Me and my memes

Here's a snippet from the increasingly hypertextual MickeyƂ Kaus: "I don't think the Lehane/Mulholland Arnold-insulted-Arianna-and-all-women meme will go that far, in part because Arianna (unlike Hillary Clinton in the Lazio race) wasn't a major candidate whom viewers were focusing on. The bigger threat to Schwarzenegger, it seems to me, is the Tucker Carlson it-was-a-circus-that-only-helps-Davis meme, propagated also by Phil Bronstein and the S.F. Chronicle. "

Now, I haven't gone and read these Kaus cites. But I wanted to think that my handful of columns weren't reducible to a meme or phrase that I was "propagating." I like to think that every word in the 700-word piece is helping to craft a subtle and complex argument, but often it's not the case. I challenge anyone to sum up my old-man / minuteman piece in less than 10 words, or less than two sentences, without glossing over something major.

And you thought Europeans hated modified food...

Ananova reports on a "power sausage":

"Visitors to Germany's famous October Beer Festival will be kept awake this year with the help of a 'power sausage' stuffed with caffeine.
Inventor, butcher Johann Drexel insists: 'The Breaker sausage picks you up like an espresso.'
The sausage contains just 10% fat, vitamins B1 and B6 as well as caffeine and taurine. Caffeine stimulates circulation, while taurine allows to body to absorb it faster."


Meanwhile, I'm still waiting for my Dilberito.

bye bye baby

I left the wards today with a good feeling, recalling the hard work, happy outcomes, and good relationships. I had an urge to stay on after rounding this evening, just to see what's coming in. Will that urge be stronger or weaker on Emergency, where the variety of patients is so great and potential for calamity more likely?

But I was not that reluctant to go... because I was tired. And it got me thinking of the geneticist, and how Schmee approached college, compared to C.

I was impressed with shadowing the genetics counselor on Tuesday because I saw a kind of medicine (and research) that I had always suspected but had never actually witnessed: looking at a puzzling patient, ordering some labs, and trying to figure out what the kid has. Management is not the issue; there are neurologists and pediatricians working on that. Geneticists are doctors who diagnose, for the purpose of counseling on future pregnancy risks (and to better guide the PCP's management). They live in an interesting realm -- a huge chunk of diseases are readily diagnosable by any doctor, and perinatologists can pick up more in utero. The geneticists have to pore over those remaining malformations triggered either by spontaneous mutations, or extremely rare hereditary diseases.

How rare? OMIM on Jumping Frenchmen of Maine. I thought they were kidding.

So I guess a lot of times, geneticists have got to give up and say, "this collection of bizarre but nonlifethreatening malformations or reflexes are probably unrelated and may not pose much of a risk to future pregnancies beyond the background 3-5%". Other times, they can try to get insurance companies to pay for a $3000 gene test to rule out one possible cause of the child's symptoms.

But sometimes -- and maybe the bulk of a day is spent on these cases -- the doctor collects the observations and labs and experience and starts searching, online or in malformed facebooks -- for the variant of the extremely rare disorder already described. They can find the clues to management and future risk! Or describe all-new syndromes.

How rare is that? I used to think that physicians would be confronted with mystery on a more regular basis. When I was a first-year I wrote up a nice case on a mysterious rash that I concluded must be caused by Nickel allergy. But I understood that that case was one out of a hundred, maybe more. And so far in third year you don't see much that causes you to scratch your head and hit the books. All the decision-trees have been plotted, with percent likelihoods and odds ratios. If it were any other way, docs wouldn't be able to see 30 patients a day (unlike the four I saw on Tuesday. Just four!)

This relates to the contrasting approaches of Schmee and C. Schmee was a perfectionist and would rest up, mentally and physically, before tackling a big project. I do this too, and not just with academics -- housework, letter-writing, you name it. It's like I have to prepare my mind for the task. The bigger the task, the more rest and preparation is required. You can call it procrastination, and it might be that simple, but I think it's more nuanced.

On the other hand is C. C's mother once said if you've got to clean the kitchen, just clean a little of it, and soon you'll be "cleaning the kitchen" and it's easy to progress from there. It sounds ridiculously obvious but upon reflection strikes me as kind of radical. I can't tackle problems like this, or at least, not chores. Reading, studying, sure, maybe a little. But this is why C can study on a bus or while watching the game... while I need a good night's sleep and a full day at the library (and maybe not even then).

Medicine, it seems, is geared toward C's approach. You have to see these patients, because they're coming. You have to write her up, and quickly, because she needs her meds and orders and the next patient is on the way. My notes still often look like crap; I could have done a better job with a bigger template and infinite interview time. I didn't have that time, or that template, so I asked and wrote what I could remember and got it signed and moved on.

Would my old lab have been like this, if we had free coffee and call rooms? Probably not. Medicine wouldn't even be like this, if it wasn't for the onslaught of patients and paperwork. And the free coffee, and call rooms. There's something about working on just a few hours of sleep that forces you out of the Schmee mode and into the C mode. If you're a little tired, and faced with new tasks, you just leap into them, like C's mother advocated.

It was when you were too-rested and had time to think, that's when the perfectionism creeped in. Notes wouldn't be written unless they were perfect. I guess even the geneticist, with her seemingly luxurious one hour per patient, must eventually assess and plan and move on to the next one.


Early Adopters

I used to think "early adopters" -- people who use the latest products ahead of everyone else -- were asking for trouble. They paid more for essentially under-tested products. Sure, it might have seemed cool to own a DVD player before anyone else, but you would have paid less and gotten more features if you waited a year or two. Even worse, not every gizmo catches on (remember laserdiscs?)

But early adopters for email, like me, might look back nostalgically at the good old days of 5 or 10 years ago. It was just as fast. It was easier to read because fewer people sent gussied-up colors and fonts. And it was the days before spam, when every email was from a friend or classmate or professor. (Snail-mail used to be like that, I guess, too -- thirty years ago. Sure, no one looked forward to bills, but more frequent letters and magazines sure beats junk mail).

I wonder if we'll look back on cell phones as nostalgically -- back in 2003, when every call was from family or friends... before movement-tracking and text-spam.

What should we call this, anyway? GPSpam?

Contact Inhibition

October first is when the national do-not-call registry goes into effect, barring telemarketers from calling pretty much anyone who doesn't want to be called (ie, everyone).

Closer to home, UMassMed is employing a spam-blocker, with impressive results thus far.

Another new regulation, taking effect in November, will allow cell-phone users to carry their number to new carriers. The folks at Gizmodo are predicting a melee as thousands of people switch phone companies.

All seem like substantial victories for the little guy in the battle to control communications devices. But bigger battles are looming: location-based monitoring and text-message spam. Virgin Mobile recently revealed it was tracking the locations that customers made their calls from (using cell-antenna triangulation), and new GPS services will be even more precise. Coupled with text-message spam, the day may not be far off when driving past McDonald's triggers a message on your phone, informing you of the $2 for 2 quarter pounder deal (which, I must admit, was quite a deal).

We're already at the point where people say, "I don't want to visit that site or publish my email -- I'll get spammed." In the future, people may not want to walk down Main Street for the same reason. Or they'll leave their phone in the car before they enter the Mall. In short, one of the most powerful modern conveniences -- the mobile phone -- could quickly become less convenient, or even burdensome.

I'm not so convinced regulators will attack the location/spam beast like they've gone after email spam and telemarketers, either. Email spam, aside from annoying 9.999 out of 10 million recipients (the actual response rate for most spam is really 1 in 10 million), actually places a huge burden on servers and backbones, without paying a cent to those providers. Even telemarketers aren't so parasitic, though their intrusiveness is often considered worse.

But location/spam will be bankrolled by huge mobile-phone technology investments, and by the spammers themselves, who would happily pay your carrier for the chance to reach you and study your habits, your movements.

Put it this way, because I'm not feeling particularly articulate: email spam has a response rate of less than one in a million, but that's enough to pay the bills because spammers can abuse the free-ness of the internet to send billions of emails a year.

Telemarketing has a better response rate, but requires bigger staffs and payments to the phone companies, too. And it really, really annoys people, much moreso than email spam.

No one knows what location-spamming response rates will be (I imagine they'll be high at first, until the novelty wears off). If the ads and alerts sent over the system are really well-targeted, or if the special discount offered is great enough, it might work. But if it doesn't, if companies abuse the system and send hundreds of useless bulletins to phones every day (like email spam does now) well, people will want to block the spam. But the spamming companies will already be in cahoots with your carrier. And your carrier will have already invested millions in making the technology work. In short, they'll have little incentive to block the spam. Unless, say, you pay them an extra $5 a month for "protection."



Show of hands

Boston Globe article on new handheld transmitters in UMass-Amherst lecture halls:

"To connect with students in vast auditoriums, professors sprinkle multiple-choice questions through their lectures. Students point and click their transmitters to answer, pushing blue buttons numbered 1 through 9 on their keypads. A bar graph appears on the professor's laptop, showing the number of right and wrong answers; teachers can slow down or backtrack when there are too many wrong answers. Each device is registered and assigned a number, so professors can check who is present, and reach out after class to those who give wrong answers frequently."

"... Students have already started asking friends to carry their transmitters to class for them so they can skip. Professors, in turn, have learned to guard against double-clickers by doing a head count and figuring out whether there are "extra" answers."


I remember how my first real PI would never wear a pager or give out his vacation home number. He would always say, "If we need to talk, I will contact you." In the future, maybe status will be noted by the absence of these transmitters. It reminds me of the dispatchers who can see their truckers dithering via GPS. Whether it's GPS or these PRS education interfaces, employers and profs are collecting more and more data on the individuals under their guidance.

Location, attendance, tardiness, right answers... It used to be that if you knew the right answers on the final, if you filled your quota on your routes, you'd get by. Now, in the name of catching problems early and limiting liability, underlings are going to have to accept more tracking. And more motivation to succeed: maybe, if they're good, they can have a tracking-free holiday or weekend.

When you combine this with Wal-Mart's proposed inventory-tracking RFID system, the possibilities are endless (indulge me for a minute, will you?) A course book or laptop with course-specific software can send a TXT message back to the coordinator, letting those in charge know whether you took your work home with you or accessed materials. Just like Word docs can already time how long each person has spent editing a file, profs will know how long you actually had the books open or read the online materials.

Seems unnecessarily meddlesome, doesn't it? The issue used to be whether you know the material or not, whether you get the job done or not -- so it didn't really matter if you crammed it all in the last week, or got special insight from your roommate instead of your TA. It seems that if they can track attendance, attendance will start to count -- 5 or 10%, maybe. How many times your computer hits the course website will be another 5 or 10%. The points you for actually knowing the material will shrink relative to the points you get for showing up and going through the motions. This might be good for grade-schoolers who need to establish good habits, but seems extravagant and wasteful for college students.

Role Reversal

Andrew Sullivan notes a great email addendum to the Buruma essay: "Some of you may know Albert Hirschman's classic book, 'The Rhetoric of Reaction,' in which he parses the tropes of conservative argumentation in Western culture. A reader reminds me:
Hirschman lays out 3 aspects of this rhetoric:
1. The Perversity Thesis: 'any purposive action to improve some feature of the political, social, or economic order only serves to exacerbate the condition one wishes to remedy.'
Opponents of the war on terror claim that fighting this war will only lead to more terrorism. Toppling Saddam Hussein has only worsened the condition of the Iraqi people, etc. etc.
2. The Futility Thesis: 'attempts at social transformation will be unavailing.'
Iraq can't possibly become a democracy.
3. The Jeopardy Thesis: 'the cost of the proposed change or reform is too high as it endangers some previous, precious accomplishment.'
Fighting the war on terror will lead to the destruction of democracy at home."


Well, this is partly a function of the Left being out of power and hating Bush. A few years ago these same isolationists were fighting to free East Timor and pushing for more in Bosnia and Kosovo. By some crazy circumstances, they've finally got a president who's a huge spender with a cowboy attitude, freeing people from despotism in Central Asia, the Middle East, and Africa (Liberia). But if the guy's got a spotty environmental record and an eye towards his Big Oil buddies, well, the intervention and liberation can't be right, right?

Then again, who would have thought that one's opinions of whether hanging chads count as votes falls exactly in line with faith in tax cuts? It was an amazing coincidence that Republicans, who traditionally despise the activist judiciary, all spontaneously agreed on arcane procedures of vote counting and furthermore agreed that the courts should intervene. It's funny just how deeply political thought can penetrate into the most trivial of matters.

What interests me more is the possibly long-term changes to the social reputations of Left and Right. I grew up thinking Antiwar meant free love, cool drugs and great music. And something about self-determination 'n stuff. The Right was stodgy, afraid and, in a word, Conservative. Since my time at Brown, though, I've seen leftists do nothing but bitch, bitch, bitch. Everything the US does is imperialist, every enemy of the US is misunderstood... They've grown so reactionary and defeatist that I can't imagine many of them will have a good time at the Boston convention next year.

Meanwhile, SNL and the Daily Show, while still doing a number on Bush, have begun to target the lunatic antiwar fringe as well. Were they such an object of ridicule in Vietnam? During the freeze movement of the 80's? I don't know. But it seems to me that a group can't stay so angry, so humorless, so dogmatic -- and expect to remain a force, let alone grow. Especially not if the US makes substantial improvements to Iraq and Afghanistan. Which is why the Antiwar people are so anxiously hoping the US fails.

Maybe someday, the term Young Republican will stop connoting awkward Aryan-appearing preppies in ties. That's when we'll know the pendulum has swung.

There's no "we" in Dean

Michael Wolff in New York Magazine notes the similarities between Dean's blog and McGovern's direct-mail campaign. Both candidates leapt to the forefront after accessing a previously untapped source of funds. Best of the Web paraphrases : "Wolff argues that Dean's campaign may likewise be 'based around people who are too engaged. Too happy to be involved. Too emotionally joined at the hip. Too convinced of their own specialness--in turn imbuing the campaign itself with an exaggerated sense of uniqueness.'"

This is what's so frustrating about following the buzz, whether it's for politics or movies or cars. In recent years it happened to Tsongas, Bradley and McCain -- outspoken, brainy, and unsual candidates capture the interest of the 'media elite' and the few hundred thousand cable- and blog-watchers. Everyone gets excited, the story gets a Newsweek cover, and people wait for middle America to catch on. Except the muscle of the party usually knows the voters best, and endorses a bland but electable politician who can fight for the vital center.

Maybe Dean, like McGovern, will capture enough dollars and win the nomination. But I think Wolff would argue that the angry, "special" followers of Dean will revel in the spotlight, and rub their uniqueness in the face of the centrists. The undecided center, in turn, will lean to a genial W.

Clinton couldn't beat Tsongas on substance, yet won the nomination because he charmed more halls and donors. But if Tsongas' followers in 1992 had the tech-connections of 2003 (meetup.com and the Dean staff blogs), could the nomination have gone differently? Maybe -- but it seems unlikely Tsongas would go on to unseat the first President Bush.

It's easy to lose sight of the fact that most Americans aren't cable news junkies or blog readers. So what if Dean was on the cover of Newsweek -- which is read by just 1% of the nation?. So what if he is leading in NH Democrat polls (or trailing only the undecideds?). He's still largely unknown in most states.

Those who do know Dean tend to love him, and throw cash at his campaign. But hey, there's a cult of people willing to shell out thousands for Segways, too. They swear by their Segways, revel in their specialness, and have almost zero chance of turning on average people to their benefits.

A Fine Film Idea

Here's the first entry in an ongoing feature: wacky screenplay ideas!

An armed robber is holding hostages at a mall. The Feds arrive and start negotiating. The guy demands $100,000 in unmarked nonconsecutive tens and twenties. The negotiator phones in the demands to the local FBI office. THE REST OF THE MOVIE ( more than 90%) is about how some guy at the office tries to put together a suitcase full of money for the negotiator.

1) it's his first week and he always assumed suitcases of money were pre-packed
2) he goes to the bank and tries to withdraw the money straight up but it gets complicated
3) when he gets the money it doesn't even come close to fitting in the suitcase, he ends up mixing in some hundred-dollar bills to save space.

Also there's a well-integrated subplot about a budding office romance. And the guy has Knicks tickets for tonight, should he go to the game or is he obligated to see what happens at the mall?

OK, you're not loving that? Well, my best screenplay idea ever is about health care proxies and is too good to be posted here, where any Johnny Internet can steal it.

I already had a script idea stolen. It was a romantic comedy about two late-90's tech-savvy hipsters who hate each other in real life but flirt and connect well online. It was going to be called "Now Would Be A Good Time For You To Check Your Email." You know the rest.

The Happiness of Pursuit

The Times magazine, on the other hand, has a great article on Daniel Gilbert's studies on our ability to predict our happiness (affective forecasting). Also cited are the works of Wilson, Kahneman and Loewenstein -- economists and psychologists all testing whether we're smart about maximizing utility.

"In other words, we might believe that a new BMW will make life perfect. But it will almost certainly be less exciting than we anticipated; nor will it excite us for as long as predicted... On average, bad events proved less intense and more transient than test participants predicted. Good events proved less intense and briefer as well."


What's funny is how shallow this makes me -- I've long since realized that my car, my GPS, and yes, several friendships have generated a large and sustained "utility" -- greater than one might expect from an average guy. Maybe I'm lucky that such fulfillment is readily obtainable. Maybe I'm foolish that I haven't really re-oriented my life around any of these things. But if I did, if I binged, would they cease to amaze and delight?

"Our emotional defenses snap into action when it comes to a divorce or a disease but not for lesser problems. We fix the leaky roof on our house, but over the long haul, the broken screen door we never mend adds up to more frustration."


At last, a coherent justification for the speed-dial! Or command-key shortcuts. These options may saves a few seconds per operation, but can take hours to learn and implement. I don't think people really end up saving much time. But they DO diminish the frustration of repetitive tasks...

Money graf:
''Happiness is a signal that our brains use to motivate us to do certain things. And in the same way that our eye adapts to different levels of illumination, we're designed to kind of go back to the happiness set point. Our brains are not trying to be happy. Our brains are trying to regulate us.'' In this respect, the tendency toward adaptation suggests why the impact bias is so pervasive. As Tim Wilson says: ''We don't realize how quickly we will adapt to a pleasurable event and make it the backdrop of our lives. When any event occurs to us, we make it ordinary. And through becoming ordinary, we lose our pleasure.''


I think this gets back to a dilemma I noticed in (here come the googles) Star Trek. Kirk and company are always striving to improve themselves, yet they revel in humanity's inefficiencies and imperfections. These utopians have learned from Gilbert's observations and can anticipate their affect adaptations. Thus, they've chosen to make self-improvement itself the source of their happiness, rather than a measurable gain in knowledge or skill (let alone materialistic gains).


Yet Gilbert warns:
''I don't think I want to give up all these motivations,'' he says, ''that belief that there's the good and there's the bad and that this is a contest to try to get one and avoid the other. I don't think I want to learn too much from my research in that sense.'' ... ''When choosing between two jobs, you wouldn't sweat as much because you'd say: 'You know, I'll be happy in both. I'll adapt to either circumstance pretty well, so there's no use in killing myself for the next week.' But maybe our caricatures of the future -- these overinflated assessments of how good or bad things will be -- maybe it's these illusory assessments that keep us moving in one direction over the other. Maybe we don't want a society of people who shrug and say, 'It won't really make a difference.'

''Maybe it's important for there to be carrots and sticks in the world, even if they are illusions,'' he adds. ''They keep us moving towards carrots and away from sticks.''


Now, this reminds me of Vonnegut and coping with futility. But rather than concede we will always overestimate a change in affect, I think it's wise to explore things we find surprisingly enjoyable. Rotate through variety of pursuits -- hiking, research, writing, whatever -- that don't fade as quickly when attained, that leave you richer for having tried it. Yeah, in the end you might be just as happy if you bought a big TV and watched it, but at least my way you'll have more vivid and fond memories. And that's the gift that keeps giving.






Full Circle

I've been reading newspapers regularly now for 12 years. The process began with the Boston Globe comics, then Ask the Globe (on the comics page), then the Living / Arts tidbits, then Ann Landers and other short bulletins in the Sci-Tech (later Health & Science) section. Later, the jump to Letters to the editor and the Op-Ed pages. In the past few years, the lengthy pieces in the sunday Magazine and Focus (now Ideas) held my interest.

But all that is rapidly reversing; the leisurely Sunday morning reading on the NYTimes and Globe has given way to a rushed skimming of long articles. I assume I know where the author is going and just skim to confirm or surprise myself. Is this a consequence of reading blogs? Or charts? Or writing that thesis, with its ponderous, style-free chain of thought?