NETFUTURE
Technology and Human Responsibility
--------------------------------------------------------------------------
Issue #157 October 21, 2004
--------------------------------------------------------------------------
A Publication of The Nature Institute
Editor: Stephen L. Talbott (stevet@netfuture.org)
On the Web: http://www.netfuture.org/
You may redistribute this newsletter for noncommercial purposes.
Can we take responsibility for technology, or must we sleepwalk
in submission to its inevitabilities? NetFuture is a voice for
responsibility. It depends on the generosity of those who support
its goals. To make a contribution, click here.
CONTENTS
---------
Editor's Note
Quotes and Provocations
The Heart's Song
Tech Tonic
DEPARTMENTS
About this newsletter
==========================================================================
EDITOR'S NOTE
Welcome back to NetFuture! My four-month break from the publication has
ended. One thing that's happened in the meantime is that The Nature
Institute's website has been seriously upgraded, with much more content
and greatly improved navigation: http://natureinstitute.org.
I expect to put out some shorter-than-usual issues of NetFuture (such as
this one), occasional longer-than-usual issues (such as the next one), and
perhaps an issue here or there of a distinctly weird sort (we'll see).
The publication schedule will be less regular than before. In general,
I'm gripped by a rather more experimental spirit than in the past as I try
to figure out whether there continues to be a useful place for a
publication like NetFuture in today's world.
SLT
Goto table of contents
==========================================================================
QUOTES AND PROVOCATIONS
The Heart's Song
----------------
The image of the heart as a "ticker" generating a clock-like beat is the
product of a mechanical age. Such an image did not always prevail. The
historical psychologist, Jan Hendrik van den Berg, has pointed out that
when the idea of a beating heart was broached a few hundred years ago, it
was regarded by many people as downright crazy; this just wasn't the way
they experienced the "whispering, wailing, loving, longing tale" of the
body's rhythmic center. It is easy to overlook how thoroughly the
character of our perceptions is dictated by our mechanistic habits of
thought.
If the older view seems romanticized and imprecise, you ought to look at
the work of Ary Goldberger, a cardiologist and director of the Laboratory
for Nonlinear Dynamics in Medicine at Boston's Beth Israel Hospital.
Goldberger has long sought clues to human health by attending to the
heart's subtle and, you could almost say, artistic performance. His
conclusion is that the normal heartbeat "is more a dance than a march".
Perhaps the most striking thing about Goldberger's research is its
highlighting of the organic richness of the heartbeat. Contrary to
expectation, even under the quietest conditions there are continual and
scarcely predictable variations in rhythm, but these variations are not
merely random. By bringing the mathematical tools of chaos and complexity
theory to bear on recordings of the heart, Goldberger's team has found,
amid all the unpredictable variation, a deep, complex patterning.
Strikingly, they discovered that only under certain diseased conditions
does the heart degenerate into mechanical regularity. Pathology,
Goldberger remarks, turns out to be "very monotonous".
Obviously, this has tremendous bearing upon the various efforts to develop
artificial heart-assist or heart-replacement devices. If the heart's
performance is unpredictable, surely it is because there is a two-way,
cause-and-effect relation between heart activity and all the other
processes of the body -- a complex interaction that is in turn an
expression of the organism's governing unity. How do you integrate a
mechanical device into an organism in this way?
If the complex patterning of the heart's rhythm is an expression of the
whole organism, so, too, we can assume, is much else in the body.
Goldberger's lab is now looking at other physiological patterns as well,
such as those exhibited in the human gait. Our walking, it appears, is
also subject to continual variation within an organic pattern of order,
and the researchers think that degradation of this order may be an
indicator of diseases such as Huntington's, Parkinson's, and Alzheimer's.
A database has now been set up by the National Institutes of Health for
collecting all sorts of physiological data sets and making them available
to researchers like Goldberger. You'll find the database and associated
resources at http://www.physionet.org.
As a side-project, the Beth Israel researchers have devised a way,
involving various sorts of statistical processing, to translate heart
rhythms into a crude kind of music. The interval between beats is
conveyed through the pitch of sounds, while rapid changes in interval from
one beat to the next are represented by tinkling sounds. A clarinet-like
hum corresponds to a running average of the heart rate. According to
Gareth Cook, writing in the Boston Globe Magazine (Feb. 22, 2004),
As a rough test of the system, a group of undergraduates was given
soundtracks created from healthy and sick hearts. Surprisingly, the
students were able to distinguish between them, even though they had no
medical training.
Cook remarks further that "the sounds generated by healthier hearts seem
more organic, with the tones varying in unpredictable ways". By contrast,
as the diseased heart loses some of its natural variability and beats more
mechanically, the corresponding music sounds "more grating". Sicker
hearts "sound more like something created by a machine, like bad techno
music". (You'll find examples of the soundtracks at
http://www.music.psu.edu/Faculty%20Pages/Ballora/sonification/sonex.html.)
Of course, the music at issue here -- from healthy and sick hearts alike
-- is created by a machine. We need to keep this in mind so that we can
be alert to the artifacts and abstractions by which the musical
translation separates us from the heart itself. Actually, the
abstraction here is extreme, with the music representing little more
than certain quantitative measures. But, of course, these measures
do correlate with some aspects of the heart's performance. And the
diagnostic effectiveness of a more qualitative presentation -- even when
it is a mere re-clothing of abstractions -- reminds us of the value of
qualitative assessment. You can be sure that those undergrads would have
had a more difficult time distinguishing healthy from sick hearts if they
had been given, not a soundtrack, but the usual data sets.
But, nevertheless, because the synthesized soundtracks do represent only a
set of mathematical abstractions, most of the heart's perceptible
performance is missing from this re-presentation. All of which makes it
seem rather odd that in the literature about Goldberger's work I have not
yet found anyone offering the most obvious comment: "Gee, if we want to,
we can go far beyond these soundtracks. We can listen to the full
symphony of the heart itself -- and we can even add to this a direct
perception of the blood pulsing through arteries".
There are, after all, medical traditions where listening to the heart and
feeling the pulse are taken to be crucial for diagnosis. Moreover, those
working within these traditions have long insisted upon the same truth
that has so excited the more recent researchers: a sensitive attention to
rhythm and sound, pattern and variation, can give us access to conditions
of health and ill-health throughout the entire organism.
One wonders whether we've got here another case where the abstracting
enthusiasms of the complexity theorists (valuable enough in their
proper place) will smother the qualitative sensitivities they might
have encouraged. Given our reigning propensities, the smothering is
not terribly difficult. The skill of pulse-reading and stethoscope use,
once emphasized in medical training and practice, is already a nearly
disappeared art. In a letter to the New York Times Magazine (June 13,
2004), George Mallis, a medical doctor, cites a case where mitral-valve
stenosis (narrowing of a heart valve) was misdiagnosed twice by
echocardiogram. He goes on to say that the diagnosis could have been
achieved routinely "using traditional skills, including auscultation with
a stethoscope", adding:
It is unfortunate, if widely acknowledged, that the skills needed for
such bedside diagnosis are rapidly disappearing as young physicians
come to depend more and more on technology like echocardiography. And
there are ever fewer mentors to teach these clinical skills. This
case, with its delay in diagnosis, illustrates that it is patients who
suffer when these skills are lost.
All this indicates a double aspect of medical science today. New research
repeatedly points us toward the crucial value of qualitative assessment,
but because our love of technical procedure is so great, we continually
employ mere technique, not to support our own, ever greater powers of
perception (wherein the technique could have tremendous value), but rather
to substitute for those powers. This, of course, is the risk of
technology in general. The question regarding Goldberger's work is
whether, once he has succeeded in drawing attention to the intimate
revelation of the heart's song, there will be any physicians left with the
time, interest, and skill for actually hearing it.
Related Articles:
"Between Discordant Eras", an essay examining how we got from the
"whispering wailing, loving, longing" heart of an earlier time to the
beating heart of today, and asking where the truth lies between these two
experiences.
"On Being Wholehearted" in NF #140, concerning the limitations of a
mechanical view of the heart.
"The Lure of Complexity" in In Context #6. This essay (along with
its sequel) looks at the abstracting tendencies of the complexity
theorists.
Tech Tonic
----------
Every so often one finds a public document so balanced and lucid, so
filled with uncommon good sense, so genially expressed, that it flashes
across the rhetorical firmament like a meteor. We saw such an unexpected
document in Beyond Therapy, the report of the President's Commission on
Biotechnology. (See NF #152 and 154.) Now we have another example in
Tech Tonic: Towards a New Literacy of Technology.
This report was prepared by the Alliance for Childhood. I probably
ought to list here the report's "ten principles for a new literacy of
technology", along with its seven recommended "key reforms". But the
richness of the authors' treatment, the helpful background discussion,
the inspiring examples, and the detailed references discourage me from
any attempt at a brief summary. Instead, I will do no more than list the
chapter headings:
Overview: Preparing Children for a New Century
Reclaiming Technology: Why We need a New Definition of Technology
Literacy
What's Wrong with a High-Tech Childhood?
A Critique of Current Technology Education Standards
Ten Principles for a New Literacy of Technology
The Ten Principles in Action
Developmental Guidelines for Technology Literacy
Technology Education for Democracy: Guidelines for Citizen Action
Technology Literacy Guidelines for Teachers and Teacher Education
Questions and Answers about Children and Technology
Resources for Technology Awareness
The full text of Tech Tonic is available on the Alliance's website,
http://www.allianceforchildhood.net. You will find other valuable
material on the site as well, including assessments of the importance of
play for children, commentary on the push for high-stakes testing, and the
earlier report on technology literacy, entitled Fool's Gold.
(In the interest of full disclosure: the initial seed for the Alliance's
report was a roundtable discussion in which I participated. But I had no
hand in preparing the current document.)
SLT
Goto table of contents
==========================================================================
ABOUT THIS NEWSLETTER
Copyright 2004 by The Nature Institute. You may redistribute this
newsletter for noncommercial purposes. You may also redistribute
individual articles in their entirety, provided the NetFuture url and this
paragraph are attached.
NetFuture is supported by freely given reader contributions, and could not
survive without them. For details and special offers, see
http://netfuture.org/support.html .
Current and past issues of NetFuture are available on the Web:
http://netfuture.org/
To subscribe or unsubscribe to NetFuture:
http://netfuture.org/subscribe.html.
This issue of NetFuture: http://netfuture.org/2004/Oct2104_157.html.
Steve Talbott :: NetFuture #157 :: October 21, 2004
Goto table of contents
Goto NetFuture main page