An early attempt at the anatomy pop-up book.
Almost every medical problem in some way boils down to a faulty feedback cycle. The simplest examples are endocrine diseases like diabetes, but the model can be applied to cancer cells, where cell division fails to switch off, and immune diseases, where antibodies mistakenly attack a person’s own tissue. A lot of economic or political debate falls into this same category of trying to fine-tune a system. For instance, using higher interest rates to reduce borrowing, or tougher sentences to reduce crime. Sometimes a system breaks down, failing to respond to feedback, like the heating systems on East Midlands Trains, which have fallen victim to the fashion for Hot Yoga.
Today, we learn that the Co-operative Group is ungovernable. That seems like an over-reaction, based on my experiences at the local Co-op supermarket. But when I think about it more carefully, the signs have been there for a while. Firstly, the car parking spaces went from impossibly narrow to Humvee size. Then there were the yellow sticker reductions – from £2.99 to £2.97. Not enough action there to clear a pile of steak pies facing a tight sell-by date. And when the pet food and pet product aisle became longer than the people food section (I accept there’s an overlap), we should have seen the writing on the wall. As well as the actual writing on the wall, which says ‘Laura H is Easy’.
During its flirtation with electricity, Psychology showed an interest in Biofeedback. This was an attempt to exert conscious control over a supposedly unconscious function, like blood pressure or heart rate. To learn this, a person needed a machine that would continually measure and reveal the reading concerned, and a system of relaxation. You can still buy biofeedback machines, but they are competing with tablets like beta blockers that don’t need plugging in. There could be a biofeedback revival once access to Functional MRI gets easier, for instance if you can get one on your android phone. For Apple you’d need the £25 adaptor.
I just got back some feedback on myself, from colleagues and patients, in the form of a so-called 360 degree assessment. We have to do one every five years. It seems like a slow process, but that’s about 20 times more frequent than the Cooperative Society. Alleged ‘crystal methodist’ and adult-content-consumer Paul Flowers, who chaired the co-op bank until last year, apparently did very well in aptitude and psychometric tests prior to his appointment in 2010. I suspect he’d have passed his 360 with flying colours too. Flowers was said for instance to have been excellent at engaging other people’s views. History may yet regard him as a great chairman. If he’d worked in the NHS he’d have been reinstated by now in a different branch at twice the salary.
To make feedback work we need to make the sampling frequency higher and the amplitude lower – a process that cuts in as soon as someone goes ‘off message’. Something more akin to the kind of feedback Jimi Hendrix achieved in his version of Star Spangled Banner. Imagine a system for instance that connects a politician or corporate giant to a brain imaging device. This could display his brain activity as he goes along, either to himself on an autocue, or to the audience, on a powerpoint display. Similar techniques have been applied to audience feedback during political speeches and even movies, using appreciation buttons.
Amazon apparently know which are the best pages in novels, based on how quickly they are read. Imagine what the great novelists could have done with this technology. Maybe it would have stopped characters suddenly dropping dead from a chill, or selling their wife at a market. Or making Laura H, suddenly, ‘difficult’.
It’s said that people who become habitual liars fail to notice whether they are even lying or not and even come to believe their own lies. Yet lie detectors have been around for decades. We already have a host of biological measurements such as EEG and skin conductance. We already have heads up interactive displays such as Google Glass. We already have portable electric shock devices. And somewhere in the world there is probably a large pile of testicle electrodes. Surely it won’t be long before someone connects up these technologies?