Why Watson May Not Be Quite the Great Civilizational Advance IBM Says It Is

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The joke goes like this:

Sherlock Holmes and Dr. Watson decide to go on a camping trip. After dinner and a bottle of wine, they lay down for the night, and go to sleep.

Some hours later, Holmes awoke and nudged his faithful friend.
“Watson, look up at the sky and tell me what you see.”

Watson replied, “I see millions of stars.”

“What does that tell you?”

Watson pondered for a minute.

“Astronomically, it tells me that there are millions of galaxies and potentially billions of planets.”

“Astrologically, I observe that Saturn is in Leo.”

“Horologically, I deduce that the time is approximately a quarter past three.”

“Theologically, I can see that God is all powerful and that we are small and insignificant.”

“Meteorologically, I suspect that we will have a beautiful day tomorrow.”

“What does it tell you, Holmes?”

Holmes was silent for a minute, then spoke: “Watson, you idiot. Someone has stolen our tent!”

Last week, I found this eight page insert in the New York Times, and I was left wondering if this IBM ad was inadvertently another form of the joke.

IBM, you see, is trying (again) to transform itself.  Once the industry leader in whatever it wanted to do, it has now spent years slowly decapitalizing as it tries to find a commercial niche.

Now, it is offering services based on Watson, noting that “Watson is designed to understand, reason and learn.  In a sense, to think.”

In a sense?

Here’s a quick summary from Wikipedia:

Watson is a question answering (QA) computing system that IBM built to apply advanced natural language processing, information retrieval, knowledge representation, automated reasoning, and machine learning technologies to the field of open domain question answering.

The key difference between QA technology and document search is that document search takes a keyword query and returns a list of documents, ranked in order of relevance to the query (often based on popularity and page ranking), while QA technology takes a question expressed in natural language, seeks to understand it in much greater detail, and returns a precise answer to the question.

According to IBM, “more than 100 different techniques are used to analyze natural language, identify sources, find and generate hypotheses, find and score evidence, and merge and rank hypotheses.”

Is that thinking? Stanley Fish offered this view:

Far from being the paradigm of intelligence, therefore, mere matching with no sense of mattering or relevance is barely any kind of intelligence at all. As beings for whom the world already matters, our central human ability is to be able to see what matters when.

So, in short, IBM is offering an expensive tool that might help corporate executives troll through lots of data and try to divine commercially relevant strategies. It suggests that, “When your business thinks, you can outthink” the competition.

IBM five-year stock price summary

I guess the proof of the pudding is whether this approach can be applied to IBM itself.  What I see instead is a behemoth of a corporation, with tens of thousands of employees spread across the world unfocused in purpose and execution, stagnant in the capital markets–with thirteen straight quarters of decline in revenues.  The company is an exemplar of brute force decision-making, being outflanked left and right by more nimble players in the marketplace.  The additional value offered by Watson is unlikely to be attractive to industry leaders in other fields.  The millions of dollars spent on the Times insert is, in my mind, just another example of ineffective corporate thinking.  What’s the audience, and how is the ad persuasive?

Back in the 1960’s, you could drop by the IBM building in New York City and pick up the iconic blue think desk sign seen above.  I still have mine.  I’m saving it for my daughters to take to Antiques Roadshow someday, where it might have some value as an a piece of industrial archeology.

Paul Levy is the former CEO of BIDMC and blogs at Not Running a Hospital, where an earlier version of this post appeared. 

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8 replies »

  1. Unfortunately IBM can’t go back in time and change the name of their founder from Watson to Holmes. It’s named Watson because TJ Watson founded IBM, not because Watson was smarter than Holmes.

  2. Can Watson be trained to:

    1) prescribe z-paks?
    2) tell people they can get a pregnancy test at the Dollar store?
    3) advise patients they don’t need to check their blood pressure 47 times per day, and call the doctor every time it’s NOT 120/80?
    4) advise drug seekers they will not be given refills on their Dilaudid?
    5) communicate with mid-level providers who are good at ordering lots of outpatient tests, but then don’t know what to do with the results?
    6) automatically consult social services?

    IF SO, I’m all for putting a Watson Kiosk in waiting room of every ER in the country. We could knock out about 89 million ED visits right off the bat.

  3. Erratum. The cognitive research was done by Kenneth R. Hammond, as reported in his book, “Beyond Rationality:The Search for Wisdom on a Troubled Time,” published by Oxford University Press in 2007.

  4. Thanks very much to Mr. Levy for shining a light on a critical issue in medicine that is being

    The abilities of humankind’s brain wetware still far exceeds the algorithmic approach to question answering. Yes, human cognition makes mistakes, but research by cognitive psychologist Ken Robinson showed that human decision making involves a give and take between rational-analytic thinking and experience-based intuition. He showed that rational-analyitic thinking led to to fewer mistakes, but that those mistakes tended to be of high consequence. Decisions based on experienced-based intuition, on the other hand, made more mistakes, but the consequences tended to be minor. Hmm.

    This evidence from cognitive science is neglected in our health sector, where insurance companies have wrangled the definition of medical necessity from the hands of physicians. The insurance industry definition of medical necessity strike is found contract language, where it is commonly defined as generally accepted medical opinion, supported by the results of platinum level, population-based, randomized, controlled studies published in at least two journals of record.

    This definition stomps on experience-based medical intuition. Yes, Watson can win at Jeopardy!, but can it win when it comes to determining what matters most to patients? That remains to be seen. If you ask my patients, who came to me for help with chronic health problems that persisted despite excellent medical care, Watson would leave them high and dry, just as “evidence-based” specialists left them high and dry.

    I wish modern medical guidelines would stop discounting the complexity of the physician’s cognitive task. I wish insurance companies would stop bludgeoning our mission to heal.

  5. On the other hand, you have to hand it to them.

    Watson is a pretty cool idea. And the idea of humanizing computers is smart.

    After the initial shock wore off, IBM always wanted to be Apple.

    This is their attempt to turn themselves into a sort of enterprise-level Apple store. I’m not sure it’s going to be enough to save them. But a not bad idea.

  6. HOLMES has always been smarter than Watson. One needs the power of human observation added to any logic machine – especially Holmesian logic.