Part the First: Is There No Place to Hide, or Just Be Yourself? Caitlin Johnstone points out once again that while we have been snoozing happily in a virtual haze, we are being followed by the latest incarnation of Big Brother to come along. ** From Today in Dystopia: We Have Cameras Everywhere in that Town**:
Today in dystopia, police have been wrongfully arresting people based on faulty information from AI-assisted Flock surveillance footage instead of actually investigating the evidence of the crime.
In an article titled “
[She Spent 7 Months in Legal Hell After Cops Used Flock Surveillance To Identify the Wrong Car,]” Reason Magazine documents multiple instances of innocent people having their lives upended in legal battles because police slammed them with charges based on incorrect Flock camera data which could have easily been ruled out by some basic verification.
Just click on the link. And the next one where this is described: Reason shared a
[police body cam video]of a cop confidently handing a court summons to a woman for package theft, telling her and her husband that it was “100 percent” certain she was guilty because Flock surveillance had her on camera committing the crime.“We have cameras everywhere in that town; you can’t get a breath of fresh air in or out without us knowing,” the officer asserts on camera, saying “It is her, it is 100 percent, it is locked in, there is zero doubt; I wouldn’t have come here unless I was 100 percent sure.”
If that wasn’t Orwellian enough for you, Reason reports that the woman was only able to exonerate herself by providing police with “her cellphone tracking data, camera footage from her truck, and video placing her elsewhere at the time of the theft.” In other words, she was only saved from wrongful conviction based on faulty mass surveillance by providing correct information from other forms of mass surveillance. I suppose this is a case of two negatives making a positive. Cue those who will prattle on and on about, “If you have nothing to hide, then you have nothing to worry about.” One of these days that dawn will come up like thunder for my self-righteous friends who fear the perceived other so much it has warped them beyond all recognition since we were young. And as Caitlin notes:
All these wrongful arrests based on faulty Flock camera evidence is another illustration of the way people are making themselves dumber by outsourcing their thinking to machines. Police let AI tech do their job for them instead of using their own brains to rule out the suspect.
Regarding AI, as this Coffee Break is posted, I will be attending a mandatory workshop on how to coach medical students into engaging with something called “self-directed learning” (SDL). A version of ChatGPT seems to be involved, to the extent I have managed to read the instructions. SDL is all the rage these days. But most of the faculty in these parts have been doing it since they were college freshmen, or they would not be here. This is, of course, true for anyone who has done something useful in this life. This is not something new that we must “teach.” The medical students who don’t already know how to teach themselves new things will have a satisfying career as a wellness doc in a strip mall or a pain doc working out of his house. They are hopeless, but I do worry about their patients. I wonder, is it too late to declare myself a conscientious objector against being forced to use a chatbot in my work. Last Monday morning I told the incoming class that AI is a crutch that will make them stupid. It usually takes me a bit longer to transition into full-blown hypocrisy.
Regarding Flock, I just looked. There is one Flock camera a few blocks from my house that is unavoidable due to the limited access highway that sliced our neighborhoods in half during the late-1960s. But maybe this is a passing phase? Nah, probably not. The 158 Flock cameras throughout my medium-sized city are up and running and unlikely to go anywhere. But if any of the local good ol’ boys ever get caught up in something they did not do because they got flocked, they and their friends have a lot of Remington 20-gauge shotguns loaded with bird shot plus a high-resolution online map of the Flock cameras that looks like a satellite photograph taken during night…And no, there is no place to hide.
Part the Second: Science Communication As It Should Be Done. There really was a time when (many) scientists felt it was one of their duties to communicate what science is, what it can do, and what it cannot do. One of my favorite collective biographies is called The Visible College, by the historian Gary Werskey. His subjects included Joseph Needham, Lancelot Hogben, Hyman Levy, and J.D. Bernal, and J.B.S Haldane. More recent examples include Stephen Jay Gould, Francois Jacob, and Lewis Thomas, but by and large the field seems to be fairly empty these days (yes, I realize I tend to the biological side of things).
Since the beginning of the now recrudescent pandemic, loss of the art of scientific communication has made itself felt more than I would have imagined ten years ago. We have had our erstwhile leaders, scientific and political, prattling on about “trusting the science” and even identifying themselves with science so much that genuine scientists have been repelled (when they were paying attention). It has been a mess, and the outcomes have not been good.
We need more people like Liz Marnik, whose life as a scientific communicator is recounted in ** She grew up unvaccinated. Now she’s a leading voice for science – and empathy**. This is a fine story, beginning with:
At the age of 23, Elisabeth Marnik approached her doctor with an unusual request: Vaccinate me. Against everything.
She had never received a single vaccine. But now, angry and defiant, she was turning away from the beliefs of her childhood, instilled by a mother who distrusted science. A doctor for adults doesn’t typically have childhood immunizations on hand, so she made her way to a travel clinic and eventually got all the once-forbidden shots.
A year would pass before she told her mother about the vaccines. And several more years would go by before Marnik came to have sympathy for her mother’s choices.
That happened, as it so often does, when Marnik became a mother herself, in 2019. A harrowing childbirth necessitated several blood transfusions. Overwhelmed and foggy-headed, Marnik balked when a nurse asked to give the baby a hepatitis B shot, saying she’d do it later. A friend gently reminded her why it’s important to vaccinate at birth, and the baby did get the shot before leaving the hospital.
But Marnik had hesitated. And she was starting to understand her mother’s burdens. “That moment, plus the whole entry into motherhood, really changed my perspective,” Marnik said. “You have this immense pressure that if you don’t do it right, things could happen. That really gave me more compassion.”
Marnik’s mother, Teresa Ryan, can still recall the pamphlet she came across decades ago, one of many such tales that she read. It described a healthy child who, after a series of vaccinations, started crying uncontrollably and running a high fever, and then went limp. The family’s doctor merely stated that children must follow an immunization schedule. He offered no balm for her worries. Ryan decided her two children would absolutely not get those shots.
Today, Marnik, now 37 and with a Ph.D. in immunology, is striving to counteract the kind of misinformation that ensnared her mother. With 64,000 followers on Instagram as @ScienceWhizLiz and 4,500 subscribers on her Substack,
[the Science Classroom], she speaks to those who already support vaccines,[urging empathy and patience]for the doubters. Shaming and excluding people like her mother, she argues, will do nothing to improve vaccine acceptance. Although strong evidence shows that vaccines are safe, facts alone rarely change minds.
That Liz Marnik is now an immunologist who teaches was not in the cards for her when she was growing up. From Central Connecticut State University she went to Tufts, where she received her PhD in immunology while doing her research at the Jackson Laboratory in Bar Harbor. We are most fortunate that she did not take the traditional path:
Marnik enrolled in a Ph.D. program offered by Tufts University but based at the Jackson Laboratory in Bar Harbor, Maine, where she studied autoimmune disease in mice and published three research papers. By the time she started as a postdoctoral researcher at another Bar Harbor institution, the MDI Biological Laboratory, she knew she wouldn’t pursue the typical next step — setting up her own lab. Much as she loved doing science, Marnik found herself most drawn to teaching people about it.
She invited fourth graders to her lab and developed a summer program that brought high school students to Mount Desert Island to learn about research. Eventually, she became the MDI lab’s director of science education and outreach.
Her mentors came to accept her decision to abandon research. “I realized at one point that she’s doing something a lot bigger than I’m capable of doing and really making the science relevant in ways that most of us scientists can’t do,” said Dustin Updike, her adviser at MDI.
And we are lucky that her research advisor was Dustin Updike! They are few and far between, as I learned when senior colleagues reacted badly when I did not push my graduate students into what has become a professional cul de sac for so many.
What Liz Marnik has is empathy. She knows people do not want to listen to scientists because they know when they are being talked down to:
In the New York Times, she described growing up unvaccinated and later coming to understand that her mother only wanted to protect her children.
One commenter in the Times wrote: “I have zero empathy or compassion for those whose myopic worldviews endanger those most vulnerable to communicable diseases.” Another declared: “I would have charged your Mom with Child endangerment.”
These critiques assume that people rejecting vaccines have access to good information about them, but that’s not always the case, Marnik said. “My mom only ever finished eighth grade,” she said. “
The one person she asked questions to wouldn’t answer them, and then we didn’t have the privilege to be able to go to another provider.”
That one person was** their family doctor**. And therein lies the problem. He (undoubtedly) could not and would not meet his patients where they were. Likewise, too many scientists fail to even try to explain what they are doing in their laboratories and why it is important, to them, and will perhaps advance our understanding of the natural world. Back when I was more active and attending international meetings, I always volunteered to sit at a table and listen to the elevator pitches of graduate students and postdocs. The saying is true: “If you cannot explain to a nonscientist what you are doing and why your research is important in a two-minute elevator conversation, then you are doing it wrong.” The typical American scientist simply thinks that nonscientists are too stupid to understand what he (99% of the time) is doing with his public support.
Finally, going back to The Visible College, it is no accident that those five scientists inhabited a world with a serious Left of which they were a part (while also remaining respected members of the academic establishment; ‘twas a different time). Each of them could be wrongheaded, just anyone. But not one of them looked down on those who were not like them. Why they were so unlike the stuffy and purblind eugenicists who surrounded them is a forgotten story. At the same time, those same purblind eugenicists have been reincarnated, perhaps is some kind of spontaneous generation. And therein lies another story.
Part the Third: AI in Medicine, the Saga Continues. The deluge has begun and it might drown us all. I have seen it firsthand just this morning. A clinical note about my much better half, no doubt “written” by a chatbot with defective ears inhabiting EPIC, ended with the following sentence: “(The patient) has a history of tonsillar malignancy treated…with cisplatin and radiation and recalls prior treatment-related neutropenia/leukopenia” (low white blood cell count). No. That is what I said about myself during a three-way conversation with the surgeon. If you are reading IM Doc, your predictions have been spot on.
Anyway, more nonsense has been discussed in another article in STAT News, ** AI has created a shadow medical system**. I rather tend to think that soi-disant AI mavens have created a medical system that is very real and very dangerous and thrives in the deep shadows of profit taking by the Great American Medical System:
Every few weeks, another headline announces that artificial intelligence has
[matched a doctor],[beaten a doctor], or is finally ready to become one. The latest wave arrived with familiar force: Several studies claim that AI outperforms physicians on clinical reasoning tasks.The implication is hard to miss. Doctors are slow, expensive, and human. AI is faster, and potentially better.
Headlines about AI replacing doctors have already helped fuel a parallel, industry-driven medical system outside the walls of the hospital.
More than 40 million Americans ask ChatGPT a health question every day. Most of those conversations happen outside clinic hours, and most of them lead not to a doctor but back to the user — someone with no training in what to provide, how to prompt, or how to critically appraise what comes back. The models themselves are doing less and less to redirect them to appropriate care pathways. A study published this year found that medical disclaimers, once standard in chatbot answers to health questions, have largely disappeared; today’s leading models will not only respond to health questions but ask follow-ups and
[attempt a diagnosis].… Why is this transformation occurring at such speed and scale in medicine, rather than in law, finance, or software, where AI is also being used as an accelerant? Money. Health care represents close to one-fifth of the American economy. Capturing part of a doctor’s work, or persuading a hospital, an insurer, or a patient that they can save money without sacrificing quality of care, represents an enormous financial incentive. This has driven every major AI company into health care. Headlines implying that AI is ready to replace doctors only fuel the market.
But this too will eventually come a cropper. I am not a clinician but my students to hear it from me that no machine can hold a patient’s hand and see what is really wrong or hold a patient’s hand and tell her that s/he has worried too much about something that is a problem that can be corrected.
As the authors end this hopeful opinion piece:
IBM put it best in a 1979 internal training manual: “A computer can never be held accountable, therefore a computer must never make a management decision.”
Change “management” to “medical” and the wisdom should jump right out. One of my pleasant and frequent companions on the golf course is a surgeon enamored with the ability of the current version of ChatGPT or whatever to convert a clinical scenario into a diagnosis and plan for treatment. As they say about surgeons and internists: The first does everything but knows nothing while the second knows everything and does nothing. ChatGPT, it is impressive on the outside. But the chatbot still cannot be present with and visible to the patient and the patient’s family. Only the physician can.
Perhaps I am being naïve (it would not be the first time) but analogy with basic research is apropos. There are things I can do in ten minutes that were unimaginable when I began this journey in the mid-1970s, as the bright-eyed youngest person in the lab. Now I am the (still bright-eyed) oldest person in the lab, when time allows, and discovery continues to remain ineffable. True discovery happens only when intuition can play its part. Intuition is the one thing a large language model lacks despite an uncanny ability to spit back nice sounding slop. Or, that is my story and I am sticking to it for the time left to me.
Thank you for reading! See you next week. In the meantime we should continue to search for the brake lever, even if we are only second- and third-class passengers on this runaway train.