Desert of My Real Life

Media outlets of all types see April 1st of each year as a time to play with their audiences.  These stories rarely “catch” me because they typically have to be so outrageous that it’s clear from the outset that they are April Fool’s Day jokes.  This morning, however, National Public Radio ran a minute and a half long story that totally caught me.  I spent about 60 seconds planning my blog response to it.

The story is about the fact that 3D viewing technology has really exploded in the entertainment market but the technology still requires us to wear cumbersome 3D glasses.  An opthamologist claimed to have pioneered an eye surgery that would allow us to watch 3D entertainment without having to wear those glasses.  They even had one of the first people who had the surgery talk about how great it was to watch Gnomeo and Juliet in 3D without those glasses.  The line of the story that really made me want to respond was about how this surgery would allow us to live in a 3D world.  In my head, I was yelling “We already live in a 3D world!”  And that was the moment that I knew it was an April Fool’s Day joke.  The beauty of this story is that it mimicked real stories of this type, where people do crazy things to further immerse themselves in online entertainment.  I’ve been reading a bunch about how Reality is Broken and what we can do about it so this story didn’t seem particularly far-fetched to me.  Good job, NPR!

{January 26, 2011}   No Posts

I have been sick for about 10 days.  With what started out as a cold.  It still amazes me that, with all our sophisticated technology, we cannot figure out how to cure the common cold.  And then for me, the common cold typically turns into a sinus infection.  I am allergic to many of our modern antibiotics (including penicillin) and so I really try not to take antibiotics for sinus infections.  I have an arsenal that I employ against sinus infections but it sometimes take longer than otherwise to get rid of them.  I say all of this to explain why I have not yet posted this year (which of course is 26 days old).  I assure you that I have several posts in the works and will post them very soon now.  Stay tuned.

{April 17, 2010}   The Common Cold

I have a cold.  It is a very common cold.  Nothing special.  Just enough to make me want to sleep at 2 in the afternoon.  We can land humans on the moon and yet we can’t cure the common cold.

Coincidentally, yesterday’s RadioLab podcast was indirectly about the common cold.  The podcast was about complexity and the limits of human understanding.  When we have complex systems, with many parts that interact and affect each other in complex ways, it is difficult for humans to make sense of the chaos.  Despite its commonness, the common cold is one of these complex systems.  The way that the cold virus interacts with the genes and proteins and other parts of the human body is extraordinarily complex.  The human brain cannot make sense of such a large number of interactions.  We have a limited capacity for understanding these kinds of interactions.

And so, according to RadioLab, we build robots.  My sense is that these are artificial intelligence tools which map the interactions and attempt to create mathematical equations to model those interactions.  And we have been successful in creating the equations that model those interactions.  The problem is that we don’t understand the equations.  We recognize that the equations are correct in the sense that they can predict the future.  That is, given new data, they can predict the consequences on other variables in the system.  These kinds of tests are common in neural networks, an artificial intelligence technique that attempts, in a limited sense, to model the human brain.  One of the ways that we test whether a neural network has been created correctly is to measure its ability to generalize, to predict the results of new data.  The problem with neural networks is that they can’t tell us WHY they predict what they predict.  Instead, they create mysterious, almost mystical equations to predict the consequences of new data, to predict the future.  But we can’t understand these equations.  We know that the equations tell us that when one variable goes up another variable goes down by some fractional amount.  But we don’t understand why.  We cannot make sense of the equations.  And so researchers are pushing our tools to explain themselves.  To tell us why one variable goes up when another goes down or vice versa.  Interesting.

And still, I have a cold.  I know how this virus manifests itself in my body.  But no one yet understands why.   Or how to cure it.

{January 23, 2010}   Influenza Epidemics

My grandmother will turn 92 this April.  If you do the math, you will see that she was born in 1918, a year in which hundreds of thousands of Americans were killed by an influenza epidemic.   In October, 1918,  in the midst of World War I, 195,000 Americans died of the flu, making it the deadliest month in American history.  The flu killed the most robust of people who contracted it.  Soldiers were among the hardest hit, both in Europe and in the United States. I figure that I’m lucky to have ever been born, given that my grandmother was six months old, with little immune defenses against one of the deadliest influenza epidemics in modern history, in this deadliest month.  A bunch of coincidences have brought this flu epidemic to my mind in recent days.

As I have written about in earlier blog posts, I recently bought a Kindle.  One of my favorite authors is Dennis Lehane (a Boston author who wrote Mystic River, among other great novels) and so the first work of fiction that I’ve been reading on my Kindle is The Given Day, Lehane’s novel set in 1918.  It focuses on labor and race issues set against the deadliness of the flu epidemic of that year.  I haven’t finished the novel yet, but so far, it has been informative and enjoyable. 

As I have also written about in earlier blog posts, I decided to get the flu vaccine this year.  The swine flu was predicted to have been the deadliest since 1918 although it has turned out not to be.  The reasons for its relative mildness are not yet known but perhaps one thing is that we now understand how the flu is spread.  And of course, we do have vaccines that are quite effective.

The other night, PBS showed a documentary about the 1918 influenza epidemic.  The documentary details the devastation of the flu as well as the doctors who fought against.  They developed a vaccine which didn’t work because they were focused on bacteria and the flu is viral.  Little was known about viruses in 1918.  Luckily, according to the documentary, “As mysteriously as it had come, the terror began to slip away.”  It had virtually disappeared in Boston by early November.  Armistace Day (Nov 11) brought end to war in Europe and the worst of the epidemic was passing.  It appears that the flu ran out of “fuel”–people who were susceptible.  Survivors developed immunity.  550,000 Americans had died in the 10 months of the epidemic.  At least 30 million people around the world had died.  Nearly every human being on Earth was infected with the virus and therefore developed immunity.  And that probably explains why the swine flu of 2009, although not as deadly as predicted, didn’t hit elderly people very hard.  They had developed immunity from previous exposures.

An interesting side note to this story is that I had lunch with my grandmother today.  She lives in an elderly housing building in Goffstown, NH, where she, and my father, and I, all grew up.  This was the building that she had gone to high school in, and my father had gone to junior high in, and I had gone to 5th and 6th grade in.  When it was no longer needed as a school, it was renovated into apartments for the elderly.  She noted today that she graduated from high school in 1935 (at the age of 17 since she had skipped a grade when she was the only student in her grade in her one room school house).  This is the 75th anniversary of her high school graduation, a high school that was located in the building in which she now lives.  I asked if her class was going to have a reunion.  She said probably not, since she is one of only two of the sixteen she graduated with who are still alive.  And the other woman, who is nearly two years older than my grandmother, is not in very good health.  So no, they will probably not get together to celebrate their graduation from high school 75 years ago.

Life goes on and on and on.  And I’m struck by the arbitrariness, the luck, of it all.

{November 29, 2009}   H1N1

I had my annual physical last week and my nurse practioner mentioned that they had an abundance of the H1N1 flu vaccine.  Because I have asthma, I almost always get the regular, seasonal flu vaccine.  In addition, flu (probably both H1N1 and the seasonal flu) is running rampant on our campus right now.  So I decided that I would get the H1N1 vaccine.

There has been a lot of controversy about the H1N1 vaccine.  Most of the discussion of risks has been focused on Guillian-Barre Syndrme (GBS) which is a disorder in which the body’s immune system attacks itself, causing weakness and potential paralysis.  No one really knows what triggers GBS but occasionally someone will get it after having had a vaccination.  By “occasionally”, I mean one in one million.  So for every million vaccinations given, one person will develop GBS.  Two or three percent of people who develop GBS will die and about twenty percent never recover.   There is no known cure for GBS and so this potential risk is causing lots of people to refuse vaccination for themselves and their children. 

Meanwhile, the risk of death from H1N1 is one in one thousand.  Humans are particularly bad at measuring statistical risks, especially when faced with media hype concerning events that are out of the norm.  Although every person has to decide for herself whether to get vaccinated, it seems to me that the risk of contracting GBS is very very small and should not be the reason to avoid the vaccination.

Another reason that people are giving for not getting vaccinated is that somehow they believe that this vaccination has been “rushed through” the safety checking phase of its development.  The reasoning goes like this.  Drugs take years to develop and test for their safety.  The H1N1 vaccine didn’t take years to develop since we only learned about the appearance of H1N1 last year.  Therefore, the safety testing must have been skipped.  Therefore, the vaccine is likely to be unsafe.  The problem with this logic is that it ignores the fact that the H1N1 vaccine was developed and tested using the same procedures that are used for the seasonal flu each year.  Each year, scientists anticipate the mutation of the flu virus and manipulate the previous year’s vaccine to address this mutation.  This is exactly what was done to develop the H1N1 vaccine.  The risks of the seasonal flu vaccine are not zero but they are very very small.  I would take this to mean that the safety risks of the H1N1 vaccine are also very very small.  In fact, the chance of dying from the vaccine is much smaller than the chance of dying from the flu.

The final major reason people give for not getting the H1N1 vaccine is that it contains thimerosal, a form of mercury that is used to prevent bacterial infection of the vaccine.  Mercury is toxic to humans and so, the reasoning goes, this preservative is toxic to humans.  Thimerosal is less toxic than other forms of mercury.  Extensive studies have shown that there is no difference in the occurrence of problems when someone receives a vaccine with thimerosal than when they receive a version of the vaccine without thimerosal.  This may still not convince people that the vaccine is safe so you should know that there are three forms of the vaccine and only one contains thimerosal.  The nasal spray version of the vaccine does not contain thimerosal.  Neither does the version of the vaccine that comes in single dose vials.  Only the version of the vaccine that comes in multi-dose vials contains this protection against bacterial infection.  So if you’re worried about thimerosal, ask for a version of the vaccine that doesn’t contain it.

As I said, I got the H1N1 vaccine last week.  I have had absolutely no complications from the shot, not even a sore arm.  And I’m protected against H1N1.  In my mind, that’s not a bad deal.

Unless you have been on an island somewhere lately, you probably know that Eunice Kennedy Shriver has been hospitalized for the past few days and died this morning at age 88.  The achievement she is most well-known for, of course, is founding the Special Olympics.  She often cited her sister Rosemary as the inspiration for founding the Special Olympics, a fact that has been mentioned many times in the past few days.  I heard an interesting comment about Rosemary on NPR today.  The reporter said that Rosemary herself lived a very long life but had to be institutionalized for much of it because of her mental retardation.  I think this is actually a false statement. 

By all accounts, Rosemary’s mental retardation was mild.  In fact, there is some dispute as to whether she was mentally retarded at all.  But as an adolescent and young adult, she had violent mood swings and became difficult to control.  Her parents heard about a radical new procedure that could mellow out those mood swings and met the man who performed the procedure.  The man they met was Walter Freeman, whom I have written about before.  He popularized the lobotomy in the United States and performed thousands of them, including one on Howard Dully when Dully was twelve years old.  Dully went on to write the amazing memoir My Lobotomy, revealing that he probably is able to function as well as he does precisely because the procedure was performed when he was so young and his brain was able to recover.  Rosemary Kennedy was not as lucky.  Freeman performed the procedure on her when she was 23 years old and it left her with the mental capacity of an infant, incontinent and unable to speak.  She was institutionalized for the rest of her life.  Rose Kennedy (Rosemary’s mother) is said to have considered Rosemary’s incapacitation via the lobotomy to be the first of the Kennedy tragedies.  So it was Walter Freeman and his revolutionary procedure that caused Rosemary to be institutionalized for most of her life, not her mental retardation.

My area of research when I was in computer science was artificial intelligence.  AI is a broad field with many subfields, each of which has many applications.  Within AI, I was particularly interested in pattern recognition via machine learning techniques. When I left computer science, I turned my research attention to the topic of this blog and began to focus more and more on the impact of technology on society and media technology issues.  So I was quite interested this morning when my favorite National Public Radio show, On the Media, broadcast a story that shows the connection between these two research interests.

Pattern recognition sounds like an esoteric subfield of AI.  But in today’s computer-focused society, there are many useful applications of pattern recognition.  For example, I worked on two problems in microbiology while I was a graduate student.  My master’s work involved looking for patterns in strands of DNA of an organism called Onchocherca volvulus which causes river blindness.  We were trying to determine whether we could determine the evolution history and path of the organism to help with understanding the epidemiology of the disease.  For my PhD, I worked on the famous “protein folding problem“, trying to predict the 3-dimensional structure of a strand of protein by looking at just the sequence of amino acids that make up the protein.  The theory is that if we can predict the 3-D structure, we can predict the function of the protein as well and the implications of that are far-reaching.  As I said, there are many practical applications of pattern recognition by computers.

On today’s edition of On the Media, there was a story that reminded me of the fact that pattern recogniton by computers is everywhere in our society.  The story was about a contest by NetFlix, the DVD rental site.  NetFlix allows subscribers to rate movies via a star system, where one star means “hated it” and five stars means “loved it”.  Based on the ratings that a particular subscriber has given a set of movies, NetFlix attempts to recommend other movies that the subscriber will enjoy.  NetFlix’s business model depends on these recommendations since a larger percentage of their movie rentals come from subscribers listening to these recommendations.  Without the recommendations, subscribers would likely run out of movies that they know they want to see and then would eventually give up their subscriptions.  But predicting what movies a person will like is a very difficult problem.  

NetFlix does a pretty good job with their movie recommendation system, Cinematch, but if they can make better predictions, they’re likely to hang on to more subscribers.  So they created a contest, offering a million dollars to anyone who can develop an algorithm that does 10% better in its predictions than Cinematch.  Apparently, a number of groups immediately were able to develop algorithms that were 5% more accurate than Cinematch.  Even getting to 8% more accuracy didn’t take that long.  But a number of intriguing issues made reaching the 10% mark difficult.  One of the most interesting is known as the “Napoleon Dynamite problem.”  Napoleon Dynamite is a quirky, independent movie that came out in 2004.  It seems that it is quite difficult to accurately predict whether a particular subscriber will like or dislike this movie.  In fact, two people whose likes and dislikes are quite similar can disagree drastically about Napoleon Dynamite.  So getting to the 10% mark will probably require a solution to the “Napoleon Dynamite problem.”

The contest closed a couple of days ago, although no winner has yet been announced.  NetFlix says that they received 44,014 entries from 5169 teams in 186 countries.  One of the requirements of the contest is that the winners must disclose their techniques to the world.  Although getting more accurate movie recommendations is not a  life or death problem, the solution to it is likely to provide insight into how to accomplish other pattern recognition tasks.  And that’s good news for all of us.

{June 4, 2009}   Changing Medical Technology

I just finished reading My Lobotomy by Howard Dully and Charles Fleming.  Howard Dully received a transorbital lobotomy (also known as an “ice-pick lobotomy”) when he was 12 years old.  The doctor who performed the lobotomy was the king of transorbital lobotomies, Walter Freeman.  The book chronicles Dully’s life as well as his search, more than 40 years after the lobotomy, for answers as to why this surgery was performed on him.  It’s a harrowing story, especially because by almost all accounts, Dully was a normal kid.  The problem in his life seems to have been his step-mother who for some reason just didn’t like him and was probably afraid of him because he was a big kid.

Antonio Egas Moniz was the pioneer of the lobotomy and in fact, received the Nobel Prize in Medicine in 1949 for his work in this area.  By the late 1950’s, with the introduction of drugs that worked far better than lobotomies, the procedure fell out of favor in the mainstream medical community.   In fact, some have characterized the lobotomy as the biggest mistake ever made by mainstream medicine.  My favorite quote about the lobotomy comes from Norbert Weiner who is the father of cybernetics.  He said on page 148 of his book Cybernetics, “…prefrontal lobotomy …has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier.”

Reading My Lobotomy is an eye-opening experience.  Throughout the entire book, I wondered where the authorities were.  Surely there were adminstrators at the hospitals where Freeman worked who realized that his methods for diagnosing patients as having major psychoses were problematic.  Why did they let him continue to practice for so long?  What about all those doctors that Dully’s step-mother took him to who said he was a fine, normal kid?  Why did none of them recognize that she was going to continue in her pursuit until she found the diagnosis she was looking for?  The problem, of course, is that at the time, a lobotomy could be prescribed for conditions as mundane as “youthful defiance” or even just “moodiness.”  There is no doubt that Howard Dully was a defiant youth.  Reading the book, I get a portrait of him as a really smart kid who was bored in school and who probably had attention deficit disorder as well as an incredible amount of stress as a result of being an abused child.  But the kind of trouble he got into was normal kid stuff and probably could have been dealt with by someone paying a little bit of attention to him and maybe challenging him a little more in school. 

The other question that kept popping into my head was whether things are better now.  Could this sort of thing happen today?  Obviously, there are not a lot of lobotomies performed today but kids are put onto serious psychotropic medicines all the time.  What kind of safeguards do we have in place to protect kids (or adults for that matter)?  Do we require multiple physicians to look at a kid before he or she is diagnosed as schizophrenic or bipolar or whatever?  My guess is that we don’t.  Although it seems like the effects of taking drugs for these conditions would not be permanent in the same ways that having a lobotomy would be permanent, some of the stigmatization that Dully describes would be present and very damaging simply with a diagnosis of schizophrenia or some other serious mental disorder.

One of the most moving parts of the book is the afterword to the paperback edition of the book.  Dully is contacted by two brain researchers to have a detailed MRI taken of his brain to determine the kind of damage that was done by the ice picks.  The researchers suspected they would find little damage because Dully seemed so normal, too normal for someone who has had a lobotomy.  What they found was brain damage that was so significant that if it had been done to an adult, that person would be a vegetable.  But because Dully had the surgery when he was 12, his brain was still maleable.  It adapted to the damage so that after 40+ years, he was a normally functioning adult.  Dully then says that he had always felt burdened by the lobotomy, like something really bad had been done to him as a child.  After the MRI, he realized that he actually was quite lucky that he had the lobotomy at such an early age.  If it had been done even five years later, he probably would never have left the institutions he grew up in.  He would never have had a life with a wife and kids and a job.  So he now sees his life as lucky.  It’s an inspirational shift in perspective, I think, and I’m not sure how many of us would be able to make that shift. 

From a technology standpoint, this story reminds me that we have developed lots of tools that we can use in a variety of situations.  But having the tools doesn’t mean that we should actually use the tools.  And when we do use the tools, we need to put into place significant checks and balances to avoid abuses of power and to protect the powerless as much as we can.  I don’t think we’ve really learned these lessons yet.

By the way, National Public Radio did a 22-minute documentary about Howard Dully back in 2005.  Here’s that story–I strongly encourage you to listen to it by clicking on “Listen Now” in the upper left corner of the page.

et cetera