Stesheni kumi na moja

I'm a bit late to the "social science bloggers love Station Eleven" party. Chris Blattman put it in his 2014 favorite novels list, and Jay Ulfelder shared a nice excerpt. I loved it too, so I'll try to add something new. Station Eleven is a novel about what happens after - and just before, and during - a flu pandemic wipes out 99% of the human population. The survivors refer to that event as the Collapse, and mostly avoid talking about or thinking about the immediate aftermath when all was a fight for survival. But Station Eleven is not just derivative post-apocalyptica. The book avoids a garish focus on the period just after the Collapse, but instead focuses on the more relatable period just as things are beginning to unravel, and much later, as bands of survivors who made it through the roughest bits are starting to rebuild. The main characters are a band of musicians and thespians who are trying to retain some of the cultural heritage and pass it on to the next generation, who have no memory of the world before the Collapse.

It's also a novel about loss, both personal and societal. One of my favorite passages:

...No more ball games played out under floodlights. No more porch lights with moths fluttering on summer nights. No more trains running under the surface of cities on the dazzling power of the electric third rail. No more cities.… No more Internet. No more social media, no more scrolling through the litanies of dreams and nervous hopes and photographs of lunches, cries for help and expressions of contentment and relationship-status updates with heart icons whole or broken, plans to meet up later, pleas, complaints, desires, pictures of babies dressed as bears or peppers for Halloween. No more reading and commenting on the lives of others, and in so doing, feeling slightly less alone in the room. No more avatars.

Since I was reading this novel while traveling for work in Tanzania and Zimbabwe and Liberia, I was struck by its focus on Canada and the US. Nothing wrong with this: the author is Canadian* and the presumed audience is probably North American. But I kept wondering what the Collapse would have been like elsewhere. It was global, but would it have been equally catastrophic elsewhere? Urban centers like Manhattan are ludicrously unworkable in the absence of the electricity and cars and subways and other bits of the massive, distributed, and - to casual eyes - largely invisible infrastructure working to constantly feed them with supplies and people and information.

The novel implies that these urban centers fared worse, and focuses on suburbia and rural areas, where survivors re-learn how to farm, how to make things for themselves. We see nothing of the global "periphery" where the fall from wealth might be less great, where the collective psychological trauma of losing 99 out of 100 people might dominate the loss of technology. Of course, the periphery is defined by the observer and the writer, and isn't the periphery at all to those who live in it. Maybe things would fare better, or maybe not.

Imagine the same novel, but set in Tanzania, or some other country where the majority of people are small-holder subsistence farmers. Maybe it would use the device of following two relatives, one living 'upcountry' or in 'the village' (i.e., poor rural parts) and the other living in Dar es Salaam. Relationships are established in an early chapter when the successful urban relative visits the village, or the rural relative visits the big city, and both marvel at their differences.

Then the flu hits, and things start to break down. Narrative chapters are intersperse with transcripts of SMS (text message) exchanges, demands for mPesa transfers, the realization that money doesn't matter anymore, and finally the realization that the networks aren't getting anything through anymore. Some city dwellers flee for the countryside but find themselves shunned as bearers of contagion. The urban protagonist makes her way, over the course of months or years, to the rural area where her relative once lived, hoping to find things are better there. Her belief that the village will be the same mirrors the readers' belief - and common trope in writing about developing countries - that subsistence farmers today somehow live just as they did centuries or millenia ago. Bullshit, of course.

As the urbanite nears the village, her encounters reveal all the ways the modern fabric of village life was related to society and technology and has likewise broken down with the Collapse. Perhaps the power vacuum set off struggles amongst survivors and led to some new social order, where none of her skills are that useful. Nearing the village, she finds that the rural relative is now leader, revealing his situation has been reversed by the Collapse just as the once successful urbanite finds her way into his village with her last shilling.

Maybe this novel already exists. Or something else using the post-apocalyptic form to explore somewhere that's not Canada or the US or Europe and not reliant on mechanized agriculture. Pointers, please, as I'd love to read it.

*originally I wrote the author was American. Oops. Apologies, Canada!

The greatest country in the world

I've been in Ethiopia for six and a half months, and in that time span I have twice found myself explaining the United States' gun culture, lack of reasonable gun control laws, and gun-related political sensitivities to my colleagues and friends in the wake of a horrific mass shooting. When bad things happen in the US -- especially if they're related to some of our national moral failings that grate on me the most, e.g. guns, health care, and militarism -- I feel a sense of personal moral culpability, much stronger when I'm living in the US. I think having to explain how terrible and terribly preventable things could happen in my society, while living somewhere else, makes me feel this way. (This is by no means because people make me feel this way; folks often go out of their way to reassure me that they don't see me as synonymous with such things.)

I think that this enhanced feeling of responsibility is actually a good thing. Why? If being abroad sometimes puts the absurdity of situations at home into starker relief, maybe it will reinforce a drive to change. All Americans should feel some level of culpability for mass shootings, because we have collectively allowed a political system driven by gun fanatics,  a media culture unintentionally but consistently glorifying mass murderers, and a horribly deficient mental health system to persist, when their persistence has such appalling consequences.

After the Colorado movie theater shooting I told colleagues here that nothing much would happen, and sadly I was right. This time I said that maybe -- just maybe -- the combination of the timing (immediately post-election) and the fact that the victims were schoolchildren will result in somewhat tighter gun laws. But, attention spans are short so action would need to be taken soon. Hopefully the fact that the WhiteHouse.gov petition on gun control already has 138,000 signatures (making it the most popular petition in the history of the website) indicates that something could well be driven through. Even if that's the case, anything that could be passed now will be just the start and it will be long hard slog to see systematic changes.

As Andrew Gelman notes here, we are all part of the problem to some extent: "It’s a bit sobering, when lamenting problems with the media, to realize that we are the media too." He's talking about bloggers, but I think it extends further: every one of us that talks about gun control in the wake of a mass shooting but quickly lets it slip down our conversational and political priorities once the event fades from memory is part of the problem. I'm making a note to myself to write further about gun control and the epidemiology of violence in the future -- not just today -- because I think that entrenched problems require a conscious choice to break the cycle. In the meantime, Harvard School of Public Health provides some good places to start.

"As it had to fail"

My favorite line from the Anti-Politics Machine is a throwaway. The author, James Ferguson, an anthropologist, describes a World Bank agricultural development program in Lesotho, and also -- through that lens -- ends up describing development programs more generally. At one point he notes that the program failed "as it had to fail" -- not really due to bad intentions, or to lack of technical expertise, or lack of funds -- but because failure was written into the program from the beginning. Depressing? Yes, but valuable. I read in part because Chris Blattman keeps plugging it, and then shortly before leaving for Ethiopia I saw that a friend had a copy I could borrow. Somehow it didn't make it onto reading lists for any of my classes for either of my degrees, though it should be required for pretty much anyone wanting to work in another culture (or, for that matter, trying to foment change in your own). Here's Blattman's description:

People’s main assets [in Lesotho] — cattle — were dying in downturns for lack of a market to sell them on. Households on hard times couldn’t turn their cattle into cash for school fees and food. Unfortunately, the cure turned out to be worse than the disease.

It turns out that cattle were attractive investments precisely because they were hard to liquidate. With most men working away from home in South Africa, buying cattle was the best way to keep the family saving rather than spending. They were a means for men to wield power over their families from afar.

Ferguson’s point was that development organizations attempt to be apolitical at their own risk. What’s more, he argued that they are structured to remain ignorant of the historical, political and cultural context in which they operate.

And here's a brief note from Foreign Affairs:

 The book comes to two main conclusions. First is that the distinctive discourse and conceptual apparatus of development experts, although good for keeping development agencies in business, screen out and ignore most of the political and historical facts that actually explain Third World poverty-since these realities suggest that little can be accomplished by apolitical "development" interventions. Second, although enormous schemes like Thaba-Tseka generally fail to achieve their planned goals, they do have the major unplanned effect of strengthening and expanding the power of politically self-serving state bureaucracies. Particularly good is the discussion of the "bovine mystique," in which the author contrasts development experts' misinterpretation of "traditional" attitudes toward uneconomic livestock with the complex calculus of gender, cash and power in the rural Lesotho family.

The reality was that Lesotho was not really an idyllically-rural-but-poor agricultural economy, but rather a labor reserve more or less set up by and controlled by apartheid South Africa. The gulf between the actual political situation and the situation as envisioned by the World Bank -- where the main problems were lack of markets and technical solutions -- at the time was enormous. This lets Ferguson have a lot of fun showing the absurdities of Bank reports from the era, and once you realize what's going on it's quite frustrating to read how the programs turned out, and to wonder how no one saw it coming.

This contrast between rhetoric and reality is the book's greatest strength: because the situation is absurd, it illustrates Ferguson's points very well, that aid is inherently political, and that projects that ignore that reality have their future failure baked in from the start. But that contrast is a weakness too, as because the situation is extreme you're left wondering just how representative the case of Lesotho really was (or is). The 1970s-80s era World Bank certainly makes a great buffoon (if not quite a villain) in the story, and one wonders if things aren't at least a bit better today.

Either way, this is one of the best books on development I've read, as I find myself mentally referring to it on a regular basis. Is the rhetoric I'm reading (or writing) really how it is? Is that technical, apolitical sounding intervention really going to work? It's made me think more critically about the role outside groups -- even seemingly benevolent, apolitical ones -- have on local politics. On the other hand, the Anti-Politics Machine does read a bit like it was adapted from an anthropology dissertation (it was); I wish it could get a new edition with more editing to make it more presentable. And a less ugly cover. But that's no excuse -- if you want to work in development or international health or any related field, it should be high on your reading list.

Obesity pessimism

I posted before on the massive increase in obesity in the US over the last couple decades, trying to understand the why of the phenomenal change for the worse. Seriously, take another look at those maps. A while back Matt Steinglass wrote a depressing piece in The Economist on the likelihood of the US turning this trend around:

I very much doubt America is going to do anything, as a matter of public health policy, that has any appreciable effect on obesity rates in the next couple of decades. It's not that it's impossible for governments to hold down obesity; France, which had rapidly rising childhood obesity early this century, instituted an aggressive set of public-health interventions including school-based food and exercise shifts, nurse assessments of overweight kids, visits to families where overweight kids were identified, and so forth. Their childhood obesity rates stabilised at a fraction of America's. The problem isn't that it's not possible; rather, it's that America is incapable of doing it.

America's national governing ideology is based almost entirely on the assertion of negative rights, with a few exceptions for positive rights and public goods such as universal elementary education, national defence and highways. But it's become increasingly clear over the past decade that the country simply doesn't have the political vocabulary that would allow it to institute effective national programmes to improve eating and exercise habits or culture. A country that can't think of a vision of public life beyond freedom of individual choice, including the individual choice to watch TV and eat a Big Mac, is not going to be able to craft public policies that encourage people to exercise and eat right. We're the fattest country on earth because that's what our political philosophy leads to. We ought to incorporate that into the way we see ourselves; it's certainly the way other countries see us.

On the other hand, it's notable that states where the public has a somewhat broader conception of the public interest, as in the north-east and west, tend to have lower obesity rates.

This reminds me that a classmate asked me a while back about my impression of Michelle Obama's Let's Move campaign. I responded that my impression is positive, and that every little bit helps... but that the scale of the problem is so vast that I find it hard seeing any real, measurable impact from a program like Let's Move. To really turn obesity around we'd need a major rethinking of huge swathes of social and political reality: our massive subsidization of unhealthy foods over healthy ones (through a number of indirect mechanisms), our massive subsidization of unhealthy lifestyles by supporting cars and suburbanization rather than walking and urban density, and so on and so forth. And, as Steinglass notes, the places with the greatest obesity rates are the least likely to implement such change.

On efficiency

A friend of mine who is working in public health in a South American country writes great email updates about the specifics of her work, which often end up illustrating something universal. I thought this note -- about the latest delays in accomplishing a relatively simple task that has taken weeks when it should have taken hours, or maybe half a day at most -- nicely illustrates how much time can be wasted through the accumulation of minor inconveniences or annoyances. No single act is backed by poor intentions, but the final effect is that no one can get much done. Shared with permission:

Today’s visit to the Municipality of [...] was particularly silly.

It went like this: I arrived at 10:45am and went to the Budget Office. The Budget Office sent me to Provisions Office, which sent me back to Budget Office, which sent me backed to Provisions Office accompanied by a secretary.

The Provisions Office sent us to the Head Administration Office, which sent us to a different Administration office on a different floor, which sent us back down to the Provisions Office, which sent us back up to the Administration Office, which sent us back down to the Provisions Office. This all took an hour.

Then, I waited in the Provisions Office while they looked for the resolution that was supposed to be attached to my project, and they all blamed a different secretary in the office for why they couldn’t find it. After an hour of waiting in the Provisions Office, I got tired and hungry and had to pee, so I made up an excuse for why I had to leave and I asked when I should come back and where I should go.

They told me to come back in two days, which is what they always tell me. So, I’ll go back in two days.

Mystification

I read a bunch of articles for my public health coursework, but one that has stuck in my mind and thus been on my things-t0-blog-about list for some time is "Mystification of a simple solution: Oral rehydration therapy in Northeast Brazil" by Marilyn Nations and L.A. Rebhun. Unfortunately I can't find an ungated PDF for it anywhere (aside: how absurd is it that it costs $36 USD to access one article that was published in 1988??) so you can only access it here for free if you have access through a university, etc. The article describes the relatively simple diarrhea treatment, ORT (oral rehydration therapy), as well as how physicians in a rural community in Brazil managed to reclaim this simply procedure and turn it into a highly specialized medical procedure that only they could deliver. One thing I like is that the article has (for an academic piece) a great narrative: you learn how great ORT is ... then about the ridiculous ritualization / mystification of a simple process that keeps it out of reach of those who need it most ... then about the authors' proposed solution ... and finally a twist where you realize the solution has some (though not certainly not all) of the same problems. Here's one of their case studies of how doctors mystified ORT:

Benedita, a 7-month-old girl with explosive, watery diarrhea of 5 days duration, weakness, and marked dehydration, was brought by her mother to a government hospital emergency room. White-garbed nurses and physicians examined the baby and began ORT. They meticulously labeled a sterilized baby bottle with millimeter measurements, weighed the child every lSmin, mixed the chemical packet with clean water, gave the predetermined amount of ORT, and recorded all results on a chart, checking exact times with a wristwatch. The routine continued for over 3 hr, during which little was said to the mother, who waited passively on a wooden bench. Later interviews with the mother revealed that she believed the child’s diarrhea was due to evil eye, and had previously consulted 3 [traditional healers]. Despite her more than 5 hr at the clinic, the mother did not know how to mix the ORT packet herself. When asked if she thought she or a [traditional healer] could mix ORT at home, she replied, “Oh no, we could never do that. It’s so complicated! I don’t even know how to read or write and. I don’t even own a wristwatch!”

They then discuss how they trained a broader group of providers (including the traditional healers) to administer the ORT themselves. But the traditional healers end up ritualizing the treatment as much or more than the physicians did:

... Dona Geralda cradled the leaves carefully so as not to spill their evil content as she carried them to an open window and flung them out. The evil forces causing diarrhea are believed to disappear with the leaves, leaving the child’s body ‘clean’ and disease-free...Turning to the small altar in a comer of the healing room, Dona Geralda offered the ORS 'holy water' to the images of St Francisco and the folk hero Padre Cicero there.

There's more to both sides of the ritualization in the body of the article, and the similarities are striking. I'm not sure the authors intended to make it this way (and this likely speaks more to my own priors or prejudices), but the traditional healers' ritualization sounds quite suspicious to me, full of superstition and empty of understanding of how ORT works, while at the same time the physicians' ritualization, as unnecessary as it is, is comfortingly scientific. The crucial difference though is that the physicians' ritualization seriously impedes access to care, while the healers' process does not -- in fact, it even makes care more accessible:

Clearly, our program did not de-ritualize ORTdelivery; the TH’s administration methods are highly ritualized. The ceremony with the leaves, the prayer,the offering of the ORS-tea to the saints, are all medically unnecessary to ensure the efficacy of ORT.They neither add to nor detract from its technologial effectiveness. But in this case, the ritualization, insteadof discouraging the mother from using ORT and mystifying her about its ease of preparation andadministration, encourages her to participate actively in her child’s cure.

Neat.

Weekend reading: race in America

Ta-Nehisi Coates is one of my favorite writers -- I highly recommend his memoir, The Beautiful Struggle, about growing up in Baltimore. His writing has a riveting flow even on the most innocuous subjects, so when he writes about something serious it really kills. He has a long and excellent cover story in The Atlantic this month on Barack Obama: "Fear of a Black President". It's the best thing I've read this month:

What black people are experiencing right now is a kind of privilege previously withheld—seeing our most sacred cultural practices and tropes validated in the world’s highest office. Throughout the whole of American history, this kind of cultural power was wielded solely by whites, and with such ubiquity that it was not even commented upon. The expansion of this cultural power beyond the private province of whites has been a tremendous advance for black America. Conversely, for those who’ve long treasured white exclusivity, the existence of a President Barack Obama is discombobulating, even terrifying. For as surely as the iconic picture of the young black boy reaching out to touch the president’s curly hair sends one message to black America, it sends another to those who have enjoyed the power of whiteness.

Read it.

Phantom data

How did Phantom of the Opera get to 10,000 (!) Broadway performances? Patrick Healy reports (NYT):

From years of detailed audience surveys, the producers and creators of "Phantom" have honed the ways to maximize its appeal, whether emphasizing the show’s love story in advertising or offering sharp discounts so audience members will return. More than 40 percent of "Phantom" patrons have seen it at least once before, and a majority of "Phantom" audiences in 2011 saw no other Broadway show that year. About 68 percent were women, and nearly 60 percent were tourists.

"Based on all our data, we’re able to predict, for virtually each week of the year, what the demand for seats will be, what types of people will be coming and how to price the seats," said Alan Wasser, the production’s general manager.

Values and humility in economics

Greg Mankiw is a Harvard economist, former chairman of President Bush's Council of Economic Advisers, and currently an advisor to the Romney presidential campaign. He teaches a large introductory economics course at Harvard and writes both the widely used Principles of Economics and a blog that displays the same crisp, eminently-readable prose as his textbook. In a show of solidarity with the Occupy Boston movement, some of his students walked out of that class earlier this year. Much has been written about the walkout  (Update: here's the students' open letter and a response that outlines why walking out of this particular class isn't the most informed move.) Still I wanted to highlight Mankiw's column in yesterday's New York Times, titled  "Know what you're protesting." I share some of his reaction:

But my second reaction was sadness at how poorly informed the Harvard protesters seemed to be. As with much of the Occupy movement across the country, their complaints seemed to me to be a grab bag of anti-establishment platitudes without much hard-headed analysis or clear policy prescriptions. Ironically, the topic of the lecture that the protesters chose to boycott was economic inequality, including a discussion of recent trends and their causes.

Fair. But later in the piece Mankiw says something that really rankles (emphasis added):

I don’t claim to be an economist of Paul Samuelson’s stature. (Probably no one alive can.) But like him, I have written a textbook that has introduced millions of students to the mainstream economics of today. If my profession is slanted toward any particular world view, I am as guilty as anyone for perpetuating the problem.

Yet, like most economists, I don’t view the study of economics as laden with ideology. Most of us agree with Keynes, who said: “The theory of economics does not furnish a body of settled conclusions immediately applicable to policy. It is a method rather than a doctrine, an apparatus of the mind, a technique for thinking, which helps the possessor to draw correct conclusions.”

That is not to say that economists understand everything. The recent financial crisis, economic downturn and meager recovery are vivid reminders that we still have much to learn. Widening economic inequality is a real and troubling phenomenon, albeit one without an obvious explanation or easy solution. A prerequisite for being a good economist is an ample dose of humility.

I'll preface my reaction to this with my own dose of humility: my studies at the Woodrow Wilson School this semester are my first exposure to serious economics, and I'm realizing every day that I have ever more to learn. I think it can be helpful to approach a field with fresh eyes so I hope my thoughts here won't be entirely discredited by my fresh arrival to the dismal science.

That said, No! This seems like denial, pure and simple. My impression is that one of the areas where economists have most often failed to display humility is when thinking of and talking about the interaction of their values and methodologies.  Yes, economics has epistemological limitations, but these are equaled or surpassed by its axiological limitations, and may be more consequential because -- unlike with the more readily acknowledged methodological shortcomings -- economists themselves don't always make clear the values implicit in their worldviews. I think economists and those who are impacted by their views (ie, everyone else) would benefit from clearer statements of how values impact economics.

Mankiw's textbook does very briefly address the political philosophies underlying views on income redistribution, from utilitarianism to liberalism to libertarianism (pages 442-3 in the 5th edition). But this is halfway through the text and only in the context of the chapter on "income inequality and poverty." In reality, your views on maximizing utility for all versus (at another extreme) only caring about how policies affect the poorest have an impact on pretty much every piece of welfare economics. Here from what I can tell Mankiw is quite mainstream -- when considering the effects of a particular policy using the tools of welfare economics, the underlying philosophical preferences are almost always assumed. The conclusions of those studies are then touted as positive statements ("Policy X is bad for the economy") when that may or may not be true, depending on whether you share the same fundamental normative roots.

Prof. Mankiw spoke at Princeton on October 20 (you can view the lecture here) and it was a well-presented talk. His remarks were broad and intelligent, though maybe a bit constrained by the fact that he is associated with a presidential campaign and thus can't rock the boat too much (even with a disclaimer that his remarks were his own). In that talk Mankiw similarly began by emphasizing the need for economists to show greater humility in light of recent failures; he then proceeded to discuss a good number of specific policy recommendations with quite a bit of confidence. My biggest question coming out of the lecture was how to square the Mankiw who calls for greater humility from economists with the Mankiw who makes policy prescriptions. If we don't know with certainty what the impacts of particular policies will be or how to do more than tweak the performance or recovery of an economy, why not start with the policies least likely to do harm to the most vulnerable members of society? That would generally be my preference, growing out of my own nascent political philosophy.

In his textbook (5th edition page 35) Mankiw evenly explicitly notes that "Economists give conflicting advice sometimes because they have different values." This is true, and if anything it is under-emphasized. Elsewhere Mankiw has been more direct, contrasting the philosophies of Nozick and Rawls and noting how those might result in very different policy prescriptions on taxation. Mankiw ends up closer to Nozick and so it's no surprise that his policy prescriptions are for lower corporate taxes (re-emphasized in the Princeton talk as one of the things on which he very strongly agrees with Romney).

How is this anything but a heavy dose of ideology being injected into economics? How can we square this with the Mankiw who says he doesn't see the study of economics as "laden with ideology"? Part of the problem is that there are figures such as Mankiw who are concurrently serious researchers on scientific questions within economics and proponents of normative preferences in the political sphere. Can the outside observer tell when an economist is being one and not the other? Can economists realize this in themselves? When you couch these preferences in the language of economics without making the underlying values explicit, it's hard to believe that the field is not laden with ideology. To the extent that he doesn't even recognize how these value statements pervade the field, Mankiw is -- in his own words -- as guilty as anyone for perpetuating the problem.

Advice not to trust

Yesterday morning I came across the gentleman pictured below in New York's Union Square. I've been meaning to take more pictures of "things you only see in NYC" -- a category which generally consists of extremes of pets and fashion -- but I think this deserves its own post:

He was either selling or trying to give away copies of a book titled Uropathy: The Most Powerful Holistic Therapy by one Martin Lara. Since the review of Uropathy on Amazon.com is from the Village Voice, I assume that the evangelist was either Lara or one of his disciples. The review:

Vitamin Pee! Urine is a natural remedy, so raise a glass! That's what alternative therapist Martin Lara wants everyone to do. In his Uropathy: The Most Powerful Holistic Therapy, pee's the ultimate cure-all. Gagging aside, it's not so unconventional: former Indian prime minister Morarji Desai guzzled ounces each morning, observing an ancient Hindu practice. Lara learned about it 11 years ago, when the self-taught therapist he's never studied traditional medicine became disenchanted with science's inability to cure his ailments. Since then he's lectured to thousands. Not any pee will do it must be your own, which Lara says is a nontoxic biofeedback stimulator that boosts immunity by activating the lymphatic system, thus restoring the body to an internally balanced state of health. Dosages range from a few drops of Lara's "Ultimate Universal Remedy" an elixir of water, urine, and white rum to several ounces for serious conditions like cancer, dysentery, or Alzheimer's. Of course, not everyone is ready for this leap of faith. On his Web site Lara argues against obsessing over taste and smell: "Urine is a sample of what is flowing through your veins and repulsive urine should be a motivation to improve the internal conditions, rather than an excuse for not using Uropathy." -- The Village Voice

He was quite earnest. I didn't engage him in conversation because two other passersby were already talking to him. A girl was explaining that urine is what your kidneys decide your body doesn't need. But she wasn't just explaining it, she was disgusted, and angry. His response was similar to a major defense of homeopathic medicine, that the "toxin makes the remedy" (or something like that). The girl got exasperated and left with her friend, and you could hear her ranting as she walked away. I chose not to continue the conversation because I was on my way to meet friends, but in hindsight I wish I had stayed because there are some questions I don't have the answers to:

  • How often does he talk publicly about this? What does he do for a living? Ie, is this it, or does he have a boring day job and this is his true passion?
  • Does he feel that drinking urine has cured whatever health problems that he originally sought help for? (I would guess so.)
  • Why does he think drinking urine has not been more widely adopted?
  • Does he think that his approach (especially the t-shirt and public 'evangelism') is the most effective way to spread his message? I would guess he enjoys the attention on some level, but also promotes his beliefs through other, more effective channels.
  • What are the typical reactions he gets? How many people stay and talk with him at length, and of those how many eventually adopt his therapy?
  • I'd like to talk a bit about Western medicine. Not necessarily the biomedical interventions we favor, but the scientific process by which we (ideally) establish that a practice is beneficial. Does he think urine therapy could be tested by a randomized controlled trial? If not, why not?
  • If the passerby had stuck around: why did she choose to argue with him? Did she really think that a guy wearing a bright yellow "Drink Urine" t-shirt in Union Square was likely to change his mind? And for the man himself: how common is her argumentative reaction?

I think a natural first reaction to something this out of the ordinary is laughter or mockery, or the assumption that he's clinically insane. On further thought, what he believes -- in factual support and argumentative method, if not in substance -- isn't that different from much of alternative medicine, and his methods have been widely adopted by many mainstream religions and social movements as well as less-respected 'fringe' beliefs. If those are both true, why isn't his belief more widely adopted? Is it just too taboo?

I think I could have learned valuable things about the mixture of reason and emotion and belief that guide human choices if I had stayed and asked some of these questions. I don't think I'll change his mind, but I plan to look for him if I'm ever strolling through Union Square on a weekend again.

(Note: evidently "urine therapy" is a thing. The Wikipedia page starts with "In alternative medicine..." -- never a good sign.)

This is all very meta

One of the best things about XKCD is that the mouse-over text (simply rendered using the title attribute in the <img> HTML tag) will almost always give you a second laugh or an interesting thought. This comic isn't his best, but it has this great mouse-over text:

Wikipedia trivia: if you take any article, click on the first link in the article text not in parentheses or italics, and then repeat, you will eventually end up at "Philosophy."

Naturally, I went to Wikipedia and clicked Random Article, which gave me the Bradford-Union Street Historic District in Plymouth, Massachusetts. The links followed in order were:

  1. Bradford-Union Street Historic District
  2. Plymouth, Massachusetts
  3. Plymouth County, Massachusetts
  4. County (United States)
  5. U.S. state
  6. Federated state
  7. Constitution
  8. State (polity)
  9. Institution
  10. Social structure
  11. Social sciences
  12. List of academic disciplines
  13. Academia
  14. Organism
  15. Community
  16. Interaction
  17. Causality
  18. Event
  19. Observable
  20. Physics
  21. Natural science
  22. Science
  23. Knowledge
  24. Fact
  25. Information
  26. Sequence
  27. Mathematics
  28. Quantity
  29. Property (philosophy)
  30. Modern philosophy
  31. Philosophy

According to the Wikipedia page on the phenomenon (of course there's one, which also of course already referenced the XKCD mention) the longest known link chain is just 35 links back to philosophy, so my random find is way up there.

It's interesting to observe how the selections work back from entries on specific, literal things to broader categories.  The selections go from place to categories of place to knowledge to a meta-description of what knowledge. I imagine that if you grouped Wikipedia entries by category you'd see similar chains leading back to philosophy. For instance, I think all place names should follow a similar trajectory to my example.

I also wonder what the distribution would look like if you took a list of all entries on Wikipedia and graphed them by this philosophy index number. I think all articles listed together would be messy, but a list of articles weighted by web traffic would yield a a logarithmic distribution with the bulk of the entries being people, places, or things that are far from philosophy but eventually link there. Also, the distribution of any single category (places in the United States, for example) should be more similar to a normal distribution, and the narrower the category is the more true that would be. Now if someone will just build a computer program to test my hypothesis.

Everyday science

David Brooks highlights a discussion "on what scientific concepts everyone’s cognitive toolbox should hold" on Edge.org. Brooks' first highlight is this:

Clay Shirkey nominates the Pareto Principle. We have the idea in our heads that most distributions fall along a bell curve (most people are in the middle). But this is not how the world is organized in sphere after sphere. The top 1 percent of the population control 35 percent of the wealth. The top two percent of Twitter users send 60 percent of the messages. The top 20 percent of workers in any company will produce a disproportionate share of the value. Shirkey points out that these distributions are regarded as anomalies. They are not.

The full Edge.org symposium is here. I'm not sure these individual insights are science or even scientific concepts, as much as "insights on thinking that some scientists have found useful" -- but still interesting. Here's Richard Dawkins on the Double-Blind Control Experiment (emphasis added):

....Why do half of all Americans believe in ghosts, three quarters believe in angels, a third believe in astrology, three quarters believe in Hell? Why do a quarter of all Americans and believe that the President of the United States was born outside the country and is therefore ineligible to be President? Why do more than 40 percent of Americans think the universe began after the domestication of the dog?

Let's not give the defeatist answer and blame it all on stupidity. That's probably part of the story, but let's be optimistic and concentrate on something remediable: lack of training in how to think critically, and how to discount personal opinion, prejudice and anecdote, in favour of evidence. I believe that the double-blind control experiment does double duty. It is more than just an excellent research tool. It also has educational, didactic value in teaching people how to think critically. My thesis is that you needn't actually do double-blind control experiments in order to experience an improvement in your cognitive toolkit. You only need to understand the principle, grasp why it is necessary, and revel in its elegance.

If all schools taught their pupils how to do a double-blind control experiment, our cognitive toolkits would be improved in the following ways:

1. We would learn not to generalise from anecdotes.

2. We would learn how to assess the likelihood that an apparently important effect might have happened by chance alone. 3. We would learn how extremely difficult it is to eliminate subjective bias, and that subjective bias does not imply dishonesty or venality of any kind. This lesson goes deeper. It has the salutary effect of undermining respect for authority, and respect for personal opinion....

Review: "The Panic Virus"

Review of The Panic Virus, by Seth Mnookin. Simon & Schuster Jan 2011 (Available at Amazon) [Disclosure: I got a free copy of the Panic Virus from a friend who has a friend that works at the publisher -- I wasn't given the copy specifically to write a review, but it's still probably better to disclose I didn't pay for the book.]

Seth Mnookin's The Panic Virus starts and ends with two stories of parents whose seemingly normal children come down with a serious illness. He describes their children before the episodes, and then their dread as they go downhill, are hospitalized, and fight for their lives. These stories intentionally parallel the narrative of the vaccines-cause-autism movement -- "our child was normal, then he got the vaccine, and then he got autism, so it must have been the vaccine." However, Mnookin's carefully chosen stories don't support the anti-vaccine movement; they do just the opposite and make you feel heartsick for the children affected by vaccine-preventable diseases.

Mnookin knows how to tug on heart strings, and how to get his readers riled up, so it's a good thing that he comes down strongly pro-vaccine. His case studies are selected for emotional value, and they illustrate how a thoughtfully written narrative can humanize statistics about disease outbreaks and the danger of the anti-vaccine movement. But I approve of Mnookin's tactics ultimately because his stories are true -- vaccines save lives, and much harm has been done by the spread of unfounded fear.

That said, Mnookin's book isn't at all a fearmongering tale of what will happen if you don't vaccinate your child -- the bookend stories are just that, and he could probably have included a few more narratives throughout without stretching it. For the most part his book is a sober narrative of a social movement that goes back to the earliest vaccines, but has only come to nationwide fruition with the rise of the Internet.

Mnookin chronicles the development of early vaccines, and, to his credit, spends a good deal of time on what was done badly by the scientists and advocates. The Cutter Incident is there,  along with the 1976 swine flu vaccine. Mnookin doesn't mince words in describing injuries that have been caused by vaccines, and at many times I found myself cringing and thinking "why weren't better systems in place earlier?" and "they really should have done more".

This willingness to confront unpleasant truths is a strong point for the Panic Virus, and it also gives Mnookin an opportunity to introduce the safety innovations that stemmed from each incident, all while setting the stage for the anti-vaccine movement. Another strength is that The Panic Virus also offers compelling humanizations of many of the parents of autistic children who have been involved in the anti-vaccine movement. Their despair at seeing their children suffer, their ostracization in a society where autism is not accepted, their occasionally callous treatment by physicians who have no easy answers to offer -- all of this makes it impossible not to sympathize with them.

For the most part, Mnookin doesn't present parents as the villains of his story. That role is reserved for shoddy physicians, scientists and pseuodoscientists, and most of all for journalists. Andrew Wakefield, Mark and David Geier, and journalist/author David Kirby all come in for harsh reckonings, along with many other "expert witnesses" for anti-vaccine lawsuits. This book left me quite depressed regarding the role of journalists and TV personalities in the whole fiasco. There has been so much bad reporting, and so little good.

While reading The Panic Virus, I kept thinking that its major shortcoming is a lingering uncertainty about its target audience. Is Mnookin writing for the uninitiated who want an introduction to where the anti-vaccine movement? Or is he writing a broadside for those already staunchly in the pro-vaccine community? There are sections where the rhetoric made me think it was the latter, while the majority of the book seems to be for those with little outside knowledge of vaccine science. Since Mnookin cautions so much against being led astray by charlatans who peddle fear with a thin veneer of scientific-sounding verbiage, I wish he had done a bit more to explain the science done in recent years on vaccine safety, thiomersal, MMR, and autism. I understand why an author writing a popular narrative would avoid trying to describe these subjects: they are incredibly complicated and divert the reader from the narrative. [Note that I haven't read Paul Offit's Autism's False Prophets, which I understand might have a bit more of that.] And it's not like good science writing is entirely missing from The Panic Virus. Some things are explained well, but overall there's just a bit too much deference to the authority of  science and scientists for my tastes, especially for a book intended for lay audiences. It's a good book, but not a great book.

I also wish Mnookin had provided a better counter-narrative in the second half of the book. Broadly speaking, the first half follows the development of vaccines and early vaccine injury scares (founded and unfounded), and the second half explores the rise of the anti-vaccine social movement. The second half is missing strong pro-vaccine characters, such as one or two scientists or policymakers who have been working to combat the anti-vaccine crowd. A lot of good research has been done to disprove fallacious claims, and to look for policy solutions aimed at decreasing opt-out rates on a state level, but none of that is here.

To date the anti-vaccine crowd has really won the narrative war: their message is simpler, and scarier, and has the added perk of being anti-establishment in appealing ways. The Panic Virus didn't give me much hope that that would change soon -- although the book itself is mostly a step in the right direction, combining a pro-science view with a few emotional narratives about vaccine-preventable diseases.

Our best hope is that eventually our scientific explanations of autism etiology will solidify a bit more, and coupled with much more demonstrably effective treatments, the snake oil appeal of the "cures" sold by the anti-vaccine movement will lose their charm. One theme of the Panic Virus is that the anti-vaccine movement arose because parents of autistic children weren't getting the sympathy, explanations, and help they needed. Many factors including a lack of understanding by doctors and communities, isolation, weak scientific explanations, and a lack of viable treatments all created a situation like a field of dry grass. When a powerful idea -- "vaccines cause autism" -- arose and was amplified by the echo chambers of Internet communities, it ripped through the dry field like a wildfire, sowing panic and fear. And the fire still hasn't been put out.

Arkansas

I arrived back in my hometown of Searcy, Arkansas. I haven't been back in a year -- I was living in DC from January through June, then traveling in Guatemala for the summer, and most recently living in Baltimore -- so it's good to be back. Searcy is ~18,000 people in central Arkansas, where the flat plains of the Mississippi Delta meet the first foothills of the Ozarks. The town once put up a billboard that proclaimed "Searcy, where thousands live as millions wish they could." It's also the home of Harding University, a conservative Christian university affiliated with the Church of Christ. My dad's been a professor at Harding for decades, so Searcy has always been home and likely always will be. Because I lived in the same small town for the first 23 years of my life, moving to Washington, DC in May of 2008 was a huge change. I had culture shock, but mostly in positive ways. When people would ask me if I liked DC, I would answer "Yes! But... I don't really have anything to compare it to, because it's my first city." I was never sure if I just liked DC, or what I actually liked was the urban environment in general. (My friends from NYC laugh because DC hardly feels urban to them.) Now that I've lived for several months in my second city, Baltimore, I can say that I do like it, but maybe not as much as DC.

One realization I've had over the last year is that I believe the divide between urban and rural America (to dichotomize it) is as significant, or maybe more significant than the divide between liberal and conservative, religious and secular. Most of my friends from high school and college are rural, Southern, politically conservative (though often apathetic), married (some with kids on the way), and quite religious -- of the evangelical Christian persuasion. No Jews, Muslims, Hindus, or Buddhists here. All of those adjectives (except married) once described me, but now I'm a politically liberal, secular, single young professional living in a big city. Yes, these traits are correlated: there are relatively few very religious young professionals living in big cities, there are relatively few hardcore secularists in rural Southern towns. But I think the urban/rural divide has a bigger impact on my daily experience, and on shaping my views and actions, than any of the others traits.

I think I've become a thoroughly urban creature, but the small town roots linger. I like so many things about cities: the density that leads to so many people, so many jobs and so much food, culture, entertainment and transportation all being close. But I also like the space and beauty of the small town. That's kind of a universal American narrative in a way; we all like to think we were born -- and remain rooted -- in small towns, even though the majority of us live in cities. I appreciate having grown up in a small town, and it's nice to be back for an occasional visit, but it's hard for me to imagine coming back here to live.

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A few random observations from my visit back to Arkansas so far:

1) Little Rock ain't that big, though it felt huge when I was growing up.

2) There's so much space around the roads and freeways, and within the towns. The space gives you a sense of openness, but it also means you have to drive everywhere.

3) I'm at my favorite coffeeshop in town (one of two, and the only other options for places to hang out are churches, a Hastings, and Wal-Mart) and the first person who walked in the door after me is wearing a t-shirt that says (only) "JESUS".

4) People are different. Strong Southern accents for one. A lot more baseball caps, and pickup trucks. Women are wearing more makeup. More overweight and obese people than you typically see on the streets in a city. Lots of white people, few of anything else.

5) Finally, today's lunch spot was the Flying Pig BBQ:

Culturomics

Several prominent scholars and the Google Books team have published a new paper that’s generating a lot of buzz (Google pun intended). The paper is in Science (available here) and (update) here's the abstract:

We constructed a corpus of digitized texts containing about 4% of all books ever printed. Analysis of this corpus enables us to investigate cultural trends quantitatively. We survey the vast terrain of "culturomics", focusing on linguistic and cultural phenomena that were reflected in the English language between 1800 and 2000. We show how this approach can provide insights about fields as diverse as lexicography, the evolution of grammar, collective memory, the adoption of technology, the pursuit of fame, censorship, and historical epidemiology. "Culturomics" extends the boundaries of rigorous quantitative inquiry to a wide array of new phenomena spanning the social sciences and the humanities.

It’s readable, thought-provoking, and touches on many fields of study, so I imagine it will be widely read and cited. Others have noted many of the highlights, so here are some brief bulleted thoughts:

  • The authors don’t explore the possible selection bias in their study. They note that the corpus of books they studied includes 4% of all published books. They specifically chose works that scanned better and have better metadata (author, date of publication, etc), so it seems quite likely that these works differ systematically from those that were scanned and not chosen, and differ even more from those not yet scanned. Will the conclusions hold up when new books are added? Since many of the results were based on random subsets of the books (or n-grams) they studied, will those results hold up when other scholars try and recreate them with separate randomly chosen subsets?
  • Speaking of metadata, I would love to see an analysis of social networks amongst authors and how that impacts word usage. If someone had a listing of, say, several hundred authors from one time period, and some measure of how well they knew each other, and combined that information with an analysis of their works, you might get some sense of how “original” various authors were, and whether originality is even important in becoming famous.
  • The authors are obviously going for a big splash and make several statements that are a bit provocative and likely to be quoted. It will be great to see these challenged and discussed in subsequent publications. One example that is quotable but may not be fully supported by the data they present: “We are forgetting our past faster with each passing year.” But is the frequency with which a year (their example is 1951) appears in books actually representative of collective forgetting?
  • I love the word plays. An example: “For instance, we found “found” (frequency: 5x10^-4) 200,000 times more often than we finded “finded.” In contrast, “dwelt” (frequency: 1x10^-5) dwelt in our data only 60 times as often as “dwelled” dwelled.”
  • The “n-grams” studied here (a collection of letters separate from others by spaces, which could be words, numbers, or typos) are too short for a study of copying and plagiarism, but similar approaches could yield insight into the commonality of copying or borrowing throughout history.