Creating Smart Assholes

Just because you made a machine “smart” doesn’t mean you made it intelligent.

Smart homes, IoT, AI, ubicomp, robotics, ambient media, pervasive computing – all are words that in one form or another describe our attempt to embed digital intelligence into the otherwise dumb, lifeless devices around us. However, as we engineers so often do, many of us have been all-consumed by the pursuit of a single focus at the expense of other equally, if not more important factors. The fields of IoT and AI have been racing ahead trying to get some basic functionality in place, yet in doing so, we’ve created another problem. We’ve been building greater and greater smarts and functionality, but in the process, created smart devices that are a bunch of assholes.

What we neglect in the pursuit of intelligence is that there is more than one type. Our current efforts have understandably chased after the more obvious, functional definition of intelligence, however, this narrow perspective on the word has created a bunch of basic gadgetry that no one wants to interact with. We’re actively building the electromechanical equivalent of genius savants – all IQ with no EQ.

And in fact, even that statement may be a massive overgeneralization. Human intelligence is potentially comprised of countless aspects. While there are many ways we can deconstruct these intelligences, all of which are incorrect or limiting in one way or another, for the sake of exploration in the digital sphere, let’s pick one and play.

Howard Gardener’s 1983 book, Frames of Mind: The Theory of Multiple Intelligences, is one of the more popular perspectives on the mind which views intelligence as a set of differentiated modalities, rather than as a single, general trait or ability. Though often criticized for blurring the line between innate smarts and developed ability, Gardener’s theory breaks down intelligence into 9 distinct, though somewhat interrelated types: logical-mathematical, linguistic, bodily, musical, naturalist, intra-personal, spatial, and existential.

If we hold these 9 as an expanded definition of the word intelligence, we can compare the technology of today against this expanded standard to see how smart our devices really are.

Naturalistic

Our Natural Intelligence defines our ability to recognize and interact with the natural world around us - plants, animals, rocks, clouds, etc. Though not added until nearly a decade after publishing, Gardener described this intelligence as core to our evolutionary success as hunters, gatherers, and farmers.

Developmentally, this intelligence should be marked by little more than high-resolution vision and olfactory systems coupled with an extremely in-depth natural database to analyze against. In theory, this seems like a less important ability for machines to have, however, if we are to rely on them as tools for our need, you’ll likely want your smartphone not to accidentally serve you poison-ivy tea. Moreover, even a robot will likely suffer from mistaking a jaguar for a house cat, so there could be some important survival aspects here.

Current Artificial Level: City-Slicker

Leading Example: Bosch Bonirob

Implication: Device may be destroyed by nature or angry user.

Bodily-Kinesthetic

Our body-smarts describe our ability to leverage our body and manipulate objects effectively around us. This intelligence relies greatly on a good sense of timing, perception, and control, enabling the perfection of fine or gross motor skills.

Plainly put, machines typically suck at this one. While a device can be programmed to perfectly optimize a single motion, such as in manufacturing environments, the moment any variability is introduced, all hell breaks loose. However, body intelligence is further complicated by the fact that devices are often build modular and adaptable; the equivalent of being caught in a permanent state of robotic puberty, where audio drivers drop a few octaves and new wires start growing where there weren’t any before.

Current Artificial Level: Drunken Toddler

Leading Example: Boston Dynamics Atlas

Implication: One wrong step and a half-million dollar piece of equipment becomes an impressive paperweight.

Spatial

Spatial intelligence is a bit of a tricky one. At a glance, it is described as little more than the ability to think in three dimensions, however, the implications of this get a bit more interesting. Because of the human capacity to speculate, spatial intelligence effectively ties into our imagination and creativity, allowing us to perceive hypothetical versions of the world around us.

Can a computer think in three dimensions? Of course – it can likely think in four or five. However, very few machines have taken the next leap into projecting new thoughts and hypotheses into this three-dimensional world, meaning that as it stands, our best machines are little more than environment rendering software.

Current Artificial Level: Following the Lego Instructions

Leading Example: Autodesk Inventor

Implication: Cold-war era, brutalist design and architecture.

Logical-mathematical

This intelligence represents our ability to calculate, quantify, consider propositions, and carry out logical operations. Beyond simply the manipulation of numbers, this intelligence has a heavy implication on pattern recognition and the ability to develop effective strategies.

This is the place where computers are currently kicking our asses. While some people may argue that machines still trail humans in pattern recognition and strategy development, anyone who has suffered the embarrassment of playing an RTS on “Insane” mode knows this to be a fallacy.

Current Artificial Level: Rain Man

Leading Example: Google AlphaGo

Implication: Younger generations not bothering to learn math and an impending enslavement of the human race.

Musical

Our musical intelligence – obviously – pertains to aspects such as pitch, rhythm, and timbre. However, beyond the simple identification of music, this creative intelligence allows us the ability to recognize, reflect upon, and even create our own musical patterns.

While the audio processing half of this equation seems to be little to no problem at all, once again, the greater creative aspect is where things become a challenge. That said, by analyzing historic data points of music, we have been able to create quite sophisticated music generation software. However, to date the music created by these programs falls into one of two categories: blatant rip off or painfully unlistenable.

Current Artificial Level: Starving Singer/Songwriter

Leading Example: Melomix109

Implication: We will continue to listen to top 40 songs produced by human pop-machines.

Linguistic

Our word smarts represent our ability to understand and express through words and language. However, even beyond this, Linguistic intelligence helps us to see broader context and apply meta-linguistic skills to understand the deeper meaning of language and communication; reading between the lines.

In theory, the artificial version if this intelligence is simply an effective natural language processing unit. The problem is that no one has built a good one yet, since human communication is fraught with subtle nuance, sarcasm, context-sensitivity, and lies. Basic linguistic intelligence is simply understanding the words – a task nearly cracked by the world of computational linguistics – but understanding the words behind the words is a feat that requires an understanding of who those words are coming from, which leads us to our next point…

Current Artificial Level: Super-Intelligent Parrot

Leading Example: Bruce Wilcox’s “Rose” Chatbot

Implication: Automated customer support lines will cause you to throw your phone across the room for at least another decade.

Interpersonal

People smarts define our capacity to understand and interact with others without making things terribly awkward. This is the empathy category hinges off the ability for someone to interpret all types of verbal and nonverbal communication and be sensitive to the individuals around them.

We’re now getting into the territory where our technology simply sucks. Our current ability for technology to pick up on human context and emotion is only made look less pathetic by the ability for that technology to react to it. We’ve devoted entire fields – UX, HCI, and others – to attempting to improve this form of artificial intelligence, but to date, no one has really made a device that at some point doesn’t deserve to become airborne.

Current Artificial Level: Autistic Teenager

Leading Example: RoboThespian

Implication: No robot girlfriends just yet.

Intrapersonal

Intrapersonal intelligence describes our ability to look within and deconstruct ourselves. It is crucial to be able to identify and understand our own emotions, as well as to put these within a broader context of what it means to our lives and our futures.

This intelligence is practically non-existent within the technology world, however, not for lack of success, but lack of even trying. To date, few people have seen the value in a device that can be introspective, however, in coming years, this type of intelligence may be the key to unlocking broader interpersonal and existential smarts. How can we expect to understand others and the world around us, unless we can first understand ourselves?

Current Artificial Level: Dog Fighting its Reflection

Leading Example: Nico Robot

Implication: The emergence of artificial psychiatrists for robots that live in denial and refuse to acknowledge their own emotions.

Existential

Existential intelligence is likely the highest form and deals with broader questions of the limits of life and our existence. It highlights the part of our brains that allows us to think beyond the literal and contemplate broader concepts like the origins of life, spirituality, and how they get the caramilk into the chocolate.

At the top of the hill sits the most complex and elusive form of intelligence that, to our knowledge, few other species let alone technologies, have ever cracked. While I can’t be certain that pigs don’t think about where bacon truly comes from, I do know that it will be a long time before robots start developing their own religion. That said, the interesting thought exercise emerges once an AI has met and potentially surpassed this ninth intelligence and begins to explore the realms beyond… but I digress.

Current Artificial Level: Non-Existent

Leading Example: NA

Implication: DO robots dream of electric sheep? IS there a robo-god?

More Human than Human

Cyborgs, embeddables, and androids, oh my.

Never has the question, “what does it mean to be human?” been more relevant than right now. Granted in five or ten years, that question will surround an even more thought-provoking, conflicted world, however, for the time being, it forces us to confront the reality of our evolving technology and potentially devolving humanity.

The wearables movement hit business and society with the promise of heralding a change in the very way we live and while it yet may, wearables are really nothing new; they are more intricate and complex extensions of the technologies we as a species have been wearing for thousands of years. VR headset, running shoe, knife – a seemingly unrelated list, yet taken in the same breath, we can view them all as temporarily ‘worn’ tools that help to augment and expand the limits of the human body.

One could argue that the embeddables movement accomplishes the same thing: the ability to augment and expand the limits of the human body. However, one stark difference stands between wearables and embeddables: permanence.  This implicates not a temporary boost in human capability, but a fixed, unnatural evolution in our body’s design. In short, there’s no guarantee of being able to hit Ctrl-Z. By contrast to wearables, which we can view as external tools, embeddables have the potential to be seen not as independent objects, but as integrated extensions of ourselves.

If we build off of this loose definition, an argument could easily be made that society has a long history of embeddables as well. The cardiac pacemaker was first conceptualized in the 20s and first implanted into a human subject in the 50s. Though if we look beyond active embeddables, we can view a long history of passive attachments to our bodies such as fake eyes, prosthetic limbs, intramedullary rods, and dentures dating back hundreds if not thousands of years.

Still, something is different about the emerging generation of body modifications. We are teetering on the edge of a time when embeddables and bodily integrated technologies are being viewed not simply as restorative, but augmentative and enhancing. We are no longer simply thinking about how to replace a lost limb, faulty organ, or broken body part, but instead are now asking the question of how we can improve upon nature’s design. And while this isn’t necessarily a bad thing, we need to at least acknowledge the implications of cracking ourselves open and tinkering with the fleshy bits. We need to realize that elective surgeries and hacks to ourselves will have consequences, both immediate and long-term, personal, and societal.

The potential for bodily harm is an obvious risk and one that will be taken at varying degrees by a range of people who opt to roll the dice on more unproven procedures all the way to the rigorously routine. And while a few people will undoubtedly die on the operating table, or a cardboard mat in a dark back alley, I view a much more frightening risk about the decade-plus implications of a population of people stuffing themselves with servos and circuits with no long-term testing. These could alter our physiology and cause massive issues with chronic pain or disablement. The use of chemicals or electromagnetic communication could lead to mutations and bring on new forms of cancer variants. The potential for harm is literally as diverse as the spectrum of things we choose to shove inside of ourselves.

From a societal perspective, there are some pretty scary thought exercises to mull as well. While the augmentation of human ability will potentially do wonders for our efficiency as humans and push the limits of human achievement, outside of a socialist utopia, only a select group of individuals will benefit from these breakthroughs. The class divide will be as present within the embeddable movement as it is within any other facet of our world, however, unlike other aspects of our lives, this divide will manifest as literally making certain people better human beings than others. You won’t simply have more money, more things, and greater access, you will literally have a stronger body, smarter brain, and longer lifespan.

At an extreme, this divide could become less about classism and even start to be viewed as a specist. While other “isms” may fade with time, concern over the colour of your skin, sexual orientation, or faith could simply be replaced by judgment of the electromechanical contents of your body. Yet far from the organic-purist view often portrayed in popular science fiction of judging cybernetically-enhanced individuals as some form of digital-junkie, the reality is far more likely that it will be the enhanced who have the funds to augment themselves and who will hold power, and judgment, over technologically “lesser” individuals. This is a frightening world for both sides, as history has more than its fair share of examples of the downtrodden rising up against extreme discrepancies of quality of life and redistributing the wealth of power –rather gruesome imagery in the case of body implants.

And while my last point raises an alarming issue on a societal level, the same considerations must be brought down to the reality of the individual. Modifications to the body of such an extreme nature bring into focus the existential questions raised at the start of this article. Are androids and cyborgs human, or some other species entirely and if so, where do we make that divide? Regardless, what are the implications of turning our historically sacred biological beings into commoditized vessels with swappable parts and quarterly upgrade modules?

Well beyond phantom limb syndrome, the human brain may not be capable of adapting to such massive bodily modifications and even if it is at a functional level, what of mental health? As we spiral further into this physical loss of self, how will we emotionally cope with the reality of not recognizing our own flesh and bone when it becomes silicone and steel? With our current hyperactive, digital existence already contributing to a host of issues around depression, identity crisis, and social isolation, it is easy to imagine how the further integration of technology, not only into our lives but our very beings, will only exacerbate these issues. We will mourn limbs actively chosen to be replaced or augmented. We will yearn to silence the digital voices actively being streamed into our minds. We will feel uncomfortable within our own skin, sensing the ticks, tocks, and buzzes of something unnatural underneath. In short, we could reject what we have become, even if it is of our own making.

While anyone who reads my articles would likely agree that I am far from being considered a sobering voice in the field of technoethics, we’re remiss not to ask the moral and ethical questions at hand. I could care less about playing god, however, I do understand that for millennia we have held technology as a collection of tools to support and enhance our lives, and all of that is about to change. The looming singularity does not simply change the nature of technology or our relationship to it, but the very essence of what it means to be human. Who among us is ready or worthy to shoulder that burden of responsibility?

Cyborgs Among Us

Far from being the stuff of freaky science fiction, countless examples exist of embeddable technology that people have stuffed inside of themselves in order to become more human than human.

·         Artificially ‘Enhanced’

While in many cases, artificially grown ears, heart valves, bladders, and other organs can be life-altering or lifesaving procedures, recent work being done by an institute in North Caroline has shown promise for growing artificial penises and vaginas. Though the work is presently being promoted for individuals with congenital abnormalities or post-trauma, it doesn’t take much to envision another, much more lucrative elective application for such a breakthrough.

·         Night Vision Eyes

A team in California recently enhanced a man’s eyeballs with Chlorin e6, a substance found in deep-sea fish, in order to allow him to have more sensitive vision to better recognize objects in low-light. Though temporary, this type of experiment highlights our ability to alter our own body’s chemistry to enhance our senses.

·         Blade Runners

Popularized by Oscar Pistorius’ inspiring victories (and later tragic arrest), many amputees are still able to compete athletically through the use of engineered carbon-fibre prosthetics, or blades, that enhance sprinting. However, Pistorius’ success within able-bodied competition raised criticism over having a technologically unfair advantage that one would assume will be a source of even more contention as the technology improves and biological legs are viewed as inferior.

·         Wet Ware

Though envisioned by William Gibson’s short story, Johnny Mneumonic, cybernetic neural implants may not be simply science fiction as DARPA has been developing a neuromodulatory device called ElectRX. As our understanding of the brain continues to progress, such devices use small electrical stimulations throughout the nervous system to achieve a variety of desired outcomes from removing joint pain to promoting healing.

·         Ear Speakers

A Nevada-based bodyhacker had small magnets implanted in his tragus (cartilage just outside the ear) in 2013 to act as small, in-ear speakers activated by a magnetic coil worn around his neck. While initially crude, this type of experiment paves the way for humans to have a discreet, permanent audio link to others and the web for anytime access.

Dr. Me

Let’s start by taking the following as givens:

•            As the growing elderly population floods the healthcare system, it will introduce a strain that our current methods of care will not be able to properly handle

•            The desire for patient empowerment will continue to shift greater care responsibilities away from traditional providers and towards the individual who will manage themselves

•            Medical technologies will aid this empowerment by commoditizing historically complex and expensive medical procedures into common tasks performed by smartphone accessories

•            Medical diagnosis and treatment knowledge will become universally and freely available and, more importantly, translated into humanistic, accessible language to be used by all

The convergence of these trends and more will lead us to, in my opinion, two inevitabilities. First will be a healthcare renaissance. By placing the knowledge, technology, and responsibility for care in the hands of everyday people, we will upset thousands of years of reliance upon medical professionals. We will change the basic roles in the healthcare system out of both desire and necessity. We will reserve doctors as consultants for only the most complex and challenging medical conditions. We will give greater authority to nurses and technicians to carry out increasingly common and routine medical functions. We will create machines capable of automating a number of medical procedures such as surgery and basic checkups. And at the center of all of this will sit you and I: everyday individuals who will essentially act as our own GPs and be the centerpiece of monitoring, managing, and making decisions about our own health.

The second inevitability will be the absolute clusterfuck that ensues around giving every Tom, Dick, and Harry their own stethoscope and telling them “you’re in charge.” While the health community will undoubtedly do their best and take every precaution to transfer this responsibility seamlessly and effectively, if history has anything to say about how changes to our health system roll out, we can anticipate at least a few hiccups. Misinformation, wrongful self-experimentation, abuse of medications and treatments, and medical obsessions are only a few of the challenges that await this “utopian”, fully-empowered health system. And while guys like me will do our best to help design a system that is completely foolproof, I am reminded of the Douglas Adams quote: “A common mistake that people make when trying to design something completely foolproof is to underestimate the ingenuity of complete fools.”

Bigger, Stronger, Faster, Deader

Naturally, we can expect many people to abuse these newfound tools and responsibilities. In true human fashion, it’s never enough to simply be healthy, and one could easily imagine the use of devices and medications to be experimented with in an attempt to augment and enhance our bodies. However, when is enough, enough? In the pursuit of human perfection, how far will we push the baseline of health and our understanding of normalcy? We’re already starting to see these types of enhancements in experiments with night vision eyes, superior prosthetic legs, and even cosmetic surgeries. Where do we draw the line?

Some people may end up being successful with these modifications and could find ways of using medical technologies to push their abilities and health beyond the status quo. Others, largely bereft of the experience or intelligence to understand the consequences of their actions, will fail miserably, making themselves even sicker, possibly disabled, or, while simultaneously upping the competition in the annual Darwin awards, dead.

Black Market Care

Even with self-administered care available, limitations will obviously be put on the availability and dispensing of medicines or treatments. But fear not; where there’s a will, there’s a black market. In order to support the abuses outlined above, the underground economy will undoubtedly find a way to provide access to medications and technologies for your every whim and fancy. Even when considering legal access to medical resources, this reality simply highlights the need for new distribution models, which will emerge through whatever channels, above or below the board, it can.

Beyond simply enabling off-label use and abuse, the creation of such a market could have a host of knock-on effects present in any criminal activity – theft, murder, bribery, and all sorts of other fun for the whole family. In short, the medical black market of the future may make today’s drug trade look like a game of Monopoly. Perhaps some in the legal community also envision this future and are taking steps, such as the life imprisonment of Silk Road founder, Ross Ulbricht, to send a clear message reminding us that government is the only one who’s allowed to dabble in narcotics.

Hyper Hypochondriacs

We all have one of those friends who believes they’re always sick; whenever some new outbreak or condition is announced on the news, they’re convinced they have it. They got E. coli from their burger. They got an STD from a toilet seat. That rash on their arm is necrotizing fasciitis. Imagine what these types of people will do when you give them the knowledge, technology, and responsibility for diagnosing themselves. Suddenly, the blissful ignorance that so many of us living under the care of medical professionals enjoy will be snatched from our medically-apathetic selves. And for those who constantly fret and worry their bodies, we will show them the spiral through which they might decent into a medical information-fuelled madness.

While some hypochondriacs may actually benefit from the immediacy of self-monitoring, others will fall into this spiral of health and body obsession. They will collect every piece of data available on their body and scream bloody murder each time the slightest deviation surfaces in one of their health metrics. And worse than the massive time sink and anxiety source for these individuals, think of everyone around them (who is also a sort of doctor), who will have to listen and be consulted every time their heart skips a beat or shit comes out a slight off-shade of brown.

Medical Celebrities

Our celebrity-obsessed society may encounter a few issues in this empowered future as well. Initially, traditional celebrities – athletes, actors, models, etc. – will become templates for the rest of us to model our lives after. Instead of simply buying an athlete’s workout routine or a model’s diet cookbook, they’ll now be able to package and sell the full set of their health data to compare against and use as an unnatural target point for our own bodies. However, over time, we will enable an entirely new form of celebrity whose rise to fame will not be through athletic prowess or artistic talent, but simply the rarity of medical perfection. Individuals will be revered simply for having a numerically superior health makeup, and I shudder to envision the dangers and insanity around coveting better, yet unattainable for most, medical metrics.

Our obsession with such meaningless and impossible numbers will drive us to take unnatural actions in the name of better data. Drugs could be developed to artificially adjust the blood’s chemical composition. Surgeries could be performed to unnaturally raise or lower heart rate. We will lose sight of the importance of health and go to dangerous lengths to optimize our numeric health, potentially at the expense of our actual health.

In Closing

The scenarios presented are not intended to be prophecies of doom and gloom, but instead speculations on how our health system could evolve given the emerging shifts we see around us and our natural curiosity and human inclination to mess with everything we touch. If stakeholders in the health system are aware of the changing social and technological landscapes and are smart about their designs, these types of scenarios can likely be avoided. The last thing we need is for one of the greatest shifts in healthcare since the Hippocratic Oath to be mired by the irresponsible follies of man. However, we do love our follies.

I hope I’m wrong… I truly do. However, if anyone disagrees strongly, I’m open to bets.

Hacking the Body

Ryan O’Shea runs the business side of Grindhouse Wetware, a Pittsburgh collective of programmers, engineers, and enthusiasts working towards body augmentation using safe, affordable, and open-source technologies. Started in 2012 by a group of colleagues through the biohack.me forums, Grindhouse has rapidly grown into a key figure in the biohacking movement and gained a great deal of press through initiatives such as Tim Cannon’s 2013 implanting of the Circadia body monitor into his forearm.

The funny thing about a dialogue with a biohacker like Ryan O’Shea is that while he acknowledges that integrating machines into the human body to enhance ourselves is weird, the entirety of human history with technological development is also pretty weird, if you think about it. Airplanes, space travel, Facebook – in many ways we are already a transhumanist society and for people like Ryan, body hacking is simply the next logical step.

Yet when we begin to explore the traditional medical system, O’Shea’s tone is somewhat less empathetic. His frustration with the media and public’s views of biohackers as “disturbed people in basements cutting themselves open and jamming cellphones inside” is completely understandable when you learn of the impressive roster of scientific professionals working with the team. However, they do still work out of basements, garages and other places away from the public eye, largely out of necessity. Money aside, working from the coffers of a large biotech or academic institution would allow a much more professional setting, however, massively hinder the speed and transparency of their work through patents, regulation, ethics reviews, and other red tape.

So what can the medical community learn from a group of rag tag pioneers such as the Grindhouse crew? Through a conversation with Ryan O’Shea, we uncovered a few things where the pros could take note.

Medical Science’s Biomimicry

“People seem to be fine with getting a prosthetic limb if they need one, or getting a cochlear implant if their hearing is damaged. Medical science is fine with bringing people who are considered “damaged” in some way up to normal, but it seems largely uninterested in making “normal” humans better.”

While O’Shea’s point is very relevant in the recovery vs. enhancement argument, there is an even deeper learning here about the ways in which medical science treats the body. Due to either our conservatism or the limits of our imaginations, by and large the types of treatments we pioneer to humanity’s ailments are attempts to copy nature, assuming it had it right all along.

But we only need to look to examples like composite running blades, ultrasonic neural stimulation, and Chlorin e6 injectable night-vision to realize that the unnatural is at times a better way forward. While we have traditionally sought to restore body functionality to a state of normalcy through biomimicry, we are in essence setting for ourselves an upper-limit on the types of treatments we are able to create. This is a constraint not simply on the functionality of our bodies, but also a handcuffing of medical researchers who are told to hit the “sweet spot” of human ability – not too little and not too much.

Our Bodies are Vessels

“There’s this lingering belief that the human body is some perfectly crafted, preplanned organism. It’s not. It’s the byproduct of generations of accidental mutations, adaptation, and survival. Parts of our biology are vestigial remnants of our animalistic past.”

This extreme view should remind us that while it’s important to tend to the body’s ailments, ultimately the body is simply what transports and serves our minds. Each year, it seems, our advancements in prosthetics, artificial organs, and synthetic body chemicals leaps forward, while our understanding of the mind inches at a snail’s pace. We hold the body on a pedestal though as O’Shea points out, it is nothing more than a byproduct of centuries of evolution and our current attempts of integrating technology into the body, while somewhat risky, are simply an acceleration of this change.

The medical community needs to pull the human body off the pedestal and to stop enabling society’s narcissistic view of ourselves as Adonises. If this article’s first point has merit, then future treatments will likely inch further and further away from the body’s original state. If we do not begin to reset the norm of medical care to be one of optimizing ourselves instead of simply restoring the functionality of our evolutionarily-mutated flesh-bags, then we will begin to see a divergence in health between the trailblazers who are willing to hack their bodies and the stalwarts who are too scared to vaccinate their families with over 200 year-proven technology. Our bodies are not sacred temples. They are imperfect and at times broken systems that we need to get comfortable with augmenting or repairing through any means necessary if we truly want to optimize health.

DIY

“The fact that we choose to go the route of the open source, citizen science, and maker communities isn’t an indictment of our methodology or vision. If anything, it is a conscientious stand against ridiculous patents, hindering regulations, and bureaucratic red tape that would keep us from innovating how we see it.”

And perhaps the most obvious, yet important thing the medical community can learn from a group like Grindhouse is how to rapidly innovate. While decades of regulation have made our health systems more safe and reliable, this has also prevented the medical community from sprinting forward on many advances. Yes, we must always weigh the risks and consequences of our actions, however, those aware of the risks should have the choice to circumnavigate regulation.

This would allow the types of incredible pioneering work being done at places like Grindhouse, Science.Mic, Biohackspace, or DIYbio, to take place under far more safe, controlled, and scientific communities. It could mean that new drugs and new medical devices could be in-market within months instead of years. Regulation and property are crucial concepts for the business world, but when it comes to matters of our health, we have a moral imperative to serve the needs and health of people ahead of our organizations and governments. Yet until we resolve this dissonance, expect that more and more of the major medical breakthroughs you read about over the next decade will not come from the top Universities or Biotechs of the world, but by the basement-dwellers and hackers like Ryan O’Shea.

Death to Process

Process is designed to let us be stupid.

Though don’t take my harsh words the wrong way, this isn’t necessarily a bad thing. However, it’s still a reality. Process has a positive side. It affords us consistency, reliability, simplicity, repeatability, and repeatability. It allows us to take complex tasks and break them down into much simpler parts to be executed by specialists or even automated by machines. At an extreme, process takes the world we live in and quantizes it into easy to manage, binary decisions and actions: do or don’t do. Ultimately, what it really affords us is efficiency. By optimizing each part of a process – though specialization, experience, and blind repetition – we can optimize the whole and create faster, bigger, stronger, better systems.

The other effect of this optimized worldview is that it reduces cognitive load. By boiling a complex sequence down to a series of simple steps, the true efficiency comes in never having to question the world around you, but instead simply becoming a master of your small domain. By allowing our world to exist between the confines of our inflows and outputs, we slowly lose is our ability to think beyond our stations and ourselves. We turn the brilliance and inquisitive nature of the human mind into a simple cog to be plugged into someone’s process. And because we’re lazy, we gladly bury our complications, trusting the giants whose shoulders we stand upon were facing the right direction and pointing us the right way when they set our process. For the most part, they probably were. For the most part, you can feel comfort, standing on those broad shoulders, gazing off into the great beyond to which their ancient, wise fingers point.

“For the most part” – you had to see this one coming.

The dawn of industrialization introduced more processes into our lives in the past 100 years than ever existed prior in the whole of human history. And yes, these processes have brought us massive efficiencies and vaulted our advancements forward exponentially. However, who’s to say that these processes will continue to hold as the best way forward? It’s not that process is a bad thing, it’s simply that it is a fragile thing. What works today has no guarantee of working tomorrow and as the world we live in continues to change at an ever-accelerating pace, this risk should scare us more and more.

Yet with the way we blindly charge forward, we don’t seem to be afraid. And even in lieu of catastrophic failure, what if our processes are holding us back and our complacency and laziness is the only thing getting in the way of even greater breakthroughs and innovations? How often do we stop and take the time to step back and see the bigger picture; to truly evaluate what we’re doing in a context broader than what’s expected of us and to ask questions that might at first seem foolish? How often do we ask “why?”

One of the things I love about my job is the ability to attack a problem with a certain sense of foolish ignorance. As consultants, we’re expected to be able to take on nearly any problem thrown at us. Given the diversity of what we work on, this necessarily means that we can’t be experts at everything. Yet, it is in this blissful ignorance that I often find comes our greatest strengths: naïve curiosity and the ability to make non-intuitive connections between diverse problems.

We do this not by strictly following process, but in fact by intentionally breaking it.

Because it is in the breaking of process that we force ourselves to think. We remove the guardrails that act as quick decision-making tools and question the underlying assumptions surrounding the task at hand. And, if there is a serious problem with the task at hand, this is precisely the type of thinking that we need – curious not complacent, skeptical not safe, and exploratory not efficient. We break process not to simply find holes in it and patch or improve them, but to rethink it entirely to constantly and consistently find entirely newer and better ways of doing things.

Take our Health practice as an example. Years ago, when we first started formalizing, we were confronted with an industry that largely served the financial needs of payers, the functional needs of doctors, and the tolerability of patients. But with a movement towards patient empowerment shifting the ground out from under the foundation of the industry, we questioned traditional healthcare models and built an entire practice on the understanding of a patient-first approach. We asked “why” such a heavy emphasis was placed on the system players while so little was given to the end-consumer and in an industry where decision-making authority is slowly shifting hands, this is exactly the question to be asking. Yet far from resting on our laurels or growing complacent, with each new project and each new problem, we re-evaluate the industry and patient experience to understand the hierarchy of needs we must serve and to add to our ever-evolving perspective on healthcare.

Though this role is exhausting, the potential pitfalls of not questioning ourselves are the business equivalent of setting cruise control on your car, letting go the steering wheel and letting our imperfectly designed systems steer us into the unknown. Granted this metaphor was a lot more compelling before self-driving cars became commonplace, but we can still understand the punch line: you may drift along safely for a while, but eventually an inevitable swerve in the road will send you careening off a cliff.

So I say death to process. To hell with the black belts. Leave the process to those who wish to play with cookie cutters. I, for one, would much rather play the role of the foolish skeptic. And though it takes every ounce of my being to fight my inner engineer and businessman each time I play the fool, I’ll gladly spend the energy because I’d rather be exhausted from swimming upstream than continue blindly down a path of self-fulfilling validity… even if I am wrong. At the end of the day, I’d rather be an exhausted fool than a cog.