Gross reflections

 

Flexor digiroum superficialis!

The scientific dissection of human bodies has had a long and storied history of being condemned.  The original Hippocratic Oath forbade the “use of the knife,” one of those quaint clauses that are now swept under the rug – like that bit about how medical education should be delivered “without fee or covenant.”  Roman law forbade human dissection, so Galen had to make do with examining monkeys.  Even from the late medieval period onwards, when dissections became accepted, they were still back-alley affairs, with cadavers limited to the corpses of murderers or other low criminals, and enmeshed in a black market in cadavers and body parts.  (You could probably make a heck of a movie about anatomists in the early 19th century – scientific fervor, personal ambition, and the intersection of learned academics with the sordid underworld, maybe culminating in the Burke and Hare murders.  I’d watch it, anyway.)

Routine dissection is a very novel idea, something that we find very much counterintuitive, and the only reason it happens at all is that there’s a sufficiently big incentive – learning about anatomy that way saves lives. And the corollary of that old taboo is that we didn’t evolve to intuitively comprehend the workings of the human body either.  There was no reason to.  Until the antiseptic age of Lister et al, surgery usually did more harm than good, and any weakening in our instinctive aversion to cutting up corpses runs the risk of weakening our aversion to harming live people as well.  Better to have humans with strong anti-cutting-up-other-humans instinct, and leave them ignorant of what’s going on under the hood.

At the end of our anatomy course, this evolutionary heritage leaves me in the odd position of intellectually understanding what’s inside the human body, without really viscerally believing it in everyday life.  I can see airplanes and computers and imagine the complex machinery that powers them, but it takes a lot of effort and mental abstraction to look at someone’s hand and see the intricate meshwork of tendons, or at someone’s face and see the zygomatic arch curving away behind the cheek.  It’s much easier to slip into instinctive mode, just rely on our highly evolved facilities for detecting facial expression, and regard people as composed of Essence of Human, powered by élan vital.

Speaking of the face, the first thing we did in our first lab was to cover up our cadaver’s face, hands, and feet – ostensibly to prevent further decay but I suspect also to soothe our jitters by obscuring the most human-like part of the body.  And it worked shockingly well – the mood immediately went from somber and respectful to practical and even gung-ho, and by the second session most of the camraderie, levity, and friendly competitiveness of our class was back in the room.  Again, it makes sense that the mind would use the face and hand as a proxy for “this is a human,” rather than tacking on expensive mental modules to ID humans more rigorously.  But it’s still surprising that covering less than 10% of the skin surface area of a human can suddenly turn it into a laboratory apparatus.

As we were dissecting, it also struck me that although there was huge variation in the size and proportions of internal organs, none of us had any aesthetic response to this diversity whatsoever.  This is weird, considering how painstakingly precise we are at evaluating people’s facial symmetry and external body shape – judging miniscule differences to mean the difference between transcendent beauty and horrifying repugnance.  The aesthetic sense of human beauty feels like a very important, essential difference between people, one that can massively change the trajectory of lives.  But seeing this internal variation really brought home that it’s merely an algorithm for evaluating genetic potential, tailor-made for a bunch of primitives that hadn’t invented blood tests and DNA sequencing yet.  Judging people by looks – a universal human compulsion – is not only shallow in the sense that it’s evaluating people based on things besides their thoughts and actions, but also literally shallow in the sense that you’re only looking at surface information that happened to be available thousands of generations ago, ignoring the biochemistry and hidden anatomy that is just as relevant to someone’s biological fitness as high cheekbones or a distinguished jaw.

Anatomy, like quantum physics, is one of those fields where our rationally derived knowledge violently contradicts our evolved instincts.  We tend to view the human body as a single essential thing, and place a lot of emotional weight on our observations of superficial things that were the only data our ancestors could observe.  I expect that as I am exposed to more and more medical knowledge, I’ll eventually adapt more and more to thinking like a reductionist doctor.  But for now, interesting things are happening at the science/monkeybrain interface.

Science classes are evil

Philosophers of science often critique actual scientists for being too concerned with proving their hypothesis (and thereby getting grants and faculty appointments) rather than subjecting their models to rigorous scrutiny which might falsify them.  This post explains how the mistake takes root earlier than we think:

This is how science classes mostly went in high school. We would learn about a topic that had been discovered scientifically, for instance that if you add together two particular solutions of ions, some of the ions will precipitate out as a solid salt. Then we would do an experiment, wherein we would add the requisite solutions and get something entirely wrong in its color, smell, quantity, or presence. Then we would write a report with our hypothesis, the contradictory results, and a long discussion about all the mistakes that could be to blame for this unexpected result, and conclude that the real answer was probably still what we hypothesized (since we read that in a book).

This is what it takes to get a publication

The unsuccessful self-treatment of a case of writer’s block

A multi-site cross-cultural replication of Upper’s unsuccessful self-treatment of writer’s block

[NOTE TO SELF: Placeholder for incisive commentary on the above]

Caution on microfinance

I’ve been a pretty big proponent of microfinance as a highly leveraged, self-sustaining way to help the poor, and one that’s underappreciated because of its lack of photogenicity.  (A characteristically approving article from the Economist here.)  All the more reason, then, to link to an excellent Volokh Conspiracy post promoting caution.  The main point: it’s hard to optimize two things at once.

Microfinance tries to both subsidize lending to people who are very difficult to extend credit to, and subject the charity to market discipline so that people on the ground can fund projects that they believe most likely to improve their lives.  But in some areas, an excess of capital has led to laxer attitudes towards piling up debt, and institutions who focus on signing up large numbers of people have the same bad incentives as subprime mortgage lenders – they lose their “market discipline” strength and fail to ensure that the people they’re lending to are the creditworthy ones.

Mostly, it’s simply a hard question of how to balance between ensuring that the aid is well-directed vs. maximizing the volume of aid; of course the tradeoff of too much market discipline is lack of penetration into the really remote poor areas.  But bad incentives for the roaming lenders of some institutions are a serious concern.

Welcome Marginal Revolutionaries

I originally elucidated my thoughts on partisanship and different inequalities here; ironically the initial prompt was an offhand Cowenite comment.

Some other posts you might find of interest: temporal inequality and redistribution, social psych insights, health care reform from a med student point of view, and an underrepresented way of thinking about Chinese diplomacy.

Edited to add my followup comment from the thread:

Yes the labor wing of the left is shrinking, but support for redistribution is as strong as ever, whether that means higher marginal tax rates to lower the status of the richest, or more services to raise the status of the poorest. Either way the effect is to lower the importance of economic competition, relative to competition on looks, height, and social status.

I would argue that big business is actually relatively bipartisan, which makes sense since you’ll want a foot in the lobbying door. Either way, business lobbying is not part of this macro divide, it’s simply an example of self-interested parties doing what they do best. Ditto farm subsidies. On the other hand, the left is much more likely to favor government regulation of business as a whole, while the right prefers both less regulation and freer international trade.

Remember, furthermore, the Cowen/Hanson dictum that politics is more about group loyalties than about policy. A clearer way of seeing the basic impulses behind policy proposals is simply looking at attitudes of both sides towards different groups – what’s praiseworthy and what’s contemptible. And that “cultural” view clearly shows this money vs. social status dichotomy. (The one thing that DOES weaken my framing is the anti-immigration right, which is often framed as protecting poor natives from economic competition.)

The major contribution of my framework, as I see it, is a way to explain the appeal of social norms to non-conservatives, many of whom see norms as merely a way for the powerful to oppress the weak. To the contrary; if you look at “power” in terms of social status rather than belonging to particular groups, social norms are a protection of the weak against the excesses of the strong.

 

Optimizing the wrong thing

After several late-night cram sessions, I’ve gotten really good at reading, repeating out loud, and even copying my notes at top speed.  The only problem…I’ve also gotten really good at doing all the above without thinking.

Connected

The book (written by an MD!) is a good overview of social psychology – starting from the basics (ultimatum game, Dunbar’s number, group selection) and working up.  One part that struck me was the following:

Although there is often wisdom in crowds, they often go horribly awry when making a decision.  The difference between the two extremes has a lot to do with the path-specific motion of information through networks.  Whether people are able to make correct decisions about something (the value of a product, the number of jelly beans in a jar) depends on whether decisions are made at the same time or sequentially.  If a group of people deciding on the price of an item and bid on it independently, then their average guess is probably a good indicator of its market value.  However, if people make decisions in sequence and are aware of prior decisions, if information moves from one person to the next, we can end up with the blind leading the blind.  Once a critical mass of people make a decision, the rest of the group goes along, reasoning that others cannot all be wrong.

Bayesians often argue that we are too certain of our own flawed reasoning faculties, and should defer more to the average opinion.  After all, if everyone has similar but noisy reasoning abilities, then lots of people coming to a conclusion is a much better indicator than a single person coming to another conclusion – and there is no reason to privilege the latter just because that brain happens to be your own.  On the margin, this is probably true, but you have to adjust for the fact that on many issues people don’t actually apply their full attention and come up with independent conclusions.  In some areas, this is the case: markets encourage rationality by punishing those who over- or under-estimate the value of a product, and in many areas – “how do you make friends?” or “how do you become a great boxer?” – most people with an answer have had to do their own research, reflect on their experience, and come up with independent answers.  But in many issues, including the most contentious ones, each person with an opinion hasn’t actually done a lot of research and critical thinking to justify it; most people subscribe to the opinions held by people that they respect.  Most people on both sides of the climate change debate, for example, have not conducted a lot of independent research; they may look up a few papers to buttress the views they already held, but few take the time and effort to do an unbiased review of the literature.  (Certainly I haven’t, and I’ve probably done more reading than most!)

There’s good reason for that – doing serious, first-principles research is hard and time-consuming.  Gary Taubes’ investigation of diet science required a decade of effort and a mastery of biochemistry and physiology.  Yes, he was fortunate to turn up enough interesting material to make a book out of it, but for most of us it’s neither realistic nor worthwhile to take the effort required to audit each of our beliefs, especially the mostly symbolic ones we use to demonstrate to our friends that we’re good moral people.  Which is fine, but in such areas we need to lower the amount of importance attached to the consensus view, since it represents fewer units of independent cognition.  For the rookie boxer, deferring to the consensus is probably the best choice.  But for many the issues, when you read “everyone thinks that,” it’s reasonable to substitute “a small, highly incestuous group of interested parties and political spinners thinks that.”  In such fields, the truth-value of consensus is relatively low.

Other interesting bits from the book:

Beauty is much more of a zero-sum competition than money; people will take much more of a beauty hit to make everyone else uglier than they would take a money hit to make everyone else poorer.  Implication: to whatever extent you believe that we should tax income because it’s just about relative not absolute well-being, we should tax cosmetics, gym membership, and plastic surgery about an order of magnitude more.

People reported that they would rather work at a company where their salary was $33,000 but everyone else earned $30,000 than at another, otherwise identical company where their salary was $35,000 but everyone else earned $38000….[by comparison], 75 percent of people preferred being in [a world where your physical attractiveness is 6, others average 4] than in [a world where your physical attractiveness is 8, others average 10].

Abstinence pledging is not about sex:

In a small number of “open” schools, where most opposite sex friendships and romantic ties occur with individuals outside the school, more [abstinence] pledgers indeed meant delayed sexual debut.  Surprisingly, though, in “closed” schools, where most ties occur inside the school, more pledgers meant a greater likelihood of sexual debut.  These findings suggest that the pledge movement is an identity movement and not solely about abstaining from sex.

The difference between black and white HIV rates may be attributable to a greater level of sexual inequality (more celibates and more players) among blacks, not to higher promiscuity overall:

A peripheral black person (where peripheral is defined as having only one sexual partner in the past year) is five times more likely to choose a partner in the core (defined as having four or more partners in the past year) than is a peripheral white person.  No one has yet discovered why this is the case, but the result is that STDs would be more likely to be contained within the white core, whereas they are more likely to spill out into the black periphery.

Survivor’s appeal is because it recreated, to a much greater extent than other entertainments, the small group status struggles that were the staple of our ancestral social lives – it makes our monkey brains happy.  Implication: reality shows that focus on exotic challenges will work less well than those that simply focus on group dynamics.

Part of the fascination with the show was not only the characters but also their complicated interactions.  Survivor presents a series of interlocking, connected biographies – a sociography, actually, something akin to a novel.  And, like a Russian novel, the story follows the shifting connections between people in the group and all the social complexity, as well as the group’s fluid morality.  Shows like Survivor are alluring precisely because the mirror the ancient struggles within our minds and among our peers.

A thought-provoking comment

From here:

Certainly in some parts of the country “fat” is the worst insult imaginable, far worse than those directed at one’s character.

We can argue about how common such attitudes are, but most would agree that they do exist in certain segments of society.  This pithy observation says two things about such segments, neither of them good.

Putting the “med” in med school

Today, I:

1. Learned to suture, using a pig’s leg. Those needle drivers aren’t as easy to play around with as you’d think.

2. Saw a helicopter landing on the hospital roof.

It was a fun day.

A very good post

Julian Sanchez on how the birthers don’t really mean what they say:

Now, certainly it would be unsettling if a significant chunk of the population had abandoned the realm of reasonable disagreement for racially-tinged conspiracist fantasy. But I’m not panicking quite yet.  As my colleague at Democracy in America notes, comparable numbers of Democrats during the Bush Administration told pollsters that they thought Bush had foreknowledge of 9/11….Assume a hefty chunk literally meant that they thought a sitting U.S. president deliberately allowed (if not engineered) the murder of thousands of American civilians for his own nefarious purposes. Yet I can’t help but notice that, however much people may have expressed intense disdain for Bush, you did not really see a lot of behavior consistent with millions upon millions of people being seriously convinced that their president was a treasonous mass murderer.

I mean, what would you do if you were really-and-truly convinced that something like that were true? Take up arms? Throw yourself into a quest for conclusive evidence? Move to Canada?  Something, probably—or if you wouldn’t, at any rate, some non-trivial proportion of the people who shared the belief would—or so I’d imagine. It’s obviously too stringent to make it a condition of ascribing belief that people act on all the logical and practical implications of holding it, but when the disconnect is too profound, I think we’re justified in characterizing some of these as pseudobeliefs, one subset of which is what I want to call “symbolic beliefs.”

Read the whole thing.  Of course I believe that we should take it to the next level: among non-politicians, allegiance to even concrete policy proposals are “symbolic beliefs:” often more about group affiliation and local status competition rather than rational calculation about the optimal action.