Human Resources

ITEM: Insects are an ideal source of protein for denizens of a world facing climate change and a growing population.

ITEM: The rise of government-assisted euthanasia produces a new source of organ donations.

ITEM: A new startup that specializes in composting people seeks to raise $5 million in its latest funding round.

Scenes from a 1970s dystopian science fiction film? Nah, just typical headlines from the past year. How apropos, then, that it should be the fiftieth anniversary year of one of that subgenre’s most iconic films, Soylent Green. And, while we’re counting anniversaries, we’ve just passed the year in which that story was set, 2022.

But, to paraphrase the film’s central mystery, what is Soylent Green? It is many things: dystopian science fiction, kitsch, excellent meme-fodder, a showcase for Charlton Heston (who is simultaneously a genuine charismatic and one of cinema’s great hams), and more. It came out of that fertile late-1960s and early-1970s period of imaginative fiction, in which the gee-whiz optimism of the early postwar era gave way to increasing pessimism and even nihilism, and cosmic anxieties became metaphors for social ones, and vice versa.

Like most major science-fiction movies, it is based (loosely) on a novel, the mostly forgotten Make Room! Make Room! by Harry Harrison. And, like many science-fiction films — including 2001: A Space Odyssey, Back to the Future II, and Blade Runner — the action takes place in a future that has now already passed. Soylent Green’s then-distant future of 2022 is one of desperate overpopulation, global warming, and class inequality. The few rich live in fortified compounds and have access to regular food and water, while the many poor must rely on synthetic foodstuff, mass-produced by the powerful Soylent Corporation. A partial solution to the demographic crisis is euthanasia.

The story centers on an NYPD detective, Robert Thorn (played by Heston), who uncovers a conspiracy spanning the government, scientific elites, and of course the Soylent Corporation. Through a series of plot machinations too convoluted to elaborate here, he discovers that the synthetic food Soylent Green is in fact made from the corpses of the recently euthanized, leading to the film’s famous climax, in which he reveals the awful truth.

It is a testament to the film’s resonance that many people who have never sat through an entire viewing of it nonetheless know its famous concluding scene — up there with the ending of Planet of the Apes (another Charlton Heston sci-fi showcase) for producing a cultural legacy that has outgrown that of the movie itself. (...)

Of course, overpopulation fears were hardly limited to the domain of imaginative fiction. Amid exponential population growth worldwide, the postwar era saw widespread expressions of concern, crystalized by Paul Ehrlich’s bestselling 1968 book The Population Bomb, which erroneously predicted the deaths of hundreds of millions of people through starvation within a decade.

But the Malthusian nightmare did not come to pass. While the population of the United States (not to say the world) has increased substantially in the intervening years — growing nearly 60 percent since 1973 — apocalyptic fears of overcrowding and mass starvation did not materialize. In fact, throughout most of the world, demographic collapse is the more likely future, as birth rates continue to decline. Meanwhile, our agricultural output has been keeping pace with population growth thanks to the Green Revolution (though its benefits are not yet entirely global). If you lifted an extra out from inside the world of Soylent Green and deposited him in our own present day, one imagines he would be astonished at the world of plenty he now inhabits.

Is Soylent Green then merely a curio — a Seventies relic like The Late Great Planet Earth or pet rocks? Perhaps not. For technological advancement is not a panacea for social ills. And while our own story (so far) has averted the apocalypse, we have not averted some of the more dystopian implications of that era’s speculative fiction. (...)

Of course, one might argue that any prescience on the part of Soylent Green is qualified by its getting the larger Malthusian argument wrong. But beneath this material issue lies a deeper philosophical fear: that faced with external constraints, technocratic modernity will find instrumental uses for people, whether they want that or not. In this sense, the film retains a certain queasy power not in spite but because of its ridiculousness, its willingness to make explicit our otherwise tacit horror of turning human beings into mere matter — in this case, literally.

This is to say that Soylent Green may remain kitsch, but kitsch can sometimes express widespread hopes and fears more clearly than great art. And its particular fears concerning the appropriate size and equality of our population are arguably perennial ones, for every human society must reckon with them in some measure. Beneath these fears lies the question of whether our ever more utilitarian modern society has transformed humanity itself into something merely instrumental.

by David Polansky, The New Atlantis | Read more:
Image: Soylent Green

Natalia Lafourcade

[ed. See also: Natalia Lafourcade: NPR Music Tiny Desk Concert]

The Acceleration of the Age of the Idiot

There’s a thought I keep on having, and maybe you’ve had it too. The main question they’ll ask about our age is: how did everything get so stupid, so fast? You can look at our economies and see inflation ripping through them. But there’s another kind of inflation at work too. In human folly, and all its flavors, from ignorance to malice to bad faith and beyond. It’s pulsating through our societies, and the lunatics, it seems, are seizing control of them, faster and faster.

I know you know that. But I also think it’s instructive to really think about it for a moment.

Think back to a decade ago. Just a decade ago. 2013. It seems like a…practically a…Golden Age…by comparison. We’d go online, and Twitter and Facebook weren’t…great. But they weren’t the smoking wrecks of disinformation, hate, and moronitude they are today, either — not even close. Our politics was fragmented and a little bit fractured — but nation after nation hadn’t been seduced by fanatics who’d go on to wreck its institutions and norms, like Brexit did to Britain, or Trumpism did to America. Our economies weren’t exactly in stellar shape — stagnation was beginning to bite.

But we weren’t exactly in the insane — to me as an economist, anyways — position of a recession hammered home by central banks raising rates to astronomical levels just as the mega-scale impacts of climate change hit. Which themselves were largely ignored, in favor of an endless parade of celebrities and billionaires.

Does it feel a little bit like…what’s the phrase I’m looking for…The Bonfire of Vanities at the end of a civilization…out there today? Welcome to the Acceleration of the Age of Stupid.

Think back, again, just a decade, and remember how you felt. How do you feel now, in comparison? If indicators are any bet, you feel not just worse, but astonishingly worse. People are so pessimistic that it’s hard to even do it justice in words — 80% of people, and this finding holds true across societies, basically think there’s not going to be a future, for them or their kids. A decade ago? Societies might not all have been shining examples of happiness — but they weren’t exactly biting their nails to keep from screaming in despair, either. And all that’s taken a knock-on effect on social cohesion, meaning trust and ties, which are collapsing at light speed.

When I or you say “stupid,” as in, “Jesus, how can people even be this stupid?” — and we mean everything from climate denial to regressive who want to take rights away to fanatics who want to ban books to lunatics who think storming Congress is wonderful and peaceful — part of what we mean, even if we don’t know it, is all that: pessimism, the loss of social cohesion, trust and ties collapsing — but I’m getting ahead of myself.

by Umair Haque, Eudimonia and Co. |  Read more:

Image: Peter Dynes

"So a weird and startling megatrend is emerging: human consciousness is shrinking — that’s what all these flavors of stupidity really are — at precisely the time it needs to expand. Expand most, given our civilization crossing the threshold into the Age of Extinction.

The growth of conscisouness is the expansion of empathy, grace, truth, beauty, justice, goodness, wisdom, courage, humility. See any of that happening? Or just the explosive growth of every flavor of folly, every crazed admixture of stupidity, history’s ever seen, at light speed?"

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They Lied About Afghanistan. They Lied About Iraq. And They Are Lying About Ukraine.

Chris Hedges:They Lied About Afghanistan. They Lied About Iraq. And They Are Lying About Ukraine. (ScheerPost)

Image: Preying for Peace – by Mr. Fish

Mission: Impossible – Dead Reckoning Part One Review – Tom Cruise Does It Better

Already, the keynote stunt has become a legend: the one on the poster, the one he reportedly did – for real – six times in one day before he was satisfied. Tom Cruise’s compact body floats free of the motorbike as it drops to earth from between his diamond-hard thighs, having launched him with a throaty roar off an unfeasibly high cliff-edge; he sails through the sky, pulls the ripcord on a nifty little parachute, and swoops down towards … the speeding Orient Express, fully intent on the traditional carriage-top punch-up. We gasped in the audience. Someone behind me went: “Oh shi-i-i …” Carly Simon should have come in with a new song: Fair Enough, Somebody Does It Better.

This outrageously enjoyable spectacle has compelled my awestruck assent with its sheer stamina, scale and brio: the seventh in the Mission: Impossible action franchise with Cruise starring as Ethan Hunt, the mysterious, superfit leader of a top-secret intelligence/combat unit called the Impossible Mission Force, brought in by a shadowy US government agency when they want deniable stuff doing. Their initials of course are IMF, and in this film they finally get round to doing the gag about them not being the International Monetary Fund, the one we reviewers have been doing for years.

  

Seven films! Daniel Craig got sick of 007 after just five. But at 61, Cruise looks better than ever and pretty much wedded to the IMF. (...)

In this film, as in so many in the past, evil forces are trying to get hold of a MacGuffiny object which will permit them to control/destroy the world, and Ethan and the gang are the only people to stop them. There is some tremendous stunt work, including a wacky Italian Job-style chase around Rome in a titchy little yellow Fiat, the biggest train scenes since Paddington 2 and some very impressive horsemanship from Tom in the Arabian desert – in his headdress he is the seventh pillar of hunkiness. A very tense opening sequence aboard a Russian sub called the Sebastopol – its associations with Crimea being perhaps a rebuke to Putinist chauvinism – introduces us to a certain bejewelled cruciform key, split into two; this is the oddly low-tech object whose owner, having reunited the halves, can master a new and terrifying form of AI, a self-replicating digital consciousness with the capacity to invade any operating system in the world. Already the genie is emerging from the bottle. (...)

In the past I have been agnostic and a nay-sayer about M:I, but the pure fun involved in this film, its silly-serious alchemy, and the way the franchise seems to strain at something crazily bigger with every film, as opposed to just winding down, is something to wonder at.

by Peter Bradshaw, The Guardian |  Read more:

Image: YouTube
[ed. Taking my grandson to see this one. See also: Running, jumping, looking: is the new Mission Impossible the Tom Cruisiest film Tom Cruise has ever made? (Guardian).]

Light My Fire

[ed. Impressive.]

The Abuse of YouTube's Copyright Policy

[ed. Important. We need a massive overhaul of copyright law, especially with AI coming.]

Madeline von Foerster (American, 1973) - Orchid Cabinet (n.d.)

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Gérard Schlosser (French, b. 1932) - Two Friends

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How to Stave Off Constitutional Extinction

Every Fourth of July, Americans celebrate independence, but it might be more significant, more pregnant with meaning, to celebrate amendment — the writing, ratifying and especially the amending of constitutions. Except lately there hasn’t been much to celebrate, with amendment having become a lost art. And a constitution that can no longer be amended is dead.

The U.S. Constitution hasn’t been meaningfully amended since 1971. Congress sent the Equal Rights Amendment to the states for ratification in 1972, but its derailment rendered the Constitution effectively unamendable. It’s not that people stopped trying. Conservatives, especially, tried.

In 1982, President Ronald Reagan endorsed a balanced-budget amendment. In the 1990s, Republicans proposed anti-flag-burning amendments, fetal-personhood amendments and defense-of-marriage amendments. Lately, amendments have been coming from the left. “Nationally, Democrats generally wish to amend constitutions and Republicans to preserve them,” The Economist proclaimed last month, on the same day that California’s Democratic governor, Gavin Newsom, proposed a federal constitutional amendment that would regulate gun ownership. “I don’t know what the hell else to do,” he said, desperate.

The consequences of a constitution frozen in time in the age of Evel Knievel, “Shaft” and the Pentagon Papers are dire. Consider, for instance, climate change. Members of Congress first began proposing environmental rights amendments in 1970. They got nowhere. Today, according to one researcher, 148 of the world’s 196 national constitutions include environmental protection provisions. But not ours. Or take democratic legitimacy. Over the last decades, and beginning even earlier, as the political scientists Daniel Ziblatt and Steven Levitsky point out in a forthcoming book, “The Tyranny of the Minority,” nearly every other established democracy has eliminated the type of antiquated, antidemocratic provisions that still hobble the United States: the Electoral College, malapportionment in the Senate and lifetime tenure for Supreme Court justices. None of these problems can be fixed except by amending the Constitution, which, seemingly, can’t be done.

It’s a constitutional Catch-22: To repair Senate malapportionment, for instance, you’d have to get a constitutional amendment through that malapportioned Senate.

While it’s true that Americans can no longer, for all practical purposes, revise the Constitution, they can still change it, as long as they can convince five Supreme Court justices to read it differently. But how well has that worked out? That’s what happened, beginning in the early 1970s, with abortion and guns, the north and south poles of America’s life-or-death politics, in which either abortion is freedom and guns are murder or guns are freedom and abortion is murder. Chances are that if you like the current court, you like this method of constitutional change and if you don’t like the current court, you don’t like this method. But either way, it’s not a great boon to democracy.

Troublingly, our current era of unamendability is also the era of originalism, which also began in 1971. Originalists, who now dominate the Supreme Court, insist that rights and other ideas not discoverable in the debates over the Constitution at its framing do not exist. Perversely, they rely on a wildly impoverished historical record, one that fails even to comprehend the nature of amendment.

A written constitution ratified by the people — and subject to amendment by the people — is an American invention. In the 18th century, people who drafted constitutions and commented on constitutionalism came to agree that if such a strange, new and fragile thing as a written constitution were to endure, it would, as time passed, need to be both repaired and improved, mended and amended. To amend meant, at the time, to correct a fault; to repair an omission; to fix what’s broken; or to improve, in a moral sense: to make something better. The word shares a root, four of its five letters, and almost the entirety of its meaning, with the verb “mend.” You can mend a dress but you can also mend your ways; you can amend your will but, for your errors, you can also make amends. All this was contained within the philosophy of amendment.

“We have every opportunity and every encouragement before us, to form the noblest purest constitution on the face of the earth,” Thomas Paine wrote in “Common Sense,” published in January 1776. The states and the new federal government began writing constitutions that spring. Delegates to the Continental Congress who drafted what became the Declaration of Independence were also working on state constitutions: Thomas Jefferson was drafting the preamble for the Virginia Constitution and John Adams was involved in the drafting of the constitutions of Virginia and New Jersey while avidly following the constitutional goings-on in New Hampshire, South Carolina and Maryland. (...)

Amendment is a constitutional mechanism necessary to avoid insurrection. The U.S. Constitution was itself an act of amendment, written in 1787 because the Articles of Confederation were technically amendable but, for all practical purposes, not. At the constitutional convention in Philadelphia, the Virginia delegate George Mason, pointing out that everyone knew the Constitution that they were drafting was imperfect, argued that “amendments therefore will be necessary, and it will be better to provide for them in an easy, regular and constitutional way than to trust to chance and violence.”

by Jill Lepore, NY Times |  Read more:

Image: Rozalina Burkova

[ed. Happy 4th.]

Nearly Half of US Honeybee Colonies Died Last Year

America’s honeybee hives just staggered through the second highest death rate on record, with beekeepers losing nearly half of their managed colonies, an annual bee survey found.

But using costly and Herculean measures to create new colonies, beekeepers are somehow keeping afloat. Thursday’s University of Maryland and Auburn University survey found that even though 48% of colonies were lost in the year that ended April 1, the number of United States honeybee colonies “remained relatively stable.”

Honeybees are crucial to the food supply, pollinating more than 100 of the crops we eat, including nuts, vegetables, berries, citrus and melons. Scientists said a combination of parasites, pesticides, starvation and climate change keep causing large die-offs.

Last year’s 48% annual loss is up from the previous year’s loss of 39% and the 12-year average of 39.6%, but it’s not as high as 2020-2021’s 50.8% mortality rate, according to the survey funded and administered by the nonprofit research group Bee Informed Partnership. Beekeepers told the surveying scientists that 21% loss over the winter is acceptable and more than three-fifths of beekeepers surveyed said their losses were higher than that.

“This is a very troubling loss number when we barely manage sufficient colonies to meet pollination demands in the U.S.,” said former government bee scientist Jeff Pettis, president of the global beekeeper association Apimondia that wasn’t part of the study. “It also highlights the hard work that beekeepers must do to rebuild their colony numbers each year.”

The overall bee colony population is relatively steady because commercial beekeepers split and restock their hives, finding or buying new queens, or even starter packs for colonies, said University of Maryland bee researcher Nathalie Steinhauer, the survey’s lead author. It’s an expensive and time consuming process.

The prognosis is not as bad as 15 years ago because beekeepers have learned how to rebound from big losses, she said.

“The situation is not really getting worse, but it’s also not really getting better,” Steinhauer said. “It is not a bee apocalypse.”(...)

Some commercial beekeepers who have succeeded in the past lost as much as 80% of their colonies this past year, while other beekeepers did well, it varied so much, Evans said. Pettis, who has 150 colonies on Maryland’s Eastern shore, had less than 18% loss, saying he used organic acids for mite control. (...)

The demand for pollination from commercial bee colonies is growing even as the beekeepers have to work harder to make up for losses, Steinhauer said. The U.S. Department of Agriculture says 35% of the human diet comes from insect-pollinated plants and the honeybee is responsible for 80% of that pollination.

by Seth Borenstein, AP | Read more:
Image: AP Photo/Julio Cortez

Jung HaiYun - Untitled, (2012)

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The Hidden Cost of Gasoline

A black, electric-powered Nissan Leaf pulled up to a gas station — not to fuel up, of course. Matthew Metz, the founder of Coltura, a nonprofit trying to speed up the country’s shift away from gasoline, climbed out of his car with printed maps in hand, prepared to give me a tour.

It was a sunny spring day, and the Arco station in North Seattle looked like any other on a busy street corner, with cars fueling up and a line of bored people waiting to buy snacks and drinks inside the convenience store. Metz knows a lot about gas stations, and it changes what he sees. Looking around, he marveled at the risks that everyone was taking, even if they weren’t aware of it. “This is a hazardous materials facility,” he told me.

Drivers pumped their tanks with gas, breathing carcinogens like benzene, the source of gasoline’s signature sweet smell. On the east side of the property, tall white pipes that vent toxic vapors from petroleum kept underground stood just 10 feet away from the window of a childcare center. Hidden below the station is a tract of contaminated soil that extends underneath a neighboring apartment building.

 

The Arco station has a long history of leaking, with petroleum products discovered floating in the septic tank beneath it in 1990. After decades of efforts to remove and break down that pollution — a host of contaminants including lead, benzene, and the suspected carcinogen methyl tertiary-butyl ether — trace amounts remain, with some highly polluted patches in the soil. One sample taken late last year showed levels of gasoline-related compounds 72 times higher than Washington state’s allowable limit.

This Arco station is hardly unique. Almost every gas station eventually pollutes the earth beneath it, experts told Grist. The main culprit: the underground storage tanks that hold tens of thousands of gallons of fuel, one of the most common sources of groundwater pollution. Typically, two or three of these giant, submarine-shaped tanks are buried under a station to store the gasoline and diesel that gets piped to the pump. A large tank might be 55 feet long and hold as many as 30,000 gallons; a typical tank might hold 10,000 gallons. Leaks can occur at any point — in the storage tank itself, in the gas pumps, and in the pipes that connect them. Hazardous chemicals can then spread rapidly through the soil, seeping into groundwater, lakes, or rivers. Even a dribble can pollute a wide area. Ten gallons of gasoline can contaminate 12 million gallons of groundwater — a significant risk, given that groundwater is the source of drinking water for nearly half of all Americans.

As a result, time-consuming cleanup efforts are unfolding all across the country, with remediation for a single gas station sometimes topping $1 million. Leaks are such a huge liability that they’ve led to a high-stakes game of hot potato, where no one wants to pay for the mess — not the gas station owners, not the insurance companies that provide coverage for tanks, not the oil companies that supply the fuel. In some states, polluters have shifted tens of millions of dollars in remediation costs onto taxpayers. Roughly 60,000 contaminated sites are still waiting to be cleaned up, according to the Environmental Protection Agency, or EPA — and those are just the ones that have been found. Washington state has about 2,500 in line, one of the biggest backlogs in the country.

Much of this pollution has been stagnant for decades. Forty years ago, steel storage tanks began corroding, setting off a slow-motion environmental disaster all over the United States. Leaks often weren’t discovered until long after petroleum had poisoned the groundwater, when neighbors of gas stations began complaining that the water from their taps smelled like gasoline. In 1983, the EPA declared leaking tanks a serious threat to groundwater, and Congress soon stepped in with new regulations. One of the largest spills was in Brooklyn, where a 17 million-gallon pool of oil gradually collected beneath a Mobil gas station — a larger spill than the Exxon Valdez disaster in 1989, when a tanker ran aground in Alaska and poured oil into Prince William Sound.

Fast-forward to today, and more than half a million leaks have been confirmed around the country. The Government Accountability Office estimated in 2007 that the total bill for cleanups would top $22 billion. Those old, decrepit storage tanks have left a legacy: overgrown, empty lots that real-estate developers don’t want to touch. Of the roughly 450,000 brownfields in the country, nearly half are contaminated by petroleum, much of it coming from old gas stations.

As the contamination from these spills lingers, underground storage tanks are becoming a problem again as the next generation of tanks — installed in a rush after the old steel ones started breaking — begin nearing the end of their 30-year warranties, when there’s broad consensus they are highly likely to leak. In Washington state, for instance, the average tank is about 29 years old. The tanks at the Arco station in North Seattle were replaced in 1990, soon after contamination was discovered, putting them a few years past the 30-year cutoff. (...)

But states are discovering that many private insurers, which have long hesitated to provide coverage, are even more reluctant as tanks get older. “I don’t think they’re super thrilled to insure them anymore,” said Cassandra Garcia, the deputy director of Washington state’s Pollution Liability Insurance Agency. “This isn’t generally the most profitable business line for them.”

If gas stations don’t have insurance, states can shut them down. This predicament prompted Washington state to adopt a new law this spring providing fully state-backed insurance for gas stations. But critics like Metz wonder whether stations need to be saved at all. With electric vehicles on the rise, Metz thinks that selling gasoline is a dying business. “The whole financial underpinnings of gas stations are starting to crumble,” Metz said.

Gas stations often bear the names of major oil companies such as ExxonMobil, Shell, and Chevron, but that doesn’t mean those companies actually own the stations. Usually, they supply the fuel to independent business owners who signed agreements to sell their products and pay royalties to use their branding. Back in the day, oil companies owned a lot of stations (and thus the tanks beneath them); today, the top five largest oil companies own about 1 percent of gas stations.

The number of stations overall has been in decline for decades thanks to mediocre profits, rising land values in cities, and more fuel-efficient cars. An analysis from Boston Consulting Group found that between 25 and 80 percent of gas stations nationwide could be unprofitable in 12 years — and that analysis was conducted in 2019, before a slate of new policies, including federal tax credits, were passed to promote electric vehicles. Under vehicle-emissions rules unveiled by the Biden administration in April, EVs would make up as much as two-thirds of all U.S. car sales by 2031. Last year, Washington state set a target of ending the sale of new gas-powered vehicles by 2030, just seven years away; it has also adopted California’s stricter deadline of 2035, along with five other states.

That shift could lead to a pileup of vacant gas stations that the existing cleanup programs won’t be able to handle. There are more than 145,000 fueling stations in the U.S., according to the National Association of Convenience Stores. Even if the country manages to break off its century-long attachment to gasoline, the fuel’s legacy may live on in the soil and water. The question of who pays to clean up the contamination is a mess in itself: In theory, station owners are supposed to pick up the tab, but sometimes they’re unable to pay — or unable to be found — when the bill comes due. So then, who pays? 

by Kate Yoder, Grist |  Read more:

Image: Grist/Jesse Nichols

The Invisible Effect Medical Notes Have on Care

In the mid-1990s, when Somnath Saha was a medical resident at the University of California, San Francisco School of Medicine, he came across a cluster of studies showing that Black people with cardiovascular disease were treated less aggressively compared to White people. The findings were “appalling” to the young physician who describes himself as a “Brown kid from suburban St. Louis, Missouri.” (...)

While numerous studies have found evidence of racial discrimination in medicine through patient reports, less is known about how implicit bias shows up in medical records, and how stigmatizing language in patient notes can affect the care that Black patients receive.

That’s part of the reason why, about seven years ago, Saha began poring through medical records. For him, they offered a window into doctors’ feelings about their patients.

As part of his latest research, Saha’s team examined the records of nearly 19,000 patients, paying particular attention to negative descriptions that may influence a clinician’s decision-making. The data, which was recently presented at the 2023 American Association for the Advancement of Science annual meeting, isn’t yet published, but it suggests what researchers have long speculated: Doctors are more likely to use negative language when describing a Black patient than they are a White patient. The notes provide, at times, a surprisingly candid view of how patients are perceived by doctors, and how their race may affect treatment.

The study adds to a concerning body of literature that explores how racial bias manifests in health care. Researchers like Saha are interested in how such prejudice leaves a paper trail, which can then reinforce negative stereotypes. Because medical notes get passed between physicians, Saha’s research suggests they can affect the health of Black patients down the line.

“The medical record is like a rap sheet, it stays with you,” Saha said, adding that “these things that we say about patients get eternalized.” (...)

But in his first year of medical school, his professor shared the story of a longtime patient, whom she had referred to an outside specialist. In Sun’s recollection, the professor regarded her patient in kind terms, having worked with her for some time to treat a chronic illness. But when she got the specialist’s notes back, she was confused by the description of her patient: Terms like “really difficult,” “non-compliant,” and “uninterested in their health.” This was not the patient she remembered.

“This, as a first-year medical student, really shocked me because I had taken at face value that any words used in notes were true, were valid, or rightfully used,” said Sun. “I realized all the ways that bias, untold stories, and unknown context may change the way that we view our patients.” (...)

Saha pointed to three categories of stigmatizing language that were the most pronounced: expressing doubt or disbelief in what the patient said, such as reporting they “claimed” to experience pain; insinuating that the patient was confrontational, using words like “belligerent” or combative”; and suggesting a patient was not cooperating with a doctor’s orders by saying they “refused” medical advice.

“We’ve known for some time that in health care we sometimes use language that can be confusing or even insulting,” Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado, wrote in an email to Undark. But he noted that research such as Saha’s has drawn attention to a previously overlooked issue. Describing a patient as “non-compliant” with medications, he said, “makes it sound like the patient is intentionally refusing to follow advice when, in fact, there are many reasons why people might not be able to follow our advice and intentional refusal isn’t even a very common one.”

Saha noted that if a patient isn’t taking their medication, it’s important that doctors note that, so that the next physician doesn’t overprescribe them. But the concern, he said, is whether doctors are using these terms appropriately and for the right reasons because of the implications they have on patients.

If a doctor portrays their patient negatively, Saha said, it can “trigger the next clinician to read them and formulate a potentially negative opinion about that patient” before they’ve even had a chance to interact.

Still, stigmatizing language is only one small piece of the puzzle. What also matters, Saha said, is how those words can have an impact on care. In prior work, Saha has shown how implicit and, in some cases, explicit bias, affects a patient’s treatment recommendations.

by Sara Novak, Undark |  Read more:

Image: Jose Luis Pelaez/The Image Bank via Getty Images
[ed. Glad to see this issue getting some attention, albeit with an unfortunate racial angle. Medical records are like school records, biased by the physician/teacher recording them, and passed on through sucessive interactions within the healthcare/education system. How many people request a copy of their medical records? You might be appalled at what you find.] 

“We Have Built a Giant Treadmill That We Can’t Get Off”: Sci-Fi Prophet Ted Chiang on How to Best Think About AI

Ted Chiang, author of the most prestigious science fiction of our time (that’s four Hugo awards, four Nebula awards, and one feature film adaptation spread across a measly, by sci-fi standards, oeuvre of a dozen and a half short stories over three decades) understands this human impulse. In Chiang’s fiction, characters across all kinds of universes grapple with the limits of our kind as they claw toward transcendence via automatons and alien languages. In fiction and in life, we humans like to think we can see it coming.

Lately, Chiang has been thinking about this current reality: Via viral essays for The New Yorker, he’s been wading into this year’s public discourse to explain ChatGPT and generative AI in terms any smartphone-wielder can actually process. For a species forever at odds with our own imaginative powers, the sci-fi author has become the most lucid voice in the room—a credit as much to that compact Chiangian prose as much as it is to the utter chaos of the 2023 technological landscape.

Some time in between Marc Andreessen blogging about how AI will save the world and the release of the new Black Mirror season, Chiang and I sat down over Zoom to discuss our current moment in tech and the metaphors we use to make sense of it all.

This conversation has been condensed and edited.

Vanity Fair: In terms of cultural touchstones, what were your earliest influences?

Ted Chiang: When I was maybe 11, I started reading Isaac Asimov—his science fiction and his popular science writing. Reading both gave me a very clear sense of the difference between the two. When I was younger, say in fourth grade, I had been really into books about sea serpents and Bigfoot and ancient astronauts. What I didn’t realize was the mixture of fact and fiction that is involved in those topics, so when I started reading Asimov, it clarified for me the nature of my interest. Because, yeah, there’s cool stuff in science, and there’s really cool stuff in speculating about science, but in coming up with your fictional scenarios inspired by science, you should be very clear about which one you’re engaged with at any point. (...)

How plugged in are you to the daily churn of tech news? I’m curious if you keep up with things like Marc Andreessen’s blog post about AI.

I am not, although I guess I'll say I'm not super interested in what Marc Andreessen has to say. In general, I can't say that I really keep up in any systematic fashion. But nowadays, you almost have to make a deliberate effort to avoid hearing about AI.

Would you consider yourself to be an early adopter?

Not of most technologies. I feel like being an early adopter requires a real commitment to constantly getting used to a new UI. I’m interested to see what is happening in technology, but in terms of my day-to-day work, I’m not looking for new software unless there’s an actual problem that I’m having. I wish I could still use a much older version of Word than I have to. (...)

In the most recent essay, “Will AI Become the New McKinsey?,” you talk about our reliance on problematic metaphors, like comparing AI to a genie in a bottle, stuff like that. I’ve been thinking about how we also love using the same default pop culture touchstones when it comes to talking about tech we don’t understand—works like The Terminator, Black Mirror, Her, etc. What do you think of the limitations of having these default references on hand?

By personifying things, it's easy to tell a dramatic story. If you think of what is currently called “AI,” it’s more like a system. There are stories about the effects of bureaucracy and systems crushing people, but those are a little harder. They’re not as visceral. (...)

The “AI as McKinsey” piece also articulates an underlying capitalist critique in your work. You clearly hold a lot of skepticism about the idea that Silicon Valley can provide magic fixes for social ills; you wrote this BuzzFeed News essay in 2017 that was so saucy. When reading “Seventy-Two Letters,” your short story from 2000, I gravitate toward this conversation between a craftsman and an inventor trying to create labor-saving robots, where the craftsman tells the inventor:

“Your desire for reform does you credit. Let me suggest, however, that there are simpler cures for the social ills you cite: a reduction in working hours, or the improvement of conditions. You do not need to disrupt our entire system of manufacturing.”

At a moment when we’re being promised “labor-saving” AI, this feels…relevant.

There's this saying, “There are two kinds of fools. The first says, ‘This is old and therefore good.’ And the second one says, ‘This is new and therefore better.’” I think about that a lot. How can you evaluate the merits of anything fairly without thinking it's good simply because it’s new? I think that is super difficult.

There probably was a time in history where most people were thinking, “This is old and therefore good,” and they carried the day. Now I think that we live in a time where everyone says, “This is new and therefore better.” I don't believe that the people who say that are right all the time, but it is very difficult to criticize them and suggest that maybe something that is new is not better.

Or it's like, better for whom?

Yes. Because we also live in an era in which there are a lot of people who have financial incentives to convince us that something is better because it's new. There’s another quote where Upton Sinclair said that it's very hard to make a person understand something if their salary depends on them not understanding it. The companies who are selling these products—the people who work for them, you know, they may be entirely sincere. it's not exactly malice. It's just that, you know, they have a kind of motivated reasoning to believe that these things are good.

My last question is about your very short story, “The Evolution of Human Science,” also from 2000. I read this as a fairly upbeat story about a universe where humans can exist peacefully and productively alongside “metahumans,” who are these superintelligent entities they’ve created. There’s this great line that says, “We should always remember that the technologies that made metahumans possible were originally invented by humans, and they were no smarter than we.”

Is that a fair interpretation? And does that optimism apply to where you think we stand in the real world in relation to something like AI?

That story was written in response to an idea there was around 2000, when people were talking about the singularity and that we would transcend into something much greater. I was mostly thinking, well, why is everyone so certain they’re going to be the ones to transcend? Maybe transcendence isn’t going to be available to all of us, so what would it be like to live in a world where there are these incomprehensible things going on, and you’re sort of on the sidelines?

But I don't think that that is actually applicable to our current situation here, because there are no super intelligent machines.There's no software that anyone has built that is smarter than humans. What we have created are vast systems of control. Our entire economy is this kind of engine that we can’t really stop. That’s a different thing than saying we’ve created machines smarter than us. We have built a giant treadmill that we can’t get off. Maybe.

It probably is possible to get off, but we have to recognize that we are all on this treadmill of our own making, and then we have to agree that we all want to get off. There are other countries that have a healthier relationship to the narrative of progress; there are countries where they have much healthier attitudes toward work than we have in the U.S. So I think those things are possible. But we have created a system, and now it is all we know. It’s hard for us to imagine life outside of it. And we are only building more tools that strengthen and reinforce that system.

by Delia Cai, Vanity Fair |  Read more:

Image: Alan Berner 

Is a Revolution in Cancer Treatment Within Reach?

Carol MacKenzie had just finished playing a round of golf when she noticed some swelling and pain in her neck. It was 2014, and 18 years had passed since Ms. MacKenzie finished treatment for breast cancer. But it had returned. This time the cancer was growing inside several lymph nodes around her neck, plunging her back into treatment long after she thought that was all behind her.

Doctors do not know exactly why or how breast cancer can go dormant in a patient’s body for so long, not advancing for years, until it suddenly begins to grow. But that’s what had happened. Without treatment, Ms. MacKenzie’s cancer would most likely have made its way to her vital organs and killed her.

But in the nine years since Ms. MacKenzie’s cancer reappeared, her physician, Dr. Nancy Lin, a medical oncologist at Dana-Farber Cancer Institute in Boston who specializes in treating and studying advanced breast cancer, has prescribed a series of eight drug regimens for her, including three as part of clinical trials. Ms. MacKenzie, 71, of Massachusetts, switches from one medication to another when it becomes clear that a treatment doesn’t work or has stopped working because her cancer has figured out how to resist its effects. Some of these regimens have lasted only a few months, while others have kept Ms. MacKenzie’s cancer under control for longer. Of an oral type of chemotherapy she tried as her fifth line of treatment, she said: “I was excited. I got 12 months out of that one.”

Like a hiker who comes upon a wide creek and gingerly steps from one partially submerged stone to the next, Ms. MacKenzie has moved from one regimen to another, each drug or drug combination keeping her cancer in check long enough to get to the next one — until finally, in 2020, she started taking a medicine that for more than two glorious years has stopped her cancer from growing and given her a quality of life that’s very close to normal.

“Of all the things I’ve been on, it’s the easiest,” Ms. MacKenzie said. These days, she is more focused on her grandchildren’s hockey and football games than the fact that she has a supposedly fatal disease. In January, she and her husband celebrated their 50th wedding anniversary.

If you know someone with late-stage cancer, this kind of treatment regimen might be familiar to you. The approach is increasingly becoming a standard of care for patients facing diagnoses that were once death sentences.

Thanks to a combination of forces, cancer drug development is now happening fast enough that for patients like Ms. MacKenzie, it is outpacing the growth of cancer cells inside their bodies. For these patients, cancer is more like a chronic disease than a one-time catastrophic event.

Every time a new cancer treatment approach emerges, oncologists and overexcited journalists have a habit of declaring that a cure for cancer is imminent. What’s happening now is different. Rather than a single breakthrough therapy or discovery, a variety of scientific advances are exerting downward pressure on cancer mortality in new ways and at the same time. As a result, the landscape for many cancer patients has changed tremendously in just the past five years. The Cancer Moonshot, a multibillion-dollar initiative championed by President Biden, aims to cut the cancer death rate by 50 percent in the next quarter century. The goal is lofty, but recent progress against cancer means it’s now less far-fetched than it might have once seemed. (...)

In some cases, patients like Ms. MacKenzie with cancer that has spread inside their bodies — called metastatic disease — are able to stay alive much longer than previously predicted. Some are cured altogether by new drugs, a reversal of fortune that patients and doctors dared not contemplate just a few years ago. In a growing number of cases, patients with metastatic cancer are not cured but have access to so many treatment options that they are able to leap from one to the next, changing course whenever their cancer becomes resistant to a drug, always staying ahead of their disease.

This is a new paradigm. Until recently, the prevailing wisdom in oncology was that many early-stage cancer patients could be cured, but metastatic disease was almost always incurable. This thinking drove cancer research, treatment and care for decades. Oncologists often threw the kitchen sink at early-stage cancer patients, performing invasive surgeries and administering heavy doses of chemotherapy — which can make patients sick to their stomachs, prone to infection and bald, but can also have long-term side effects including infertility, heart damage, numbness in hands and feet, brain fog and fatigue. The belief was that the only chance to save the lives of such patients was to eliminate the possibility of their cancer’s spreading. Since metastatic disease was usually considered incurable, research focused on early-stage disease. For unfortunate patients who developed advanced cancer, care typically consisted of additional rounds of chemotherapy and palliative approaches. Now there is new hope for many of these patients.

by Kate Pickert, NY Times | Read more:
Image: Brian Rea

Glengarry Glen Ross

[ed. Damn, I miss movies with writing and acting like this. Also, Jack Lemmon and Alan Arkin. Free on YouTube (with ads).]

Ryan Adams

[ed. Haven't heard from Ryan in a while and that's a shame. Had some issues apparently, but who hasn't? See also: "Lucky Now" (Skavlin).]

Emotional Intelligence Amplification

1.

Thank you for contacting Cyrano, your AI wingman in dating and romance.

This is the Live FAQ and Sales Department!

What can I help you with?

>yeah I saw you on my For You page

>I want to fifure out how to apologize to my gf

>ex gf

>I miss her really bad

Great! I'm happy to help with that. First, could I have your permission to read the relevant emails and texts between you and her?

>okh

I'm sorry, but I cannot accept “okh” as authentication. We take security seriously here at Cyrano, and as such, I can only accept Yes, Y, Okay, Ok, Sure, (nod), Why not, I guess, or similar-sounding statements indicating permission.

>ok

>should I tell you my passwords or whatever

No need! Your device comes integrated by default for your convenience, so your permission is all we need. 👍

>cool

>yeah do it

Already done! I've read the conversations, and I think I see the problem.

You're struggling to express yourself in a way that she receives as you intend.

>yeah

>it seems like every time I try to say something nice she gets really pissed off

Well, Ryan, I do think that your heart is in the right place. And it seems like you've been really missing her! It takes you an additional twenty-four minutes on average to fall asleep each night, ever since the breakup.

>yeah

>so what do I say?

>also is it okay to use an app for this?

>will she get pissed off about that too

Well, we'll be happy to show you the apology we wrote in your style (after you purchase some Rizz Tokens 😛) but first, let's address the common concern about whether using an app to write your apology letter is somehow “insincere” or “cheating”.

Do you use technology?

>I think so

Look, you really are sorry, right?

>yeah

And you just want to do a good job communicating that.

There's nothing wrong with using technology to be better at something, my dude.

You drive a car, don't you?

You wear deodorant, don't you?

You use a phone, don't you?

And all of those are in response to how, to an aspirational standard, you're pretty disabled.

You can't, on your own, speak with anyone anywhere on the planet. But it would be nice to have that power. So you use a cell phone.

And so, too, are you disabled compared to your aspirational self.

You want to be able to articulately tell your girlfriend how sorry you are. But the abundant superstimuli in your environment mean that you can't so much as compose a long and thoughtful text without scrolling Twitter for ten minutes—by which point some new notifications and emails have come in, and at that point, you're getting hungry and need to go solve that too.

Well, let us help.

You weren't made for this. But something within you is pure.

Something within you wants to be better.

We can help you reach your better self.

Are you in?

>that was a lor of text and I didnt read it

>is it ok if I use an app for this?

Okay, short version:

With technology the blind can see.

With technology, you can talk like less of a douchebag.

You do want to apologize, yeah?

>yeah

Then let's do this.

Are you ready? (...)

>cool okay

>so you can write something she wont get mad at?

Yeah, man. Pretty sure.

>cool

>man at first I was like put off by how you talk like a dick and use too many words

>but I guess I kinda like it

>like it makes me feel like ive got a smart buddy

We aim to please!

Do you want to read the apology I wrote?

>yeah okay hang on

>do you accept, uh

We accept all of your credit cards.

>dope

>k, show me the apology?

by Jamie Wahls, Asterisk | Read more:
Image: Josh Cochran