With the rise of Chatbots and AI, we are left to wonder: what remains for paltry humans to do in this ever-evolving world?
A partial answer is here. Allison Whitten writes an evocative piece about the mammalian neocortex and the researchers using Single Cell RNA sequencing to tease apart the difference between ancestral salamander brains, modern reptilian brains and mammalian brains that include a neocortex.
I love this stuff. And it seems that the neocortex (for now, based on best evidence) is purely a mammalian innovation, the ability for higher level reasoning and thinking (and ? the seat of consciousness) different from ancestral or reptilian brains.
It makes me wonder about Wonderful Life, the Burgess Shale, where Gould talks about evolution and the dice-rolling that has occurred and how random it is that WE are here instead of completely different beings.
CMIO’s take: Learn about how we think, in the service of making tools that align and support these thoughts. AI does not supplant human. A human augmented with AI will supplant the human alone.
The Hype Cycle (peak of overinflated expectations)
The caution needed as our tools grow in skill exponentially
The ongoing risk of hallucination and unexpected errors in chatbots
The “grounding” problem with AI and robots
I particularly love the following quote:
Roy Amara, who died on the last day of 2007, was the president of a Palo Alto based think tank, the Institute for the future, and is credited with saying what is now known as Amara’s Law:
We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run.
I’m feeling an upward acceleration of AI skill with GPT applications, which could open up substantial risks as well as benefits.
For example, in the EHR space, there is discussion that GPT could take a patient and physician’s recorded conversation and automatically write a progress note, qualitatively more accurate and much faster than current commercial tools. Further, it could potentially summarize weeks of progress notes on hospitalized patients and write the discharge summary, a document that, when well-written, can take a human many hours of work. Or even, receive patients’ incoming MyChart messages and clinical questions and “reply to the patient in the voice of their clinician” based on the decade of writing by that clinician in the EHR.
Sure, these seem great. How about the potential deluge of GPT agents writing notes, requests ON BEHALF of patients, or other authors, that could junk up our systems? If 183,000 incoming patient messages is a lot (current monthly patient message volume at UCHealth), what if GPT somehow enabled 10x that number?
How much discussion will be GPT talking to GPT on behalf of employers/ patients/ discussants? I understand science fiction editors now have a 10x increase in sci-fi story submissions, a SUBSTANTIAL FRACTION now being written by GPT based on prior stories?
“I worry that we are very much in a ‘move fast and break things’ phase,” says Holstein, adding that the pace might be too quick for regulators to meaningfully keep up. “I like to think that we, in 2023, collectively, know better than this.”
CMIO’s take? Take a breath, everyone. It’s going to be a bumpy ride.
My Asian background and the hunger for achievement
The constant threat of conflict
The importance of being comfortable with ambiguity
The unease of global tensions and political disagreement
The cultural clash between Asian and American habits
Moore’s law playing out in our lifetime
Lithography as art and the pinnacle of tech
The necessity of trust to drive innovation and growth
The knowledge that TSMC tech powers the vast majority of devices and servers without which American healthcare’s Electronic Health Records cannot exist.
Yes, it is a long read. This is what deeply researched, wide-ranging, thoughtful writing is about.
I’m a Taiwanese native American citizen. Taiwan Semiconductor Manufacturing Corporation (TSMC) probably isn’t a household name for most, and yet it produces the vast majority of the most advanced chips for the most advanced smartphones, laptops and computers. TSMC makes me proud to have been born on that tiny island.
CMIO’s take? I enjoyed this very much. This is a brilliant read. You may not agree with all of it, but it is a fascinating journey into the interconnectedness of our personal relationships, our technologies, our trust, our nations and leaders and nothing less than the future of our world.
My dad bought me an Apple II in the 1970’s. It ran off 8 inch floppies. I learned Microsoft Basic, played Adventure (text game), where I learned about “xyzzy“, and lost many hours of childhood.
Then I got a Mac that ran on 3.5 inch floppies, and have never looked back. In junior year in college (1984) I bought a 128K Mac (128K of RAM! What more could one want?). It had one floppy drive. Microsoft Word fit on ONE floppy disk. Of course if you wrote a paper, you would have to eject the Word disk and insert a fresh disk to store your paper. If the paper was longer than 3-4 pages, you could quite some time swapping the Word disk and the document disk to fully save your paper.
Roommate: “Hey, CT want to have lunch?”
Me: “Yes! Oh, wait, let me save my document”
Mac: Click / whirr / disk ejected / “Please insert document disk”
Mac: Click / whirr / disk ejected / “Please insert Word disk”
Mac: Click / whirr / disk ejected / “Please insert document disk”
(repeat x 30)
Me: “Uh, you guys go ahead, I’ll be down in about 30 minutes. I gotta save my paper.”
I wrote my undergrad thesis (Mapping the P4 Bacteriophage gene!) on 3 Macs: one to write the manuscript, one for my friend to help me generate figures (using MacPaint!) and one (full time) to print the current draft of what I was writing so I could clip them in a 3 ring binder and take the bus and deliver it to my professor to read, red-line, and return to me for another re-write. See below for an actual video of the image writer printing 1/2 line of text with each pass. At the time: AMAZING!
Wired reports on the surprising finding that 3.5 inch floppies are still around and still crucial in a number of industries, including IN 747-200’s!!! They carry the weekly updates in navigation and there is NO OTHER MEDIUM to transfer this information.
Invented FORTY YEARS AGO in 1981 by Sony, the latest evolution of spinning disk, from the original 8-inch, to the 5 1/4-inch to the 3.5 inch, was very popular for decades. The the last manufacturer stopped producing 3.5 floppies in 2010, and here we are 13 years later, still buying up the remaining supply and using them as storage and transfer media.
Like many adults my age (50’s), I lived through a phase-transition in technology. From most things being analog, to most things being digital:
and yes, foot-high stacks of paper medical records BECAME the EHR (electronic health record, with “…” indicating “scroll for more”)
We even had to explain to my mother-in-law, the difference between analog and digital, after which, she announced that her new name would be “gram-alog”. Cute.
The bigger picture
It occurs to me, that perhaps my generation is the last to know many of these analog technologies, and the accidental discoveries, or serendipity, of thumbing through a card catalog and finding unrelated, but delightful books. Or walking the actual stacks of a library and seeing titles jump out at you in unexpected corners.
Yes, we click on links in google searches, but is that really the same?
We have also lost the sensory input of that “foot-high heavy stack of paper records” or the moldy smell of records pulled out of the archives that smells of 1970. How can one miss the paper chart that is filled with yellow-colored paper that all radiology reports were typed on? This folder is FULL of YELLOW.
In contrast, our EHR’s have 30 lines of “chart review” history, and one can scroll for more. Sometimes even “click here to see more.” We don’t know if “more” is one more line, or 1000’s more. There is no “heft” no “moldy smell” no FAT SECTION FULL OF YELLOW.
I wrote about this before, in Grokboard, a way to rethink the way humans engage with large volumes of data.
Here we are 5 years later, still pining away for ways to re-engage our senses. How might we approach this?
A homunculus to show us which organ systems are disordered?
Sit in a Gamer’s Vibrating Chair? Perhaps it would vibrate your left arm to warn you of a penicillin allergy, or your right calf to remind you of an elevated creatinine?
Maybe your mouse vibrates when it rolls over a patient chart with high risk, unaddressed alerts?
Maybe we need Smell-o-vision so that we can smell the fruity breath of the patient in diabetic ketoacidosis.
Something is missing. The Glass Cage?
We are in a Glass Cage, just like airline pilots. The critique is: instead of the “glass cockpit” where the convenience of electronics give you context-specific controls (wow, great), pilots instead are in a “glass cage” where everything is anesthetized. Your fingers no longer feel the ‘thrum’ of the wires connecting you to the aircraft wing, and feel turbulence. You see the iPad electronic display and move the virtual sliders and knobs.
Similarly for physicians, sitting at the EHR, we no longer see and smell the patient, we view pages on pages of test results and progress notes and assemble the patient virtually in our head.
The Technological Discontinuity
Just like the industrial age kicked off with the advent of the steam engine, and work would never be the same, computerization and the internet have kicked off an information revolution. We will never think the same.
Of course in the short term (the past 50 years), we have learned to be Burned Out with all the keyboard and mouse work. We have learned that information is at your fingertips, but MORE is not BETTER.
We have learned that putting things under Glass might look pretty and cool and win some design awards, but we lose the use of other types of senses (smell, texture, resistance, vibration, weight, heft), and we become disembodied brains.
And, serendipity, where art thou?
What else might be missing on our headlong rush to digitization? When should we push the pendulum back the other way?
Sure, AI and Chatbots are coming. The balance of skill and power is shifting between human brain power and silicon compute power. Meanwhile, is the physical world disappearing? Are we paying attention?
If you’re like me, you struggle with the addiction to online media sites (eg: what you scrolling right now, that you’re reading this?).
Love the ideas on this post from the MIT technology review, particularly step 3: find the “bigger, better offer”, once you recognize: you’re in a habit loop, the endless scroll triggers micro-dopamine. Create even a small break in that cycle and find something that is a “bigger, better offer” that is aligned with what YOU want out of life, not just mindless scrolling.
“The Billionaire’s Daughter Knows What You’re Thinking” (and she’s not wrong)
I’m hopeful when I read articles about people like Ms. Koch. Daughter of a billionaire, very much aware of her privilege, and exploring herself and inviting others to examine their own assumptions about their own lives and that of others.
CMIO’s take? I think we need more introspection and openness like this.
Here is our next AI challenge, as our jobs undergo gradual transformation. How will we as knowledge workers in informatics accommodate the growing sophistication of narrow AI assistants? Scheduling appointments, helping with spelling and grammar, now writing fluid manuscripts based on the library we point them to?
Teachers are starting to change “take home” assignments to in-class writing with no internet connection, to ensure students don’t outsource their thinking/writing to an AI chatbot.
What will we do? Can an AI replace us in writing the “one-pager” that summarizes thinking and succinctly and convincingly makes the case for change? Is Machiavelli vulnerable to being toppled? Do we no longer have need for governance and leadership if we can outsource thinking and fluency to an AI? Will my AI go up against your AI in the battle for mindshare?
CMIO’s take? Yet again, time to re-imagine our jobs with the tools we have at hand.
We know that setting fewer goals (actually setting just ONE dramatically improves your likelihood of success) is better for you. And in the pursuit of that one goal, setting a daily habit is crucial to achieving it.
If, for example, your goal is “being present” or “being more joyful”, it helps to set a daily habit that moves you in the right direction. Is it a daily walk? a daily 30 minute read? A daily 10 minute sketch? A daily swim? Stretch? Birdwatch?
From the article, I particularly love the “gin rummy” habit at 6pm, between husband and wife. Popcorn, hot tea, play 5 hands, fiercely contested, joyfully celebrated by the winner. And, 5 minutes later, no one can remember who won.
CMIO’s take: Dear readers, what non-negotiable daily habit do YOU have that brings you joy, and can share with us? We are all looking for inspiration.