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Bruce Sterling: State of the World 2010
permalink #26 of 223: Jon Lebkowsky (jonl) Sun 3 Jan 10 07:51
permalink #26 of 223: Jon Lebkowsky (jonl) Sun 3 Jan 10 07:51
It's interesting to look at the traditionalist vs modernist approaches to Barolo production, as described in the Wikipedia article on Barolo as "the Barolo wars." (http://en.wikipedia.org/wiki/Barolo) What evolves is a mashup of traditional and modern approaches to leverage the strengths of each. Where else can we see that happening? I've had conversations aboout the future of journalism (most recently with journalist Pete Lewis, who's got a Stanford fellowship to give him space to think about such things), and forward-thinking journalists like Pete are trying to figure out how bloggers and journalists can relate to each other - again, how you retain the strengths of traditional journalism and leverage the persistent and extended focus that bloggers can have, working outside market constraints. As digital convergence progresses and the future emerges from the past and present, you see more and more of this sort of thing. Healthcare is another example - the world of medicine is changing radically as patients become more knowledgeable - often enough they'll have knowledge about their condition that their physicians lack, because they have access to the data via the Internet, and strong motive for better understanding what's happening to their bodies. Physicians get this, and a sometimes uneasy partnership is forming between the more knowledgeable patients and treatment providers - participatory medicine. You also see organizations like Science Commons/Health Commons pushing for open data on medical research, and there's pressure (built into healthcare reform, but already building before that legislative wrangling even started) to make all health records digital. Patients are demanding access to their digital records so that they can validate their accuracy - bad data in your health record can kill you, so they have a real stake. Journalism and healthcare are a couple of examples, but you see this stuff happening elsewhere. We also see a fragmentation of mindshare into niche areas of focus; it's really hard to build a mass audience. Marketers are freaking out and trying to redefine what they do as "social media" practice, though rather than bring the strengths of old and new approaches together, marketing people seem confused and unable to let go of a sense of control and certainty, so they persist the weaknesses of their traditional approaches, carrying those weaknesses into new online social environments. Digital is transforming the way we do politics, the way we make war, the way we prepare food, the way we create and perceive cultural artifacts, the way we build prototypes and manufacture products. You've written and thought about this convergence for years, especially from a design perspective. What significant changes are you seeing that most fascinate you?
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Bruce Sterling: State of the World 2010
permalink #27 of 223: The devil is in the detail (robertflink) Sun 3 Jan 10 10:45
permalink #27 of 223: The devil is in the detail (robertflink) Sun 3 Jan 10 10:45
Great conversation even if it leaves me a little intellectually breathless. I tend to think that much of modernity rests on an infrastructure run effectively by experts of various stripe while we pay attention to the so-called "movers and shakers" public and private. Any comments on or tends among these infrastructure experts that we should give a little attention to from time to time?
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Bruce Sterling: State of the World 2010
permalink #28 of 223: Bruce Sterling (bruces) Sun 3 Jan 10 10:59
permalink #28 of 223: Bruce Sterling (bruces) Sun 3 Jan 10 10:59
The media never covers green energy. Would a hundred billion pounds do it for ya? http://www.guardian.co.uk/business/2010/jan/03/gordon-brown-wind-energy-progra mme
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Bruce Sterling: State of the World 2010
permalink #29 of 223: for dixie southern iraq (stet) Sun 3 Jan 10 12:20
permalink #29 of 223: for dixie southern iraq (stet) Sun 3 Jan 10 12:20
>Healthcare is another example - the world of medicine is changing radically as patients become more knowledgeable - often enough they'll have knowledge about their condition that their physicians lack, because they have access to the data via the Internet, and strong motive for better understanding what's happening to their bodies. Physicians get this, and a sometimes uneasy partnership is forming between the more knowledgeable patients and treatment providers - participatory medicine. Participatory medicine is a palliative and helps but doesn't speak to the underlying problem, which is information overload. The amount of medical information available both on the general side -- biological + medical + genomic; and on the specific side -- patient records, tests, images, and genome -- is utterly beyond any physicians or other humans. And it enlarges daily. It's a total mismatch, made much worse by the almost incomprehensible reticence of many physicians and hospitals to move not out of the 20th but out of the 19th century in record keeping, as anyone who has ever seen a disorderly pile of folders of handwritten papers and printouts -- "these are your records" knows. A guy who is trying to change this equation on both sides, the research and the individual clinical is Carl Kesselman (confession; I work with him); one of the co-inventors of Grid -> Cloud computing. He's got a pile of money from a bunch of sources and he's working on creating a Center for Health Informatics -- http://www.chigrid.org/about.html
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Bruce Sterling: State of the World 2010
permalink #30 of 223: for dixie southern iraq (stet) Sun 3 Jan 10 12:22
permalink #30 of 223: for dixie southern iraq (stet) Sun 3 Jan 10 12:22
Here's Carl's explanation of what he's doing http://viterbi.usc.edu/news/news/2009/carl-kesselman-discusses.htm
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Bruce Sterling: State of the World 2010
permalink #31 of 223: Brian Slesinsky (bslesins) Sun 3 Jan 10 15:02
permalink #31 of 223: Brian Slesinsky (bslesins) Sun 3 Jan 10 15:02
Nice rant but I gotta point out that Io is a moon around Jupiter, not Saturn.
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Bruce Sterling: State of the World 2010
permalink #32 of 223: Rick Brown (danwest) Sun 3 Jan 10 17:34
permalink #32 of 223: Rick Brown (danwest) Sun 3 Jan 10 17:34
Details.
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Bruce Sterling: State of the World 2010
permalink #33 of 223: Jon Lebkowsky (jonl) Sun 3 Jan 10 21:57
permalink #33 of 223: Jon Lebkowsky (jonl) Sun 3 Jan 10 21:57
It's pretty fascinating - Wikipedia's Io page has quite a bit of data and links to various image pages: http://en.wikipedia.org/wiki/Io_%28moon%29
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Bruce Sterling: State of the World 2010
permalink #34 of 223: Bruce Sterling (bruces) Mon 4 Jan 10 01:32
permalink #34 of 223: Bruce Sterling (bruces) Mon 4 Jan 10 01:32
*Man, what are we gonna do with these left-wing pointy-headed scientist geek types who insist that Jupiter and Saturn aren't the same place. Jupiter and Saturn are both PAGAN GODS, fella! Wake up! You in your so-called secular religious arrogance, you are WORSHIPPING PAGAN GODS and you don't even realize it! You and your Io -- a pagan goddess shaped like a cow! -- it's the biggest socialist hoax since evolution and global warming. *Put down the dang Wikipedia and get right with the Gospel, fella.
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Bruce Sterling: State of the World 2010
permalink #35 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 02:06
permalink #35 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 02:06
Which brings up a real problem. People used to think that if scientists said we had a problem, we had a problem, and even though attacks against researchers who touched nerves were not unknown (ask Nobel Laureate Sherrie Rowlands about what happened when he connected flourocarbons and the ozone hole) the debate remained about science. Now, we have total illiterates shouting at the top of their lungs on media that science is a hoax and a conspiracy, and it's working. Where the hell do we go from here?
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Bruce Sterling: State of the World 2010
permalink #36 of 223: Bruce Sterling (bruces) Mon 4 Jan 10 02:10
permalink #36 of 223: Bruce Sterling (bruces) Mon 4 Jan 10 02:10
*Digital revolutionizes this, digital revolutionizes that... Yeah, it's been quite a spectacle, but after watching it so long, it's become kind of obvious to me that digital is actually best at revolutionizing digital. The Revolution Eats Its Young. Digital is always attacking, disrupting, and disintermediating itself faster than digital ever changes anything else. *So it's not like we shove a dysfunctional health system through the digital Wonderland mirror, and then we get a nifty digital health system. That never happens for anybody, for any institution, profession or system of governance. It's more like we shove some creaking analog system through a whole dizzy hall of digital mirrors, until we forget what a "health system" was in the first place. Doctors get redefined as self-educated social networking geeks who have some kind of vague interest in the human body, but are mostly busy upgrading their netbooks and seeking a revenue model. Which they don't have. *You can read an Internet guidebook from the 1990s and it's like they're talking about a different planet. You know, Saturn, Jupiter, whatever.... There's a tremendous tone of urgency about what this dusty old guidebook says -- "Drop every other concern, you need to do this right away" -- but every strategy and tactic recommended there is pitifully obsolete. If you tried those things now you'd be gone in a week. *Internet stuff changes very fast, and the Internet's past just vanishes. Databases vanish, GeoCities, UseNet. The Net's got huge Gothic holes in it, places that looked solid and are just massive hard-disk failures, grinding empty noises. Or trash-heaps, huge spammy trash-heaps generated by zombie botnets of abandoned robots. *An Internet year is like seven Earth years, so the Internet looks 210 years old in 2010. It's forgotten how to be a solution to analog problems, if it ever was any such thing. As it's socializing, it's becoming less a techie platform and more a human institution, and a particularly frail, senile, piratical, treacherous weird one. *Today, people look at our crazy, broken, self-absorbed finance system, which we used to frankly worship like a pagan god, and they're so full of bitterness and skepticism... "How could they ever let things get into such a parlous state! What benefit did they ever bring us? They're all crooks and charlatans!" I don't think that modern Internet zealots are crooks and charlatans, but I see no reason why a weird system of small-pieces-loosely-joined couldn't drift into fungal lunacy just like the financial system did. Maybe harder, faster, and less retrievably. They're children of the same era. They're built with the same logic. *After all -- who's minding the store there? To what end? It's all about whatever seemed to work -- moguls, monopolies, offshoring... Works great technically (sometimes), might create utter social mayhem (somebody else's problem). All the broadband you can eat and you're left with a mouthful of ashes. *If that happened, who would we blame for that? Wouldn't we be staring at each other with that same shocked, shocked look that Alan Greenspan had in Congress? "Gosh, I can't believe that they would irrationally do such bad things to themselves." Markets are not inherently rational, and the Internet isn't rational either. Not a bit of it. *Some day this too will pass. "What comes after network culture?" We're so enmeshed in network culture that it's hard for us to envision anything outside it now. That's dangerous. It's like believing in contemporary finance to the point that alternatives become unthinkable. Stewart Brand, years ago: "And the larger fear looms: we are in the process of building one vast global computer, which could easily become The Legacy System from Hell that holds civilization hostage -- the system doesnt really work; it cant be fixed; no one understands it; no one is in charge of it; it cant be lived without; and it gets worse every year." Does that sound familiar? It's sounds plenty familiar if you're talking about the global economy now, but that's not what Stewart was talking about. "Todays bleeding-edge technology is tomorrows broken legacy system. Commercial software is almost always written in enormous haste, at ever- accelerating market velocity; it can foresee an 'upgrade path' to next years version, but decades are outside its scope. And societies live by decades, civilizations by centuries..."
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Bruce Sterling: State of the World 2010
permalink #37 of 223: better smoke!!!! better mirrors!!! (robertflink) Mon 4 Jan 10 05:29
permalink #37 of 223: better smoke!!!! better mirrors!!! (robertflink) Mon 4 Jan 10 05:29
>And societies live by decades, civilizations by centuries..."< Yet our "leaders" tell us that they are responsive to will and, thus, can be dramatically and quickly altered as in "nation building" and "health care", all without unintended consequences. While we are trying find leaders that can steer the beasts to our rosy objectives, what of the fads and fashions of those that operate elements of the systems we depend on? While I agree no one is in charge can we divine some early warning of change by observing the foot work rather than the head fakes?
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Bruce Sterling: State of the World 2010
permalink #38 of 223: Jon Lebkowsky (jonl) Mon 4 Jan 10 06:39
permalink #38 of 223: Jon Lebkowsky (jonl) Mon 4 Jan 10 06:39
"So it's not like we shove a dysfunctional health system through the digital Wonderland mirror, and then we get a nifty digital health system. That never happens for anybody, for any institution, profession or system of governance. It's more like we shove some creaking analog system through a whole dizzy hall of digital mirrors, until we forget what a 'health system' was in the first place." Acknowledging and agreeing with your point that digital can be disruptive and destructive (having never said otherwise), I'm not sure I agree with your point about healthcare. Capturing and storing patient data in a standard and patient-accessible way, and bringing the patient into the healthcare conversation, seems like a net positive. Opening data as broadly-shared research also seems like a positive - if all researchers could access all pharma research data, how much faster would treatments evolve? On the other hand, digitizing an analog mess can leave us with a digital mess. But I think it's an oversimplification to say that digital is *inherently* destructive. "Doctors get redefined as self-educated social networking geeks who have some kind of vague interest in the human body, but are mostly busy upgradin their netbooks and seeking a revenue model. Which they don't have." I've spent some time with physicians of late, and I don't see this happening at all. Many are conservative about new digital foo, mainly because they don't have time to think about it. Others are beginning to adopt digital technology in constructive ways - using it, for instance, for closer communication with patients. Still others, younger guys in med school who have digital as a "first language," are just inherently in the digital world and fully expect to be doing digital rounds and assessments. "Internet stuff changes very fast, and the Internet's past just vanishes. Databases vanish, GeoCities, UseNet. The Net's got huge Gothic holes in it, places that looked solid and are just massive hard-disk failures, grinding empty noises. Or trash-heaps, huge spammy trash-heaps generated by zombie botnets of abandoned robots." The stuff that was important to me is still around. I'm still talking to you on the WELL after two decades hanging out here, and the technical foundation is still the same - Picospan with Engaged sitting on top of it. What vanishes disappears because it wasn't useful and wasn't used, it's natural selection applied to technology. Usenet never went away, it's active as ever. Ask Giganews. God knows there's piles of steaming digital crap on digital servers everywhere, but what's useful remains useful, for the most part. Otherwise agreeing with much of what you say. You ask "What comes after network culture?" We might ask that differently - "What does network culture become?" For me the emphasis is always on the social, not the technical. The social web is bringing more and more people into some kind of conceptual proximity, but the conversations are weirdly disconnected - drive-by conversations, I often call them. The challenge to me is to create real coherent social engagements that are less like the barroom - people hanging out, talking at each other but not necessarily with each other - and more like effective meetings, where people come together with the idea of creating action items, getting things done, producing deliverables. We could also benefit by acknowledging, and overcoming, the echo chamber effect that this technology supports so well - where we can select for conversation those we agree with and exclude those we don't, so that we never have to engage with conflicting views in a civil and meaningful way. I'd love to see real dialog and deliberation with thinking people who have opposing views - vs shouting machines between unthinking people who've been propagandized and polarized. Social media could be useful, if it was less marketing people and self-helpers with their weird proliferation of numbered lists ("Ten ways to build your Twitter following, never mind the conversation "), and more real people having authentic conversations about real problems - and that's happening, too, I'm sure. There's just too little signal in the noise at the moment. Back to your question of what comes after network culture - do you have a vision for that future?
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Bruce Sterling: State of the World 2010
permalink #39 of 223: Jon Lebkowsky (jonl) Mon 4 Jan 10 06:55
permalink #39 of 223: Jon Lebkowsky (jonl) Mon 4 Jan 10 06:55
By the way, I think this is relevant: "Educators say that, for adults, one way to nudge neurons in the right direction is to challenge the very assumptions they have worked so hard to accumulate while young." http://www.nytimes.com/2010/01/03/education/edlife/03adult-t.html
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Bruce Sterling: State of the World 2010
permalink #40 of 223: Cogito, Ergo Dubito (robertflink) Mon 4 Jan 10 07:24
permalink #40 of 223: Cogito, Ergo Dubito (robertflink) Mon 4 Jan 10 07:24
Thanks for the link. I now understand why I enjoy our Socrates Cafe sessions here in the Twin Cities so much.
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Bruce Sterling: State of the World 2010
permalink #41 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 15:26
permalink #41 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 15:26
>Acknowledging and agreeing with your point that digital can be disruptive and destructive (having never said otherwise), I'm not sure I agree with your point about healthcare. Capturing and storing patient data in a standard and patient-accessible way, and bringing the patient into the healthcare conversation, seems like a net positive. Particularly compared with the existing situation. I mean, talk about legacy system hell....
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Bruce Sterling: State of the World 2010
permalink #42 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 16:00
permalink #42 of 223: for dixie southern iraq (stet) Mon 4 Jan 10 16:00
But as long as we're crushing our digital hopes - one of the the longest standing of these hopes is that digital can somehow encode that granddaddy of legacy systems, our brains, and move our perceptions and memories and emotions onto new platforms -- perhaps even immortality on a chip, not the best place to be immmortal, but still maybe better for some. That digital (back to the medicine thing) create much better prosthesis for damaged limbs or even nerve tissue. Is this another SF delusion or is the distance actually closing.
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Bruce Sterling: State of the World 2010
permalink #43 of 223: Scott MacFarlane (s-macfarlane) Tue 5 Jan 10 05:39
permalink #43 of 223: Scott MacFarlane (s-macfarlane) Tue 5 Jan 10 05:39
<scribbled>
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Bruce Sterling: State of the World 2010
permalink #44 of 223: Scott MacFarlane (s-macfarlane) Tue 5 Jan 10 05:51
permalink #44 of 223: Scott MacFarlane (s-macfarlane) Tue 5 Jan 10 05:51
Bruce, This odd article in yesterday's Seattle Times got me thinking about your comments on Putin and the "Wild, Wild West" quality of post-Soviet capitalism in Eastern Europe: http://seattletimes.nwsource.com/html/storm/2010697655_bird05.html First, I had no idea that stars from the WNBA (Women's Nat'l Basketball Assoc.) were being showcased in Russia by ex-KGB-cum-Mafioso types. Very strange outgrowth from the wealth amassed by the corrupt-to-the-core, find-a-horse-head-in-your-bed, free-market capitalism in the land formerly known as Behind-the-Iron-Curtain. You also mentioned Sweden. Nominally Lutheran, formerly homogeneous Sweden has found itself in the precarious situation of having invested heavily in Eastern Europe while, at home, trying to assimilate a new immigrant population that often resists assimilation. Right now Swedes are mourning the loss of the Swedish national icon, SAAB, and coping with the same Global economic declines that have hit most everywhere. The Swedes cling to a social system where 80% of the population is obstinately middle-class and well-protected by unions with long-held givens like strong unemployment benefits and a bedrock, universal healthcare system. About 10% of the population is wealthy, about 10% poor. And, underlying the Swedish way is, by-and-large, a core honesty and low-key social ethic infused through Swedish culture that is being tested like never before by immigration, very high taxation, electronically-cocooned and jaded youth, and questions about upholding a social safety net that may be unsustainable. Back in the height of the Cold War, Sweden was said to offer "The Middle Way" between US Capitalism and USSR Communism. As the U.S. reels from the fallout from its own sordid brand of unfettered corporate capitalism, coupled with our discombobulated attempt at a hybrid National Healthcare system, I'm beginning to wonder whether America is on the verge of adopting the more centrally-controlled Swedish Way with its underlying "Social Democracy", or if, at the slightest hiccup we'll be charging headlong again toward the unbridled "wild, wild west" of eastern Europe. (By comparison to Sweden, in the US there is no longer a strong third leg of employee unionism to counterbalance corporate private-sector power and government public-sector power.) What would James West say? What would Martin Luther say? What would Martin Luther King say? What would the daughter of a socialist governor in Sweden and cuckold "wife" of the richest American athlete say? Is everything running amok and going berserk, as the Vikings would say? Most importantly, are there notable glimmers of hope (say, from the Climate summit in the Swedes' backyard of Copenhagen?)? What's the [S]terling answer?
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Bruce Sterling: State of the World 2010
permalink #45 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 07:01
permalink #45 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 07:01
"Capturing and storing patient data in a standard and patient-accessible way, and bringing the patient into the healthcare conversation, seems like a net positive." Maybe, but that's also what the newspapers once thought, or pretended to think... "look, the Net allows us to bring the people formerly known as the audience into the conversation! How grand!" It also allows Google to write eyeball-tracking algorithms that do a much better job of agglomerating audiences and advertiser dollars than newspapers could ever do. End of newspapers. Obviously there are some positives to that situation, but it's disingenuous to think that it's (a) technically inevitable or (b) it serves the interests of democracy. It's easy to point out downsides of tech developments when they're employed by entities you already dislike and distrust. For instance, "chilling effect" and "mission creep" are always used in civil liberties discourse, but nobody talks much about "chilling effects" and "mission creep" in developments that we LIKE. If you build a web 2.0 knowledge swapping network for patients, it's gonna get mission creep pronto. If patients end up doing their own diagnoses by aggregating patient data, using Web 2.0 style collective intelligence, and especially if they then start suing doctors who make demonstrable, dumb mistakes, the practice of medicine will be wrecked. Not improved, wrecked. It'll be hugely damaged, in the same way that the music business was damaged by Napster, and newspapers were wrecked by Craigslist, or the Democratic Party was outmaneuvered and tamed by some Chicago guy who had social media and a digital fundraising machine. Doctors do make dumb mistakes all the time. That's the nature of a knowledge guild that restricts vital knowledge to a professional clique. We didn't want amateur brain surgeons because they are dangerous quacks without medical ethics. But there's no physical reason why one couldn't have amateur brain surgeons with instructables off Wikipedia, and no reason why theses jaspers couldn't do a sort-of-okay job, too. Not perfect, but cheap and fast and distributed and upgradeable, like Wikipedia compared to Encyclopedia Britannica. That's network culture. If medicine gets the big wikipedia treatment, you don't get a computer-literate doctor, you get a doctor-literate web activist. Doctors are keenly jealous of their pre-eminence. They spent hard years in med school, unlike Joe Keyboard. Doctors also earn much, much more money than they would if arteriosclerosis was re-defined as some kind of hardware problem to be scanned by an iPhone app. You can argue that, "well, those arrogant gatekeeper-types, we oughta let 'em have it," but the end-point of the path-toward-free is that everything's sorta free and nobody's got a paying job. Everybody in capitalism is sitting on some kind of pinchpoint because that's where the money-flow is. I kinda like the idea of a future world where everything's sorta free and nobody's got a paying job, just like I'm frankly thrilled to see advertising dying. But if that's what we really want, we should start small, and test that out with something reversible, like, say, a small town where that seems to be working. We shouldn't blithely let convulsions happen while we're pretending to do something else.
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Bruce Sterling: State of the World 2010
permalink #46 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 07:21
permalink #46 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 07:21
You know, I've been to Sweden a couple of times, and although I've always been treated well and it's a society I respect very much, I think I'd be hard put to live there. I don't think it's got anything to do with Sweden, and everything to do with the imp of the perverse. People don't need what they want, and don't want what they need. My intuitions about this have been sharpened by reading Vaclav Havel's new memoirs TO THE CASTLE AND BACK. It's about what happened to him and his circle and his society AFTER the glorious 1989 revolution. Havel's a tired, sick old man now, and he doesn't have the revolutionary fire he once did, but he really is wise. There's a lot of stuff in there about people being surprised and even flummoxed by the spectacular glee of being given what they want -- great things that are clearly good for them. They're better off by almost every objective measure, and they'd never go back, but somehow they seem to live less. Havel talks a lot about the dangers of technocratic government in this book. Of handing over politics to well-trained experts who know what they are doing and can prove it. I happen to favor technocracy in politics because I think politics ought to be dull, and business should be rather dull too, while efforts like science and the arts ought to have all the vibrancy. But after reading Havel's warnings about the crimping and demeaning effect this has, the loss of a sense of purpose, I'm troubled. I don't think Havel has an answer, either. He talks a lot about eternity. He's a moralist by nature with a faith in eternal values. It's a sense of purpose that got him through five hard years in a slammer that probably would have killed me dead, but he's a hero, and I'm not. Even if I somehow turned to be a hero, through some godawful circumstance, I'm pretty sure eternity would be the last thing on my mind. As for America somehow becoming like Sweden, that's about as likely as Mexico becoming like Sweden. We might conceivably become rather more like New England and less like the Confederacy. We're a whole lot like the Confederacy now, and it hasn't been good for us.
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Bruce Sterling: State of the World 2010
permalink #47 of 223: for dixie southern iraq (stet) Tue 5 Jan 10 09:03
permalink #47 of 223: for dixie southern iraq (stet) Tue 5 Jan 10 09:03
>f patients end up doing their own diagnoses by aggregating patient data, using Web 2.0 style collective intelligence, and especially if they then start suing doctors who make demonstrable, dumb mistakes, the practice of medicine will be wrecked. Not improved, wrecked. I agree; it's wrong on so many levels. Every time I see an ad for a drug on television, followed by the ritual recital of possible catastrophes ("should not be taken by human beings with a pulse of more than 30 beats per minute, may cause loss of appendages or homicidal impulses, keep in explosion-proof storage container at a temperature of less than -5 C, my gorge rises. It's an abuse. I do think that the practice of medicine now desperately needs better IT - for doctors.
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Bruce Sterling: State of the World 2010
permalink #48 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 11:19
permalink #48 of 223: Bruce Sterling (bruces) Tue 5 Jan 10 11:19
"But as long as we're crushing our digital hopes - one of the the longest standing of these hopes is that digital can somehow encode that granddaddy of legacy systems, our brains, and move our perceptions and memories and emotions onto new platforms -- perhaps even immortality on a chip, not the best place to be immmortal, but still maybe better for some. That digital (back to the medicine thing) create much better prosthesis for damaged limbs or even nerve tissue. Is this another SF delusion or is the distance actually closing." *Messing around with nerve tissue: distances closing *Building digital prosthetics that sense and react to human nerve signals: chugging right along *Migrating human brains onto a computer network: about as likely as migrating human brains onto plankton.
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Bruce Sterling: State of the World 2010
permalink #49 of 223: for dixie southern iraq (stet) Tue 5 Jan 10 11:34
permalink #49 of 223: for dixie southern iraq (stet) Tue 5 Jan 10 11:34
>*Migrating human brains onto a computer network: about as likely as migrating human brains onto plankton. Not human brains, human memories/personalities/identities. Been a staple of science fiction in one state or form forever. Where's the impossibility?
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Bruce Sterling: State of the World 2010
permalink #50 of 223: Jon Lebkowsky (jonl) Tue 5 Jan 10 11:36
permalink #50 of 223: Jon Lebkowsky (jonl) Tue 5 Jan 10 11:36
(Responding on participatory medicine... and music!) "Obviously there are some positives to that situation, but it's disingenuous to think that it's (a) technically inevitable or (b) it serves the interests of democracy." It's related to what some call "democratization of knowledge," though the d-world is always problematic because it can mean different things to different people. "Participatory" is a useable term, I think - it just suggests that there is more involvement. Traditionally patients have been passive recipients of "care" or "treatments," and they couldn't be much else because there was so much they didn't know. Now patients can have access to medical knowledge that, before, was buried in medical texts. Of course this has downsides. Most patients don't have the physician's understanding, which is based on a lot of training and a particular context for knowledge. However in many cases patients are picking up a lot of focused knowledge about their specific conditions, and given that intense focus (it's their body, after all), they'll sometimes know more about some aspects of their conditions than the doctors who're treating them. And they'll know their own bodies. "If patients end up doing their own diagnoses by aggregating patient data, using Web 2.0 style collective intelligence, and especially if they then start suing doctors who make demonstrable, dumb mistakes, the practice of medicine will be wrecked. Not improved, wrecked." Patients already do their own diagnoses - *all the time* - and they're constantly suing doctors for malpractice. That's not a change, but it's also not what participatory medicine is about. It's about patients having an informed and active, rather than uninformed and passive, role in their treatment. It seems to work well. I'm part of a group that founded a Journal of Participatory Medicine (http://jopm.org) to gather research and evidence to develop an understanding of how, and how well, it works. This absolutely doesn't mean the patients take over, self-diagnose, perform their own surgeries, etc. "It'll be hugely damaged, in the same way that the music business was damaged by Napster, and newspapers were wrecked by Craigslist, or the Democratic Party was outmaneuvered and tamed by some Chicago guy who had social media and a digital fundraising machine." I don't think Napster hurt the music business, though P2P might be damaging some parts of the business. The artists are finding a new model, where they make more of their money from performance. They're no longer fiefs in thrall to music companies that fund their recordings and tours and take pretty much everything they make, with few exceptions. Sure, some people have lost jobs over this, and some very rich people are less rich and the music business is transformed, maybe for the better, overall. Nothing's permanent, and the Internet and digital convergence are changing things fast some for better, some for the worse. What's the alternative? "Doctors are keenly jealous of their pre-eminence. They spent hard years in med school, unlike Joe Keyboard. Doctors also earn much, much more money than they would if arteriosclerosis was re-defined as some kind of hardware problem to be scanned by an iPhone app." If we could heal everybody with technology, the doctors would be out of work, for sure. So if that killer healing app appeared, would you want to suppress it so that doctors could hang in? I don't think anybody expects medical intervention to be free, and it will almost certainly be necessary for most of us. The real point of participatory medicine is to make it better - to make US better. We'd still be paying doctors and nurses and hospitals to do what they do (though hopefully it'll be more affordable).
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