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Ryan Bose-Roy

Orange, Green, and Red – The Colors of Tribalism

BY MIKE MAGEE

As Thanksgiving Day approaches, let’s give thanks for the study of history, in part because it reminds us that Trumpian words like “vermin” have been used before and serve to alert the human race that we have entered danger zone

One President who understood the power of words more than many others was FDR. When he structured up “a series of programs, public work projects, financial reforms and regulations…to provide support for farmers, the unemployed, youth and the elderly”, he memorably packaged the plan under the label, The New Deal.”

Seizing alliteration in 1933, he further defined his new policies as the 3 Rs – Relief, Recovery, Reform”, promising “…action, and action now.”

When his enemies began to coalesce against him in 1936, he chose his words carefully in the public defense. Seizing the largest venue he could find at the time –Madison Square Garden – he stood tall and erect, supported by heavy leg braces, and declared defiantly, They are unanimous in their hate for me – and I welcome their hatred.”

With a heavy dose of humility and learned wisdom, he rose again eight years later, on January 11, 1944, fifteen months before his death, and delivered the State of the Union Address as a Fireside Chat from the Oval Office in the White House. 

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We’re All In The Hot Seat Now.

BY MIKE MAGEE

It’s not that easy living in the “Big Easy” these days and co-existing with a world dominated by water concerns. When Times-Picayune gossip columnist Betty Guillaud (as the folklore goes) “coined New Orleans’ undisputed nickname” in the 1960’s, it was a lifestyle eponym meant to favorably contrast life in “The Big Easy” with hard living in “The Big Apple.”

That was well before August 23, 2004, when the levies failed to hold back the Gulf waters, and 1,392 souls perished leaving two names to last in infamy – Katrina and Brownie, of “Brownie, you’re doing a heck of a job” fame.

Now it’s not as if it’s been all smooth sailing for New York City and water. I mean, look at the history. When the British overran the Dutch in 1667, one of the first priorities was to dig the first public well and include a marvelous technologic attachment – a hand pump. That was in front of an old fort at Bowling Green, near Battery Park.

But by the early 1700s, the absence of a sewage system and saltwater intrusion from the Hudson and East Rivers, plus a crushing population explosion, had foiled the clean water supply. The solution – temporary at best – haul in fresh groundwater, in limited quantities, from Brooklyn.

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Altman, Ive, and AI

BY KIM BELLARD

Earlier this year I urged that we Throw Away That Phone, arguing that the era of the smartphone should be over and that we should get on to the next big thing.  Now, I don’t have any reason to think that either Sam Altman, CEO of OpenAI, and Jony Ive, formerly and famously of Apple and now head of design firm LoveFrom, read my article but apparently they have the same idea.  

Last week The Information and then Financial Times reported that OpenAi and LoveFrom are “in advanced talks” to form a venture in order to build the “iPhone of artificial intelligence.”  Softbank may fund the venture with as much as $1b.  There have been brainstorming sessions, and discussions are said to be “serious,” but a final deal may still be months away. The new venture would draw on talent from all three firms.

Details are scare, as are comments from any of the three firms, but FT cites sources who suggest Mr. Altman sees “an opportunity to create a way of interacting with computers that is less reliant on screens.” which is a sentiment I heartily agree with.  The Verge similarly had three sources who agreed that the goal is a “more natural and intuitive user experience.”

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“The Greatest Scientist of All Time” says Scientific American. Who is it?

BY MIKE MAGEE

When it comes to our earthly survival as a human species, words are often under-powered and off-the-mark. Clearer concepts, definitions and terms are required for clarity. Here are five terms that are useful and worth remembering:

  1. Planetary Boundaries
  2. Earth Systems
  3. Human Perturbations
  4. Planetary Scale Destabilization
  5. Holocene Epoch vs. Anthropogenic Epoch 

These terms all tie back to a single source – a child of World War II, only seven when his home in Amsterdam was overrun by Nazis. His father was a waiter, his mother a cook in a local hospital. He’d later recall with a shudder the Fall of 1944, the beginning of “hongerwinter” (winter of  famine) which he blamed for stunting his growth and contributing to his short stature. The event also exposed him to death for the first time, losing several classmates to starvation and frozen temperatures that winter.

There were no early signs of brilliance. He attended a technical school and prepared for a life in construction. He met a Finnish girl, Terttu when he was 25, and they settled in a small town 200 km north of Stockholm. It was his wife who recognized his potential first, pointing him toward a newspaper ad for a job as a programmer at the Stockholm University’s Meterorologic Institute (MISU). No matter that he had no experience in computer programming. They moved to Stockholm. He worked and they both took college courses. By age 30, with sponsorship from the world’s expert on acid rain and first chairman of the Intergovernmental Panel on Climate Change (Bert Bolin), he received a master’s degree in meteorology. Five years later, after focusing on stratospheric chemistry, he earned his doctorate.

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All the Lonely People: Primary Care isn’t a Team Sport Anymore, We’re Only Interacting with Our Computers

BY HANS DUVEFELT

In spite of all the talk these days about health care teams and in spite of more and more physicians working for bigger and bigger healthcare organizations, we are becoming more and more isolated from our colleagues and our support staffs.

Computer work, which is taking more and more time as EMRs get more and more complex, is a lonely activity. We are not just encouraged but pretty much forced to communicate with our nurses and medical assistants through computer messaging. This may provide more evidence of who said or did what at what point in time, but it is both inefficient and dehumanizing.

Why do people who work right next to each other have to communicate electronically? Why can’t my nurse simply ask me a question and then document “Patient asked whether to take aspirin or Tylenol and I told her that Dr. Duvefelt advised up to 2,500 mg acetaminophen/24 hours”. It would be a lot less work for me, even if I have to sign off on the darn thing.

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The One Question FOX News Moderators Should Ask Tonight

Editor Note: This article was published a week after the Republican Party Primary debate

BY MIKE MAGEE

This evening, the Republican Party will sponsor their first Primary Debate. It will be historic in featuring the absence of their lead contender for the 2024 Presidential campaign, a candidate  who appears committed to the destruction of their own political party

Events over the past year clearly have confirmed that we are a “work in progress” even as we stubbornly affirm our good intentions to create a society committed to “life, liberty, and the pursuit of happiness.”

With the Dobbs’ decision, our Supreme Court has unleashed long-abandoned regressive state laws designed to reinforce selective patriarchy and undermine the stability and confidence of America’s women and families. As a result, our nation’s health professionals, and the patients they care for, potentially find themselves “on the wrong side of the law.”

Three months ago, our former President decided to deliver a message to North Carolina Republican supporters claiming that he was engaged in the “final battle” with “corrupt” forces, most especially the “Deep State” that was “out to get him.” This is the same state that politically birthed Mark Meadows, former Congressman from the 11th District of North Carolina, a position he resigned to become Trump’s Chief of Staff on March 21, 2020. That ultimately landed him a position on the roster of 19 individuals indicted by District Attorney Fani Willis on RICO charges for conspiracy and racketeering.

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Let’s Start Over

BY KIM BELLARD

When I first read the reports about some Silicon Valley billionaires wanting to start a new city, I figured, oh, it’s just a bunch of rich white guys wanting to take their toys and go to a new, better home. After all, they’ve seen what’s been happening to downtown San Francisco (or Portland, or Chicago – pick your preferred city).  

Cities these days may be an what one expert calls an “urban doom loop” – struggling to recover after having been hollowed out by the pandemic. These so-called elites probably figured it’s easier to build something new rather than to try to fix what already exists.  And, you know, they may be right.  

Now that I think about it, the same may be true of our healthcare system.

The group, fronted by a mysterious entity called Flannery Associates, has been busy buying up land outside San Francisco for the past five years, spending a reported $1b for some 57,000 acres in Solano County. The proximity of its purchases to Travis Air Force Base had already raised concerns. Believed to be behind the group are a number of well known tech names, including LinkedIn co-founder Reid Hoffman; former Sequoia Capital partner Michael Moritz; venture capitalists Marc Andreessen and Chris Dixon; Stripe co-founders Patrick Collison and John Collison; Laurene Powell Jobs, Steve Jobs widow.

It doesn’t help that earlier this year Flannery sued dozens of local landowners for colluding to drive up prices, or that they’ve been so secretive. John Garamendi, one of the area’s Congressmen, said: “Flannery Associates has developed a very bad reputation in Solano County through their total secrecy and mistreatment of generational family farmers.” 

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The Next Pandemic May Be an AI one

By KIM BELLARD

Since the early days of the pandemic, conspiracy theorists have charged that COVID was a manufactured bioweapon, either deliberately leaked or the result of an inadvertent lab leak. There’s been no evidence to support these speculations, but, alas, that is not to say that such bioweapons aren’t truly an existential threat.  And artificial intelligence (AI) may make the threat even worse.

Last week the Department of Defense issued its first ever Biodefense Posture Review.  It “recognizes that expanding biological threats, enabled by advances in life sciences and biotechnology, are among the many growing threats to national security that the U.S. military must address.  It goes on to note: “it is a vital interest of the United States to manage the risk of biological incidents, whether naturally occurring, accidental, or deliberate.”  

“We face an unprecedented number of complex biological threats,” said Deborah Rosenblum, Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs. “This review outlines significant reforms and lays the foundation for a resilient total force that deters the use of bioweapons, rapidly responds to natural outbreaks, and minimizes the global risk of laboratory accidents.”

And you were worried we had to depend on the CDC and the NIH, especially now that Dr. Fauci is gone.  Never fear: the DoD is on the case.  

A key recommendation is establishment of – big surprise – a new coordinating body, the Biodefense Council. “The Biodefense Posture Review and the Biodefense Council will further enable the Department to deter biological weapons threats and, if needed, to operate in contaminated environments,” said John Plumb, Assistant Secretary of Defense for Space Policy. He adds, “As biological threats become more common and more consequential, the BPR’s reforms will advance our efforts not only to support the Joint Force, but also to strengthen collaboration with allies and partners.”

Which is scarier: that DoD is planning to operate in “contaminated environments,” or that it expects these threats will become “more common and more consequential.” Welcome to the 21st century.  

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Lash of St. Francis

BY MIKE MAGEE

On September 25, 1939, Southern California woke with fear of The Lash of St. Francis or El Cordonazo on the horizon. The term refers to northwestern tracking, cyclone-laden storms that can hit the western shores of Mexico and California most commonly around the Feast of Saint Francis, on October 4th. This one made landfall at San Pedro, California.

The calamity that day in Southern California was a rare event, the only one of its kind in the 20th century. The last one to hit, prior to this was in San Diego on October 2,1858. The Earth’s rotation normally assures that such cyclones in this region move from east to west, and out to sea. But the 1939 storm was the exception, and the big problem was the rain, some 5 1/2 inches over a 24-hour period (though the town of Indio, in the Coachella Valley of Southern California’s Colorado Desert region experienced 7 inches and buried the valley in 4 feet of water. Forty-five died on land, and 48 perished at sea. One positive – the storm marked the end of a 1-week heat wave where Los Angeles reached 107 F degrees and claimed 100 lives.

History repeated itself 84 years later this weekend, with a memorable “Lash” on the backend of a summer heat wave. The human, economic, and ecological tolls remain to be calculated. But one thing is for certain, global warming has arrived, and with it the production of both heat and water and a new, all too familiar meteorological phenomenon, the “atmospheric river.”

NOAA defines “atmospheric river” this way: “Atmospheric rivers are relatively long, narrow regions in the atmosphere – like rivers in the sky – that transport most of the water vapor outside of the tropics. While atmospheric rivers can vary greatly in size and strength, the average atmospheric river carries an amount of water vapor roughly equivalent to the average flow of water at the mouth of the Mississippi River. Exceptionally strong atmospheric rivers can transport up to 15 times that amount. When the atmospheric rivers make landfall, they often release this water vapor in the form of rain or snow.”

To be clear, these drenching above-ground collections of water are generally a blessing because they provide most of the much-needed precipitation to California’s dry areas and replenish the water cycles in the region. But as the Earth has warmed, they more frequently represent “too much of a good thing”, and are now responsible for 90% of California’s flood damage.

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What Robotaxis Mean for Healthcare

BY KIM BELLARD

You may have seen that last week the California Public Utilities Commission (CPUC) gave approval for two companies to operate self-driving taxicabs (“robotaxis”) in San Francisco, available 24/7 and able to charge fares.  Think Uber or Lyft but without drivers. 

It has seemed inevitable for several years now, yet we’re not really ready.  It reminds me, of course, of how the future is coming fast for healthcare too, especially around artificial intelligence, and we’re not really ready for that either.

The two companies, Cruise (owned by GM) and Waymo (owned by Alphabet) have been testing the service for some time, under certain restrictions, and this approval loosens (but does not completely remove) the restrictions. The approval was not without controversy; indeed, the San Francisco police and fire departments,  among others, opposed it. “They are failing to regulate a dangerous, nascent industry,” said Justin Kloczko, a tech and privacy advocate for consumer protection non-profit Consumer Watchdog.  

The companies brag about their record of no fatalities, but the San Francisco Municipal Transportation Agency has collected almost 600 “incidents” involving autonomous vehicles, even with what they believe is very incomplete reporting.  “While we do not yet have the data to judge AVs against the standard human drivers are setting,” CPUC Commissioner John Reynolds admitted, “I do believe in the potential of this technology to increase safety on the roadway.”

I’m willing to stipulate that autonomous vehicle technology is not quite there yet, especially when mostly surrounded by human-driven vehicles, but I also have great confidence that we’ll get there quickly, and that it will radically change not just our driving but also our desire for owning vehicles. 

One of the most thoughtful discussions I’ve on the topic is from David Zipper in The Atlantic. He posits: 

A century ago, the U.S. began rearranging its cities to accommodate the most futuristic vehicles of the era, privately owned automobiles—making decisions that have undermined urban life ever since. Robotaxis could prove equally transformative, which makes proceeding with caution all the more necessary.

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