inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #26 of 223: Jon Lebkowsky (jonl) Sun 3 Jan 10 07:51
    
It's interesting to look at the traditionalist vs modernist approaches
to Barolo production, as described in the Wikipedia article on Barolo
as "the Barolo wars." (http://en.wikipedia.org/wiki/Barolo) What
evolves is a mashup of traditional and modern approaches to leverage
the strengths of each. Where else can we see that happening? I've had
conversations aboout the future of journalism (most recently with
journalist Pete Lewis, who's got a Stanford fellowship to give him
space to think about such things), and forward-thinking journalists
like Pete are trying to figure out how bloggers and journalists can
relate to each other - again, how you retain the strengths of
traditional journalism and leverage the persistent and extended focus
that bloggers can have, working outside market constraints. 

As digital convergence progresses and the future emerges from the past
and present, you see more and more of this sort of thing. Healthcare
is another example - the world of medicine is changing radically as
patients become more knowledgeable - often enough they'll have
knowledge about their condition that their physicians lack, because
they have access to the data via the Internet, and strong motive for
better understanding what's happening to their bodies. Physicians get
this, and a sometimes uneasy partnership is forming between the more
knowledgeable patients and treatment providers - participatory
medicine. You also see organizations like Science Commons/Health
Commons pushing for open data on medical research, and there's pressure
(built into healthcare reform, but already building before that
legislative wrangling even started) to make all health records digital.
Patients are demanding access to their digital records so that they
can validate their accuracy - bad data in your health record can kill
you, so they have a real stake.

Journalism and healthcare are a couple of examples, but you see this
stuff happening elsewhere. We also see a fragmentation of mindshare
into niche areas of focus; it's really hard to build a mass audience.
Marketers are freaking out and trying to redefine what they do as
"social media" practice, though rather than bring the strengths of old
and new approaches together, marketing people seem confused and unable
to let go of a sense of control and certainty, so they persist the
weaknesses of their traditional approaches, carrying those weaknesses
into new online social environments.

Digital is transforming the way we do politics, the way we make war,
the way we prepare food, the way we create and perceive cultural
artifacts, the way we build prototypes and manufacture products. 

You've written and thought about this convergence for years,
especially from a design perspective. What significant changes are you
seeing that most fascinate you?
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #27 of 223: The devil is in the detail (robertflink) Sun 3 Jan 10 10:45
    
Great conversation even if it leaves me a little intellectually
breathless.  

I tend to think that much of modernity rests on an infrastructure run
effectively by experts of various stripe while we pay attention to the
so-called "movers and shakers" public and private.  

Any comments on or tends among these infrastructure experts that we
should give a little attention to from time to time?
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #28 of 223: Bruce Sterling (bruces) Sun 3 Jan 10 10:59
    
The media never covers green energy.  Would a hundred billion pounds
do it for ya?

http://www.guardian.co.uk/business/2010/jan/03/gordon-brown-wind-energy-progra
mme
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #29 of 223: for dixie southern iraq (stet) Sun 3 Jan 10 12:20
    
>Healthcare
is another example - the world of medicine is changing radically as
patients become more knowledgeable - often enough they'll have
knowledge about their condition that their physicians lack, because
they have access to the data via the Internet, and strong motive for
better understanding what's happening to their bodies. Physicians get
this, and a sometimes uneasy partnership is forming between the more
knowledgeable patients and treatment providers - participatory
medicine.

Participatory medicine is a palliative and helps but doesn't speak to
the underlying problem, which is information overload. The amount of
medical information available both on the general side -- biological +
medical + genomic; and on the specific side -- patient records, tests,
images, and genome -- is utterly beyond any physicians or other humans.
And it enlarges daily. It's a total mismatch, made much worse by the
almost incomprehensible reticence of many physicians and hospitals to
move not out of the 20th but out of the 19th century in record keeping,
as anyone who has ever seen a disorderly pile of folders of
handwritten papers and printouts -- "these are your records" knows.

A guy who is trying to change this equation on both sides, the
research and the individual clinical is Carl Kesselman (confession; I
work with him); one of the co-inventors of Grid -> Cloud computing.
He's got a pile of money from a bunch of sources and he's working on
creating a Center for Health Informatics -- 
http://www.chigrid.org/about.html 
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #30 of 223: for dixie southern iraq (stet) Sun 3 Jan 10 12:22
    
Here's Carl's explanation of what he's doing
http://viterbi.usc.edu/news/news/2009/carl-kesselman-discusses.htm
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #31 of 223: Brian Slesinsky (bslesins) Sun 3 Jan 10 15:02
    
Nice rant but I gotta point out that Io is a moon around Jupiter, not
Saturn.
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #32 of 223: Rick Brown (danwest) Sun 3 Jan 10 17:34
    
Details. 
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #33 of 223: Jon Lebkowsky (jonl) Sun 3 Jan 10 21:57
    
It's pretty fascinating - Wikipedia's Io page has quite a bit of data
and links to various image pages:
http://en.wikipedia.org/wiki/Io_%28moon%29
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #34 of 223: Bruce Sterling (bruces) Mon 4 Jan 10 01:32
    
*Man, what are we gonna do with these left-wing pointy-headed
scientist geek types who insist that Jupiter and Saturn aren't the same
place.  Jupiter and Saturn are both PAGAN GODS, fella! Wake up! You in
your so-called secular religious arrogance, you are WORSHIPPING PAGAN
GODS and you don't even realize it!  You and your Io -- a pagan goddess
shaped like a cow! -- it's the biggest socialist hoax since evolution
and global warming.

*Put down the dang Wikipedia and get right with the Gospel, fella.
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #35 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 02:06
    
Which brings up a real problem. 

People used to think that if scientists said we had a problem, we had
a problem, and even though attacks against researchers who touched
nerves were not unknown (ask Nobel Laureate Sherrie Rowlands about what
happened when he connected flourocarbons and the ozone hole) the
debate remained about science. 

Now, we have total illiterates shouting at the top of their lungs on
media that science is a hoax and a conspiracy, and it's working. Where
the hell do we go from here?
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #36 of 223: Bruce Sterling (bruces) Mon 4 Jan 10 02:10
    
*Digital revolutionizes this, digital revolutionizes that...  Yeah,
it's been quite a spectacle, but after watching it so long, it's become
kind of obvious to me that digital is actually best at revolutionizing
digital.  The Revolution Eats Its Young.  Digital is always attacking,
disrupting, and disintermediating itself faster than digital ever
changes anything else.

*So it's not like we shove a dysfunctional health system through the
digital Wonderland mirror, and then we get a nifty digital health
system. That never happens for anybody, for any institution, profession
or system of governance.   It's more like we shove some creaking
analog system through a whole dizzy hall of digital mirrors, until we
forget what a "health system" was in the first place.  Doctors get
redefined as self-educated social networking geeks who have some kind
of vague interest in the human body, but are mostly busy upgrading
their netbooks and seeking a revenue model. Which they don't have.

*You can read an Internet guidebook from the 1990s and it's like
they're talking about a different planet.  You know, Saturn, Jupiter,
whatever....  There's a tremendous tone of urgency about what this
dusty old guidebook says -- "Drop every other concern, you need to do
this right away" -- but every strategy and tactic recommended there is
pitifully obsolete.  If you tried those things now you'd be gone in a
week.

*Internet stuff changes very fast, and the Internet's past just
vanishes.  Databases vanish, GeoCities, UseNet.  The Net's got huge
Gothic holes in it, places that looked solid and are just massive
hard-disk failures, grinding empty noises.  Or trash-heaps, huge spammy
trash-heaps generated by zombie botnets of abandoned robots. 

*An Internet year is like seven Earth years, so the Internet looks 210
years old in 2010.  It's forgotten how to be a solution to analog
problems, if it ever was any such thing.  As it's socializing, it's
becoming less a techie platform and more a human institution, and a
particularly frail, senile, piratical, treacherous weird one.

*Today, people look at our crazy, broken, self-absorbed finance
system, which we used to frankly worship like a pagan god, and they're
so full of bitterness and skepticism...  "How could they ever let
things get into such a parlous state!  What benefit did they ever bring
us? They're all crooks and charlatans!"  

I don't think that modern Internet zealots are crooks and charlatans,
but I see no reason why a weird system of small-pieces-loosely-joined
couldn't drift into fungal lunacy just like the financial system did. 
Maybe harder, faster, and less retrievably.  They're children of the
same era.  They're built with the same logic.

*After all -- who's minding the store there?  To what end?  It's all
about whatever seemed to work -- moguls, monopolies, offshoring... 
Works great technically (sometimes), might create utter social mayhem
(somebody else's problem).  All the broadband you can eat and you're
left with a mouthful of ashes.  

*If that happened, who would we blame for that?  Wouldn't we be
staring at each other with that same shocked, shocked look that Alan
Greenspan had in Congress?  "Gosh, I can't believe that they would
irrationally do such bad things to themselves."  Markets are not
inherently rational, and the Internet isn't rational either.  Not a bit
of it.

*Some day this too will pass.  "What comes after network culture?" 
We're so enmeshed in network culture that it's hard for us to envision
anything outside it now.  That's dangerous.  It's like believing in
contemporary finance to the point that alternatives become unthinkable.

Stewart Brand, years ago:  "And the larger fear looms: we are in the
process of building one vast global computer, which could easily become
The Legacy System from Hell that holds civilization hostage -- the
system doesn’t really work; it can’t be fixed; no one understands it;
no one is in charge of it; it can’t be lived without; and it gets worse
every year."  Does that sound familiar?  It's sounds plenty familiar
if you're talking about the global economy now, but that's not what
Stewart was talking about.

"Today’s bleeding-edge technology is tomorrow’s broken legacy system.
Commercial software is almost always written in enormous haste, at
ever- accelerating market velocity; it can foresee an 'upgrade path' to
next year’s version, but decades are outside its scope. And societies
live by decades, civilizations by centuries..."
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #37 of 223: better smoke!!!! better mirrors!!! (robertflink) Mon 4 Jan 10 05:29
    
>And societies live by decades, civilizations by centuries..."<

Yet our "leaders" tell us that they are responsive to will and, thus,
can be dramatically and quickly altered as in "nation building" and
"health care", all without unintended consequences.  

While we are trying find leaders that can steer the beasts to our rosy
objectives, what of the fads and fashions of those that operate
elements of the systems we depend on?  While I agree no one is in
charge can we divine some early warning of change by observing the foot
work rather than the head fakes?
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #38 of 223: Jon Lebkowsky (jonl) Mon 4 Jan 10 06:39
    
"So it's not like we shove a dysfunctional health system through the
digital Wonderland mirror, and then we get a nifty digital health
system. That never happens for anybody, for any institution, profession
or system of governance.   It's more like we shove some creaking
analog system through a whole dizzy hall of digital mirrors, until we
forget what a 'health system' was in the first place."

Acknowledging and agreeing with your point that digital can be
disruptive and destructive (having never said otherwise), I'm not sure
I agree with your point about healthcare. Capturing and storing patient
data in a standard and patient-accessible way, and bringing the
patient into the healthcare conversation, seems like a net positive.
Opening data as broadly-shared research also seems like a positive - if
all researchers could access all pharma research data, how much faster
would treatments evolve? On the other hand, digitizing an analog mess
can leave us with a digital mess. But I think it's an
oversimplification to say that digital is *inherently* destructive. 

"Doctors get redefined as self-educated social networking geeks who
have some kind of vague interest in the human body, but are mostly busy
upgradin their netbooks and seeking a revenue model. Which they don't
have."

I've spent some time with physicians of late, and I don't see this
happening at all. Many are conservative about new digital foo, mainly
because they don't have time to think about it. Others are beginning to
adopt digital technology in constructive ways - using it, for
instance, for closer communication with patients. Still others, younger
guys in med school who have digital as a "first language," are just
inherently in the  digital world and fully expect to be doing digital
rounds and assessments. 

"Internet stuff changes very fast, and the Internet's past just 
vanishes. Databases vanish, GeoCities, UseNet.  The Net's got huge
Gothic holes in it, places that looked solid and are just massive
hard-disk failures, grinding empty noises.  Or trash-heaps, huge spammy
trash-heaps generated by zombie botnets of abandoned robots."

The stuff that was important to me is still around. I'm still talking
to you on the WELL after two decades hanging out here, and the
technical foundation is still the same - Picospan with Engaged sitting
on top of it. What vanishes disappears because it wasn't useful and
wasn't used, it's natural selection applied to technology.

Usenet never went away, it's active as ever. Ask Giganews. God knows
there's piles of steaming digital crap on digital servers everywhere,
but what's useful remains useful, for the most part. 

Otherwise agreeing with much of what you say. You ask "What comes
after network culture?" We might ask that differently - "What does
network culture become?" For me the emphasis is always on the social,
not the technical. The social web is bringing more and more people into
some kind of conceptual proximity, but the conversations are weirdly
disconnected - drive-by conversations, I often call them. The challenge
to me is to create real coherent social engagements that are less like
the barroom - people hanging out, talking at each other but not
necessarily with each other - and more like effective meetings, where
people come together with the idea of creating action items, getting
things done, producing deliverables. We could also benefit by
acknowledging, and overcoming, the echo chamber effect that this
technology supports so well - where we can select for conversation
those we agree with and exclude those we don't, so that we never have
to engage with conflicting views in a civil and meaningful way. I'd
love to see real dialog and deliberation with thinking people who have
opposing views - vs shouting machines between unthinking people who've
been propagandized and polarized.

Social media could be useful, if it was less marketing people and
self-helpers with their weird proliferation of numbered lists ("Ten
ways to build your Twitter following, never mind the conversation…"),
and more real people having authentic conversations about real problems
- and that's happening, too, I'm sure. There's just too little signal
in the noise at the moment.

Back to your question of what comes after network culture - do you
have a vision for that future?
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #39 of 223: Jon Lebkowsky (jonl) Mon 4 Jan 10 06:55
    
By the way, I think this is relevant:

"Educators say that, for adults, one way to nudge neurons in the right
direction is to challenge the very assumptions they have worked so
hard to accumulate while young."

http://www.nytimes.com/2010/01/03/education/edlife/03adult-t.html
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #40 of 223: Cogito, Ergo Dubito (robertflink) Mon 4 Jan 10 07:24
    
Thanks for the link.  I now understand why I enjoy our Socrates Cafe
sessions here in the Twin Cities so much.





 
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #41 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 15:26
    
>Acknowledging and agreeing with your point that digital can be
disruptive and destructive (having never said otherwise), I'm not sure
I agree with your point about healthcare. Capturing and storing
patient
data in a standard and patient-accessible way, and bringing the
patient into the healthcare conversation, seems like a net positive.

Particularly compared with the existing situation. I mean, talk about
legacy system hell....
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #42 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 16:00
    
But as long as we're crushing our digital hopes - one of the the
longest standing of these hopes is that digital can somehow encode that
granddaddy of legacy systems, our brains, and move our perceptions and
memories and emotions onto new platforms -- perhaps even immortality
on a chip, not the best place to be immmortal, but still maybe better
for some. That digital (back to the medicine thing) create much better
prosthesis for damaged limbs or even nerve tissue. Is this another SF
delusion or is the distance actually closing. 
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #43 of 223: Scott MacFarlane (s-macfarlane) Tue 5 Jan 10 05:39
    <scribbled>
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #44 of 223: Scott MacFarlane (s-macfarlane) Tue 5 Jan 10 05:51
    
Bruce,

This odd article in yesterday's Seattle Times got me thinking about
your comments on Putin and the "Wild, Wild West" quality of
post-Soviet capitalism in Eastern Europe:

http://seattletimes.nwsource.com/html/storm/2010697655_bird05.html

First, I had no idea that stars from the WNBA (Women's Nat'l
Basketball Assoc.) were being showcased in Russia by
ex-KGB-cum-Mafioso types.  Very strange outgrowth from the wealth
amassed by the corrupt-to-the-core, find-a-horse-head-in-your-bed,
free-market
capitalism in the land formerly known as Behind-the-Iron-Curtain.

You also mentioned Sweden.  Nominally Lutheran, formerly homogeneous
Sweden has found itself in the precarious situation of having invested
heavily in Eastern Europe while, at home, trying to assimilate a new
immigrant population that often resists assimilation.  Right now
Swedes are mourning the loss of the Swedish national icon, SAAB, and
coping with the same Global economic declines that have hit most
everywhere.  

The Swedes cling to a social system where 80% of the population is
obstinately middle-class and well-protected by unions with long-held
givens like strong unemployment benefits and a bedrock, universal
healthcare system.  About 10% of the population is wealthy, about 10%
poor.  And, underlying the Swedish way is, by-and-large, a core
honesty and low-key social ethic infused through Swedish culture that
is being tested like never before by immigration, very high taxation,
electronically-cocooned and jaded youth, and questions about upholding
a social safety net that may be unsustainable.  Back in the height of
the Cold War, Sweden was said to
offer "The Middle Way" between US Capitalism and USSR Communism.

As the U.S. reels from the fallout from its own sordid brand of
unfettered corporate capitalism, coupled with our discombobulated
attempt at a hybrid National Healthcare system, I'm beginning to
wonder whether America is on the verge of adopting the more
centrally-controlled Swedish Way with its underlying "Social
Democracy", or if, at the slightest hiccup we'll be charging headlong
again toward the unbridled "wild, wild west" of eastern Europe.  (By
comparison to Sweden, in the US there is no longer a strong third leg
of employee unionism to counterbalance corporate private-sector power
and government public-sector power.)  

What would James West say?  What would Martin Luther say?  What would
Martin Luther King say?  What would the daughter of a socialist
governor in Sweden and cuckold "wife" of the richest American athlete
say? 

Is everything running amok and going berserk, as the Vikings would
say? Most importantly, are there notable glimmers of hope (say, from
the Climate summit in the Swedes' backyard of Copenhagen?)?  What's the
[S]terling answer?  
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #45 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 07:01
    
"Capturing and storing patient data in a standard and
patient-accessible way, and bringing the patient into the healthcare
conversation, seems like a net positive."  

Maybe, but that's also what the newspapers once thought, or pretended
to think...  "look, the Net allows us to bring the people formerly
known as the audience into the conversation! How grand!"  It also
allows Google to write eyeball-tracking algorithms that do a much
better job of agglomerating audiences and advertiser dollars than
newspapers could ever do.  End of newspapers.

Obviously there are some positives to that situation, but it's
disingenuous  to think that it's (a) technically inevitable or (b) it
serves the interests of democracy.

It's easy to point out downsides of tech developments when they're
employed by entities you already dislike and distrust.  For instance,
"chilling effect" and "mission creep" are always used in civil
liberties discourse, but nobody talks much about "chilling effects" and
"mission creep" in developments that we LIKE.  If you build a web 2.0
knowledge swapping network for patients, it's gonna get mission creep
pronto.

If patients end up doing their own diagnoses by aggregating patient
data, using Web 2.0 style collective intelligence, and especially if
they then start suing doctors who make demonstrable, dumb mistakes, the
practice of medicine will be wrecked. Not improved, wrecked.   It'll
be hugely damaged, in the same way that the music business was damaged
by Napster, and newspapers were wrecked by Craigslist, or the
Democratic Party was outmaneuvered and tamed by some Chicago guy who
had social media and a digital fundraising machine.

Doctors do make dumb mistakes all the time.  That's the nature of a
knowledge guild that restricts vital knowledge to a professional
clique.  

We didn't want amateur brain surgeons because they are dangerous
quacks without medical ethics.  But there's no physical reason why one
couldn't have amateur brain surgeons with instructables off Wikipedia,
and no reason why theses jaspers couldn't do a sort-of-okay job, too. 
Not perfect, but cheap and fast and distributed and upgradeable, like
Wikipedia compared to Encyclopedia Britannica.

That's network culture.  If medicine gets the big wikipedia treatment,
you don't get a computer-literate doctor, you get a doctor-literate
web activist. 

Doctors are keenly jealous of their pre-eminence.  They spent hard
years in med school, unlike Joe Keyboard.  Doctors also earn much, much
more money than they would if arteriosclerosis was re-defined as some
kind of hardware problem to be scanned by an iPhone app.  

You can argue that, "well, those arrogant gatekeeper-types, we oughta
let 'em have it," but the end-point of the path-toward-free is that
everything's sorta free and nobody's got a paying job.  Everybody in
capitalism is sitting on some kind of pinchpoint because that's where
the money-flow is.  

I kinda like the idea of a future world where everything's sorta free
and nobody's got a paying job, just like I'm frankly thrilled to see
advertising dying.  But if that's what we really want, we should start
small, and test that out with something reversible, like, say, a small
town where that seems to be working.  We shouldn't blithely let
convulsions happen while we're pretending to do something else.
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #46 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 07:21
    
You know, I've been to Sweden a couple of times, and although I've
always been treated well and it's a society I respect very much, I
think I'd be hard put to live there.

I don't think it's got anything to do with Sweden, and everything to
do with the imp of the perverse.  People don't need what they want, and
don't want what they need.  My intuitions about this have been
sharpened by reading Vaclav Havel's new memoirs TO THE CASTLE AND BACK.
 It's about what happened to him and his circle and his society AFTER
the glorious 1989 revolution.

Havel's a tired, sick old man now, and he doesn't have the
revolutionary fire he once did, but he really is wise.  There's a lot
of stuff in there about people being surprised and even flummoxed by
the spectacular glee of being given what they want -- great things that
are clearly good for them.  They're better off by almost every
objective measure, and they'd never go back, but somehow they seem to
live less.

Havel talks a lot about the dangers of technocratic government in this
book.  Of handing over politics to well-trained experts who know what
they are doing and can prove it.  I happen to favor technocracy in
politics because I think politics ought to be dull, and business should
be rather dull too,  while efforts like science and the arts ought to
have all the vibrancy.  But after reading Havel's warnings about the
crimping and demeaning effect this has, the loss of a sense of purpose,
I'm troubled.

I don't think Havel has an answer, either.  He talks a lot about
eternity.  He's a moralist by nature with a faith in eternal values.
It's a sense of purpose that got him through five hard years in a
slammer that probably would have killed me dead, but he's a hero, and
I'm not.  

Even if I somehow turned to be a hero, through some godawful
circumstance, I'm pretty sure eternity would be the last thing on my
mind.

As for America somehow becoming like Sweden, that's about as likely as
 Mexico becoming like Sweden.  We might conceivably become rather more
like New England and less like the Confederacy.  We're a whole lot
like the Confederacy now, and it hasn't been good for us.
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #47 of 223: for dixie southern iraq (stet) Tue 5 Jan 10 09:03
    
>f patients end up doing their own diagnoses by aggregating patient
data, using Web 2.0 style collective intelligence, and especially if
they then start suing doctors who make demonstrable, dumb mistakes,
the practice of medicine will be wrecked. Not improved, wrecked.

I agree; it's wrong on so many levels. Every time I see an ad for a
drug on television, followed by the ritual recital of possible
catastrophes ("should not be taken by human beings with a pulse of more
than 30 beats per minute, may cause loss of appendages or homicidal
impulses, keep in explosion-proof storage container at a temperature of
less than -5 C,  my gorge rises. It's an abuse. 

I do think that the practice of medicine now desperately needs better
IT - for doctors.
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #48 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 11:19
    
"But as long as we're crushing our digital hopes - one of the the
longest standing of these hopes is that digital can somehow encode
that granddaddy of legacy systems, our brains, and move our perceptions
and memories and emotions onto new platforms -- perhaps even
immortality on a chip, not the best place to be immmortal, but still
maybe better for some. That digital (back to the medicine thing) create
much better prosthesis for damaged limbs or even nerve tissue. Is this
another SF delusion or is the distance actually closing."

*Messing around with nerve tissue: distances closing

*Building digital prosthetics that sense and react to human nerve
signals: chugging right along

*Migrating human brains onto a computer network: about as likely as
migrating human brains onto plankton.
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #49 of 223: for dixie southern iraq (stet) Tue 5 Jan 10 11:34
    
>*Migrating human brains onto a computer network: about as likely as
migrating human brains onto plankton.

Not human brains, human memories/personalities/identities. Been a
staple of science fiction in one state or form forever. Where's the
impossibility?
  
inkwell.vue.373 : Bruce Sterling: State of the World 2010
permalink #50 of 223: Jon Lebkowsky (jonl) Tue 5 Jan 10 11:36
    
(Responding on participatory medicine... and music!)

"Obviously there are some positives to that situation, but it's
disingenuous  to think that it's (a) technically inevitable or (b) it
serves the interests of democracy."

It's related to what some call "democratization of knowledge," though
the d-world is always problematic because it can mean different things
to different people. "Participatory" is a useable term, I think - it
just suggests that there is more involvement. Traditionally patients
have been passive recipients of "care" or "treatments," and they
couldn't be much else because there was so much they didn't know. Now
patients can have access to medical knowledge that, before, was buried
in medical texts. Of course this has downsides. Most patients don't
have the physician's understanding, which is based on a lot of training
and a particular context for knowledge. However in many cases patients
are picking up a lot of focused knowledge about their specific
conditions, and given that intense focus (it's their body, after all),
they'll sometimes know more about some aspects of their conditions than
the doctors who're treating them. And they'll know their own bodies.

"If patients end up doing their own diagnoses by aggregating patient
data, using Web 2.0 style collective intelligence, and especially if
they then start suing doctors who make demonstrable, dumb mistakes,
the practice of medicine will be wrecked. Not improved, wrecked."

Patients already do their own diagnoses - *all the time* - and they're
constantly suing doctors for malpractice. That's not a change, but
it's also not what participatory medicine is about. It's about patients
having an informed and active, rather than uninformed and passive,
role in their treatment. It seems to work well. I'm part of a group
that founded a Journal of Participatory Medicine (http://jopm.org) to
gather research and evidence to develop an understanding of how, and
how well, it works. This absolutely doesn't mean the patients take
over, self-diagnose, perform their own surgeries, etc. 

"It'll be hugely damaged, in the same way that the music business was
damaged by Napster, and newspapers were wrecked by Craigslist, or the
Democratic Party was outmaneuvered and tamed by some Chicago guy who
had social media and a digital fundraising machine."

I don't think Napster hurt the music business, though P2P might be
damaging some parts of the business. The artists are finding a new
model, where they make more of their money from performance. They're no
longer fiefs in thrall to music companies that fund their recordings
and tours and take pretty much everything they make, with few
exceptions. Sure, some people have lost jobs over this, and some very
rich people are less rich… and the music business is transformed, maybe
for the better, overall. Nothing's permanent, and the Internet and
digital convergence are changing things fast… some for better, some for
the worse. What's the alternative?

"Doctors are keenly jealous of their pre-eminence.  They spent hard
years in med school, unlike Joe Keyboard.  Doctors also earn much,
much more money than they would if arteriosclerosis was re-defined as
some kind of hardware problem to be scanned by an iPhone app."

If we could heal everybody with technology, the doctors would be out
of work, for sure. So if that killer healing app appeared, would you
want to suppress it so that doctors could hang in?  

I don't think anybody expects medical intervention to be free, and it
will almost certainly be necessary for most of us. The real point of
participatory medicine is to make it better - to make US better. We'd
still be paying doctors and nurses and hospitals to do what they do
(though hopefully it'll be more affordable).
  

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