LETTERS FROM THE GLOBAL PROVINCE

GP 2 January 2008: Getting Your Hands Dirty

“Science is the belief in the ignorance of experts”—Richard Feynman

Breathtaking.  Circa 1984 an East Side couple prepared for the birth of their first child at some Lamaze classes given by an assiduous young woman who held court in a walk up apartment in the 80s on Lexington not far from their own far more comfortable digs.  Lamaze comes to us from Soviet Russia by way of France.  As best we know it mainly consists of controlled breathing to relieve pain, though there seems to be a whole battery of associated techniques and far-reaching claims embraced by its most fanatic devotees.

A Manhattan investment banker, the husband was not great at breathing, but he was a fast talker.  His  stock-in-trade included the typical banter that is de rigeur on Wall Street. Ms. LaMazing, the class leader, not only took the pregnant women and their spouses through all sorts of techniques but counseled the ladies in detail as to how their pregnancies would go, right up to the moment of birth. Finally the irreverent husband piped up, “Do you have children?”  “No,” she replied.  She was just a well-rehearsed spectator, who seemed to know everything but actually knew little.

Clean, Soft Hands.  There, in a nutshell, you have the core problem of most experts.  They talk a good game, but they have never been to war or gotten their hands dirty.  In the Army, shrewd fellows distinguish between garrison soldiers and field soldiers.  The men in the offices run things in peacetime, but you hope that soldiers with well-worn boots are in command during war.

Most likely you will have a tragedy when the opposite is true.  It seems that the high-level bureaucrats who have called the shots in Iraq had little or no military background.  So we have squandered great numbers of lives and great amounts of national treasure, because of their imperious ignorance.

Writ large, such stories about armchair warriors also cut to the quick when we are discussing a whole panoply of experts—knowing journalists, Wall Street analysts and investment bankers, consultants, and  so on.   Our society is riddled with experts, so it behooves us to understand their limitations, how to pick them, and above all how to separate the wheat from the chaff.

We have long been working on a Dictum about experts, and hope to give some simple rules of the road for dealing with them ere long.  But here we will just advise you to never pick an expert who has not mucked about in the trenches.

Healthcare.  As good a place to start as any is healthcare.  Our healthcare system consumes just north of 15% of our gross national product—an enormously expensive national enterprise peopled with layer upon layer of experts.  In fact, the people most calling the shots in our healthcare system are quite removed from day-to-day healthcare and the nuances of illness.  Eureka!  We are not getting healthier, nor do we rank as one of the healthiest nations on earth.  One is well advised to pick one’s experts carefully.  The dirty hands rule does apply.

That is, often an informed patient who has lived with a disease can provide sufferers with practical wisdom and a breadth of knowledge not shared by physicians or healthcare workers.  For instance, both David (a.k.a. Rick) Mendosa and his wife are chronic diabetics: he aspires to be the best writer about diabetes.  The wealth of information he offers on his website is probably unparalleled, and it is rendered with clarity.  As well, one might want to consult him about the application of saw palmetto to benign prostatic hyperplasia, or BPH, since the medical community has not even gathered good data on this subject.

Similarly those with severe spinal cord injury and paralysis are well served to take a look at Matt Ginop’s Spinal Cord Injury, which is both comprehensive and passionate—the work of a sufferer.

Massive numbers of people with prostate afflictions stretching beyond run-of-the-mill BPH turn to the Internet each year to try to work their way through their problems. Sooner or later, they will run across Dr. Peter Scardino, who is taken to have written the prostate bible. It’s less likely that they will uncover Dr. Andrew von Eschenbach, a cancer expert from Houston who went on to head the National Cancer Institute.  As it happens, his father died of prostate cancer, and he himself had a bout of it.  We’re inclined to think he might have quite a few heartfelt, useful things to say about the prostate.

Of course, there are other reasons why you want to make sure your doctor has had a brush with sickness.  As our partner Steve Martin is fond of saying, “I want him to have gout because then he is successful.  And I want him to have hemorrhoids because then he will be empathetic.”  A man who has not had a brush with mortality will not have any knowledge of the human condition.

The Formation of Vegetable Mould.  We all remember Charles Darwin as the tourist of the plant and animal world who shared his adventures with us in On the Origin of Species.  He theorized about evolution, survival of the fittest, and how—maybe--we came to be.   Like the great Linnaeus before him, he helped make sense of a prolific natural world that appeared to be all of a jumble in the centuries before these two giants came along to make some sort of sense of it.  

But only lately have we completed his The Formation of Vegetable Mould through the Action of Worms, a short monograph put out in 1881.  Our friend Mr. Arch Williams got us started on the subject of worms with a book by Amy Stewart, entitled The Earth Moved, which is a nice preamble to Darwin’s work.  She was a mere reporter, but Darwin was an expert of the first order, his powers of observation more finely tuned and focused than in his earlier works.  Whatever your views of evolution, you should know that he is the most trustworthy of experts on the almighty power of worms.  As it turns out, they are a critical component of the earth’s infrastructure that make our natural world possible.  As Darwin says, “Worms have played a more important part in the history of the world than most persons would at first suspect.  In many parts of England a weight of more than ten tons … of dry earth annually passes through their bodies and is brought to the surface on each acre of land; so that the whole superficial bed of vegetable mould passes through their bodies in the course of a few years.”  Their castings turn forlorn land into the richest earth.  To observe their action, Darwin not only trained his eyes on them but enlisted his sons to chart their meanderings.

Knee-Deep.  Wherever we turn now, there are more and more subjects than perplex us, more and more perplexing events and systems that need to be decoded, need to be brought down to earth.  The trick, of course, is to find somebody who is knee deep in whatever we want to understand, because vicarious experts can only provide us with comfortable, highflying truisms that oft as not are dead wrong, especially in a world experiencing convulsive change.  We wonder even if wine and people were not better off when men and women trod on the grapes before mechanical presses took over—in vino veritas.

Swarm Intelligence.  If experts are coming up short on almost everything, one may correctly ask how to deal with this strange and unpredictable age we have entered.  One Wall Street guru tells us we must get mentally rewired to reckon with a world where the totally unexpected happens.  He calls these untoward events “Black Swans.”  His thinking has a lot to offer in the present day in which all the marketplaces, not just Wall Street, have become a crap shoot where nobody really quite knows what’s up.  So far, reverses in the financial marketplaces have brought down the chief cooks and bottle washers at Citicorp and Merrill Lynch, but many more financial titans will follow.  The heads of large companies in all manner of industry are also rolling, the axes of anxious company directors acting more swiftly than the guillotine. In a decade this reshuffling of the deck chairs will settle down a bit, once we have re-organized our business system around a different view of the world.

New tools are coming along to replace old-fashioned experts, tools that may give some leaders a heads-up.  Under certain circumstances, crowds made up of dumb people, acting as a whole, may outsmart individual experts.  They are memorialized in The Wisdom of Crowds.  More broadly we learn that we can act and gain from “swarm intelligence” which we have previously discussed in “Doubletakes” and in a note on “Swarm Intelligence.”  The trick here is to distinguish between “swarm intelligence,” which leads to an optimum conclusion, and “herd behavior,” where followers chase a few mindless steers over the cliff.  We all know better than to follow “lead steers,” now that Merrill’s Lynch’s thundering herd has come a cropper.

As well, we can gain limited insights from the application of algorithms.  We discussed the use of analytics in “Lies, Estrogen, Useful Tips, Saving on Gas, Microtrends, Homespun Wisdom, and Urawaza.”  We would caution that such mathematical analysis has very narrow application and can lead one far astray.  Broad insights are more likely to arise from chaos and complexity theory that is emerging from the Santa Fe Institute and elsewhere. These theories are less simplistic.  Broadly, we are coming to recognize that trend analysis and prediction now depend on an understanding of absolutely huge numbers and huge variables.  To find out which way the wind is blowing, we either have to join a swarm or play with tools that can master large numbers. 

Or we can rely on intuition that is born from getting our hands dirty.  The gift of the gods when all else fails is informed intuition. As Einstein would have it, “The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.”  We are at a point in history where mere rationality and tricky logic just won’t do the trick.

P.S.  In December 2006 Dr. von Eschenbach became the 20th Commissioner of the Food and Drug Administration.  We have a habit—often unfortunate—of taking people away from subjects they understand terribly well (cancer) and putting them in positions where they are not grounded (drug development and drug safety).  Both the Clinton and Bush administrations have shown a disposition for taking mid-level experts and trying to turn them into top-level policymakers. Both the Peter Principle and Parkinson’s Law have been powerfully and humorously at work for a couple of decades, saturating our highest councils with both makework and incompetence

P.P.S.  Amy Stewart has gone on to write a bestseller Flower Confidential, which is all about the flower business.  It’s a bit more commerically rewarding to write about the visible (flowers) than the invisible (worms). 

P.P.P.S.  Along with the rest of the country, our staff all seem to have bought GPS systems this year to get them where they are going.   We guess you would call them expert systems.  They suffer from some of the same limitations as experts.  As good as their programming is, they often won’t take you down the best route.  Consumers become all too dependent on them, not checking ahead to see if the routing makes sense.  As with Blackberries, cellphones, iPods, etc, many of us could do without them.  Our children, of course, can make them work better than we do.  If it’s to be a Blackberry or iPhone, or a GPS system, then pick GPS.  The Blackberry tells you where you are; GPS tells you where you are going—much more to the point in this age.

P.P.P.P.S.  Yogi Berra tells us why we need a coach, if not an expert.  “You've got to be very careful if you don't know where you're going, because you might not get there.”

P.P.P.P.P.S.  We have told you how hard it is to get the medical community to wash its hands, and that clean hands are the best hope we have to prevent super-infections in hospitals. Hospitals such as John Hopkins and Cedars-Sinai are using all sorts of tricks to get people to wash their hands.  That said, we have learned that poor sanitation and bad hygiene in poorer countries often have helped people there avoid the diseases of more developed nations.  Clearly cleanliness is not always closest to godliness.

P.P.P.P.P.P.S.  We believe that “swarm intelligence” in the form of “swarm” robots will eventually be deployed to good effect against terrorists.  As we have discussed in “Terrorism and Science,” the Israelis, who have had some experience with terrorists, believe that ‘honeypot’ theory is one way to entrap stateless malevolent cells.

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