What is the Value of our Humanity?
Posted on | November 25, 2024 | 4 Comments
Mike Magee
The image of William Westmoreland, speaking direct to the camera in the 1974 documentary “Hearts and Minds”, is stark and unapologetic. He addresses the interviewer’s question about extensive loss of civilian lives during the Vietnam War this way: “Well, the Oriental doesn’t put the same high price on life as the Westerner. And as the philosophy of the Orient expresses it, life is not important.”
Thinking of him and those years again, which in many ways I’d sooner forget, and realizing that to some extent, we have managed to repeat our mistakes, and embrace the same types of biases, well, you can understand why I sighed a bit for the human race last evening.
And yet, out of the same era, from another clearly morally compromised President, Richard M. Nixon, came the historic 1970 Clean Air Act. It passed the Senate 73-0, before gaining the President’s signature, and created the Cabinet level Environmental Protection Agency (EPA) that, if some had their way, would be on the chopping block come January 20th.
And yet, history has shown that clean air and water are pretty popular on Main Street and in the halls of Congress. In 1990, another Republican president, George H.W. Bush, signed legislation that further strengthened the law after 89 senators, including Mitch McConnell supported the changes. Of this action, the then new incoming Majority Leader, who later decried actions of the EPA as attempts to destroy “Big Coal”, stated, “I had to choose between cleaner air and the status quo. I chose cleaner air.” President Bush’s action allowed the EPA to first begin to measure levels of ozone and mercury in our air.
The EPA has been up (Obama and Biden) and down (Trump/2016) since then. It drew a 28 page chapter in the Project 2025 playbook. Trump’s 2016 director of the EPA, Mandy Gunaswkara (originally a staffer on the Senate Environment and Public Works Committee under the late Oklahoma Sen. James Inhofe) says she’s good to go again. As she put it, “The biggest difference is we have a plan from Day One, we’re going to start implementing it, and we won’t be as susceptible to process problems that really sunk a couple of those final regulatory proposals and actions we took at the tail end of the administration.”
Heritage Foundation’s Trustee, Kevin D. Roberts, is all in. As he recently wrote, “…economic freedom is not something Americans should apologize for, but harness, spur, and give free rein—for our own sake, and everyone else’s, too.” Their opinions on governmental guardrails and regulation are similarly strong, but in reverse. “America is over regulated. Every facet of daily life, from what cars we drive to what food we eat is subject to government’s regulatory reach.”
According to the Heritage Foundation, AI has arrived in the nick of time. To listen in on their planning, there is still time to register for the December 4, 2024 conference, “Digital Tools for Modernizing the Federal Permitting Process.” As they describe it, “The report tackles the obstacles created by the lack of transparency in the federal permitting process which needlessly increases the risk to investors while obscuring accountability in the democratic process.”
The Pew Research Center covered the same territory a few years back. Alexander Cho, a digital media anthropologist, was not surprised by the Heritage Foundations current focus on AI. He says that “‘digital’ acts as a magnifier, accelerator and exacerbator of historical conduits of power that may have not been as obvious to folks before.” What we are experiencing in the wake of this election cycle are “social and civic conversations that are not new but that have been catalyzed through digital media.”
Chair of Environmental Studies and Science at Pace University, Melanie DuPuis, on the same Pew centered platform, recalled David Blight’s biography of Frederick Douglas, and left open the possibility of a painfully long policy winter. In her words, technology back then was an accelerator as well. “Of course, it was technology that made Douglass’s words visible to a civic public: newspaper and, interestingly, train travel…I don’t think he would have guessed that the darkness would continue so long. I think American darkness will continue but that civil society will eventually reemerge, as it has in democratic countries over the last two centuries.”
Another participant added this, “Individuals will have to reevaluate their lives and their prospects. Whether the responses to change are successful or not depends on multiple factors, such as the current sophistication of societies, the perceived place of a shared morality and the level of education and awareness. The risk is the emergence of a disposed and disenchanted digital ‘proletariat’ whose response to change will be violent rather than reasoned.”
Others predict a backlash. One said, “The reign of Trump and other nay-sayers will lead to a countermovement that will bring about sweeping changes in the digital world. We will see a privacy set of laws similar to Europe. We’ll see the breakup of monopolies like Google that will generate new innovations.”
Where’s the common ground? All agree the debate has been engaged, and AI assisted information technology will likely fan the flames. What remains to be determined is what sprigs of new life will emerge from these ashes. We shall see what is the value of our humanity.
Tags: Alexander Cho > Frederick Douglas > heritage foundation > humanity > Mandy GunaswkaraKevin Robert > Pew Reseach Center > Pew Research > trump
Thomas E. Kurtz and “A Few Good Men”
Posted on | November 21, 2024 | Comments Off on Thomas E. Kurtz and “A Few Good Men”
Mike Magee
This has been a challenging week for me, but not for the reasons you might think. Compartmentalization skills have allowed me to push the 2024 Presidential election into the back reaches of my mind as I worked to complete teaching a course on “AI and Medicine” at the Presidents College at the University of Hartford.
Along with my students, we confronted a future filled with competing visions. Promise and dread lurked side by side at every turn. In one of the final slides of the final lecture I included an image from the 1992 Alan Sorkin legal drama, “A Few Good Men.” The face of an enraged Jack Nicholson (relentlessly baited by Tom Cruise) filled the screen under the headline “You can’t handle the truth!”
This device was employed to spotlight the fact that genAI, trained on de-identified population health data, will soon reveal numerous uncomfortable “truths” about our health care system – like its’ inefficiency, inequity, and spotty outcomes; or its wastefulness, fraud, and permissive attitude toward DTC marketing designed to drive demand.
AI’s capacity to uncover the strengths and faults of our system has already been highlighted in a January 24, 2024 JAMA article titled “Scalable Privilege” – How AI Could Turn Data From the Best Medical Systems Into Better Care For All.”
If we want to emphasize the positive, we do well to stop for a moment and acknowledge with gratitude the passing this week of 94 year old Thomas E. Kurtz. You may not have heard of him, but you likely recall his seminal invention, the first computer programming language for the masses – BASIC (Beginners’ All-purpose Symbolic Instruction Code). As Bill Gates himself reflected this week, “The approachability of BASIC and time-sharing began what the PC and the internet took to a whole new level.”
Bill would know. His high school had a teletype connection to the original time-sharing main frame computer at Dartmouth. But Gates was not alone or first in line. As Kurtz remembered, “I once estimated that even before Bill Gates got into the action at all, five million people in the world knew how to write programs in BASIC. There was something like 80 time-sharing systems in the U.S. that offered BASIC as one of their languages. And it was all over the world. I even got a letter from somebody in Siberia.”
It wasn’t until1978 that Gates teamed up with Microsoft founder, Paul Allen, and received permission to install BASIC in the first customizable personal microcomputer, the MITS Altair 8800.
Kurtz was the son of German immigrants, and displayed high aptitude in mathematics early in life. He graduated from a local college in Illinois in 1950, and by 1956 had earned a PhD in statistics at Princeton. He was recruited to Dartmouth that same year by the chairman of Mathematics, John Kemeny, who had previously been a research assistant at Princeton himself under none other than Albert Einstein. Kurtz launched a new field at Dartmouth that year – computer science.
He was starting at ground level – or more accurately, below ground level since the solitary computer the university possessed was housed in the basement of College Hall where it filled an entire room. Training students in computer science required hands on engagement. As Kurtz explained some years later, “Lecturing about computing doesn’t make any sense, any more than lecturing on how to drive a car makes sense.”
In later interviews, Kurtz make it clear that his idea didn’t meet with applause at the outset. He admitted, “The target (in computing) was research, whereas here at Dartmouth we had the crazy idea that our undergraduate students who are not going to be technically employed later on should learn how to use the computer. Completely nutty idea.”
Two barriers at the time were computer language and computer time. The main frame on campus ran on complex FORTRAN and COBOL which only a few experts had mastered. And if you wanted access, you had to wait in line.
But eight years after he had arrived on campus, on May 1, 1964, at 4 a.m., he put his new language, BASIC, to the test with the typed command “RUN” and it worked. He modestly remembered that “The whole point of this was to make computing easy for Dartmouth students, Dartmouth faculty, Dartmouth staff, and even Dartmouth janitors.”
One of Kurtz’s famous quotes was “always choose simplicity over efficiency.” It took only a one hour seminar to learn the system. At around the same time, he addressed the second problem – time. Developing what has been called “a clever workaround,” his new system permitted multiple users at remote terminals to access the computer simultaneously.
As with C.Everett Koop, who also died at age 96, he chose to live out the last few years of his life in near view of the Dartmouth green. And the world he left behind, one hurtling forward at breakneck speed, offers near unlimited computing access, and little time or delay between thought and action. Mistakes therefore run the risk of self-amplifying and potentially hurtling out of human control.
Mark Minevich, a well-respected AI Master Strategist focused on “human-centric digital transformation” understands the risks and benefits as well as anyone. He recently laid out pillars for governmental management of AI. They include risk assessment, enhanced safeguards, pragmatic governance, and public/private partnerships. Channeling Kurtz, he said, “There are no shortcuts to developing systems that earn enduring trust…transparency, accountability, and justice (must) govern exploration…as we forge tools to serve all people.”
The Dartmouth flags were lowered in Kurtz’s honor on Wednesday, Nov. 20, and Thursday, Nov. 21.
Tags: A Few Good Men > BASIC > Bill Gates > Dartmouth > John Kemeny > Koop > Paul Allen > Princeton > Thomas E. Kurtz
A Post-Election Resource
Posted on | November 13, 2024 | Comments Off on A Post-Election Resource
We are in the grip of change and our American Democracy is at risk. Change is one of the few human experiences that supports two dramatically opposed human emotions. On the one hand, change is fear, and on the other, change is exploration. And while you can support both emotions simultaneously, you can only do so for a short period of time before the tension created between the two forces you to choose one or the other.
At times like these, leadership really matters. Negative leaders embrace fear, using it as a currency to mobilize and organize populations to cement minority rules. In contrast, positive leaders are explorers who use a compelling value-centered vision as currency. Through role modeling and the strength of new ideas, they draw people in as they work through the challenges and shape an environment consistent with the majority’s long-term vision.
Negative leaders retrench and divide; positive leaders connect across the divide. Negative leaders segregate; positive leaders aggregate. Negative leaders build walls. Positive leaders build “islands of common stewardship.”
In our lifetime, we have witnessed the emergence of Intternet and HIV, of globalization and overnight delivery, of bubbles and bursts in our stock market, of the genomic revolution, and artificial intelligence. We have witnessed our health care system creak under the weight of a pandemic, and borne witness to an ongoing attempt to overthrow our democratic form of government. We are heavily armed, are always prepared for war, but show little desire for peace.
People are basically good, but they are not perfect.
People are basically kind, but when afraid can act unpredictably.
People are basically loving, but when misled can respond with hatred.
People are people.
Positive leaders are value driven role models and highly effective leaders worth emulating. They are also defenders and practitioners of Democracy.
What this book offers is one person’s stories, 10 cornerstone themes, and 52 personal challenges which are the distillation of values and lessons drawn from one life. They are no more valid than those of the reader.
Will Trump (with RFK as Intern) Play Doctor Again?
Posted on | November 12, 2024 | 4 Comments
Mike Magee
It has been a collision of past, present and future this week in the wake of Trump’s victory on November 5, 2024. The country, both for and against, has been unusually quiet. It is unclear whether this is in recognition of political exhaustion, or the desire of victors to be “good winners” and no longer “poor losers.”
Who exactly are “the enemy within” remains to be seen. But Trump is fast at work in defining his cabinet and top agency officials. In his first term as President, Trump famously placed himself at the front of the line of scientific experts sowing confusion and chaos in the early Covid response.
His 2024 campaign alliance with Robert F. Kennedy Jr. suggests health policy remains a strong interest. As his spokesperson suggested, his up-front leadership led to a resounding victory “because they trust his judgement and support his policies, including his promise to Make America Healthy Again alongside well-respected leaders like RFK Jr.”
For those with a memory of Trump’s checkered, and disruptive management of the Covid crisis, it is useful to remind ourselves of those days not long ago, and consider if throwing Bobby Kennedy Jr. in the mix back then would have been helpful.
I have been revisiting the Covid pandemic as I have prepared for a 3-session course on “AI and Medicine” at the University of Hartford’s Presidents College. The course includes a number of case studies, notably the multi-prong role of AI in addressing the Covid pandemic as it spun out of control in 2020.
The early Covid timeline reads like this:
December 1, 2019: A 70 year old man is admitted to the hospital in Wuhan, China with respiratory distress.
Mid-December, 2019: Multiple citizens in Wuhan, China are now gravely ill.
December 24, 2019: A post-mortem lung sample of a Wuhan patient yields a partial genetic sequence of the infectious viral agent. It is similar to the SARS virus that triggered an epidemic in 2003.
December 30, 2019: Word leaks out and reaches U.S. epidemiologist Marjorie Pollack, head of Promed, which alerts their 80,000 subscribers, including officials at the WHO, of a pending epidemic.
December 31, 2019: China’s National Health Commission directs the Wuhan health officers to formally announce the outbreak.
January 1,2020: Wuhan police threaten several local doctors for speaking out, labelling them as “rumormongers.”
January 3, 2020: Chinese government lets WHO know they are managing 44 confirmed cases.
January 5, 2020: A full genetic sequence of the virus is released. Chinese officials initially attempt to suppress the information.
January 13, 2020: German scientists release a test for the virus.
mid-January, 2020: Hundreds are now ill in Wuhan, and people are beginning to die from respiratory failure.
January 23,2020: There are now outbreaks in other parts of China. 571 cases are reported.
A Wuhan Central Hospital worker reports at the time: “It erupted too fast, and then there were just too many people infected, Without ventilators, without specific drugs, even without enough manpower, how were we going to save people? If you’re unarmed on the battlefield, how can you kill the enemy?”
February 15, 2020: Moderna release a “clinical-grade, human safe manufacturing, batch (of mRNA) shipped to health clinics for testing” just 45 days after the genetic sequencing had been revealed.
What normally would take years, took a few weeks. As Moderna’s chief data and AI officer, Dave Johnson PhD said later, “We were building that early preclinical engine of a company, which is, how can we target a bunch of different ideas at once, run some experiments, learn really fast and do it again… if you wanna run a lot of experiments, you have to have a lot of mRNA. So we built out this massively parallel (AI aided) robotic processing of mRNA… as things evolved as you capture data in these systems, that’s where AI starts to show up. You know, instead of just capturing, you know, here’s what happened in an experiment, now you’re saying let’s use that data to make some predictions.”
What AI did was direct the re-engineering, through purposeful mRNA mediated mutations of the virus’s genetic code, helping to generate the first batch of mRNA Covid vaccine.
December 18, 2020: Moderna receives “emergency use authorization” from the FDA Vaccine Advisory Committee.” Not a moment too soon, most would say. The death toll in the U.S. had already reached over 800,000, and projections of monthly fatalities ahead had reached 62,000.
It is now believed that rapid AI-aided development of the mRNA vaccine for Covid saved 15 to 20 million lives worldwide. The rapidity was the result AI driven hyper-accelerated mRNA generation. Prior to the integration of AI, Moderna was generating 30 samples of mRNA a month. By optimizing with AI, the yield exploded to more than 1000 per month. AI was then used again to predict how best to structure the vaccine to maximize a protein production response in the body…or as the company says, “more bang for the biological buck.”
Dave Johnson is quick to note that Moderna was fast at work with AI applications years before Chat-GPT became a household term. His background was software engineering and data science, and his PhD was in information physics. So it is not surprising that he’s comfortable forming non-human relationships. As he says, “We always think about it in terms of this human-machine collaboration, because they’re good at different things. Humans are really good at creativity and flexibility and insight, whereas machines are really good at precision and giving the exact same result every single time and doing it at scale and speed.”
As for a civilian like RFK Jr. playing doctor, that never seems to end well. Tommy Thompson tried managing the Anthrax crisis in 2001 and had to be rescued by Tony Fauci, MD. Fauci was there again in April of 2020 to clean up Trump’s bleach for Covid comments. Add to this a series of disastrous outcomes in red states where zealot bureaucrats have deemed themselves qualified to manage obstetrical emergences.
Will history repeat? We’ll know soon enough.
Tags: AI > Anthrax > ChatGPT > covid > Covid Vaccine > dave johnson phd > mRNA > RFK Jr. > Tommy Thompson > trump > Wuhan
Last day to register: AI and Medicine Course begins tomorrow.
Posted on | November 5, 2024 | Comments Off on Last day to register: AI and Medicine Course begins tomorrow.
Penn State College of Medicine’s Oath: A Vote For Democracy.
Posted on | November 2, 2024 | 2 Comments
Mike Magee
Two years ago, prior to the 2022 election, mental health experts alerted the medical world to their version of an assessment scale for yet another new condition – “doomscrolling.”
As defined in the article, “Constant exposure to negative news on social media and news feeds could take the form of ‘doomscrolling’ which is commonly defined as a habit of scrolling through social media and news feeds where users obsessively seek for depressing and negative information.”
As the distressing recent MSG Rally well broadcast, there apparently are no guard rails remaining in Trump-led “doom making.” But that does not mean that the majorities that oppose him have to fall victim as well.
Optimism is a choice and an effective political message. No one can deny a range of legitimate concerns. Faced with continued background noise from residual effects of the pandemic, we’ve been forced to absorb global warming induced weather disasters, renegade AI, sectional warfare around the globe, and the fact that (inexplicably) most elected Republican leaders have chosen to compromise all values and decency to preserve their jobs.
With real challenges like these, our troubled world needs to stay focused on values and resilience. This means aligning our humanity with our approach to self-governance. John J. Patrick PhD, in his book Understanding Democracy, lists the ideals of democracy to include “civility, honesty, charity, compassion, courage, loyalty, patriotism, and self restraint.”
We live under a constitutional and representative democracy, as do two-thirds of our fellow citizens in over 100 nations around the world. The health of these democracies varies widely. The case for democracy emphasizes its capacity to enhance dignity and self-worth, promote well-being, advance equal opportunity, protect equal rights, advance economic productivity, promote peace and order, resolve conflicts peacefully, hold rulers accountable, and achieve legitimacy through community based action.
One of the challenges of democracy is to find the right balance in pursuing “the common good” which has dual (and often competing) arms. One arm is communitarian well-being and the other, individual well-being. Blending personal and public interests is complex.
Both nursing and medicine have worked to bridge this gap through “professionalism,” and launched new graduates by voicing “oaths” or promises to themselves, their colleagues, and our society as a whole.
Louis Lasagna, MD‘s 1964 Oath included a communitarian connector: “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”
Nursing has also relied on professional Oaths. The first was the Nightingale Pledge, created in 1893 by the Farrand Training School for Nurses and named after Florence Nightingale. It is believed to be based on the Hippocratic Oath, and was modernized in 1935. In the 1950’s, the American Nurses Association (ANA), created a formal Code of Ethics, including Nursing’s 9 Provisions (or Pledges) committing to: compassion and respect, patient-focus, advocacy, active decision making, self-health, ethical environment, scholarly pursuit, collaborative teamwork, professional integrity and social justice.
The Penn State College of Medicine’s Oath in 2022 recognized that “We’re all in this together.” They gave top billing to the patient, with the oath to the patients, not to Greek gods: “By all that I hold highest, I promise my patients competence, integrity, candor, personal commitment to their best interest, compassion, and absolute discretion, and confidentiality within the law.”
As citizens and caregivers of our Democracy, in these final moments before the 2024 election, we can ill afford to go weak-kneed, and collapse into a pile of doomsayers. The vote is your’s.
As for me, I will cast my Presidential vote with the pledgers of Penn State College of Medicine for “competence, integrity, candor, personal commitment to their best interest, compassion, and absolute discretion, and confidentiality within the law.” I will vote for Kamala Harris.
Tags: Ameerican Nurses Association > ANA > Democracy > doomscrolling > John J. Patrick > Louis Lasagna > MSG Rally 2024 > Nightengale Pledge > penn state college of medicine > Penn State College of Medicine Oath > understanding democracy
Our 60’s Hippie Casts Her Vote.
Posted on | October 31, 2024 | 4 Comments
Pat Magee Jaksha
Mike Magee
This is my sister, Pat, #3 (I was #4) of 12 children born to Grace and Bill Magee. She was born on Elvis Presley’s birthday – 1 year and 12 days before I was born. That was 14 months after our father had returned from Europe at the close of WW II. He was a soldier and a healer, a happy warrior, an optimistic fighter, a good person who earned the respect of many.
The apple doesn’t fall far from the tree. Their 3rd child, Pat, is also a soldier and a healer, a happy warrior, an optimistic fighter, a good person who has earned the respect of many. She also shares with her late father an easy manner, a quick and infectious laugh, a clever wit, and a strong moral backbone. She displays and lives her values, but not in a pushy or insufferable way.
Pat can take a hit, and still be standing. Here she is above, decked out for Halloween in the 1960’s Hippie costume her daughter, Mandy, helped her pick out for Halloween festivities at “Sunrise of Edgewater” where she now lives.
The past few years have been a test of Pat’s strength, and spirit, and resilience. She lost her beloved husband of 52 years, Dave, on November 25, 2022, to Covid related complications. With a range of medical issues of her own, she moved within weeks from her life long home in Tucson, Arizona, where she had been an elementary school teacher, to New York City to be close to her only daughter and husband, Mike, and only granddaughter, Marlowe.
Two complex surgeries, and challenging recoveries followed, and multiple city moves before settling into her new home in Edgewater, NJ, a stone’s throw from where we grew up and our father practiced medicine in an office attached to the house in Fort Lee. She wasn’t alone. Besides frequent visits from her younger sisters, Sue and Kathy, who lived in the area, she had many new friends in-residence, some even who had been patients of our father as children many years ago.
As kids, when we would get down, our Mom and Dad would tell us to “Keep the Faith.” That meant to look forward, not backwards; to not waste time feeling sorry for ourselves; to be strong and above all, not give up. Pat has done all that – and a little more, a secret sauce that lights up her eyes. When she was in pain, or struggling to stand independently, those eyes that are striking mirrored determination. But as you see reflected in the picture above, they now sparkle with joyfulness and thankfulness.
Pat is alive and standing on her own again. Like many Americans, she has faced challenges, some large enough to justify just giving up, and no one would have blamed her for that. But she never did. When I spoke to her about this picture yesterday, she had one regret. She said she meant to wear her “I voted” sticker when our sister Sue took the shot. She voted by mail in her new (and our old) state of New Jersey. Keep the Faith!
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