Is Theresa May .. Stalin?

Dominic Lawson

Dominic Lawson's op-ed in The Sunday Times today:

"In truth, this secretive, politically friendless and yet virtuous woman has a surprising lack of self-confidence. It accounts for her evident shyness and the lack of spontaneity that so exasperates reporters — not that it matters what journalists think, as long as the voters respect her.

"The lack of intellectual confidence is in some respects a refreshing change from her predecessor’s excess of it: Cameron would make promises he couldn’t keep, in the belief that he could somehow bend the facts to his will — or just busk it.

"But a lack of intellectual confidence in a leader can have the unfortunate consequence that she (or he) finds it impossible to accommodate first-class minds in her top team. May’s replacement of Michael Gove with Liz Truss as lord chancellor is an example. Gove, admittedly, had already fallen out with May when she was home secretary; but Truss has now demonstrated the limitations of craven careerism as head of a judicial system that requires an intellectually rigorous grip at the top. ...

"Theresa May, to her credit, chairs countless cabinet committees and by all accounts does it well, taking account of arguments based on solid evidence and being prepared to change her mind. ...

"... the British public has always liked the idea of a strong leader who says what she’ll do and then does it. Mrs May is gaining enormous electoral traction by appealing to that tradition. Let’s hope such a mandate gives her the confidence not to run a cabinet of fearful mediocrity."

We used to live in Maidenhead, where Theresa May is MP, and once attended a hustings where all the parliamentary candidates made their pitches.

Theresa May - UK prime minister and ISTJ

It was clear that Theresa May was by far the brightest and most competent of those up for election. On the other hand, she did not impress me as scintillatingly bright. She's exactly how you would imagine a high-calibre ISTJ: no surprise that she's patronised by NT intellectuals .. and rather admired by ordinary folk.

It's early days. Too early to determine whether the reaffirmed PM will select a cabinet of the best intellectual talents (those signed up to the mission of course).

Latin's evolution to Romance

I have always been interested in the process by which Latin transitioned from being the common speech of Western Europe in the fourth century to its irretrievable fragmentation to the Romance languages - the sundry dialect precursors to modern French, Spanish, Italian, etc - by the ninth.

Why did it happen? Did people at the time even notice? Were there crisis points where definitive change occurred?

All these questions are answered in chapter 11 of Nicholas Ostler's excellent "Ad Infinitum".

Amazon link

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"After the collapse of the Empire in the west, Latin began to split into what we now see not as a language but a language family, the vernacular languages of western Europe, collectively known as Romance. ...

"The middle and latter part of the first millennium AD was a period of social "hamletization," when horizons became narrower for many people, and the chances of wide-scale activity, e.g., travel, correspondence, or trade, were highly restricted outside the topmost elites.

"Without an overarching government, movement beyond the local market town became too costly and too dangerous to be undertaken without an exceptional reason. The resulting fragmentation of Latin, hitherto a highly unitary language across its wide range, is the best example we how a former imperial language can split when the political conditions of unity and mutual contact are no longer maintained.

"Latin was transformed on the lips of its speakers into a profusion of different dialects that were one day to become recognized as languages in their own right. The intrinsic changeability of language, the code passed on not quite perfectly from generation to generation, began to assert itself, and the speech of the different communities went off in separate directions.

"The story of how this happened is fascinating in itself, although the changes took place largely unconsciously. To tell it or understand it requires a certain tough-minded determination to see Latin not (as contemporaries did) as rule-governed text on the page, but as a vast set of spoken words, each taking its part in a system, the mental grammar, that made the language make sense.

"As local accents changed the pronunciation of certain sounds, various words' grammatical relations to other words became less obvious, or even quite impenetrable. New generations of language learners made sense of how the language worked in slightly new ways. The changes rippled throughout the system, causing new systems to form, which became the grammars of the new, Romance languages.

"First and foremost, then, Romance is the name for any more or less distorted form of Latin, as the language gradually evolved and split apart in the latter first millennium.

"Over the long centuries in which the new kingdoms established themselves, the stories of Rome's continent-wide imperium and single invincible army came to seem like legends. Societies became more strictly hierarchical, with most people bound into the feudal network of personal relationships, each man (and woman) recognizing his superior lord, but few outside the Church active in that wider world that had once been ruled through Latin.

"Within three hundred years from those fateful crossings of the Rhine, the people of France, Italy, and Iberia began to find it difficult to understand one another when they did meet. Ordinary speech, wherever it was spoken, was more and more called romanica rather than Latina lingua.

"Latin, as a single written language, was still taught in classes of grammatica and increasingly took its name from that. Meanwhile the inhabitants of Rome's old domains increasingly spoke a multitude of dialects, each called an idioma: this, when it could be recognized, arbitrarily marked out the origin of speakers. But the differences between them seemed to have no meaning.

"Nevertheless, there remained the constraint of the need to communicate with the neighbours; in practice the result was not so much a set of distinct idiomata as a dialect continuum, which varied gradually across the whole field of Romance speech. Picking out particular local varieties within this continuum as "national languages" came much later.  ...

"At the end of the eighth century, the Frankish kingdom that ruled northern France had become mightier than any other. Under Charlemagne (768-814) it united all of France, western Germany, and northern Italy, with an enclave south of the Pyrenees, and began to act in concert with the papacy in Rome in a way that recalled the glorious old alliance of Church and Empire in the century after Constantine.

"This political revival had an immediate cultural manifestation, what is to-day called the Carolingian Renaissance, when Charlemagne called scholars to receive his patronage at his court in Aachen. They came, first from Italy, but later and more notably from monasteries in England and Germany, and in 781 Alcuin, head of the cathedral school at York, was appointed the director of Charlemagne's Palace School.

"Alcuin was above all a teacher and a regimenter. He presided over the establishment of new standards for the spelling and pronunciation of Latin, an attempt to return it to its classical roots, seen as the source of its fundamental value in education, thought, and culture.

"Alcuin enjoined a new, universal style of pronunciation for Latin, deliberately reconstructed to be close to its original sound. Rather than allow each local community to pronounce its Latin as came naturally, he proposed that all should follow a single norm. In his own words:

Me legat antiquas vult qui proferre loquelas;
Me qui non sequitur vult sine lege loqui.

Let him read me who wishes to carry on the ancient modes of speech;
He who does not follow me wishes to speak without law.

"This would perhaps give scholars closer access to the true sound of Latin poetry and rhetoric; importantly, it would certainly make it easier for them to communicate orally in Latin, wherever in Europe they might hail from.

"As a reform, it did not in itself tend towards vernacular literacy: indeed, quite the reverse, for the immediate effect of the new pronunciation was to make priests reading out their sermons or their church offices more or less incomprehensible to their illiterate parishioners.

"In the favourite - somewhat extreme - example, the word viridiarium, 'orchard', could no longer be pronounced in northern France as vair-jair, by then its natural rendering in the local variety of Romance.

"With each priest following his home pronunciation, it was possible - at least in Romance-speaking countries - for the Latin text to have been read pretty much in line with the local language, hence understood by those who could not read. The newly antiquated, universal Latin, by contrast, was a foreign language everywhere, accessible only to those who had studied it.

"So quite soon after Alcuin's reforms, rulings were needed to guarantee that Church services would still make sense. At the Council of Tours in central France in 813, as at the Council of Mainz in Germany in 847, an explicit exception was made, to guarantee the continued understanding of the countryfolk: "... and that each should work to transfer the same homilies into rustic Romance or German language [rusticam romanam linguam aut thiotiscam], so that all can more easily understand what is said"

"One effect of Alcuin's reforms must ultimately have been to impress on everyone that Latin, as written and spoken, was actually now a foreign language, not just the written, quasi-eternal form of Romance speech.

To restate it: after Alcuin's pronunciation reforms, people suddenly realised that Latin was a different language to those vernaculars which everyone in their diverse ways were actually speaking. It must have been quite a big deal.

Ostler also observes that later, in Dante's time (1303), it had been quite forgotten that the Romance languages even derived from Latin (or indeed anything else); Dante was controversial for suggesting otherwise (p. 176).

Diary: Evesham, Winchcombe + the Cotswolds (NT)

A few days in the Midlands with Clare plus my sister-in-law and her husband. Click on any of the pictures below to make them larger.

The Library Bar at Dumbleton Hall

Dumbleton Hall, where we were staying, is a classic Cotswold country house in its own grounds. Very stylish with five-star levels of staff attentiveness. Not quite 'if you accidentally drop your fork a waiter appears and catches it before it hits the ground' but the staff were cheerful and engaged without overdoing it.

Evesham: a lower limit of five hours: bug or feature?

We thought we'd do the towns the first day, starting with Evesham. I had in mind that it might be classy, but it's just another undercapitalised and under-powered provincial town, far from the glitzy dynamism of Bristol, Manchester or London.

It's defined by its mobile phone shops, charity shops, bookmakers, shabby ethnic restaurants with fading, peeling paint, the drop-in pregnancy advice bureau .. and minimum-wage jobs such as the above.

We rapidly translated to neighbouring Winchcombe. It's surprising how often in the 'England profonde' we see a gritty, down-at-heel town partnered with an adjacent chichi one. So Winchcombe is golden Cotswold sandstone, mediaeval buildings, an ancient Abbey and Castle (too expensive) and way too many antique shops. No technology more recent than 'between the wars' that I could see; very Jane Austen.

The rich who make their money elsewhere come here to relax and wealth-signal.

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Day two we ventured to Lawrence Johnston's legendary Hidcote (NT), with its famous Arts and Crafts gardens. Truly a delight in the sunshine.

The author and his wife at Hidcote - the kitchen gardens

Hidcote (NT): beautiful, colourful and dense

We followed up with Snowshill Manor and Gardens (NT), where the eccentric owner had filled the manor house with his eclectic collection of - dare we say - bric-à-brac?

Clare on the left: Snowshill Manor House in best Cotswold stone

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Yesterday we returned home, calling in at Newark Park (NT) where I had a stand-off with a rather showy peacock.

The garden at Newark Park (NT)

We stare at each other: Newark Park

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The National Trust is universally seen as a collection of traditional upper middle-class insulae. Nothing wrong with that. But it's Evesham which is more typical of 'the other England' - adrift in the 1950s with a sprinkled overlay of 21st century consumer tech.

Look no further for Brexit or Theresa May: it's not a happy place.

This ritualisation of Marxism is getting tiresome

Another day and the Labour leadership will be asked once again whether they "agree with Marx". They will reply - again! - that there is a lot to learn from Marx, but that he was wrong about some things.

And they will be right.

I have been reading: "Globalisation: A Systematic Marxian Account" by the excellent Tony Smith,

Amazon link

and I have read no other account of globalisation so sophisticated, profound or analytic (a detailed review here).

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We all want some kind of roadmap, a clue as to where human civilisation is heading in the twenty first century. Smith reviews four contemporary theories:

• Traditional social-democracy: capitalism plus a redistributive national state
• Neoliberalism: emphasising the benign power of global markets
• The "catalytic state": exemplified by the Chinese activist-state model
• A putative 'democratic world-state' checking the power of global capital.

All these models assume global capitalism and seek to ameliorate its more perverse or dire effects, those currently creating the popular backlash against the dominant neoliberal ideology - so-called 'populism'.

Smith then cruelly eviscerates each of these models, giving a master-class elaboration of the Marxist approach to economics. It might help to have read Michael Heinrich's "An Introduction to the Three Volumes of Karl Marx's Capital" first.

Amazon link

Such criticism is fine: indeed, a breath of fresh air. Where Marxism fails is not so much in the analysis - who could deny that the 'structures' of society are, in any deep analysis, highly-sophisticated protocols of systematised (but malleable) human behaviour? - but in the remedy.

Describing capitalism for what it is should be ethically-neutral .. in the tradition of scientific analysis.No Marxist analysis has, for example, demonstrated that capitalism would collapse through its own inner nature through some terminal crisis.

But Marxists then add something new and extraneous: an ethical criticism.

They claim that capitalism is inherently unfair, oppressive and - dare I say it? - evil. In opposition, a communitarian solution is proposed (although the Marxist tradition was - and is - understandably sketchy on the details).

The model of future-communism is seldom subject to the level of rigorous criticism correctly bestowed on capitalism, but if it was, it would be understood to be an impossibility. It presupposes a biological human nature which does not exist.

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There have been precisely zero attempts to integrate Marxism with current understanding of human (evolutionary) psychology, genetics or genomics. Attempts to do so are disavowed as if some category error is being proposed. Marxist blank-slatism reacts with horror to the idea that there could even be such a thing as human nature, detachable from specific and historic relations of production and exchange.

Such a lack of seriousness: the sure hallmarks of an ideology to be taken on faith.

If we learned one thing from Marx, let alone from the Stalinist experience, it's that lack of development of the productive forces is the root of all evil. Conversely, as capitalism increases those forces seemingly without limit, who can predict - yes, who? - as to how future-humanity may be able to organise itself?

In the meantime, let's just crack on and increase those productive forces, while ameliorating the consequences of their current inadequacy.*

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* Yep, a lot of people think that. And then the arguments start 😟 ..

Steganography with an AI flavour

Security sources say that in the old days, the bad guys used to encrypt their secret files. Bad idea: when the computer was forensically audited, the interesting files came pre-marked.

Nowadays, whole drives are encrypted, but the authorities have the right - under penalty - to make you divulge the decryption keys.

The solution has long been known: hide your secrets in plain sight. Steganography is usually discussed in the context of image tweaking, hiding your message in the least significant bits of pixel intensity or colour codes.

But that's a bit cumbersome.

Here's an alternative. Get an AI to write a plausible text which secretly encodes your message.

I'll illustrate with an example: your secret message, "Stuff here meet where?"

First we put it through some simple substitution code: "Fghss urer zrrg jurer". Then we get the AI to craft a little story .. each word starting with a letter from the coded message.

"Father gave her something strange. Underwhelmed, Rebecca earnestly recalled zapping relatively recent gifts. Justice underscored revenge, executed remotely."

OK, it's got going to walk by itself out of the slush-pile, but embedded in a folder of quotes it wouldn't get a second glance.

Quite challenging for the AI.

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My example has a slight issue: the substitution cipher disrupts the letter frequency in English ('e' becomes 'r' for example). A computer analysis could pick up on that.

But it's easily fixed.

Sigfrid von Shrink

The material below expands on some ideas from my most recent post.

Amazon link

From Wikipedia:

"Gateway is a space station built into a hollow asteroid constructed by the Heechee, a long-vanished alien race. Humans have had limited success understanding Heechee technology found there and elsewhere in the solar system. The Gateway Corporation administers the asteroid on behalf of the governments of the United States, the Soviet Union, New People's Asia, the Venusian Confederation, and the United States of Brazil.

"There are nearly a thousand small, abandoned starships at Gateway. By extremely dangerous trial and error, humans learn how to operate the ships. The controls for selecting a destination have been identified, but nobody knows where a particular setting will take the ship or how long the trip will last; starvation is a danger. Attempts at reverse engineering to find out how they work have ended only in disaster, as has changing the settings in mid-flight. Most settings lead to useless or lethal places.

"A few, however, result in the discovery of Heechee artifacts and habitable planets, making the passengers (and the Gateway Corporation) wealthy. The vessels come in three standard sizes, which can hold a maximum of one, three, or five people, filled with equipment and hopefully enough food for the trip. Some "threes" and many "fives" are armored. Each ship includes a lander to visit a planet or other object if one is found.

"Despite the risks, many people on impoverished, overcrowded, starving Earth hope to go to Gateway. Robinette Stetley Broadhead—known as Robin, Rob, Robbie, or Bob, depending on circumstances and his state of mind—is a young food shale miner on Earth who wins a lottery, giving him just enough money to purchase a one-way ticket to Gateway. ...

" ... once back on Earth as a wealthy man he seeks therapy from an artificial intelligence Freudian therapist program which he names Sigfrid von Shrink."

Sigfrid von Shrink is an astonishingly insightful chatbot-psychotherapist.

In the spirit of 1977, Sigfrid is a timeshared program running on a mainframe.

Sigfrid: when AI was programmed in Fortran .. or BASIC?!

Robin, deeply traumatised and held on a floormat by restraining tapes, is instrumented to the gills for Sigfrid's benefit. The program fires (Freudian) model-based questions, trying to penetrate evasions and projections, forcing him to confront his unnameable terrors.

What a gulf between Sigfrid and Eliza!

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What would we need, to build such a useful program in real life?

• General conversation capability anchored by a sense of shared aboutness 
• Real-world knowledge and psychotherapeutic task competence
• Conversation-steering abilities.

If the world's AI companies can crack the long-duration contentful-conversation chatbot, Sigfrid is only a further small stretch. And given psychotherapeutic effectiveness in conditions as disparate as schizophrenia and PTSD, such an enormous social gain.

My guess? At least a decade, but not much more.

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I first heard about Gateway in the early 1980s, when I was working at Standard Telecommunication Laboratories, one of ITT's five worldwide labs. An ITT colleague working in HCI recommended the novel, saying it had the best description of an ideal human computer interface he had ever encountered.

"But is the story any good?" I asked.

"It's not bad," came the answer, damning with faint praise.

Actually, Gateway is excellent, as suggested by this review.

Diary: flies + schizophrenia + fasting + reading

The fly menace: net curtains on the landing

A screen fronts the pantry

A dry, chilly, easterly wind gusts from the continent, so what do houseflies do? Seek nooks and crannies to avoid being dehydrated and swept away. Hence the plague of buzzing monstrosities in our bedrooms, bathrooms and kitchen.

New net curtains have gone up, the pantry screen was reattached: nothing seems to work. My latest belief is that they are crawling between the floors and emerging from small gaps around the pipework.

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Perhaps I was over-influenced by the BBC Horizon documentary on Schizophrenia, "Why Did I Go Mad?".  The programme was interesting throughout: strong on phenomenology though weak/misleading on analysis.

The usual BBC inability to accept that genetics can underlie anything of importance.

In fact schizophrenia is 80% heritable, and triggered by a variety of stress factors.

I was most interested in the schizophrenic's objectification of 'sub-personalities': auditory hallucinations (voices) and visual illusions - often eerily-scary monsters. Somehow the brain's attribution of agency is being misapplied to internally-generated subconscious events.

They say psychosis is like being awake, but living in a dream.

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Jenni Russell had an interesting piece in The Times yesterday, "It’s worth going hungry for a healthier life". She says,

"Fasting’s complex effects are still being explored but one of its most important mechanisms is that it pushes cells into repair mode, through a process called autophagy. After 12 hours or so of no food, a starving cell starts burning up diseased and damaged proteins, tumours and viruses, in a kind of spring-cleaning that only takes place when there are no alternative sources of energy.

"Autophagy has been known about for 50 years but not until recently has its essential function been widely understood. In past centuries, when food was relatively expensive and scarce, autophagy happened naturally in the long gap between supper and waking up. Now that food is so easily available many of us eat continuously, from breakfast until late-night snacks, meaning that autophagy cannot take place. That is disastrous for our physiology.

"Junk and rubbish build up in our cells and cannot be cleaned out. It is as if we are in a car driving continuously with the accelerator pedal down, never pausing to stop at a garage to have the engine parts, brakes, wheels or oil replaced. ...

"One of fasting’s most exciting consequences is its potential to regenerate the immune system. As I have mentioned on these pages before, I came across this particular research three years ago, just after it was published and just as my own treatment for a long-running auto-immune illness was about to be halted by the NHS because of its tremendous expense.

"Valter Longo, a leading anti-ageing specialist at the University of Southern California, had discovered that when mice fasted for three days at a time they generated new stem cells from their bone marrow. This was astounding. It meant that over six months of occasional fasts they replaced damaged immune cells with perfect ones. Potentially, this had huge implications for anyone with an auto-immune disorder and indeed everyone else, since a major cause of ill-health is the deterioration of our immune systems as we age.

"Dr Longo warned readers not to try this themselves but I couldn’t wait. With considerable scepticism — but more despair — I imitated the mice, started fasting on water-only for three days at a time, was cured within weeks and have never relapsed. It has made me a reluctant convert to fasting since a few days without food have proved more effective than 20 years of medical care by devoted doctors and £200,000-worth of drugs."

Assuming you don't find it paywalled, it's worth reading the whole article. In any event, we're into the recommended 36 hour fast even as I write this.

Here's Jenni Russell's previous (and very popular) article on her fasting.

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After Charlie Fletcher's final Oversight book, "The Remnant", I started reading Greg Bear's "Quantico" to Clare last night. Alas, the qualities which reward silent reading to oneself do not transfer to reading Bear aloud. In recitation, Quantico is leaden, stilted and confusing. So it's abandoned.

Tonight I'll hope for better with Frederik Pohl's classic "Gateway". The link is Readings to Clare.

The disintegration of neoliberalism

When I was in my early teens, I'd listen to Labour and Tory politicians at the General Election and be baffled. Both sides had good arguments - how was one to decide?

My adolescent confusion was far from unique. It took a few more years to figure out that politics was not maths or physics; there was no one right answer. In the Marxist jargon, political parties represent different class interests (or perhaps divergent fractions within a class) and the point was to decide where you stood.

This didn't make the exercise completely arbitrary. Perhaps one party was - in the grand scheme of things - better for everybody. Perhaps one party would be better at not crashing the economy, closing down freedoms or crushing innovation.

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Marx explained that in every age, the ruling ideology was the ideology of the ruling class. This was not a crass point. Whether it's the Roman Empire, feudalism or capitalism, the theorisation of the status quo naturally aligns with the practices, values and intentions of the elite who happen to be running things.

Western liberalism, so amplified during the last two decades of Globalisation, is fraying at the edges. Way too many people don't believe that current neoliberal elites speak for them. Real interests are diverging.

So when I hear yet another world leader castigated for liberal value atrocities, I try not to join in the ritual abuse but to figure out instead whether - in the great scheme of things - the said leader is actually trying to do good for the constituency they represent .. and whether, on balance, that would be a good thing for humanity as a whole.

I don't subcontract that analysis to the BBC, The Guardian or the rest of the liberal media.

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Neoliberal sweetness and light takes you only so far. When, for example, Allende was trashing the economy in Chile in 1973, the Americans (Nixon and Kissinger) had no hesitation in supporting the Pinochet coup which brought the Chicago Boys into economic power.

Pinochet meets Kissinger

The Chilean economy was fixed pretty fast; the parallel and one-sided civil war was vile and atrocity-ridden.

More recently, those nice Eurocrats gave Greece's Alexis Tsipras a pretty hard time.

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Erdogan seems pretty popular amongst his supporters as he rolls back the Gülenists and secularists who, with implicit approval from western elites, tried to overthrow his government in a coup last July.

From the Wikipedia article:

"The 2016–17 Turkish purges are an ongoing series of purges by the government of Turkey enabled by a state of emergency in reaction to the 15 July failed coup d'état. After the immediate arrest of military personnel accused of making the coup attempt, arrests were expanded to include further elements of the Turkish military service, as well as various civil servants and private businesses.

These later actions, reflecting a power struggle between secularist and Islamist political elites in Turkey, which began to be known as a purge, affected people who were not active in nor aware of the coup as it happened, but who were alleged to be connected with the Gülen movement, a group which the government blames for the coup."

I don't know whether the Erdogan faction is a positive factor in world history or a regressive one. Perhaps we'll just have to wait and see. But his violations of liberal check-boxes are just par for the course when you're in a civil war.

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Neoliberal ideology at its heart has a helium model of humanity: for all practical purposes people are autonomous hyper-individualistic clones, as is assumed in economics.

Thus unrestricted immigration is an unvarnished public good, dispossessed workers are arbitrarily retrainable and that there are no personal, gender or ethnic differences beyond the most trivial and inconsequential.

Yes, there are people - actors, politicians and journalists - who truly believe this.

Incidentally, Marxism also cleaves to the 'human clone' model but unlike the 'transactional-individual' model of neoliberalism, it prefers the maximally-collective 'ant-nest' model - at all scales up to the planetary soviet.

Neither ideology is consistent with evolutionary theory, psychometrics or genomics (not to mention commonplace observation).

Real doctoring: more about perception than knowledge

Expert systems were big in the 1970s and 80s, the first golden age of AI. The paradigmatic system was MYCIN, which diagnosed bacteria causing severe infections such as bacteremia and meningitis, and recommended antibiotics. MYCIN "proposed an acceptable therapy in about 69% of cases, which was better than the performance of infectious disease experts who were judged using the same criteria."

MYCIN was never used.

"...  every blue box is a perceptual task"

In hindsight this held some lessons for us about the nature of real-world competence. MYCIN had world-class book-learning but no ability to interface conversationally with actual patients or examine test results. It couldn't do the effective application of assimilated knowledge, something which takes experts in all domains years of experience (as well as eyes, ears, touch and conversational ability).

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A little gem I get every week in my mailbox: Denny Britz's "The Wild Week in AI".

This week's choice snippet, "The End of Human Doctors – Understanding Medicine", where Luke Oakden-Rayner writes this.

"Story time! Decades ago everyone thought being a medical expert was about knowledge, and computer scientists tried to automate the knowledge base of medicine. The earliest computer system that outperformed doctors was MYCIN, an AI system that was developed in Stanford in the mid 1970s.

"It was knowledge based, codifying the process of identifying the likely cause of infection and choosing a treatment for it in a set of 600 rules. ...

"With the benefit of 40 years of post-MYCIN experience, we can say a couple of things about it:

• MYCIN worked really well. The system identified an acceptable therapy more often than the infectious diseases experts that they compared it with.


• MYCIN was never used in clinical practice.

"The standard explanation for this failure to make a clinical impact was that MYCIN required time-consuming manual data input and that the IT infrastructure didn’t exist in the 70s to make use of it.

"But this argument isn’t very satisfying, because those challenges have long been solved. We can automatically mine electronic health records for phrases or keywords to populate our systems, and we certainly aren’t bottlenecked by computation or electronic infrastructure anymore. But we still don’t use MYCIN, or almost any of its successors.

"To understand my take on the clinical failure of MYCIN, imagine going to the doctor for a cough. Your doctor asks you some questions, listens to your chest, takes your temperature and your pulse rate. They send off a sputum sample or blood test. They might even get a chest x-ray. And after all that, how long does it take them to decide on an antibiotic?

"Seconds, probably. Most doctors would barely register the decision as a conscious choice.

"The fact is, the knowledge and decision making part of medicine becomes automatic for doctors. There is a long history of cognitive science research in medicine ... and it shows that senior doctors don’t really think about many of their decisions. They engage in an experience based form of pattern matching. In fact, senior doctors often perform worse if you slow them down and force them to think. ...

"The key point here is that the part of the medical process that MYCIN automated had a negligible cost (measured in time spent). Saving time on a process that takes between seconds and minutes just isn’t worth the effort of overhauling our current systems.

"But all of this does raise an interesting question: what are diagnostic doctors spending all their time on, if not “thinking”?

"Perception. ...

"The revolution that is happening in artificial intelligence can be understood in one idea; deep learning is really good at human-like perception. In fact, deep learning systems now perform around human level in a wide range of perceptual tasks, like visual object recognition and voice transcription.

"And because perception has such a big role in expertise we are achieving superhuman performance in “expert tasks”, like driving cars or playing complex games like Go. It turns out that these tasks were all bottle-necked by perception, not decision making.

"Machine learning guru Andrew Ng has a rule of thumb – “If a typical human can do it in 1 second, so can deep learning”. My experience in medical applications suggests a slight restatement of this rule:

“If an expert can perform a task in less than a few seconds, it can be automated.”

"... Your local family doctor still spends a lot of time looking, listening and feeling. A surgical specialist does too, and relies a lot on radiology and pathology tests. A psychiatrist learns a lot from sight and sound.

So we might be looking at a technology that can do parts of the work of most types of doctors, even if it can’t replace all of the jobs."

I've excerpted quite a bit here - do read the whole article.

Visiting the family doctor must be one of the least productive things anyone ever does - and I mean this in the economist's sense of productivity. The labour-intensive, manual nature of the consultation means that in the UK patients are allocated a mere ten minutes per session and told they must not mention more than one condition.

"I've got this really painful sore throat doctor, and perhaps I could schedule another appointment sometime about this odd lump?"

I imagine the near-future surgery as a quiet library of cubicles where patients interact in privacy with smart doctor-apps. A nurse helps with recommended tests (interpreted by deep-learning systems in the cloud) and a doctor or two handles referrals.

The result? Perhaps a twenty-fold increase in  productivity.

With apps like Babylon* offering pre-screening, healthcare productivity would be all the greater.

So what's holding things back? The interaction model (chatbot-style) is still tedious and leaden. Without access to the patient's medical history and personal data, the dialogue is lengthy, tedious and repetitive.

Any root-and-branch transformation of healthcare would be capital intensive (money!!) and couldn't be attempted until pilots showed that the new process model was effective, user-friendly and safe. As well as cost-effective. Perhaps doctors, despite their many, frequently-stated grievances, would not be totally supportive. Nevertheless I see glimmerings of change.

Ten years minimum - this is healthcare we're talking about.

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* I tried Babylon as well as Your.MD, one of the leading medical apps, and was not impressed: typing a query into Google still outperforms the specialized apps.

Diary: Avalon Marshes - the Sweet Track (3,806 BC)

Down to Shapwick Heath today - the last day of Alex's Easter visit. A highlight is the Sweet Track:

"The Sweet Track is an ancient causeway in the Somerset Levels, England. It was built in either 3807 or 3806 BC and was the oldest timber trackway discovered in Northern Europe until the 2009 discovery of a 6,000-year-old trackway in Plumstead, London. It is now known that the Sweet Track was predominantly built over the course of an earlier structure, the Post Track.

"The track extended across the now largely drained marsh between what was then an island at Westhay and a ridge of high ground at Shapwick, a distance close to 2,000 metres (6,600 ft). The track is one of a network that once crossed the Somerset Levels. Various artefacts, including a jadeitite ceremonial axe head, have been found along its length.

"Construction was of crossed wooden poles, driven into the waterlogged soil to support a walkway that consisted mainly of planks of oak, laid end-to-end. The track was used for a period of only around 10 years and was then abandoned, probably due to rising water levels. Following its discovery in 1970, most of the track has been left in its original location, with active conservation measures taken, including a water pumping and distribution system to maintain the wood in its damp condition."

Here are some pictures. They're quite large - click on images to make larger.

Background on the Sweet Track

A replica of a Bronze Age path through the swampy levels

Clare and Alex spotting wildlife

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We have been invaded by flies, I guess due to the warmer weather the last couple of days. Regular house flies we address with The Executioner; the millimetre long black things which seem to drift in from the fields are susceptible to damp toilet tissue: they can be dabbed up.

It's wearisome though.