Category: current events

What Kind of Census Does This Make?

We finished our Census Bureau survey and it seems like we just did this not long ago. It’s taken every 10 years but it seems like we got this form a few years ago.

They say it takes about 40 minutes to complete, but it sure felt like there were many more questions on it this time and the questions asked about a lot of things like income, taxes, etc. that we don’t remember from before.

Did anybody else get this feeling? I mean we really had to do things like get data from records and do math and sweat the details.

We asked ourselves what would happen if we just refused to do it. So, I looked it up. It turns out that there is a $5,000 penalty the bureau can impose if you refuse to do it or give false information.

On the other hand, Census Bureau officials have said nobody’s been prosecuted since 1970. I wonder what happened to that person? Is he still paying off the fine? Is he in jail because he couldn’t pay it? Was he abducted by extraterrestrials and is he still trying to get them to pay it?

There are other questions I had that led me to search the web. It looks like the best place to start might be the Census Bureau website itself. The section Census Bureau 101 for Students looks like a good place to start. The census has been around since 1790 and back then it was only a six-question survey:

What is your gender? (There are more choices nowadays)

What is your race? (It was not the 40-yard dash)

What is the name of the head of the household? (It’s always the wife!)

What is the relationship to the head of the household? (It’s always the husband!)

How many slaves do you own?

What is your occupation? (Tea party activists didn’t count)

There’s an interesting section on the web site PRB, entitled “Hard-to-Count Populations.”:

Decades of research have shown that the decennial census is very accurate, but (like population censuses in other countries) it is subject to both undercount and overcount errors that differ by age, sex, and race. The 2010 Census was no exception. Despite the best efforts and careful planning of Census Bureau staff, the direct, physical enumeration of the U.S. population is imperfect.

Part of the challenge in counting the population accurately is that some people are harder to count than others. People who lack a permanent address are less likely to complete a census form than people who have a permanent address. Similarly, language barriers, distrust of government, and frequent moves tend to make certain groups harder to count. On the other side of the spectrum, some people may be counted more than once. For example, those who own more than one home may submit a census form for each address, and children away at college may be counted at both their college and parental home.

If you decide not to complete the Census Bureau survey, they probably won’t fine you or throw you in jail. They could visit your house up to six times though. And if you manage to slip them every time, they could check with your neighbors to get the skinny on you.

You might as well do it.

The Dragon Breathes Fire Again

Sena and I saw a news video about a technology called “DAX” which uses Artificial Intelligence (AI) the other day which promises to reduce or even eliminate pajama time for physicians trying to get their clinical note dictations done during the day instead of taking them home for several more hours of work.

The video was a demo of the technology, which looked like it recorded a clinical interview between the doctor and the news reporter. I didn’t see how exactly DAX was recording the interview without obvious audio equipment. Was it doing it through the smartphone speaker? This was very different from how I and many other clinicians dictated their notes using a headphone set at their desks in front of their desktop computers. It not only records but transcribes the interview.

Later, I discovered that DAX stands for Dragon Ambient Experience, made by Nuance which was acquired by Microsoft in 2022. I posted about Dragon products and their limitations last year. The product often produced hilarious mistakes during dictation which required careful editing. Sometimes more errors turned up after you completed it and these were visible in the patient’s medical record, which would then need to be corrected.

Several years ago, I remember talking to somebody from Dragon on the phone about the problems I was having. She was a little defensive when I told her I’d been having difficulty with Dragon for quite a while because it made so many mistakes.

A recent article on the web revealed that the errors continue with DAX. According to the article, “…it will make mistakes. Sometimes it might omit clinical facts; sometimes it may even hallucinate something.” I remember trying to communicate with the Google Bard AI, which seemed to do this pretty often. It made stuff up.

DAX is not cheap. The article reveals that one hospital pays $8,000-$10,000 per year per physician to use it. And skeptics worry that the system has too many bugs in it yet, which can lead to bias and inaccurate information which could negatively affect patient outcomes.

A recently published JAMA network article also urges caution in adoption of this sort of AI-assisted technology (Harris JE. An AI-Enhanced Electronic Health Record Could Boost Primary Care Productivity. JAMA. Published online August 07, 2023. doi:10.1001/jama.2023.14525).

In this case, I think it’s appropriate to say “I told you so.”

New Dominant Covid-19 Variant EG.5

There is a new dominant Covid-19 variant called EG.5. It’s also called Eris. It’s descended from the XBB strains. It’s in the Omicron family and there is no indication it causes more severe disease and would be susceptible to current vaccines.

UI Hospitals & Clinics Gets U.S. News & World Report Recognition

This is just a shout-out to The University of Iowa Hospitals & Clinics for once again being recognized as one of the top hospitals in the nation by U.S. News & World Report.

The Ophthalmology and Visual Sciences Department ranked 6th in the nation.

Doctors Still Oppose Board Mandated Maintenance of Certification Programs

I got a pang of anti-nostalgia after reading the latest article calling for abolition of Maintenance of Certification (MOC), posted by Medscape on August 1, 2023. There is a petition by oncologists to end MOC. So, what else is new? So far it has almost 10,000 signatures.

I remember my own petition in 2014 to end the American Board of Medical Specialists (ABMS) attempt to establish Maintenance of Licensure (MOL), a kissing cousin of MOC, which would have blocked physicians from getting a state medical license if they didn’t comply with MOC requirements. It was supported by both the Iowa Psychiatric Society and the Iowa Medical Society. It got a lot of signatures and many comments in support of opposing both MOC and MOL. The glaringly obvious motive by member boards to require MOC is money and always has been, in my opinion.

I’m baffled at why this debate still rages on. It looks like almost no progress has been made in the last decade, apparently because the American Board of Internal Medicine (ABIM) and other boards ignore the clear messages from rank-and-file doctors about how MOC actually interferes with efforts to pursue practical continuing medical education.

I have always been a staunch supporter of physician-led continuing medical education. At the hospital where I worked as a consultation-liaison psychiatrist, the consult service ran the Clinical Problems in Consultation Psychiatry (CPCP). It was a weekly case-based conference, which I have written about in a 2019 post.

Ironically, the Performance in Practice (PIP) delirium clinical assessment tool module that I and one of the residents created is still offered for credit on the American Board of Psychiatry & Neurology continuing education web site. I think it demonstrates the ability of individual doctors to establish practical methods for developing their own continuing education programs.

The Empire Fires Back

I saw this reply tweet posted to the web. It was the reply of Sean Kirkpatrick, PhD, the director of the All-Domain Anomaly Resolution Office (AARO) in reply to the testimony of the witnesses at the House Committee’s UAP hearing on July 27, 2023. I’m not sure we’ll hear much more about it.

We Are All Still Learning to Play Pong

I noticed an article the other day about Monash University in Australia getting funding for further research into growing brain cells onto silicon chips and teaching them how to play cribbage.

Just kidding, the research is for teaching the modified brain cells tasks. They succeeded in teaching them goal-directed tasks like how to play the tennis-like game Pong last year. You remember Pong from the 1970s? Shame on you if you don’t. On the other hand, that means you probably didn’t frequent any beer taverns in your hometown while you were growing up—or that you’re just too young to remember.

The new research program is called Cortical Labs and has hundreds of thousands of dollars in funding. The head of the program, Dr. Razi, says it combines Artificial Intelligence (AI) and synthetic biology to make programmable biological computing platforms which will take over the world and bring back Pong!

It’s an ambitious project. The motto of Monash University is Ancora Imparo, which is Italian for “I am still learning.” It links humility and perseverance.

There’s a lot of suspicion out there about AI and projects like the Pong initiative in Australia. It could eventually grow into a vast industry run by robots who will run on a simple fuel called vegemite.

Shame on you if you don’t know what vegemite is!

Anyway, it reminds me that I recently finished reading Isaac Asimov’s book of science fiction short stories, “I, Robot.”

The last two stories in the book are intriguing. Both “Evidence” and “The Evitable Conflict” are generally about the conflict between humans and AI, which is a big controversy currently.

The robopsychologist, Dr. Susan Calvin, is very much on the side of AI (I’m going to use the term synonymously with robot) and thinks a robot politician would be preferable to a human one because of the requirement for the AI to adhere to the 3 Laws of Robotics, especially the first one which says AI can never harm a human or allow a human or through inaction allow a human to come to harm.

In the story “Evidence,” a politician named Stephen Byerley is suspected of being a robot by his opponent. The opponent tried to legally force Byerley to eat vegemite (joke alert!) to prove the accusation. This is based on the idea that robots can’t eat. This leads to the examination of the argument about who would make better politicians: robots or humans. Byerley at one point asks Dr. Calvin whether robots are really so different from men, mentally.

Calvin retorts, “Worlds different…, Robots are essentially decent.” She and Dr. Alfred Lanning and other characters are always cranky with each other. The stare savagely at one another and yank at mustaches so hard you wonder if the mustache eventually is ripped from the face. That doesn’t happen to Calvin; she doesn’t have a mustache.

At any rate, Calvin draws parallels between robots and humans that render them almost indistinguishable from each other. Human ethics, self-preservation drive, respect for authority including law make us very much like robots such that being a robot could imply being a very good human.

Wait a minute. Most humans behave very badly, right down to exchanging savage stares at each other.

The last story, “The Evitable Conflict” was difficult to follow, but the bottom line seemed to be that the Machine, a major AI that, because it is always learning, controls not just goods and services for the world, but the social fabric as well while keeping this a secret from humans so as not to upset them.

The end result is that the economy is sound, peace reigns, the vegemite supply is secure—and humans always win the annual Pong tournaments.

House Oversight Committee UAP Hearing Today

We watched the House Oversight Committee UAP Hearing today and it was one of the most interesting presentations we’ve seen in a long while.

I make fun of the topic a lot but I thought all the witnesses were credible. In my opinion, the most credible witness today was retired Commander David Fravor of the U.S. Navy. His sense of humor and down-to-earth (no joke intended) demeanor lent credibility to the issue of Unidentified Anomalous Phenomena.

I especially liked Fravor’s advice for anybody reporting UAPs: “Don’t make the fish bigger than it is.

David Grusch, a former U.S. intelligence officer, often deferred answering certain questions because the answer would have meant revealing classified information. Ryan Graves, a former fighter pilot for the Navy, emphasized the need for a safe way to let military and civilian witnesses describe their encounters with UAPs.

There will likely be another meeting, one which would allow David Grusch to be more open to answering questions involving classified information.

Raccoon in the Mulberry Tree

I was not sure what exactly I saw this between 6:30 and 7:00 this morning shaking the mulberry tree branches in our backyard. It seemed too big to be a squirrel and I dismissed the thought, telling myself that it was most likely the usual squirrel getting its mulberry breakfast.

Just prior to this incident, I had seen and heard what I thought was a blue jay in the mulberry tree. It gave a series of short whistles while bobbing up and down on the branch. I had never heard a blue jay make whistle notes, just the usual screeches. I doubted what I saw and heard. I checked my bird book, “Birds of Iowa: Field Guide” by Stan Tekiela. It didn’t mention anything about blue jays making short whistling notes and bobbing up and down as they did so. I didn’t bother to get up and try to get a video of it. It would have been through the window of our sun room and the jay didn’t sit for more than a few seconds.

So, I looked it up on the web. It turns out blue jays make a variety of noises besides the jeer. They bob up and down as a part of a courtship ritual. They make what is termed a “pump handle call” and I found a video which duplicates what I saw and heard.

Anyhow, getting back to the critter in the mulberry tree, it turned out to be a large raccoon. It was eating mulberries and I tried to take video of it as it was climbing down the tree. This reminded me of an essay by E.B. White entitled “Coon Tree.” If you’ve ever read essays by E.B. White, you probably know already that this one is about a lot more than raccoons.

It’s basically about the conflict between nature and technology. The main essay was published in 1956 and a post script was added in 1962. The coon represents nature which White idealizes and contrasts with references to new inventions, including nuclear devices which represent the destructive side of technology.

I guess we can forget for the moment that raccoons can carry diseases like rabies and roundworm. I’m also reminded of an old TV commercial in the 1970s about margarine (an alternative to butter) in which an actor says angrily, “It’s not nice to fool Mother Nature!” The idea was that margarine (which was a new invention in the late 19th century) was healthier than the natural spread, butter—although the trans fat in it makes the comparison a bit more complicated.

White also says something interesting about unsanitary homes, claiming that children who live in them become more resistant to certain diseases like polio than the kids who grow up in clean homes. The polio scourge raised its ugly head recently in New York, which renewed the recommendation by the Centers for Disease Control recently that people who didn’t get vaccinated against polio should get vaccinated—regardless of how dirty your home was.

And then there is the artificial intelligence (AI) technology. I wonder what E.B. White would say about that? AI can improve detection of some diseases and assist in medical research. On the other hand, AI can still make mistakes and it needs human surveillance.

I read you can sometimes use loud noises to keep raccoons out of your yard. For example, you could try recordings of blue jays.

What Do the Personal Brain Specialists Recommend?

Dr. George Dawson’s post “The Freak Show” reminded me of how coarse and cruel we can be to each other, even when we’re not aware of it. Maybe I should say especially when we’re not aware of it. Dr. Dawson emphasizes the importance of the empathic approach. In the same way, Dr. Moffic in the articles in his column, “Psychiatric Views on the News” draws attention to the need for a socially responsible way for us to relate to one another. The Goodenough Psychiatrist blog expresses poignantly the emotional and courageously humanistic ways we can (or could) relate to each other. Dr. Ronald Pies has highlighted the importance of how human interaction with artificial intelligence must help us find a way to treat each other with respect, and teach that to AI because AI learns from humans.

This reminds me of a character in the book “The Hitchhiker’s Guide to the Galaxy” by Douglas Adams. The character is named Gag Halfrunt who is the personal brain specialist for a couple of other characters. In fact, he’s a psychiatrist who orders the destruction of planet Earth, which is a sort of computer program designed to give us the ultimate question to the ultimate answer for life, the universe, and everything. The reason Gag Halfrunt wants to destroy Earth is, if the ultimate question is revealed, it would put psychiatrists out of work because then everyone would be happy.

Just as a personal comment, I’m pretty unhappy with the author’s position on psychiatrists in general, which tends to overemphasize our importance. And I’m pretty sure psychiatrists are not that important, having been employed as one for many years and seeing how much impact of any kind we have. We can’t make people more or less happy at all.

In fact, Adams also takes a shot at philosophers, who are also upset at being thrown out of work should the ultimate question to the ultimate answer be revealed (the ultimate answer, by the way, is 42 if you’re interested).

Giving psychiatrists and philosophers and anyone else who might have a stake in taking credit for making people happy is nonsense. We all bear responsibility for ourselves. You can argue about whether or not we have any responsibility for each other.

Rather than arguing about it, we could give something else a try. We could try a mindfulness approach like the Lovingkindness Meditation. I’m not an authority or expert on this, but you can check it out on the Palouse Mindfulness website, the link to which is in the menu on my blog. You can find the link to the Lovingkindness Meditation there.

There is no guarantee the Lovingkindness Meditation will make you or anyone else happy. But it doesn’t hurt anything to try it and, as far as I know, Gag Halfrunt is not opposed to it.