costs exacted a great toll on laborers who didn’t live long enough to reap the benefits. And we are now suffering the long-term cost of environmental degradation….

If one wants to get worked up about the US actually being a laggard or being at risk of becoming one, it’s a little late to get worked up now. How about what passes for Silicon Valley talent focusing on….help me…apps? How about our slow and overpriced broadband? How about our generally terrible infrastructure, which is imposing a cost on citizens and businesses on a broad basis? America’s lifespan is falling, and the priority is 5G?

The reason I am increasingly a Luddite is I see too much use of technology to curtail our economic rights and even now our supposed ownership, or otherwise enable better rentierism…

Technology is working towards the creation of a new debt cropper society. It may not get anywhere near as far as it did in the Reconstruction Era, but having to pay and pay and pay (then via jacked up financing charges, now via restricted ownership rights leading to unnecessarily high costs, particularly from having to replace consumer durables more often or pay high authorized servicer repair costs), but the trend is underway…

Read all of it, including the accruing comments.

"Rentierism." I am reminded of Quadrant II of Frase's Four.

Also, buy and study Yves' excellent book. One of my FIRE Sector favs (in which I did a 5-yr tenure).

The economy is far too important to all of us to leave to experts, particularly when their recommendations often have little in the way of empirical foundations. Both experts and charlatans rely on intimidation, such as the use of arcane (even if useful) terminology and a dismissive attitude to deter reasonable queries. We all need to get in the habit of demanding support, not sound bites or sixth-grade level opinion pieces, but reasoned and complete explanations of why economists believe what they believe. That was the reason for adopting mathematical exposition in the first place, to make the logic and evidence behind their reasoning explicit and transparent. It’s time they adopt that standard for communication with the public. [Ch 9, location 6551]

INNOVATION REMINISCENCE: THE ROTARY DIAL PHONE

 LOL...

THE EHR: "INNOVATIVE" OR OBSTRUCTIVE

Patients vs Paperwork
by Danielle Ofri
New York Times

Every doctor I know has been complaining about the growing burden of electronic busywork generated by the EMR, the electronic medical record. And it’s not just in our imaginations.

The hard data have been rolling in now at a steady pace. A recent study in the Annals of Family Medicine used the EMR to examine the work of 142 family medicine physicians over three years. These doctors spent more than half of their time — six hours of their average 11-hour day — on the EMR, of which nearly an hour and a half took place after the clinic closed.

Another study in Health Affairs tracked the activities of 471 primary care doctors over a three-year period, and also found that EMR time edged out face-to-face time with patients.

This study came on the heels of another analysis in the Annals of Internal Medicine in which 57 physicians were observed directly for 430 hours. These researchers found that doctors spent nearly twice as much time doing administrative work as actually seeing patients: 49 percent of their time, versus 27 percent.

These study results hovered over my head as I worked through a recent clinic session, most of which felt devoted to serving the EMR rather than my patients. It was the kind of day that spiraled out of control from minute one, and then I could never catch up. The kind of day, nowadays, that is every day.

Part of the issue is that there are simply more patients, most of whom are living longer with many more chronic illnesses, so each patient has much more that needs to be taken care of in a given visit.

But the main reason that I can’t keep up is the EMR. Like some virulent bacteria doubling on the agar plate, the EMR grows more gargantuan with each passing month, requiring ever more (and ever more arduous) documentation to feed the beast…

Yeah. That hardy perennial lament. Can't argue with the beef--except to assert that it's not the technology per se, it's the incumbent business paradigm. "Patients vs Paperwork." Interesting choice of words. I assume Dr. Ofri isn't advocating a return to actual paper recordkeeping.

Although, my friend Margalit might disagree.

Relatedly, on the "business paradigm" of health care policy:

The American Health Care Industry is Killing People

Yes, transitioning to a more equitable system might eliminate some jobs. But the status quo is morally untenable.

Won’t you spare a thought for America’s medical debt collectors? And while you’re at it, will you say a prayer for the nation’s health care billing managers? Let’s also consider the kindly, economically productive citizens in swing states whose job it is to jail pregnant women and the parents of cancer patients for failing to pay their radiology bills. Put yourself in the entrepreneurial shoes of the friendly hospital administrator who has found a lucrative new revenue stream: filing thousands of lawsuits to garnish sick people’s wages.

And who can forget the lawyers? And the lobbyists! Oh, aren’t they all having a ball in America’s health care thunderdome. Like the two lobbyists who were just caught drafting newspaper editorials for Democratic state representatives in Montana and Ohio, decrying their party’s push toward a “government-controlled” health care industry. It’s clear why these lobbyists might prefer the converse status quo: a government controlled by the health care industry. If we moved to a single-payer system, how would lobbyists put food on the table, and who would write lawmakers’ op-ed essays?

Welcome to the bizarre new argument against “Medicare for all”: It’s going to cost us jobs. Lots of jobs. Good, middle-class, white-collar jobs in America’s heartland, where Democrats need to win big to defeat Donald Trump…

Hmmm... From a prior post.

I am reminded of a passage from a David Graeber book:

wherein he asks,

Does this mean that members of the political class might actually collude in the maintenance of useless employment? If that seems a daring claim, even conspiracy talk, consider the following quote, from an interview with then US president Barack Obama about some of the reasons why he bucked the preferences of the electorate and insisted on maintaining a private, for-profit health insurance system in America: 

“I don’t think in ideological terms. I never have,” Obama said, continuing on the health care theme. “Everybody who supports single-payer health care says, ‘Look at all this money we would be saving from insurance and paperwork.’ That represents one million, two million, three million jobs [filled by] people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?”

I would encourage the reader to reflect on this passage because it might be considered a smoking gun. What is the president saying here? He acknowledges that millions of jobs in medical insurance companies like Kaiser or Blue Cross are unnecessary. He even acknowledges that a socialized health system would be more efficient than the current market-based system, since it would reduce unnecessary paperwork and reduplication of effort by dozens of competing private firms. But he’s also saying it would be undesirable for that very reason. One motive, he insists, for maintaining the existing market-based system is precisely its inefficiency, since it is better to maintain those millions of basically useless office jobs than to cast about trying to find something else for the paper pushers to do. 

So here is the most powerful man in the world at the time publicly reflecting on his signature legislative achievement—and he is insisting that a major factor in the form that legislature took is the preservation of bullshit jobs…

Graeber, David. Bullshit Jobs: A Theory (p. 157). Simon & Schuster. Kindle Edition.

'eh?

OFF-TOPIC PERSONAL ERRATUM

Hope draws nigh, scheduled to arrive this Christmas Eve. Hope Eleanor Nyquist, my first Great Niece, daughter of my awesome Niece April, wife of Neurotrainer.com CEO and Chief Scientist Dr. Jeff Nyquist.

I shot this--and a couple hundred more--at their wedding.

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More to come...

BYKOTA?

From The Atlantic:

America’s Epidemic of Unkindness
A new research institute at UCLA wants to start a virtuous cycle of generosity and do-gooding.

Take five minutes to meditate. Try to quiet the judgmental voice in your head. Call your mother. Pay for someone else’s coffee. Compliment a colleague’s work.

In an age of polarization, xenophobia, inequality, downward mobility, environmental devastation, and climate apocalypse, these kinds of Chicken Soup for the Soul recommendations can feel not just minor, but obtuse. Since when has self-care been a substitute for a secure standard of living? How often are arguments about interpersonal civility a distraction from arguments about power and justice? Why celebrate generosity or worry about niceness when what we need is systemic change?

Those are the arguments I felt predisposed to make when I read about the newly inaugurated Bedari Kindness Institute at UCLA, a think tank devoted to the study and promulgation of that squishy concept. But it turns out there is a sweeping scientific case for kindness. In some ways, modern life has made us unkind. That unkindness has profound personal effects. And if we can build a kinder society, that would make life better for everyone…

Interesting. From NPR:

“…in terms of kindness, an important feature of our species is that we are perhaps the most cooperative animal on the planet. So in no other species do you see cooperation between large numbers of unrelated individuals, or even, in many species, tolerance of large numbers of unrelated individuals.

And at the same time, our species is also an extremely conflictual one. So there's a good argument to be made that the reason we're so cooperative is because we have a long history of intergroup violent conflict. And trying to understand how the cooperation aspect of it works, the helping-one-another component of it in juxtaposition with the conflict aspect, is an important step towards understanding how we can promote a more harmonious society and a more harmonious world…”

A lot to ponder. I look forward to this initiative getting up to speed. We'll see how good the "science" is.

Update: Turns out they're out over their skis on this in PR terms. I reached out, and got a reply from a UCLA subordinate. There's as yet no physical facility, no staff, no firm agenda, no website or social media presence. And, I was told, any research output is "several years away." They're "gratified and overwhelmed" by the widespread immediate interest, but these press forays were just a tad premature.

Hmmm... Of topical relevance? Two latest books up now in my endless reading pile (click the images for links).

Is persistent chronic incivility/hostility ("unkindness") materially relevant to forthcoming potential tragedies, up to and possibly including unprecedented human mass demise? Below, I've read this one. Having trouble getting all the way there. I know he's largely right, in theory.

"...Have you been told by a newspaper pundit, politician, college professor, or television host that your friends, family, and neighbors on the other side are knaves and fools, implying that if you have any integrity, you must stand up to them or leave them behind? That people with a different perspective hate our country and must be completely destroyed? That if you’re not outraged, you’re not paying attention? That kindness to your ideological foes is tantamount to weakness?

...We are responsible for our contempt addiction, of course, just as meth addicts are ultimately accountable for their addiction. But there are also our pushers—the political meth dealers. Knowing our weakness, dividing leaders on both the left and right seek power and fame by setting American against American, brother against brother, compatriot against compatriot. These leaders assert that we must choose sides, then argue that the other side is wicked—not worthy of any consideration—rather than challenging them to listen to others with kindness and respect. They foster a culture of contempt..."

That lower banner above is that of the Maryland Department of Aging BYKOTA senior center in Towson, a few miles from my house. I just joined, initially for the basketball games (and the geezer discount of my Y membership). They take the Be Ye Kind stuff seriously. My new hoops pals could not be nicer.

I am married to the kindest person I ever met. I like to think I am generally a kind and generous person (she'd not have otherwise put up with me for our 45 years to date), but I do have to admit that I episodically engage in snarky provocation responses that some would say paint me as a sarcastic jerk. e.g., see my "Bundy's World" post with its inventory of anti-militia Photoshop savagery (I've had "Keyboard Kommando" 'death threats' over that stuff).

Then there's my pointed "Obamacare Free Riders" song and YouTube music video:

No Kumbaya magnanimity in that little ditty. In general, my M.O. is to sometimes engage in biting humor when confronting pomposity or mendacity.

At what point does "humor" bleed over into "unkindness" toward adversaries. I posed the question in a tweet to Arthur C. Brooks. He did not respond.

"YOUR A FUCKING IDIOT"

Recent discourse with a FB "friend."

Hey, I was kind in reply.

"GRATITUDE"

An old friend and former guitar student sent me this link:

Nice, Very nice.
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More to come...

Giving thanks

This year I am truly, humblingly grateful for so many things. First of all, November 28th, 2019 is my 39th wedding anniversary. And, I am blessed to have had the SAVR px last year that enabled me to be here to celebrate it. I am grateful for my grandson Keenan, and the new one soon to arrive. I am grateful for my soon-to-be-dad son Matt and his Eileen, and am blessed to have had my sorely missed late daughters Sissy and Danielle.

I am grateful to all of you who continue to show up here and read these sometimes obtuse rants.

Have a happy and safe holiday.

UPDATE: Is there a "neuroscience of kindness?"
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Nurtitional psychiatry?

Watching CBS Sunday morning. Saw this segment.

Globe-trotting photographer Dave Krugman feels at home no matter where he is in the world. But he hasn't always felt comfortable inside his own head.

He's had issues with depression, even as he was building an Instagram following of about 300,000. "It wasn't matching up with the way I was feeling about life, which was, like, that I wasn't enjoying my day-to-day life, really," he said. "I wasn't."

He tried therapy, then anti-depressants, and finally ended up with an unconventional psychiatrist who posed an unconventional question: What did he eat for breakfast, lunch and dinner? 

And thinking about what he put in his mouth really opened his eyes: "It made me realize I would just eat whatever popped into my head at that moment. Like, 'Oh, I'll go get some ramen. That sounds great.'" 

"Chocolate cake?" asked correspondent Susan Spencer. 

"Yeah! Yeah, chocolate cake!" 

Psychiatrist Drew Ramsey, who is Krugman's doctor, said, "Food is medicine. Food is brain medicine. In your everyday life, the number one factor that you have control over in terms of your mental health is at the end of your fork."

His specialty is the daily special, and how it affects your mind. Dr. Ramsey calls this growing new field "nutritional psychiatry."...

From the National Library of Medicine:

Nutritional Psychiatry: Where to Next?

The nascent field of ‘Nutritional Psychiatry’ offers much promise for addressing the large disease burden associated with mental disorders. A consistent evidence base from the observational literature confirms that the quality of individuals' diets is related to their risk for common mental disorders, such as depression. This is the case across countries and age groups. Moreover, new intervention studies implementing dietary changes suggest promise for the prevention and treatment of depression. Concurrently, data point to the utility of selected nutraceuticals as adjunctive treatments for mental disorders and as monotherapies for conditions such as ADHD. Finally, new studies focused on understanding the biological pathways that mediate the observed relationships between diet, nutrition and mental health are pointing to the immune system, oxidative biology, brain plasticity and the microbiome-gut-brain axis as key targets for nutritional interventions. On the other hand, the field is currently limited by a lack of data and methodological issues such as heterogeneity, residual confounding, measurement error, and challenges in measuring and ensuring dietary adherence in intervention studies. Key challenges for the field are to now: replicate, refine and scale up promising clinical and population level dietary strategies; identify a clear set of biological pathways and targets that mediate the identified associations; conduct scientifically rigorous nutraceutical and ‘psychobiotic’ interventions that also examine predictors of treatment response; conduct observational and experimental studies in psychosis focused on dietary and related risk factors and treatments; and continue to advocate for policy change to improve the food environment at the population level.

Keywords: Diet, Nutrition, Depression, Psychosis, Mental disorder, Neurodevelopment, Neurodegenerative, Nutraceutical, Prevention, Treatment

Interesting. On the subject of food and health more broadly, I wrote this 21 years ago in my "One in Three" essay about my late elder daughter.

A Healing Burger
Or, the "healing pizza/chocolate shake/friesî? One day not long ago, after we'd visited with a pleasant, seemingly intelligent woman of recent acquaintance who had also endured a long struggle with cancer and was committed to a "holistic healing" regimen, I ribbed Sissy that we ought cruise down Sunset for lunch, specifically to order some "healing burgers," -- my facetious reaction to having been cut off mid-sentence the prior evening after uttering the phrase "fruit juice" in the course of responding to a query concerning Sissy's daily diet. "Oh, no! No fruit juice!" "No sugar!" "No fat!" "No meat!"

The magical quality that "holistic" evangelists impute to various vitamins, herbs, and certain foods (the latter for both good and ill), frequently shouts down the more circumspect and common-sense notion of an adequate and balanced diet. In my mind I parry their personal anecdotes with the equally anecdotal evidence of the long and mostly healthy lives of the large extended family comprising my in-laws. Most of these rural northern Alabama farmers manage somehow to live into their 90's despite life-long daily breakfast doses of sausage and eggs with biscuits and gravy-- along the rest of the typical meat-laden, putatively carcinogenic and arteriosclerotic farm fare that would make a brown rice zealot shrink in horror.

Most of these dietary-herbal and related recuperative obsessions ring resonant with the "bargaining" stage of Elizabeth Kubler-Ross's dying process model. Please, Lord, I'll change my indulgent, unhealthy ways, please-- just spare my life! See, I'm doing my herbal/ carrot juice/ seaweed/ colonic/ aromatic/ crystalite/ meditative/ mega-vitamin/ macrobiotic/ psycho-spritual penance; please, please spare my life!

Yeah. But nutrition science has come a long way (though it has yet to find its way into EMRs). My only reflexive concern is that we're likely to be inundated with all manner of money-grubbing quackery around "nutritional pyschiatry."

"Food is medicine. Food is brain medicine. In your everyday life, the number one factor that you have control over in terms of your mental health is at the end of your fork."

The assertion has intuitive appeal. Rigorous clinical establishment of broad efficacy, though, is as yet a work in progress.

YET ANOTHER BOOK TO STUDY AND ASSESS?

Excerpt link here.

See also "Mosconi's Brain Food Diet." Read through the hundreds of post-article comments, too.

OTHER FACTORS

Beyond nutrition, there's exercise, and other stuff going to psych stressors:

Dysfunctional sleep patterns, work-related stress, and the gamut of chronically unresolved psych issues, etc.

I'd add to those factors things such as social isolation and poverty. All of these elements contribute overlappingly to suboptimal psych well-being. Health IT is not capturing it all very well.

UPDATE: CLIMATE CHANGE AND MENTAL HEALTH

Per Medium.com:

Uncovering the Mental Health Crisis of Climate Change

The young man believed he only had five years to live. “Not because he was sick,” said Kate Schapira, “not because anything was wrong with him, but because he believed that life on Earth would be impossible for humans.”…

Over the coming decades, rising temperatures will fuel natural disasters that are more deadly than any seen in human history, destabilizing nations and sending millions to their death. Experts say that we need to prepare for a hotter, less hospitable world by building sea walls, erecting desalination plants and engineering crops that can withstand punishing heat and drought, but few have considered the defenses we need to erect in our minds. Some, like Shapira, have called for more talking, more counseling to process our grief. But will that be enough? Climate change will do untold violence to life on this planet, and we have remarkably few tools to deal with its emotional cost…

Mental health professionals are just beginning to grapple with this fact. Renee Lertzman, a psychologist who studies the mental and emotional dimensions of climate change, believes few people have managed to process their grief about the slow decay of life on Earth. She said that many people are caught in “a state of arrested mourning,” what she calls “environmental melancholia.”

“The reason why, I think, we have a pervasive environmental melancholia is directly related to the fact that we’re not really talking about this,” Lertzman said. While psychologists have developed ways of grappling with the death of family member or the loss of job, experts are still learning how to dislodge anxieties about climate change…

I will soon be 74, a first-wave baby-boomer. The U.S. population has doubled across my lifetime to date. World population has more than tripled.

My country comprises 4% of world population, and consumes 25% of its resources. Notwithstanding its unsustainibility, the reactionary America-Firsters currently in control of my government are bent on rapaciously plowing ahead full-bore with a dirty extractive fuel-driven incumbent status quo economic regime.

When I was a kid the world seemed inexhaustibly immense, and there for the taking.

My, how times have quickly changed. See my "Covering Climate Now" posts. And, again, ponder the bracing import of Frase's "Quadrant IV."

Despite my indelible residual grief over losing both of my daughters, my mental health is fine (and, 15 months out of open heart surgery, I'm--poignantly--back on the basketball court). But, I cannot but fret about the world my kids (and soon-to-arrive new grandson) will inherent absent concerted, effective mitigating climate action.

The Dr. Lertzman cite led me to this:

Two more books.

Click either cover image for the Amazon links. Twitter link to Lesley Head here.

Don't be depressed. Be pissed, and motivated to act.

SPEAKING OF "DEPRESSING"

One of my current reads.

Again, Amazon link embedded in the cover pic. This one goes to my AI tech riffs, to which I will be returning soon. to wit,

The Power of Unintended Consequences

Neither Alfred Nobel nor Mikhail Kalashnikov anticipated how their inventions would be used for disruptive political violence. In the same way, the creators of the Internet, social media, and the many new and emerging technologies today have not foreseen the nefarious uses to which they’re being put. 

Today’s period of innovation is comparable to the explosive era of open technological innovation at the turn of the nineteenth century, and arguably even more potentially disruptive. Current and emerging technologies were not consciously designed to kill, as the AK-47 was; they are just as subject to popular whim, more tailored for attention-getting, and more wide-ranging in their potential applications, both good and bad. Because the current technological revolution is an open one, and because there is again so much money to be made by the diffusion of the new technologies, they have again spread rapidly and will continue to do so. Due to their accessibility and ease of use, clusters of new technologies will be combined in novel ways that are unanticipated. 

In the next part of the book, we will use the insights introduced in the first two sections to examine how today’s new and emerging technologies are already being used to raise the stakes of political violence, by enhancing the mobilization and reach of surprise attacks. We’ll also investigate how emerging breakthroughs in autonomy, robotics, and artificial intelligence may be harnessed for even more potent leverage...

Cronin, Audrey Kurth. Power to the People (pp. 167-168). Oxford University Press. Kindle Edition.

MORE...

In bleak report, U.N. says drastic action is only way to avoid worst effects of climate change
“We need to catch up on the years in which we procrastinated,” a top official says.

The world has squandered so much time mustering the action necessary to combat climate change that rapid, unprecedented cuts in greenhouse gas emissions offer the only hope of averting an ever-intensifying cascade of consequences, according to new findings from the United Nations…

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More to come...

"Peak human intelligence?" Are we nearing it? Have we passed it?

Recently encountered at The Neurologica Blog:

There is an interesting article at The Conversation asking the question – have humans reached peak intelligence? ... [A]re there ultimate limits to the ability of humans to think, understand, and hypothesize? If so, are we approaching that limit now? ... [I]s there is limit to our ability to manage complexity (as opposed to just comprehending reality)?...

Some might sadly conclude that we've passed peak intelligence, at least in some demographic strata.

Are the tails of the IQ bell curve distribution getting fatter ("kurtosis")? Asymmetrically so (epistemically skewed, with a thin upper tail of "cognitive elites" and a lower "fat tail" comprised of a "Dunning-Kruger" demographic)?

More from Neurologica:

...The article essentially focuses on what we are capable of when thinking clearly, but humans do not always think clearly. We therefore backslide and this also hampers progress. One question is – is the ratio of progress to backsliding changing over historical time? Will this also reach a point of equilibrium?...

...[W]e are also developing artificial intelligence. Whatever you think about the current state and the rate of progress of this endeavor, we are steadily developing more and more intelligent machines, and eventually we will very likely develop general AI with capabilities beyond humans. We may be able to evolve intelligent machines and select them for their ability to solve scientific mysteries...

I will have more to say about "AI" in the foregoing context shortly. See my prior post "Ethical Artificial Intelligence?" for now. Author Flynn Coleman in particular argues that our AI advances may well result in the "birth" of a "new species," one (or more?) with "cognitive" abilities far exceeding those of humans.

Highly recommend you read The Conversation piece in its entirety. Quoting from it:

Will science ever be able to provide all the answers? Human brains are the product of blind and unguided evolution. They were designed to solve practical problems impinging on our survival and reproduction, not to unravel the fabric of the universe. This realisation has led some philosophers to embrace a curious form of pessimism, arguing there are bound to be things we will never understand. Human science will therefore one day hit a hard limit – and may already have done so.
...
Some questions may be doomed to remain what the American linguist and philosopher Noam Chomsky called “mysteries”…

 Well, "two cheers for uncertainty." Two cheers for the "mystery."

If we all knew everything, there would be no point in living, no need for curiosity, for inquiry, for science. It would essentially all be "history" (or, for some people, the "Godhead"). Think about it. Why would you ever even bother to read a book, watch a movie, go to a ball game, take a trip, launch a startup, or whatever? Many uncertainties resolve into verifiable knowledge. Some do not (or have not yet). It's the process of sentient experiential inquiry that really comprises worthwhile living.

Ahhh... what do I know? (Q: Is being God boring? Or does that very question simply reflect a speciocentric, anthropomorphic projective neurosis?)

Tangentially apropos,

LOL.

Back to The Conversation piece:

…Biologically, we are no different than we were 40,000 years ago, but now we know about bacteria and viruses, DNA and molecules, supernovas and black holes, the full range of the electromagnetic spectrum and a wide array of other strange things.

We also know about non-Euclidean geometry and space-time curvature, courtesy of Einstein’s general theory of relativity. Our minds have “reached out” to objects millions of light years away from our planet, and also to extremely tiny objects far below the perceptual limits of our sense organs. By using various tricks and tools, humans have vastly extended their grasp on the world…

Yeah. But, if you're seriously reflective with respect to the import of the word "infinity," the universe will always exceed our "grasp," given our finitude. So, again, Two Cheers for Uncertainty.

"One hopes not only for the courage of one’s convictions, but also for the courage of one’s doubts in a world of dangerously passionate certainties." - the late Eric Sevareid, Not so wild a dream.

CODA

Full disclosure on my "Two Cheers for Uncertainty" riff.

14.4 Two Cheers for Uncertainty 

Imagine a life without uncertainty. Hope, according to Aeschylus, comes from the lack of certainty of fate; perhaps hope is inherently blind. Imagine how dull life would be if variables assessed for admission to a professional school, graduate program, or executive training program really did predict with great accuracy who would succeed and who would fail. Life would be intolerable—no hope, no challenge. 

Thus, we have a paradox. While we all strive to reduce the uncertainties of our existence and of the environment, ultimate success—that is, a total elimination of uncertainty—would be horrific...

Hastie, Reid. Rational Choice in an Uncertain World (p. 331). SAGE Publications. Kindle Edition.

One of my long-time favorite books.
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More to come...

et Tua?

Alabama star QB Tua Tagovailoa is out for at least the remainder of the 2019 season. His football career may be over.

Ours is an enthusiastic college football house. Specifically a "Roll TIDE!" house. My Alabama native wife is 'Bama Class of '72. She knew Bear Bryant and knew and worked for Joe Namath. We met at Joe Namath's Restaurant in Birmingham in 1974 when I was on tour playing guitar for Merillee Rush during my musician life.

I seriously owe ya, Mer'.

My Alabama extended family in-laws are also full-tilt 'Bama fans. This Damned Yankee, a subsequent 1985 Tennessee grad, has long gotten over my Vols' chronic SEC and national ranking subordinate status. Roll Tide, it is.

I have always loved football. Played varsity center in high school (where I got my butt severely kicked every week, as the smallest center in the conference at 5'10" and 165 lbs). When I was young, the NFL kept my rapt attention. As I've aged, though, pro ball has taken a back seat to college ball. The high-energy enthusiasm of kids with everything on the line, most of whom will never go on to pro leagues.

Of course, like most people, I am always aware of the significant injury risks associated with football (and the other "collision sports"). Concussion gets all the media ink (impelling some to Quixotically call for banning college football), but Tua's injury is terribly serious as well, and could well end his storied football days (he'd been touted to be a NLF 1st round draft pick). His hip was dislocated, and he suffered a complicating posterior wall fracture.

I'm sure he will get A+ medical treatment.

I tweeted:

Will @UofAlabama continue to honor Tua’s scholarship should his injury end up being career-ending? @AlabamaFTBL @UA_Athletics @espn @NCAA @aldotcomSports

— Bobby Gladd (@BobbyGvegas) November 17, 2019

Most people are blithely unaware that NCAA "full-ride" college athletic scholarships can be revoked in the wake of serious injury, and that they are typically contingent on a yearly basis.

I'll be watching what happens to Tua closely. Hoping for a full recovery as quickly as possible, and his return to the game.

UPDATE

Just in at STATnews:

Concussions, broken bones, and more: a week of football in the U.S.
By KATHLEEN BACHYNSKI, LISA KEARNS, and ARTHUR CAPLAN NOVEMBER 27, 2019

News about concussions and other injuries to young football players appears with alarming frequency, as do reports of the long-term damage to NFL players.

Young pro players are leaving the game for fear of permanent harm to their brains and bodies. Last month, Joshua Perry discussed his retirement at age 24 after suffering six concussions. He’s following in the footsteps of A.J. Tarpley, who retired at age 23, also because of concussion concerns.

In March, USA Today called for a ban on tackle football for kids under 14, and one month later the journal Pediatrics reported results from a survey in which a majority of parents who responded supported age restrictions on tackling…

"WE WERE JUST LITTLE KIDS, MOX"

Great movie. Raunchy, profane (NSFW), and over the top slapstick, yeah, but spot-on serious message.

NEUROTRAINER

Recall my niece's husband Jeff Nyquist is a VC-funded startup CEO.

Among their technologies are concussion risk mitigation and remediation tx in the collision sports. I've sent Jeff and April the STAT article link. I follow their progress and cite them episodically.
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More to come...

Baltimore's unhappy YTD 300

Today is Day 317 of 2019, 300 murders within the city limits thus far YTD.

Draw a mental vertical line down from the "W" in "TOWSON" to just south of the northernmost black dot. That's where we now live. Homeland District just west of the 5400 block of York Road. Our affluent, bucolic Colonial and Tudor "Shire," a mere few blocks from random (and distressingly frequent) violent mayhem clusters.

Some locals get pissed when I allude to "The Wire" on social media apps such as Nextdoor.com (which can get episodically overpopulated with pearl-clutching melodramatists decrying their why-doesn't-somebody-(else)-DO-something? proximity to the Bmore "War Zone").

Whatever. I sometimes simply retort that I've raptly watched every episode of all 5 Wire seasons at least a dozen times (it has gritty veritas out the wazoo). Moved here anyway, to be close to my son and his fabulous Eileen. No regrets whatsoever.

Notwithstanding, today denotes a very sad YTD round number milestone, just shy of a murder a day. That's just within the city. Wonder what the aggregate metro tally is?

UPDATE

Just heard on CBS affiliate WJZ local news that the Baltimore city YTD tally of non-fatal shootings is 692. So, about 3 episodes of (mostly) gun violence per day in the aggregate. Ugh.
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More to come...

Is aging preventable? Any credible science?

I'm soon to be 74. Some days, increasingly (notwithstanding my now being back on the hoops court 14 months after my open heart surgery), I feel like the guy on the above right, holding his aching lower back and leaning on his cane. But, hey, "check ball."

Comes a book review at Science Based Medicine.

We are living longer, but not much better. The average lifespan has increased, but the limit has not. 95% of people are dead before 100, and almost no-one reaches 115. The years at the end of life are filled with suffering and illness. Conventional wisdom tells us we will all experience a decline as we age, and we will all eventually die. Ben Franklin said nothing is certain but death and taxes. But what if death is not certain? What if we could stay healthy and live forever? Science is investigating some intriguing clues suggesting that aging and death may not be as inevitable as we thought.

David Sinclair believes aging is a disease, the most common disease, and he believes it should be aggressively treated. His book Lifespan: Why We Age and Why We Don’t Have To was published in September 2019. A PhD professor and researcher at Harvard Medical School and cofounder of the journal Aging, he is well informed. He explains how recent scientific breakthroughs have reversed the effects of aging in animal models. He has applied many of the scientific findings to his own life…

I've not bought this one yet. The SBM review seems excellent, thorough, appropriately critical.

Not all readers are amused. A 1-star Amazon review:

This is one of the latest self-promotion books by authors affiliated with Harvard and other once respected American academic institutions. Only small parts of the book actually address the questions posed in the title: "Why We Age--and Why We Don’t Have To." These questions are addressed in more concise form in various You Tube videos featuring the author (among other sources), and in more reliable form in publications by other investigators of foundational research in peer reviewed journals.

The remainder of the book involves numerous autobiographical interjections and discussions of various political (or politicized) topics including the environment, vaccines, the American health care system, nutrition and sustainable diets, over-population, and the social issues associated with an increasingly aged population in the developed world.

Overall, one cannot help being impressed that a man like the author, who reports working so hard within his field of expertise, could also become such a purported expert on so many other topics! However, readers who purchase this book because of an interest in the biology of aging may be disappointed or annoyed by the onslaught of unsolicited opinions presented by the author, in part due to the lack of foundation for the opinions, as well as the general absence of originality. Most of these opinions line up obediently with tired leftist cliches that have infected academia over recent decades. Beyond that, the reader will not be surprised to find that the author strongly supports the use of longevity increasing techniques (should his work out), notwithstanding the social and ethical issues that result.

Likewise, the reader will not be surprised at the author’s extended argument that aging should be classified as a “disease” so that more funding for his type of research will be made available. For the time being though, the reader may just have to purchase and ingest various supplements promoted by the author (in which he may or may not have some business interest)--although there is currently no human research showing the efficacy of these supplements to increase longevity. I guess, from the author’s perspective, this is in some sense “visionary.”

The book does summarize some of the author's animal-based research. The author should disclose, clearly and completely, any and all financial interests (direct and otherwise) in the supplements he discuses for increasing longevity or other purposes. The author uses his relationship with Harvard to promote the book and his Harvard-based research, apparently with the school's consent. Harvard itself, through its administrators, has an obligation to insist on appropriate disclosures that comply with applicable professional and ethical standards. (Providing a laundry list of entities that the author has some affiliation with does not meet these standards.)

Those who read this or any other author’s book or published research regarding supplements should be able to determine whether the author or those who fund his research have a financial interest in the promotion of those supplements. This general principle is especially applicable in the case of this book, given the author's history. Over a decade ago, the author began promoting resveratrol through various business entities which he founded and/or has had a financial interest.

Of course, the author is not just another hustler pushing the most recently hyped supplement. After all, he is a Harvard Man (he references his association with the school dozens of times in the book), and refers to his products not as mere supplements, but rather euphemistically as “molecules.” While the potential relationship between resveratrol and longevity was widely recognized when the author began selling it as a supplement, his optimistic promotion of that “molecule” was unique among serious investigators given that its very limited bioavailability in humans was also widely recognized. There is still no evidence supporting claims that supplementing with resveratrol enhances longevity in humans. There is, however, ample clinical experience that this “molecule” causes diarrhea in many people. So although the author’s former customers may not spend any additional time on the planet, many of them probably did did get some extra time in the bathroom.

Ultimately, this book might be a worthwhile read for someone who enjoys sophomoric socio-political monologues, expects to live to be 150 years old or longer (as the author maintains will be imminently possible), and is looking to kill some time.

Ouch.

Usually, when I'm considering buying a new book, I look at negative reader reviews first. Many times they are show-stoppers. Not always, but often.

Two prior reads seem relevant: "Elderhood" and "Can Medicine Be Cured?" How about "A billion tons of human bones"?

 UPDATE

My latest issue of AARP Bulletin came in the mail (may be paywalled).

 

 

Could Decreasing Inflammation Be the Cure for Everything?
Managing your body's immune response is key to diseases of aging
Mike Zimmerman, AARP

It hardly sounds serious at all. An inconvenience, perhaps, like maybe a mild fever or a creaky joint. In the lexicon of aging and disease, there are far more worrisome words: cancer, heart disease, dementia, diabetes. But researchers have suspected for years that all of these health issues, and more, have at their heart one common trigger: low-grade inflammation. And now they may finally have proof.
   
Cardiologists in Boston have reported on a clinical trial with more than 10,000 patients in 39 countries (mean age: 61) that tested to see if an anti-inflammatory drug could lower rates of heart disease. They discovered that it could. But they also found that the same drug, canakinumab, reduced lung cancer mortality more than 77 percent, and reports of gout and arthritis (conditions linked to inflammation) also fell.

"Inflammation plays a role in everyone's health,” says Dana DiRenzo, a rheumatologist and instructor of medicine at Johns Hopkins University School of Medicine in Baltimore. When inflammation levels increase, so does the risk of disease. But understanding inflammation can be tricky because, when you get a disease, inflammation levels naturally increase as your body fights the condition. Inflammation, in other words, is both good and bad.

Given how crucial this issue is to your health, AARP spoke with some of America's top experts in the field, pored over the latest studies and created this guide to understanding — and overcoming — inflammation…

@zimwrites: What would the Principals at https://t.co/7FWo2dbTuF say about your AARP Bulletin article on “inflammation?” (“The Cure for Everything”) Thinking about citing it on my KHIT blog. The headline is a yellow flag. @ScienceBasedMed @sciencemagazine @AARP @AARPMedia @NIH

— Bobby Gladd (@BobbyGvegas) November 13, 2019

TOPICAL UPDATE 

From Naked Capitalism:

Millennials’ Health Deteriorating, Projected Mortality Rates Higher Than GenX; “Deaths of Despair” a Major Culprit

Posted on November 14, 2019 by Yves Smith

You thought deaths of despair were an affliction of deplorables. Silly you. In case you weren’t paying attention, young people are under a lot of stress too and many don’t have reason to think their state will get much better. Short job tenures and the rise of McJobs mean not just uncertain incomes, which are bad enough, but weak social attachments due to shallow relationships with co-workers and often too little discretionary income to mix regularly with contemporaries. Student debt is another major source of anxiety. We’ve also written, virtually from the inception of this site, that high levels of income inequality are bad for health, even for the wealthy. 

And the reality of the accelerating effects of global warming weighs more on the young than the old, who can hope to die before serious dislocations kick in. The Jackpot is indeed coming.

Psychological, income, and time stress have knock-on health effects, including depression, poor coping mechanisms (alcohol and substance abuse; overeating), lack of time and/or money to take care of oneself well (good diet and exercise, as well as stress reducers like vacations and spending time with friends). And no or crappy health insurance means a lot of people who would benefit from health treatment or therapy won’t get it or won’t get enough. Look at the stories of deaths from inability to afford insulin...

Read all of it, including the comments.

DIVERGENT ERRATUM

Venice, Italy today:

 apropos of my "Covering Climate now" posts.
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More to come...