Wednesday, January 21, 2015


I saw a feral cat the other day, dodging and weaving her way between the bushes. A quick lunge here and a slow retreat there and her day was spent to live another day, to meet another male, to make kittens and spread her progeny around to roam other grounds. Fascinating to that in juxtaposition was the lone parrot housed in a gilded cage looking at the cat through the all glass window. He jumped from paw to paw squawking his meme, “Polly wants a cracker.”

And it dawned upon me how very diverse the universes of these two beings were. One roamed in search of food and the other repeated the rote and was fed. This deliberation clogged the synapsis of my brain for a while. Maybe Polly was the better of the two, sitting all pretty ensconced in his golden cage without lifting a feather, he was satiated just with his rehearsed mantra? Or was he?

Hmm… this was going to be a difficult deliberation.

There is a river close by and I remembered there was sign near its northern bank, which stated in Red on White, “Do not feed the wild birds. If you do they lose their ability to find food for themselves.” Funny I thought what about the emotionally-packed-willing-to-show-empathy individuals who were out there throwing crumbs at the milling flock of seagulls that cackled around, diving, flying and urging their kin to come and partake in the bounty. Were these good-intentioned people not worried about the seagulls dying because of their temporary actions; of creating dependence, that made them (the crumb-throwing people) feel good in their own minds with nary a look at the winter months to come for the seagulls?

Why then would such a sign be put up? Apparently the ecologists had reasoned that if the birds become dependent on the crumbs, they would not survive when no food was offered.  Drawing from that memory, in Taleb’s world the feral cat like the unfed seagulls would be considered “antifragile” a survivor, and the caged parrot, “fragile” much like the " Black Swan" doomed to the ultimate risk, like the turkey near Thanksgiving Day.

Another thought came reeling in, “Why do they call ‘Wild Type p53’ for the normal functioning p53 gene that is considered, ‘the guardian of the genome’ of the human cell, wild?” …Exactly! You got that, didn't you? If the wild type gets mutated it is no longer wild-type but a mutated version and a mutated p53 gene is the arsenal for the most virulent of cancers in the human body. Google that!

Searching for more clues I came across a fight between the Big Blue and Kasparov. it was a very interesting fight between an algorithm-coached machine and a human being. Kasparov the world recognized champion in Chess then, lost the game to the Big Blue in one of the most human vs. machine experiments ever witnessed. Alan Turing, in spite of his " Christopher" would have been proud. At the time the FIDE chess rating of Kasparov was maybe 2800 and Big Blue’s was around 2900. So then as circumstantiality will have it, my mind wandered into the realm of what if we combined the two; the intuit of man and the parallel-processed linearity of say IBM Watson, Big Blue’s new iteration? We might just get an intelligent and better predictive outcome wouldn't we?

In other words, let us combine the feral nature of man and the domesticated algorithm of the computer and lo and behold the outcome in say economic and political forecasting might improve, think Nate Silver. Medical care might improve too. The doctor gets the benefit of the “computer spit” and then adds his or her intuit to qualify or modify those “spit-related-computer-endorsed-actions. But here is the dark abyss in all such actions; the doctor in his or her dependency of the computer spit might and most probably will lose his honed intuit over time, out of sheer laziness, like Polly. The dependency will slowly and inexorably eek out the virtuoso in time. What then? No Beethoven’s 9th symphony, No Mozart’s 40th symphony  , No Newton’s Laws, or Einstein’s relativity, or Feynman’s “O” ring, or Jenner’s Cowpox vaccine, or Fleming’s Penicillin, or Curie’s Radium?

I agree with Eric Topol, MD, the Medscape Editor and author in his own right of two published books that change is necessary and that whether or not we like it, it is coming and those who stand by the wayside will either be forced onto it's path or die of irrelevance, but I have a problem with the thought that we should divest ourselves of our intuit and humanity for the sake of a head long dive into the totality of algorithms. Even if we took all of McCullough and Pitts Neurons, you know the kind with multiple inputs and a single output and fed these "neurons" with all of the Library of Congress information, they would not and could not provide the human reasoning. There is that nebulous thing called intuit, after all; the recruitment of the neural energy and the firing of the electrical impulse is a random and inherently human process! A cautious merger between the two might make for a better world. Relevant information gathering fed to the ceramic-chip-brain and then the gleaned output reasoned with before calling it " Care." 

Which brings me back to medicine: This, Choosing Wisely-Evidence Based Medicine rhetoric is being designed with the linear regressive models that weigh in costs more (the betas) than care for our patients. Maybe we should be careful of how we interpret and use them. There lurks within such hubris, the fallacy of Composite problem. A total subservience by doctors, is akin to the gilded caged parrot. We need the feral nature of the human mind AND the comprehensive knowledge stored within the algorithm couched databases to articulate and best provide for each other when we are patients! The touch of another human being is far superior in alleviating anxiety and pain then the cold feel of a robotic metal-in-human-skin-like-artificial-hand.

The “out of the blue" Eureka moments are non-linear paradigm-changing events and are the realm of the human brain- the random recruitment and firing. 

Ask Archimedes! For that matter ask Turing!

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