Category Archives: Health

Some Collective Intelligence Can’t Be Reduced to Thumbs-Ups and Star Ratings

In a podcast this week, I learned about Sermo, a private social network where doctors can share knowledge with each other. Seems like a good idea — let doctors submit and “rate” treatments for various diseases, Web 2.0-style*, like Digg or YouTube. (This is for fellow doctors only, not like WebMD.)

I suggested Sermo to my father (an ophthalmologist), but he was skeptical. He said each patient is different and many situations are unique. Sometimes patient comfort or reducing risk are more important than treating the disease. Sometimes “subjective” elements like fear or hearsay affect which treatments a patient will accept. How can these complexities be reduced to a simple, Web 2.0 “vote”?

Overview of Sermo

Overview of Sermo

That’s not to say doctors aren’t taking advantage of the Internet. My father subscribes to the American Glaucoma Society’s emailing list and has found it helpful. He said glaucoma specialists from around the world share stories and experiences. When a doctor tells a story he can share more detail, and the listening doctors can interpret and apply the story to their own patients. The collective intelligence in these stories can’t be reduced to a simple thumbs up/thumbs down vote or a star rating. (That’s not to say that this is Sermo’s model — I don’t know — or that my father won’t still try it.)

The book Made to Stick explains the importance of story-telling for transmitting information. A Xerox repairmen told his co-workers, over a game of cribbage and in precise detail, how he and his partner spent 4 hours repairing a photocopier that gave them a misleading “E053” error message. Here’s why:

Why do people talk shop? Part of the reason is simply Humanity 101–we want to talk to other people about the things that we have in common. Xerox repairmen work with photocopiers, so they talk about them. But that’s not the only factor at play here. For example, the storyteller above could have shared the general arc of the story without the details. “I had a real bear of a problem today–it took me four hours to get to the bottom of it. I’m glad that one’s over.” Or he could have leapt straight to the punch line: “After hours of hassle, I traced the problem back to a measly burned-out dicorotron. How was your morning?”

Instead, he tells a story that’s much more interesting to his lunch partners. It has built-in drama–a misleading code leads two men on a wild goose chase until they uncover, through lots of work and thought, that the problem is simpler than they initially thought. Why is this story format more interesting? Because it allows his lunch partners to play along. He’s giving them enough information so that they can mentally test out how they would have handled the situation. The people in the room who weren’t aware of the misleading E053 code have now had their “E053 schema” fixed. Before, there was only one way to respond to an E053 code. Now, repairmen know how to be aware of the “misleading E053” scenario.

In other words, this story is part entertainment and part instruction. Shop talk conveys important clues about how to respond to the world. It teaches nurses not to have blind faith in heart monitors. It teaches copy repairmen to beware of the misleading E053 code. (Made to Stick by Chip and Dan Heath. pp. 207-208, my emphasis.)

* I’m using Web 2.0 in the classical sense, the way Tim O’Reilly defined it to mean the aggregation of collective intelligence, not the popular connotation of brightly colored websites with rounded corners.

For Better Performance, More Awareness

Among important cognitive skills is “learning to see ‘nonjudgmentally’–that is, to see what is happening rather than merely noticing how well or how badly it is happening,” according to The Inner Game of Tennis. I read it earlier this month. The author, Tim Gallwey, is a long-time tennis coach who teaches the importance of developing cognitive skills for improving in tennis or any other activity.

When you hit a bad forehand and curse yourself, the part of you doing the cursing is “Self 1” and the part of you who hit the shot is “Self 2.”

The key to better tennis–or better anything–lies in improving the relationship between the conscious teller, Self 1, and the natural capabilities of Self 2. (p. 10)

Soon after reading the book, a talk by Kathy Sierra was queued on my iPod and she happened to mention The Inner Game of Tennis. She said, to become a better performer, tell the dumber part of your brain (who Tim would call Self 1) to “shut up.” Cut out the noise and the “chatter.”

Back to Tim:

No matter what a person’s complaint when he has a lesson with me, I have found that the most beneficial first step is to encourage him to see and feel what he is doing–that is, to increase his awareness of what actually is. (p. 25)

…a great deal of technique can be learned naturally by simply paying close attention to one’s body, racket and ball while playing. (p. 54)

The process is an incredibly simple one. The important thing is to experience it. Don’t intellectualize it. See what it feels like to ask yourself to do something and let it happen without any conscious trying. For most people it is a surprising experience, and the results speak for themselves. (p. 80)

It would be useful to all tennis players to undergo some “sensitivity training” with their bodies. The easiest way to get such training is simply to focus your attention on your body during practice. (p. 89)

Luann Udell has found it helpful to use a Wii Fitness Board in her physical rehabilitation (Wii-habilitation). The Wii system gives her immediate feedback on her balance, improving her proprioception. (Proprioception was a new word for me. It refers to our sense of the position of our body. For example, through proprioception we know the location of our tennis racket even when it’s behind us on a backswing.)

Mitt Romney and Sleep

It seems a bit odd to write about two disparate topics here, but someone pointed me to an interview of Mitt Romney on the Charlie Rose show, and I ended up watching the second half of the show about sleep. Both segments were very good.

Mitt Romney talked about issues such as amending the Constitution to protect marriage, abortion, being Mormon, and the war in Iraq.

Two doctors in the sleep segment talked about widespread sleep deprivation in the U.S., the health benefits of getting enough sleep, and some of the biology behind sleep.

Good episode: Gov. Mitt Romney / A Discussion about Sleep on the Charlie Rose show