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Tag: Mike Magee

How Did the AI “Claude” Get Its Name?

By MIKE MAGEE

Let me be the first to introduce you to Claude Elwood Shannon. If you have never heard of him but consider yourself informed and engaged, including at the interface of AI and Medicine, don’t be embarrassed. I taught a semester of “AI and Medicine” in 2024 and only recently was introduced to “Claude.”

Let’s begin with the fact that the product, Claude, is not the same as the person, Claude. The person died a quarter century ago and except for those deep in the field of AI has largely been forgotten – until now.

Among those in the know, Claude Elwood Shannon is often referred to as the “father of information theory.” He graduated from the University of Michigan in 1936 where he majored in electrical engineering and mathematics. At 21, as a Master’s student at MIT, he wrote a Master’s Thesis titled “A Symbolic Analysis Relay and Switching Circuits” which those in the know claim was “the birth certificate of the digital revolution,” earning him the Alfred Noble Prize in 1939 (No, not that Nobel Prize).

None of this was particularly obvious in those early years. A University of Michigan biopic claims, “If you were looking for world changers in the U-M class of 1936, you probably would not have singled out Claude Shannon. The shy, stick-thin young man from Gaylord, Michigan, had a studious air and, at times, a playful smirk—but none of the obvious aspects of greatness. In the Michiganensian yearbook, Shannon is one more face in the crowd, his tie tightly knotted and his hair neatly parted for his senior photo.”

But that was one of the historic misreads of all time, according to his alma mater. “That unassuming senior would go on to take his place among the most influential Michigan alumni of all time—and among the towering scientific geniuses of the 20th century…It was Shannon who created the “bit,” the first objective measurement of the information content of any message—but that statement minimizes his contributions. It would be more accurate to say that Claude Shannon invented the modern concept of information. Scientific American called his groundbreaking 1948 paper, “A Mathematical Theory of Communication,” the “Magna Carta of the Information Age.”

I was introduced to “Claude” just 5 days ago by Washington Post Technology Columnist, Geoffrey Fowler – Claude the product, not the person. His article, titled “5 AI bots took our tough reading test. One was smartest — and it wasn’t ChatGPT,” caught my eye. As he explained, “We challenged AI helpers to decode legal contracts, simplify medical research, speed-read a novel and make sense of Trump speeches.”

Judging the results of the medical research test was Scripps Research Translational Institute luminary, Eric Topol.  The 5 AI products were asked 115 questions on the content of two scientific research papers : Three-year outcomes of post-acute sequelae of COVID-19 and Retinal Optical Coherence Tomography Features Associated With Incident and Prevalent Parkinson Disease.

Not to bury the lead, Claude – the product – won decisively, not only in science but also overall against four name brand competitors I was familiar with – Google’s Gemini, Open AI’s ChatGPT, Microsoft Copilot, and MetaAI. Which left me a bit embarrassed. How had I never heard of Claude the product?

For the answer, let’s retrace a bit of AI history.

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How Bright A Light Do We Shine This Memorial Day?

By MIKE MAGEE 

According to Veterans Administration historians, the origin of Memorial Day dates back to 1864 when three women from Boalsburg, Pennsylvania joined in grief to decorate the graves of family members who had died in the Civil War. A year later, other townspeople joined in and one year later, in 1866, women in Columbus, Mississippi, joined the event, in honor of fallen Confederate soldiers. That was 14 years after the publication of Harriet Beecher Stowe’s Uncle Tom’s Cabin in 1852. 

In that first year it was published, Uncle Tom’s Cabin sold over 300,000 copies. Author and critic Alfred Kazin called it “The most powerful and most enduring work ever written about American slavery.” Its prominence in the American lexicon speaks for itself, and its relevance regarding goodness and governance, leadership by legislation, women’s roles in creating civil societies and the underpinnings of Christianity in the unrealized potential of the American dream all speak to the continued value of the publication. 

On page 2 of the preface, Harriet Beecher Stowe comments on “memorializing” human hatred and cruelty to the ash bin of history. She writes, “It is a comfort to hope, as so many of the world’s sorrows and wrongs have, from age to age, been lived down, so a time shall come when sketches similar to these shall be valuable only as memorials of what has long ceased to be.” 

To this, we must respond today, “Not yet. There is work that remains.” 

On the last page of her book, Harriet Beecher Stowe in 1852 reflects (as if on our modern day predicament), “This is an age of the world when nations are trembling and convulsed. A mighty influence is abroad, surging and heaving the world, as with an earthquake. And is America safe? Every nation that carries in its bosom great and unredressed injustice has in it the elements of this last convulsion.”

To this, we believers in human goodness and democracy must respond, “We will never be free, safe and healthy if our elected leaders promote policies – whether here or abroad – that belie our finer instincts, promote fear, and trigger predation.” 

The White House, until recently, has largely been a sacred and treasured shrine. Back in 2013, our President at the time, Barack Obama, hosted our former President, George H.W. Bush and his family there to commemorate the 5000th award of a “Daily-Point-of-Light”, that the former President had launched to “honor individuals who demonstrate the transformative power of service, and who are driving significant and sustained impact through their everyday actions and words that light the path for other points of light.” 

Here in part, is what President Obama said that day: “…given the humility that’s defined your life, I suspect it’s harder for you to see something that’s clear to everybody else around you, and that’s how bright a light you shine — how your vision and example have illuminated the path for so many others, how your love of service has kindled a similar love in the hearts of millions here at home and around the world. And, frankly, just the fact that you’re such a gentleman and such a good and kind person I think helps to reinforce that spirit of service. So on behalf of us all, let me just say that we are surely a kinder and gentler nation because of you and we can’t thank you enough.” 

Just a dozen years ago, just to be publicly “thanked” seemed enough. And “active citizenship” as a member of this great nation was viewed by many – by most – as a duty and an honor – even to the point of sacrificing one’s life in defense of this nation. 

That, after all, is what Memorial Day commemorates. Action is required, as is goodness and virtue by example and daily behavior. 

We continue to struggle in the shadow of Uncle Tom’s Cabin. We lack perfection, but we certainly could, and should, do better. Because, to be healthy in America, to realize our full potential, to be civilized, as Ralph Waldo Emerson said, “to make good the cause of freedom against slavery you must be… Declaration of Independence walking.”

Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex. (Grove/2020)

A Proud Republican Who Faced Off A Party Leader. . .and Won!

By MIKE MAGEE

This past week, Trump’s posting of himself as The Pope surfaced once again David French’s classic Christmas, 2024, New York Times column titled “Why Are So Many Christians So Cruel?

As I wrote at the time, “French and his wife and three children have experienced the cruelty first hand since he openly expressed his opposition to Donald Trump during the 2016 Presidential campaign. That resulted in threats to his entire family by white supremacists who especially targeted his adopted Ethiopian daughter. Ultimately, he was “cancelled” by his own denomination, the small (approximately 400,000 members), Calvinist “Presbyterian Church of America”.

Over the past week, American politicians of every stripe have debated what exactly was Trump’s motive in debasing the Papacy as Pope Francis was being laid to rest. Three main theories have emerged. 

1.      As a malignant narcissist, Trump could not bear the fact that Pope Francis was stealing his limelight.

2.      Trump was appealing to conservative Christian Evangelicals who are strongly opposed to the Papacy on theological grounds.

3.      Trump was appealing to conservative Catholics like New York Post columnist Charles Gasparino who says, “… we respect Trump more than the socialist Pope.” 

Of course, there likely are elements of truth in each of these. But I prefer to fall back on my New York City high school training and believe that this is the product of a dull witted school yard bully who thought this was funny. 

This is not to say he has the courage to claim ownership. (Obviously this doesn’t get posted without his approval.) No. He lies to your face, saying:

“I had nothing to do with it, Somebody made up a picture of me dressed like the pope, and they put it out on the internet. That’s not me that did it, I have no idea where it came from — maybe it was A.I. But I have no idea where it came from.” 

With his blessing, the image was posted at 10:29 PM on May 02, 2025 on his Truth Social account.

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Pope Francis Links to Scalia on Due Process: The Case Made by a Skadden Litigator

By MIKE MAGEE 

The Pope’s passing interrupted an epic battle between Trump and the rest of the civilized world over whether America remains a society “under the law.” Critical to the rule of law is the principle of “Due Process,” as described in not one, but two Amendments to our Constitution. 

The Fifth Amendment states that no inhabitant shall be “deprived of life, liberty or property without due process of law.” 

The Fourteenth Amendment, ratified after the Civil War and Emancipation, uses the same eleven words, called the “Due Process Clause,” to describe a legal obligation of all states. 

In arrogantly ignoring any pretense of “Due Process” last week by deporting accused (but not proven) alleged gang member Kilmar Abrego Garcia to an El Salvador top security prison along with 220 others, and ignoring a court order to return the planes while still in flight, Trump basically thumbed his nose at America’s legal system. This was a bridge too far, even for some of his political supporters in Congress. 

With that case still in litigation, the Administration tried to repeat the publicity stunt with another group of accused aliens this past weekend and was slapped down by the Supreme Court in an unanimous decision. 

What Trump is learning the hard way is that without “Due Process” the law profession might as well hang up its shingle. Trump thought he had Chief Justice Roberts in his pocket when he purposefully allowed himself to be caught on a hot mic as he passed the Chief Justice on his way to deliver the 2025 State of the Union Address. His words for the camera, “Thank you again. Thank you again. Won’t forget it.”  were intended to signal to the world, He owes me big time, and I own him. 

A common “Due Process” thread connecting these two current events (the Pope’s death and the illegal deportation of Kilmar Albrego Garcia)  includes another Supreme Court Justice – Antonio Scalia. Catholic and trained by Jesuits, he shared a common lineage with Pope Francis, the first Jesuit ever to lead the Catholic Church. Other Justices also share this Jesuit educational parentage including Clarence Thomas, Brett Kavanaugh, and Neil Gorsuch. 

But Francis and Antonin have a second historical connection. Pope Francis, the day before the 2025 State of the Union address, publicly labeled the immigration policies of the incoming President and Vice President, “a disgrace.” More recently, the Vatican spoke out in opposition to last weeks El Salvador imprisonments. Part of criticism tracks back to the lack of “Due Process.” 

Glaringly obvious today, this was just one arm of an aggressive Project 2025 campaign against America’s Legal Profession. By late March, multiple DC based law firms pledged allegiance to the Trump Administration to avoid being barred from entering Federal buildings to represent their clients. Some members of the targeted firms resisted. For example, Skadden associate, Rachel Cohen, resigned from her firm in protest, stating, “It does just all come around to, is this industry going to be silent when the president operates outside the balance of the law, or is it not?” 

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Feeling the Pressure

By MIKE MAGEE

After Trump crashed the markets, citizens worldwide are “feeling the pressure.” But in the spirit of calming us down, let’s consider a story of human cooperation and success from our past.

It has been estimated that a medical student learns approximately 15,000 new words during the four years of training. One of those words is sphygmomanometer. the fancy term for a blood pressure monitor. The word is derived from the  Greek σφυγμός sphygmos “pulse”, plus the scientific term manometer (from French manomètre).

While medical students are quick to memorize and learn to use the words and tools that are part of their trade, few fully appreciate the centuries-long efforts to advance incremental insights, discoveries, and engineering feats that go into these discoveries.

Most students are familiar with the name William Harvey. Without modern tools, he deduced from inference rather than direct observation that blood was pumped by a four chamber heart through a “double circulation system” directed first to the lungs and back via a “closed system” and then out again to the brain and bodily organs. In 1628, he published all of the above in an epic volume, De Motu Cordis

Far fewer know much about Stephen Hales, who in 1733, at the age of 56, is credited with discovering the concept of “blood pressure.” A century later, the German physiologist, Johannes Müller,  boldly proclaimed that Hales “discovery of the blood pressure was more important than the (Harvey) discovery of blood.” 

Modern day cardiologists seem to agree.

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The World’s Psychoactive Drug of Choice

By MIKE MAGEE

Question: What is the world’s most widely used psychoactive drug?

Answer: Caffeine

In the U.S., caffeine is consumed mainly in the form of coffee, tea, and cola. But coffee dominates. Worldwide, humans consume over 10 million tons of coffee beans a year. Roughly 16% (1.62 million tons) is devoured by Americans. The daily intake of caffeine varies depending on type of beverage and brand as the chart below indicates. 

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On average, each American consumes approximately 164 mg of caffeine each day. That’s roughly 1 small cup of Dunkin or (3.5) 12-ounce Diet Cokes (Trump consumes at least 12 cans of Diet Coke a day). 

Across the globe, daily consumption of caffeine is close to universal. Eight in 10 humans consume a caffeinated beverage daily. That makes this chemical substance the “most commonly consumed psychoactive substance globally.” Its popularity is related to its ability to deliver three useful physiological enhancements – wakefulness, motor performance, and cognition.

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Chemically, caffeine is a close cousin of adenosine which is present in brain neurons. Adenosine builds up in synaptic connections between brain neurons. When it binds to special receptors, it activates neurons that promote sleepfulness. Ingested caffeine is water and lipid soluble, and therefore is able to traverse the blood-brain barrier. Once inside, its chemical structure mimics that of adenosine, and it occupies adenosine receptors because it shares the same approximate shape and size. When these receptors are occupied by caffeine, adenosine molecules are unable to activate the receptors. The net effect is wakefulness.

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Emory, Balloon Angioplasty, and the Musk Attack on Medical Diplomacy

By MIKE MAGEE

 “The recently announced limitation from the NIH on grants is an example that will significantly reduce essential funding for research at Emory.”       

                                              Gregory L. Fenes, President, Emory University 

In 1900, the U.S. life expectancy was 47 years. Between maternal deaths in child birth and infectious disease, it is no wonder that cardiovascular disease (barely understood at the time) was an afterthought. But by 1930, as life expectancy approached 60 years, Americans stood up and took notice. They were dropping dead on softball fields of heart attacks. 

Remarkably, despite scientific advances, nearly 1 million Americans ( 931,578) died of heart disease in 2024. That is 28% of the 3,279,857 deaths last year. 

The main cause of a heart attack, as every high school student knows today, is blockage of one or more of the three main coronary arteries – each 5 to 10 centimeters long and four millimeters wide. But at the turn of the century, experts didn’t have a clue. When James Herrick first suggested blockage of the coronaries as a cause of heart seizures in 1912, the suggestion was met with disbelief. Seven years later, in 1919, the clinical findings for “myocardial infarction” were associated with ECG abnormalities for the first time. 

Scientists for some time had been aware of the anatomy of the human heart, but it wasn’t until 1929 that they actually were able to see it in action. That was when a 24-year old German medical intern in training named Werner Forssmann came up with the idea of threading a ureteral catheter through a vein in the arm into his heart. 

His superiors refused permission for the experiment. But with junior accomplices, including an enamored nurse, and a radiologist in training, he secretly catheterized his own heart and injected dye revealing for the first time a live 4-chamber heart. Two decades would pass before Werner Forssmann’s “reckless action” was rewarded with the 1956 Nobel Prize in Medicine. But another two years would pass before the dynamic Mason Sones, Cleveland Clinic’s director of cardiovascular disease, successfully (if inadvertently) imaged the coronary arteries themselves without inducing a heart attack in his 26-year old patient with rheumatic heart disease. 

But it was the American head of all Allied Forces in World War II, turned President of the United States, Dwight D.Eisenhower, who arguably had the greatest impact on the world focus on this “public enemy #1.” His seven heart attacks, in full public view, have been credited with increasing public awareness of the condition which finally claimed his life in1969. 

Cardiac catheterization soon became a relatively standard affair. Not surprisingly, less than a decade later, on September 16, 1977, an East German physician, Andreas Gruntzig performed the first ballon angioplasty, but not without a bit of drama. 

Dr. Gruntzig had moved to Zurich, Switzerland in pursuit of this new, non-invasive technique for opening blocked arteries. But first, he had to manufacture his own catheters. He tested them out on dogs in 1976, and excitedly shared his positive results in November that year at the 49th Scientific Session of the American Heart Association in Miami Beach. 

He returned to Zurich that year expecting swift approval to perform the procedure on a human candidate. But a year later, the Switzerland Board had still not given him a green light to use his newly improved double lumen catheter. Instead he had been invited by Dr. Richard Myler at the San Francisco Heart Institute to perform the first ever balloon coronary artery angioplasty on an awake patient.

Gruntzig arrived in May, 1977, with equipment in hand. He was able to successfully dilate the arteries of several anesthetized patients who were undergoing open heart coronary bypass surgery. But sadly, after two weeks on hold there, no appropriate candidates had emerged for a minimally invasive balloon angioplasty in a non-anesthetized heart attack patient. 

In the meantime, a 38-year-old insurance salesman, Adolf Bachmann, with severe coronary artery stenosis, angina, and ECG changes had surfaced in Zurich. With verbal assurances that he might proceed, Gruntzig returned again to Zurich. The landmark procedure at Zurich University Hospital went off without a hitch, and the rest is history. 

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Is American Apartheid Lurking in The Oval Office Shadows?

By MIKE MAGEE

For aging Boomers, it is impossible not to hear echoes of Apartheid re-emerging with force 3/4 of a century after the battle for social justice here and in far away lands was fully engaged. The Musk assault, disguised as “efficiency” is little more than stealing money from the poor to give to the rich, and widens an already extraordinary income gap.

The assault is large enough to draw condemnation from a dying Pope Francis, forced to remind Trump, Musk and their enablers of the historic Jesus and the tenets of Liberation Theology.

Our college years in the 1960’s were accompanied by chaos and crisis, and guided by fundamental Judeo-Christian values. My college, the Jesuit-led Le Moyne College, was activist to its core. The movement was championed by two priests, brothers Daniel and Philip Berrigan. With the assassinations of JFK, his brother Robert, and MLK;  LBJ’s Great Society legislative battles; the Civil Rights movement;  and the Vietnam War,  America was literally on fire at the time.

It was during this decade as well that a largely student-driven movement emerged to oppose Apartheid in South Africa and rapidly spread worldwide. A seminal feature of that movement was mass education and demonstrations with a goal of creating economic pressure on the leaders of South Africa by divestiture of all stocks and investments that benefited the nation.

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Disruption For the Sake of Disruption Is Not Innovation

By MIKE MAGEE

The technological leaps of the 1900s — microelectronics, antibiotics, chemotherapy, liquid-fueled rockets, Earth-observing satellites, lasers, LED lights, disease-resistant seeds and so forth — derived from science. But these technologies also spent years being improved, tweaked, recombined and modified to make them achieve the scale and impact necessary for innovations.”    Jon Gertner, author of “The Idea Factory.”

The Idea Factory is a history of Bell Labs, spanning six decades from 1920 to 1980. Published a decade ago, the author deliberately focused on the story inside the story. As he laid out his intent, Jon Gertner wrote “…when the drive to invent has become a mantra, Bell Labs offered us a way to enrich our understanding of the challenges and solutions to technological innovation. Here, after all, was where the foundational ideas on the management of innovation were born.”

One of the scholars Gertner likes to reference is Clayton Christensen. As a professor at Harvard Business School, he coined the term disruptive innovation. The Economist magazine loved him, labeling him in 2020 “the most influential management thinker of his time.”

A process thinker, Christensen deconstructed innovation, exploring “how waves of technological change can follow predictable patterns.” Others have come along and followed in his steps.

  1. Identify a technologic advance with a potential functional market niche.
  2. Promote its appeal as a “must have” to users.
  3. Drop the cost.
  4. Surreptitiously push aside or disadvantage competitors.
  5. Manage surprises.

Medical innovations often illustrate all five steps, albeit not necessarily in that order. Consider the X-ray. Its discovery is attributed to Friedrich Rontgen (Roentgen), a mechanical engineering chair of Physics at the University of Wurzburg. It was in a lab at his university that he was exploring the properties of electrically generated cathode rays in 1896.

He created a glass tube with an aluminum window at one end. He attached electrodes to a spark coil inside the vacuum tube and generated an electrostatic charge. On the outside of the window opening he placed a barium painted piece of cardboard to detect what he believed to be “invisible rays.” With the charge, he noted a “faint shimmering” on the cardboard. In the next run, he put a lead sheet behind the window and noted that it had blocked the ray-induced shimmering.

Not knowing what to call the rays, he designated them with an “X” – and thus the term “X-ray.” Two weeks later, he convinced his wife to place her hand in the line of fire, and the cardboard behind. The resultant first X-ray image (of her hand) led her to exclaim dramatically, “I have seen my death.” A week later, the image was published under the title “Ueber eine neue Art von Strahlen” (On A New Kind of Rays).

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Who Will Oppose American Apartheid?

By MIKE MAGEE

This past month Bishop Mariann E. Budde drew the Episcopal Church into the national spotlight through a single act of courage. She is not the first, nor likely the last from this denomination to do so. There is a history. More on that in a moment.

The Episcopal church is an offshoot of the Anglican Church of England which dates back to 1534 when King Henry VIII broke with the Catholic Pope who opposed his marriage to Anne Boleyn. Two-hundred and fifty four years later, in 1789, Anglican Church leaders who had helped settle colonies in North America, gathered to form a united Episcopal Church, revising their Book of Common Prayer to exclude its blessing to the English monarch.

Though declining in modern times, missionary minded Anglicans spread throughout the British empire and remain connected to the mother Church as members of the Anglican Communion. For example, British Anglican military chaplains were part of the force that occupied Cape Colony in South Africa in 1795. By 1821, they had established a formal religious foothold. Today, they claim 3.5 million members. In 2012, they elected their first female bishop, Ellinah Wamukoya of Swaziland. And yet, arguably the most influential female Anglican from South Africa is an immigrant to America, an emotional ally of Bishop Budde, and a retired Chief Justice of the Massachusetts Supreme Court.

Her name is Margaret Marshall, and her place in American history dates back to June 6, 1966. That was the date this then 20 year old student, who was vice-president of the National Union of South African Students, was asked to stand in for the organization’s president, Ian Robertson (who was under house arrest for speaking out about Apartheid). She met and transported Bobby Kennedy to speak to over 1000 university students packed into the college auditorium at their “Day of Affirmation.”

Much like Mariann Budde last week in Washington, Bobby Kennedy caught his hushed audience by surprise that evening with these opening remarks:

“I come here this evening because of my deep interest and affection for a land settled by the Dutch in the mid-seventeenth century, then taken over by the British, and at last independent; a land in which the native inhabitants were at first subdued, but relations with whom remain a problem to this day; a land which defined itself on a hostile frontier; a land which has tamed rich natural resources through the energetic application of modern technology; a land which was once the importer of slaves, and now must struggle to wipe out the last traces of that former bondage. I refer, of course, to the United States of America.”

Margaret Marshall, some six decades later, recalled that moment in a conversation with Doris Kearns Goodwin. She said, “There was great tension in the room. People were on edge…As soon as the audience realized what he said, there was laughter and a sense of total relief. It was simply fabulous.”

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