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Archive for September, 2007

Smart World

When in Tokyo I always pay a visit to my favourite bookstore – Maruzen in Oaza at Maranouchi near Tokyo Central Station. I love the top floor with its interesting English language section and always find some book there that breaks new ground for me. This time it was Smart World by Richard Ogle (ISBN 978-0462099217). Unfortunately books can be very expensive in Japan and even if you can afford them luggage soon gets unmanageable when you stuff your bags with too many of them! So I decided to have a speed-read of this book at one of the reading tables by the window.

I don’t know if you ever speed-read a book but with non-fiction books its quite easy. Most well written books have good summaries at the end of each chapter so what I read was the introduction, then the summaries of all the chapters.

I read enough to be thoroughly fascinated by it. The author focuses on the new science of networks to create what he calls the nine laws of the science of creativity, his thesis being that creativity is an emergent process of the function of networks. He draws heavily on the ideas of Varela and others about the concept of the embodied mind – the idea that we cannot understand the mind if we attempt to contain it to what happens inside a skull but rather have to understand it as inextricably woven into the environments in which it exists. It’s a small step from here to the idea of the extended mind – a mind that stretches out to network with other minds. From here he develops the notion of “idea spaces” where we see hubs or “hotspots” develop in the network. In other language these are like the “attractors” of complex systems, or like the websites which attract huge numbers of visitors and links. Out of these hotspots, tipping points occur (you’ll have come across this term as the title of Malcolm Gladwell’s book. Again in the language of complex systems these are “bifurcators” where the system undergoes a “phase transition” into a totally new and changed state.

He links these ideas to the human facility of imagination and makes the point that if we progress solely on the basis of existing knowledge then we can improve incrementally but we never achieve the big, significant, creative leaps. These latter require us to imagine what doesn’t exist and what might well not succeed, but we leap, and when it works, the world has changed.

He gives numerous examples of this but the one that caught my eye was the ipod. The ipod has changed the music world considerably but for it to be created a number of elements had to fall into place – Napster and its success in spreading the habit of downloading music, the MP3 file as a small enough sized music file to allow easy downloading, the minaturisation of hard disc drives, and Steve Jobs move from Pixar where he had gained the respect and confidence of media companies which allowed for their licensing of their music catalogues to Apple, and Steve and his team themselves for their imagination, design flair and ability to create a product unlike any other the world had seen before – one that looked good, was SO simple to use and just worked.

I like these ideas and I think its interesting to read an author who uses the analogy of networks and network science to advance them. They are entirely consistent with what we learn from the science of complex systems.

Oh, I’ve ordered a copy of the book from Amazon Marketplace and hopefully it’ll arrive shortly after I return home. Then I’ll take a bit more time with it and see what other thoughts it provokes!

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Michikusa

I’m in Tokyo just now and this is such a fascinating city. It’s significantly different from not only Scotland but all the other places I’ve visited in the world. Firstly it’s vast. From my 18th floor hotel room I look out of mile after mile of skyscrapers and buildings. Each morning has been hazy outside but the weather forecast last night said a “typhoon was knocking at the door of Japan”, and although I’ve seen no sign of rain yet the wind had picked up a lot this morning. I love the cooling breeze when the temperature is 30 degrees plus and the humidity is around 80%! The winds have blown away the haze so much to my surprise I could clearly see the distant mountains way beyond Tokyo this morning (almost reminded me of home!)

The in-house hotel magazine is usually just glossy ads for expensive branded goods but this issue has an article about Tetsuya Chickushi promoting the idea of “Michikusa” (which roughly translated means “loitering on the way or taking a pause and looking round”). He promotes “Slow Life” and says he was inspired by the Italian “slow food” movement. He says michikusa is about stopping, allowing a little time to stray off the path and follow your curiosity and he mentions an activity of drawing up a michikusa map. What a wonderful idea!

Here’s his closing paragraph –

Traditionally, Japanese society has had a very strong homogenous nature, and the economic success of the modern age was attained as a result of everyone working together in the same direction without rest. And at very high speed, too. Even now, we continue to set our priority on speed, which is why we still tend to think about everything in a shallow, narrow and brief manner. But I believe that now is the right time for us to think pluralistically in a deep, broad and thorough manner. Perhaps, Japan is about to enter a phase when we should take a pause, sometimes even enjoying michikusa, and contemplate thoroughly on what true happiness is for us.

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These 360 degree panoramic images are simply stunning.

You can see The Colosseum, The Great Wall of China, Petra, the Taj Mahal, Machu Pichu, Rio de Janeiro, Chichen Itza, the Eiffel Tower, Giza Pyramids, Cordoba Mosqu, Angkor Wat and the Yulonghe River

These images take a long time to load, even with a fast connection, so be patient, take advice from Christopher , slow down and enjoy life.

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Just read Reckoning with Risk by Gerd Gigerenzer (ISBN 978-0140297867) and it’s one of those books that has changed the way I think.

It’s about the way statistics are presented to us to create an illusion of certainty. We don’t live in a predictable world. In fact, Gigerenzer uses a quote from Benjamin Franklin (there he is again!) about certainty –

In this world nothing can be said to be certain, except death and taxes.

He refers back to this from time to time throughout the book to remind the reader that when something is presented as certain, it probably isn’t.

Why would statistics be used to present us with an illusion of certainty? Well, two reasons mainly. Firstly, we can’t handle too much uncertainty. We need some predictability in our lives. If we really felt absolutely nothing was certain we’d be paralyzed. Every morning when I get on the Glasgow train I’m pretty sure I’ll end up in Glasgow (of course, being Scotrail, I’m not at all certain exactly when I’ll get to Glasgow! But I’m pretty sure I’ll get there all the same). Even though I have this degree of daily certainty I do know, somewhere in the back of my mind, that accidents happen, that people get sick and that one day I’ll die. And I have no way of knowing if any of those things will happen to me on the Glasgow train today. But if I tried to base my daily decisions on all of those possibilities I guess I wouldn’t even be getting on the Glasgow train!) The second reason, is that others – experts, organisations, authorities and companies – want to exert their power over us. (see how to make a zombie).

Gigerenzer’s response to this is education. His book illustrates how we are all innumerate. He bases the whole book on a small handful of scenarios which makes the book both easy to understand and quick to read.

Here are the two main things I learned from him.

We understand frequencies much, much more easily than we understand probabilities. Try this out on your friends (especially doctor friends) – here are two ways to present the same information about mammography –

The probability that a 40 – 50 year old asymptomatic woman has breast cancer is 0.8%. If she has breast cancer, the probability of a positive mammogram is 90%. If she doesn’t have breast cancer, the probability of a positive mammogram is 7%. Imagine a woman with a positive mammogram. What is the probability she has cancer?

When Gigerenzer tried this out on experts very few got it right! He then showed them this version –

8 out of every 1000 women has breast cancer. Of these 8 women with breast cancer, 7 will have a positive mammogram. Of the remaining 992 women who don’t have breast cancer, 70 will have a positive mammogram. Imagine a sample of women who have positive mammograms. How many actually have breast cancer?

See how easy the second example is? This is a very good mental tool for clearing away the confusion created by probabilistic statistics. He shows how to make a decision tree using this method. This is going to make it much easier to understand clinical trial results for me. How come I wasn’t taught something about this at Medical School?

The second lesson is more important because its about how to see through attempts to manipulate us with statistics. This is slightly more technical – there are three ways to present a comparison of two groups of people who have had, say, either two different treatments, or one group gets a drug and the other placebo. The three ways are Absolute Risk, Relative Risk and Number Needed to Treat. Let me quote one of his examples.

The West of Scotland Coronary Prevention Study published a Press Release about the use of statins (the lipid lowering drugs). It said that from a study comparing a particular statin to placebo is was shown that taking the statin “reduced the risk of death from coronary disease by 22%” – well, that seems pretty convincing doesn’t it? But look at the actual study. It compared two groups of 1000. One group got the statin. 32 of them died. The other got placebo and 41 of them died. The absolute risk is the proportion who died in the placebo group minus the proportion who died on the statin. That’s 0.9%. The relative risk is the absolute risk divided by the proportion who die in the placebo group. That’s where the 22% figure comes from. The Number Needed to Treat is 111. That is, that you need to get 111 people to take the drug for one of them to get the benefit of not dying. Well, I’m sure you’ll agree, not all three of these presentations seems the same. Gigerenzer shows how drugs companies and authorities routinely use Relative Risk to emphasise the potential benefits of their treatment while at the same time presenting the potential harms as Absolute Risks to minimize the impression of adverse potential. This is just manipulation. He makes a very good case for why we all deserve to give informed consent to treatments but how we rarely get the chance to be properly informed.

He makes the interesting point that experts often claim that their tests are absolutely certain – whether its cancer tests, HIV tests or DNA matching, but shows us how that cannot be so. There really are no such certainties and we shouldn’t believe anyone who claims otherwise.

I’d recommend this book. You won’t hear TV news the same way again. He’s right. Education is our way of liberating ourselves from the agendas of the experts and so called authorities. We should make up our own minds and learn how to do that.

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Have you come across gapingvoid? It’s the website of Hugh McLeod who draws business card sized cartoons. His top post of all time is this one on creativity. It’s long but it’s worth it! And some of the cartoons are hilarious.

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moss

moss, originally uploaded by bobsee.

This almost looks like a shot of the bottom of a pond but its not. I took it of moss while I was lying on the forest floor.
There’s an astonishing variety of mosses in a very small space when you look carefully.

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fungi

fungi, originally uploaded by bobsee.

While lying on the forest floor I saw this little yellow fungus pushing its way through the mulch of leaves and seeds.
It’s lovely to see the variety of fungi in the forest at this time of year

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Forest Floor

Forest Floor, originally uploaded by bobsee.

I took a walk in a nearby forest at the weekend and you know how I have suggested one way of becoming more aware is to look up, or look down, and take a camera with you to capture what you see?
Well, I looked down and saw the forest floor like this – a profusion of nutshells, seeds, leaves and twigs. It looked good enough to lie down on.
It was.
It was soft and comfortable and smelled wonderfully woody and earthy.
I took some photos while I was down there

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You’d be forgiven for believing that medicine was all about drugs and surgery. But its not. As we begin to understand human beings as complex adaptive beings we are beginning to explore holistic approaches to health care. I’m not talking about New Age therapies of any kind. I mean ways of addressing suffering which consider the whole person within the contexts of their life.

Pain Clinics are amongst the most radical in this regard. Chronic pain can ruin lives and despite the best efforts of specialists using the best “evidence based” drugs, many patients still don’t get relief. Those who research pain these days tend to have both holistic and pragmatic views  – they know that pain is not about lesions, is not directly proportional to the pathology in the patient’s body and is modified by emotional, psychological and social factors.

A new study of “mind-body” interventions of pain rates these methods as especially suitable for the elderly (because of the dangers inherent in many powerful drugs which are not suitable for patients who are more frail).

But if a therapy for pain is effective at reducing pain why limit it to a specific age group? And why try it last? At the Glasgow Homeopathic Hospital where I work we see a lot of patients with chronic pain. We have a notice in the pharmacy – “TEETH” – its stands for “Tried Everything Else? Try Homeopathy!” – because the vast majority of patients we treat have already failed to find relief from all the other more orthodox treatments (drugs and surgery!) I think that it’s a shame people go through the harmful and side-effect laden treatments first – wouldn’t it make more sense to try the safer treatments first and reserve the more dangerous ones for those who don’t get relief from these gentle approaches?

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Rosehip

rosehip.JPG, originally uploaded by bobsee.

Out for a walk today in a forest and spied this rosehip just next to the path. I love the colour of it (and the thistle in the background helps locate the photo to Scotland, doesn’t it?)
Do you gather rosehips, or any other fruits from the forest?

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