So, I’ve finally started reading again — at least some. I seem to go in cycles where I find lots of books that interest me that I am able to digest. Then there are those times when my attention span is two minutes or less — at best. I don’t know what that’s all about.
I am reading a book called “Being Mortal” by Atul Gawande. I read one of his other books called “The Check List Manifesto” which was all about how Gawande implemented on a small scale the use of checklists in hospital operating rooms which reduced the rate of complications and ultimately cut the amount of time patients stayed in intensive care by half. His checklist strategy applies to almost all walks of life, from the checklists all commercial pilots use, to checklists that engineers use when building 60-story skyscrapers. In an increasingly complex world, the use of fundamental checklists help people avoid simple errors in complex systems. The Checklist Manifesto is amazing and a worthwhile read.
I just started “Being Mortal,” and he already has hooked me again. The book is about aging, and it looks as though he will approach the topic with the same fascinating insight and intuition as he used in the checklist book.
The first gem I stumbled across was when he was recounting spending time on the floor below his surgical floor at his hospital — the Geriatrics wing — a floor he had never set foot on. He ended up spending the day making rounds with the chief geriatrician, Juergen Bludau. After examining one 85-year-old patient with a litany of potentially serious problems, Gawande was startled to note that while Bludau did pay attention to those issues, what he spent the most time on was examining the condition of the patient’s feet. Bludau explained to Gawnde that one of the most serious dangers to seniors is falling and breaking their hip. When that happens, Bludau said, 40 percent end up in a nursing home and another 20 percent are never able to walk again.
He went on to explain that the three most important risk factors related to falling were poor balance, taking more than four prescription medications and muscle weakness. His patient, he said, had two of the three risk factors. When she first walked into the exam room he had noticed her “splay-footed” gait. Examination of her feet revealed that “her feet were swollen, her toenails were unclipped (which suggested that she had limited flexibility), there were sores between the toes, and the balls of her feet had thick, rounded calluses.”
Also, he noted that she was on five medications. When she got up from her chair, he had noted that she had not used her arms to push herself up, which, he said, indicated that her muscles were still sound.
In the end, Bludau prescribed monthly visits to a podiatrist to improve the condition of her feet. He saw no medications that could be eliminated, but he did change her diuretic to a blood pressure medicine, which would eliminate the risk of dehydration (he had noted that her tongue was gone dry when he had examined it indicating dehydration). Dehydration could cause dizziness, which, in turn increased her chances of falling.
I am not sure why I find this so interesting, but I suspect that it has something to do with the fact that it demonstrated the fallacy of an assumption and reminded me not to be too quick to judge or jump to conclusions in general.
Another book I am reading is about four media companies — The Washington Post and the New York Times and how they were damaged by and dealt with changes in technology, and how two other media companies had benefited from the same technology — Buzz Feed and Vice.
I just finished a long chapter on Facebook which discussed the election of 2016 and the role that Facebook played in releasing data on more than 80 million users to a company named Cambridge Analytica, which was owned by the Mercer family. The chapter went on to discuss the use of data in political campaigns and the startling degree to which data from Facebook could be used to identify individual preferences and predict future behavior — based in large part on research by psychologist Michael Kosinski in the emerging field of “psychometrics.” The research apparently gave Kosinski the ability to make “any number of intelligent predictions about someone about whom he possessed (only) a sliver of seemingly irrelevant information.”
The book stated that, according to Zurich’s Das Magazine, “with a mere ten ‘likes’ as input, his model could appraise a person’s character better than a co-worker. With seventy, it could ‘know’ a subject better than a friend; and with 150 likes, better than their parents. With 300 likes, Kosinski’t machine could predict a subject’s behavior better than their partner… It was a framework that allowed analysts to know as if on a deeply personal level, vast numbers of people.”
I haven’t finished the chapter on Facebook yet, but it has given me a deeply felt fear about the use and abuse of personal data by, well, by just about anybody who can get their hands on the data and has enough money to act based on the insight and knowledge that data provides. I can’t wait to finish this particular chapter and move on. It’s quite depressing. I suppose though, maybe it is balanced out by the positive experience I have found from reading Gawnde’s book.