Health Care & Complexity Science

"We need to move to the edge of chaos in our quest for the solution to health care delivery, not jump over the precipice. We need creativity and innovation, not rigid process compliance."

-- from Thinking Like a Farmer on the Cognitive Edge guest blog, focused on health care and complexity

My response to comment on More on the Role of the Listener

In response to my assertion, "We will not achieve a culture of story sharing unless we empower the role of listener," a Neurocooking reader asked, "And how do we empower the role of the listener?"

A recognition of parity between the listener and the sharer.

This became clear to me as I reflected on a scene from last night’s Improv class:

My scene partner immediately assumed what in Improv is called High Status; she assumed the role of a diva. I did not immediately take her cue and assume lower status. I didn’t feel like being subservient. It felt like giving up. Yet surrender was what was called for! If I had listened, truly gotten out of my head and listened fully to my partner, I would have heard clear and intense emotion and been able to provide her with the space and platform she needed to be fully present and shine. A substantial connection would have occurred and we both would have benefited.

(that's a one followed by eight zeroes)

Thaler's "More on the role of the listener" was NeuroCooking post number 100000000. Really. Truly.

Just as there are 10 types of people in the world: Those who understand binary, and those who don't.

(That's 100000000₂. You could, as they say, do the math.)

More on the role of the listener

• It's a compliment if a friend describes you as "a good listener".

• Leaders who "listen closely to all sides" prior to making a decision are highly regarded.

• In many cases, listening has been professionalized: e.g., psychotherapists, clergy, and other anointed listeners.

• Managers are taught "active listening skills", as if listening were solely a strategic tactic for engagement.

The rewards of listening, of hearing something as if you have never before heard it, of listening with the willingness to be changed by what you hear, are barely articulated.

We will not achieve a culture of story sharing unless we empower the role of listener.

What happens to the brain when you share a story?

I had another wonderful conversation last night with Aspen Baker, founder of Exhale. At one point, we explored the elements that are necessary for someone to share his or her story. At the very least, the sharer must feel comfortable and respected, and be in the presence of people whom they trust.

The listener, upon hearing the story, will process it alongside existing information and experiences. Most likely, memories will be sparked. The new story has been connected to the old story. Perhaps, new neural pathways have formed.

What about the sharer? In therapeutic terms, the sharer may experience release or validation or connection. What is happening inside the sharer's brain? Do we know? How might we know?

eV & EV

An eV is an electron Volt; an EV is an Exposure Value.

light science & ...

I recently got a copy of "Light Science & Magic: An Introduction to Photographic Lighting" by Fil Hunter and Paul Fuqua (2nd edition, 1997).

It's an incredible book, with more pages than you'd guess on "how to light a box".

Chapter one, entitled "How to learn lighting," ends with a section presented here in its entirety:

WHAT IS THE "MAGIC" PART OF THIS BOOK?

Learn about the light and the science. The magic will happen.

From the Kensington Parkway bridge over Rock Creek, you can see the Capital Beltway, and sometimes, beavers.

As a followup to our earlier post on beavers, here is an (undated) satellite image to show how close the new WSSC tunneling site is to our "beaver bridge". Note that the google-supplied annotations (e.g., for roads) do not include Rock Creek itself, which is a sort of smudged green line; we've indicated it, as well as the bridge carrying Kensington Parkway over it, & the nearby tunneling site:

I haven't seen X since Y began.

"So," I said, "I haven't seen a beaver since that tunneling station started up."

"I bet you're right," she replied. "That thing is like a city, or a factory that's always running. No wonder the beavers are gone."

But aren't we, I hope (note: not "hopefully") perhaps making two mistakes here? First, mistaking absence of evidence for evidence of absence? And second, mistaking correlation for causation? And two wrongs don't make a right. But damn (note: not "dam"), that worksite for the drilling of the new water tunnel is awfully close to our favorite beaver spot.

We'll see, if (when?) we see beavers in the creek again.

____

[Photos of beavers in Rock Creek, as seen from the Kensington Parkway Bridge, on 14 July 2007 & 13 July 2008, respectively; more photos here. Late edit: We provide a map in a followup post.]

not an acronym

The name of the popular computer operating system, "unix", is a joke, not an acronym.

Really. "Unix" (originally "unics") was a pun on "castrated multics", multics (which is an acronym, for "Multiplexed Information and Computing Service") being the name of an earlier operating system.

metasyntactic arguments

Computer programs have modular organization; modules interact by exchanging information.

There are two aspects of this, or rather the technical nomenclature used to refer to this, that I want to bring to your attention today, NeuroCooking friends.

The first is that the general term for the information passed from one module to another is "arguments". Isn't that odd? In real life, generally you supply either information or an argument. Here, the information is called an argument.

[In mathematical computing, the word "variable" is often used to refer to individual arguments.]

The second funny thing concerns the terminology for the placeholder names for such information. Let me explain with a math example. Suppose we write a software module to compute the power of one number raised to another:

function power( x , y )

; calculate value of x to the y power using natural logarithms

result = exp( y * ln(x) )

return, result

end

Information can be passed to this software module by invoking it using a "function call"; the calculated value is passed back (just as our function calls two others). For example, suppose, in another software module, we use the "power" function to calculate compound interest:

[...]

; compute compound interest given rate and term

value = inital_value * power( (1.0 + rate/100.) , term )

[...]

Notice that "x" and "y", the names of the arguments that appear in the program for, or definition of, the "power" function, do not appear here. Rather, "x" and "y" serve as placeholders for what actually gets passed. Now, the formal name for this is metasyntactic variable. That is, x & y are metasyntactic variables. The commonly used term though, is "dummy variable". As in, x & y are dummy variables. Isn't it odd that "dummy" can mean the same thing as such a fancy word as "metasyntactic"?

the opposite of story

The other evening, Tom asked me, “What is the opposite of narrative?”

Tom was recalling a radio interview with a Republican communications strategist about the 2008 Presidential election. The strategist said something like, “We don’t do that whole Obama narrative thing, we do x.” Tom could not recall the strategist's definition of x.

The question got me wondering, What is the opposite of story?

I posted this query to a group of colleagues working in applied narrative, and a wonderful conversation is taking place. One response, in particular, resonates:

“For me, it's "opinion". As opinions don't tell anything, that is to say the listener has no existence for the guy who expresses an opinion.” – Stephane Dangel (in French; for an interview in English, click here)

This past Sunday evening, I grew frustrated with the Storytelling class I am currently taking. Now, it was only the second class, and the focus so far has been on finding what our teacher calls the Main Event in each story that is shared. Great things are happening in the class, and of course, strong bonds are forming between my classmates as we intimately share and “workshop” our personal stories each week. But the listener has been absent in our discussions. There’s been no discussion of exploring the emotions one may be eliciting in a listener by sharing a particular story, or if you have a desired emotion or action you would like to elicit. It is obvious that many of my classmates are sharing stories for reasons other than simply entertaining an audience.

Nor has there been discussion that the act of sharing a story is akin to giving a gift. Even if one expects nothing in return (and aren’t those the best gifts to receive?), one must think about the reactions that may be generated by the sharing of the story.

In Improv, there is a co-creation with one’s Improv partners, and with the audience. Every moment is completely unexpected and will never be replicated. Great professional storytellers know that the audience is crucial to both the delivery and intake of a story.

Perhaps my background in persuasive communication has me too focused on the intent of the person sharing the story, the listener, and how and where the sharer taps into the listener’s memories and stored experiences. I want to get better at the technical aspects of sharing a story. But for now, talking about storytelling without talking about the importance of the listener leaves me empty.

Look ma, no cords!

When I got home last night, sitting on a kitchen counter was a new appliance, a SodaStream – no more lugging bottles of seltzer; now we can make our own!

Because the few electrical outlets on that counter were, I thought, already in use, I asked my wife where she had plugged it in. "I didn't," she said, "because it doesn't."

Wow. No digital display; no menu; no microprocessor; no electricity!

[Disclaimer: All trademarks are property of their respective owners; their use here does not denote endorsement or sponsorship. And, as you may recall, NeuroCooking is not supported by General Motors, makers of Cadillac vehicles, which combine legendary luxury with best-in-class performance.]

Smells like science!

From "Hearth Surgery: The quest for a stove that can save the world" by Burkhard Bilger, filed under "Annals of Invention" in the December 21 & 28 2009 double issue of the New Yorker magazine:

In seventeenth-century England, when a stovemaker wanted to test a new design, he'd soak a piece of coal in cat's urine and throw it on the fire. If the stench went up the chimney with the smoke, the design was deemed a success.

There are No Superstars of Bowling

I had the pleasure of seeing and hearing marketing guru Seth Godin in person yesterday. Seth was introduced by a friend as an "elevator: he elevates everything around him."

His talk was timed to promote the release of his new book, Linchpin. He began by admitting that of everything he was going to say, "the people in the room are the ones who need to hear it least. So it is my goal that you will take what you hear and put it in your own words and then share it with 10 people."

When asked, few, if any of the audience members admitted to thinking of themselves as a genius. Seth complained that "Albert Einstein ruined it for the rest of us" and then proceeded to explain that "what a genius does is solve a problem in a way that no one ever solved it before."

The talk, loosely, offered this equation:
Genius + Fearlessness + Internet + Passion + Generosity = Success

Seth was inspiring, always interesting, and enthusiastic. This was the first time he was delivering this talk, and the connections between the concepts were less than smooth. I offer many of his pithy statements below.

Seth defines art as "when a human being, working without a manual, connects with another human being and changes them." In an era of cheap mass production, both human initiative and connection are essential to success. "If you say to your boss, 'What should I do next?', at some point, she will say to you, "Someone else can do it cheaper.'"

He cautioned not "to engage in any activity where the best you can do is known." Such as bowling, where the best one can do is 300. "That's why there are no bowling superstars."

Seth suggested that we grade ourselves when starting a project, and to "give yourself a 'D'. If you can get over the fact that you've gotten a D, then you can go on and make art. 'I'm going to paint something that everyone hates.' - Now, you can paint!"

"No one pays attention to your ads anymore. They pay attention to how they are treated when they show up."

"Gift giving is essential to being an artist." For example, Prufrock Coffee in London, offers customers what seems like a disloyalty card: if you get the card stamped at 10 of its competitors, but then choose to return, Prufrock will give you a free cup of coffee!

"The definition of anxiety is experiencing failure in advance." [This reminded me of Mark Epstein's definition of anxiety as "attempting to make the future known."]

Seth talked about fear of failure, and the false comfort that comes from never taking risks or fully exploring one's passion. He cautioned against "Pulitzer Prizefighting: wanting to compete in an arena where there is a known prize." In other words, "Are you doing what you are doing because there's an easy way to keep score?"

We closed with two handy questions that double as mantras - and connect to the title of his book [a linchpin "has the highest usefulness to weight ratio in a car"] and -- of course! -- to Improv:

1. "What is the point of having this interaction if I can't make it better?"
2. "You are taking a seat: is that seat taken to the best of your ability?"

correlation is not necessarily causality; even if it is, it is not necessarily in the direction you presume

A followup to yesterday's post about bulking up & slimming down your brain.

While the study on learning to juggle was a longitudinal intervention study – the same people were studied before and after an intervention (in this case, learning & practicing to juggle) – the new study on ballet was a cross-sectional study, in which ballet dancers were compared to age-matched control (non-dancer) participants.

Correlation is not necessarily causality, so intervention studies are stronger than cross-sectional studies.

In the case of the ballet study, it is (formally) possible that the reductions in brain tissue seen in the professional ballet dancers were the cause of, rather than the result of, their choice & pursuit of that profession. Which reminds me that my Ph.D. advisor used to point out that cross-sectional studies purporting to show health benefits of exercise were flawed, because their results could be explained instead by healthier people being more likely to exercise. And which also reminds me of a bunch of drummer jokes...

beefing up vs. slimming down

While learning to juggle appears to increase grey matter density in the part of the brain that handles visual motion, a new study suggests that training to be a professional ballet dancer appears to decrease grey matter density in brain regions controlling motor activity.

The distinction appears to be that while acute training beefs up relevant brain regions, long-term training can slim then down, by making grey matter more efficient (so that you need less of it); also, long-term practice of repetitive motor actions (like learning to ride a bicycle!) makes things less conscious and more automatic — you use your cortex less, because you're using other resources (basal ganglia; cerebellum; spinal cord) more.

The suggestion that training can beef up short-term and slim down long-term was apparently first made in 1998.

how not to apologize

On Monday night, a friend and I were having dinner at a local restaurant. A woman in a long and puffy down coat, wearing a hat and carrying a tote bag, squeezed between our table and hers, back to us, en route to sit down. She knocked over my friend's glass of water, spilling the contents into my friend's lap. The stranger turned to face my friend and me, and simply announced, "I'm not that big."

Upon hearing this story when I returned home, Tom commented, "Well, that's sort of like an apology, in that they both begin with 'I'."

Invisible High School or Invisible College?

“The beneficiaries of the system where making things public was a privileged activity, whether academics or politicians, reporters or doctors, will complain about the way the new abundance of public thought upends the old order, but those complaints are like keening at a wake; the change they fear is already in the past. The real action is elsewhere....

"Given what we have today, the Internet could easily become Invisible High School, with a modicum of educational material in an ocean of narcissism and social obsessions. We could, however, also use it as an Invisible College, the communicative backbone of real intellectual and civic change, but to do this will require more than technology. It will require that we adopt norms of open sharing and participation, fit to a world where publishing has become the new literacy.”

Clay Shirky, pondering How Has the Internet Changed the Way You Think?

Comedy as the Failure of Drama

New year, new Improv class! Scott Eckert, my new Improv instructor, explains that there are essentially 3 types of Improv scenes:

1. Pirates on the Moon - essentially, wacky happenings in unexpected places
2. 2 People Talking - and talking, and talking, and talking...
3. Comedy as the Failure of Drama

The first two are ultimately unsustainable. When comedic moments infuse true drama, however, hilarity ensues.

It's funny, because it's real. Ain't that the way to be approaching life?

Scott also explained that long-form Improv is focused on finding patterns and connections among scenes. That "something fundamentally changes when people are together making those connections."

This reminded me of story sharing: when your story connects to my story, which connects to our colleague's story, which connects to the larger organizational narrative, deep, memorable, and sustainable understanding results. Meaning is made, complexity is conquered, and connections are cemented.

Fifty's not normal.

Today I want to warn you to make sure your prime is (at least) normal, if that's what you want.

In photography, a "prime lens" is one that does not zoom; it has a fixed focal length. A "normal lens" is one that gives a horizontal picture angle of 45 degrees. Lenses with shorter focal lengths are called "wide-angle"; lenses with longer focal lengths are called "telephoto". Historically, normal lenses have been popular for photography; some photographers never used anything else.

Tradition (& marketing) suggest that a 50 mm focal length lens is the normal prime for single-lens reflex cameras that take 35 mm film or have "full frame" digital sensors (i.e., with a detector sized 24 mm x 36 mm, same as a frame of 35 mm film).

But.

In fact, on 35 mm film, a 50 mm lens gives a picture angle of 39.6 degrees, clearly less than 45 degrees, and therefore inadequate. Simply sub-normal.

A true normal lens for 35 mm film (or a full-frame digital sensor) would be one with a 43.33 mm focal length. While no one makes such a lens, Nikon does make an autofocusing 35 mm f/2.0 lens, which gives a picture angle of 54.4 degrees. Yes, that's wide. Not super-wide. But at least it is at least normal.

So, if you're shooting full-frame, and you want to be at least normal, don't respect conventional wisdom (& marketing) by choosing a 50 mm lens. Because fifty ain't normal, no matter what they say.

[Disclaimer: All trademarks are property of their respective owners; their use here does not denote endorsement or sponsorship. While we're on the subject, please remember that NeuroCooking is not supported by General Motors, makers of fine Cadillac vehicles, which combine legendary luxury with best-in-class performance.]

formally speaking

Thank you, NeuroCooking friends, for your kind comments regarding our New Year's Day dog- and cat- blogging.

In response to an inquiry as to whether we might have a formal portrait of our dog, or of one of our cats, to coordinate with the perhaps-familiar black-tie photo of your NeuroCooking correspondents, we present this:

["formal portrait", May 2006]

"I can only give you everything."

Just one sentence from "Opportunities for Research and NIH" by Dr. Francis S. Colllins, Director of the National Institutes of Health, in this week's issue of Science:

"The revolution now sweeping the field is the ability to be comprehensive – for example, to define all of the genes of the human or a model organism, all of the human proteins and their structures, all of the common variations in the genome, all of the major pathways for signal transduction in the cell, all of the patterns of gene expression in the brain, all of the steps involved in early development, or all of the components of the immune system."

[Post title refers to this].

"...our civil rights have no dependence on our religious opinions, more than our opinions in physics or geometry..."

The Virginia Statute of Religious Freedom was written by Thomas Jefferson in 1779 and passed by the Virginia Legislature in 1786. Its preamble consists of just one sentence:

Well aware that Almighty God hath created the mind free; that all attempts to influence it by temporal punishments or burdens, or by civil incapacitations, tend only to beget habits of hypocrisy and meanness, and are a departure from the plan of the Holy Author of our religion, who being Lord both of body and mind, yet chose not to propagate it by coercions on either, as was in his Almighty power to do; that the impious presumption of legislators and rulers, civil as well as ecclesiastical, who, being themselves but fallible and uninspired men, have assumed dominion over the faith of others, setting up their own opinions and modes of thinking as the only true and infallible, and as such endeavoring to impose them on others, hath established and maintained false religions over the greatest part of the world, and through all time; that to compel a man to furnish contributions of money for the propagation of opinions which he disbelieves, is sinful and tyrannical; that even the forcing him to support this or that teacher of his own religious persuasion, is depriving him of the comfortable liberty of giving his contributions to the particular pastor whose morals he would make his pattern, and whose powers he feels most persuasive to righteousness, and is withdrawing from the ministry those temporal rewards, which proceeding from an approbation of their personal conduct, are an additional incitement to earnest and unremitting labors for the instruction of mankind; that our civil rights have no dependence on our religious opinions, more than our opinions in physics or geometry; that, therefore, the proscribing any citizen as unworthy the public confidence by laying upon him an incapacity of being called to the offices of trust and emolument, unless he profess or renounce this or that religious opinion, is depriving him injuriously of those privileges and advantages to which in common with his fellow citizens he has a natural right; that it tends also to corrupt the principles of that very religion it is meant to encourage, by bribing, with a monopoly of worldly honors and emoluments, those who will externally profess and conform to it; that though indeed these are criminal who do not withstand such temptation, yet neither are those innocent who lay the bait in their way; that to suffer the civil magistrate to intrude his powers into the field of opinion and to restrain the profession or propagation of principles, on the supposition of their ill tendency, is a dangerous fallacy, which at once destroys all religious liberty, because he being of course judge of that tendency, will make his opinions the rule of judgment, and approve or condemn the sentiments of others only as they shall square with or differ from his own; that it is time enough for the rightful purposes of civil government, for its officers to interfere when principles break out into overt acts against peace and good order; and finally, that truth is great and will prevail if left to herself, that she is the proper and sufficient antagonist to error, and has nothing to fear from the conflict, unless by human interposition disarmed of her natural weapons, free argument and debate, errors ceasing to be dangerous when it is permitted freely to contradict them.

Welcome to the twenties!

...Nineteen ninety-seven,

nineteen ninety-eight,

nineteen ninety-nine,

two thousand,

two thousand one,

two thousand two,

two thousand three,

two thousand four,

two thousand five,

two thousand six,

two thousand seven,

two thousand eight,

two thousand nine,

twenty ten,

twenty eleven,

twenty twelve,

twenty thirteen,

twenty fourteen,...

TTL

"TTL" means both "transistor-transistor logic" (& associated voltage levels for logic signals) as well as "through the lens" metering for flash photography.

New Year's Day dog-blogging, III.

[with Frasier, 16 May 2009]

New Year's Day cat-blogging, II.

[13 November 2006]

New Year's Day dog-blogging, II.

[with Zack & Thunder, 9 April 2004]

New Year's Day cat-blogging.

[13 November 2006]

New Year's Day dog-blogging.

[by the fire, 17 December 2009]