Iatrogenics OR When Doing Nothing Might Be the Best Alternative

i·at·ro·gen·ic /īˌatrəˈjenik/
Relating to illness caused by medical
examination or treatment.
— Google Definitions

I learned about the word iatrogenic when reading the book Writing to Learn by William Zinsser. The book, written in 1984, used the following passage as an example of medical writing. It talks about the link between medical prescriptions and opium addiction:

The medical profession has a long record of treating patients with useless or harmful relatives, often in clinical settings of complete mutual confidence. Iatrogenic diseases, complications and injury have been, in fact, common in the history of medicine. Only look upon addiction to certain dispensed drugs as one variation among the occasional effects of drug therapy.

I thought, “What an interesting new word!” as did Zinsser who also had to look it up. Then I came across Nicholas Nassim Taleb’s book Antifragile and found that he also fell in love with the word and expanded the idea into a class of issues that he called iatrogenics that went beyond medicine.

Iatrogenics are different from malpractice. Malpractice is doing an operation wrong. Iatrogenics is about doing a treatment correctly but it still having harmful side effects. When doctors ignore these side effects, they are far more likely to use all the tools at their disposal, like drugs or surgery,  whether or not it’s a good idea in the long term.

Let’s look at a recent example. The New York Times recently published Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used. While they have no medical benefit, putting in a stent makes both doctors and patients feel like they are doing something — that they are in control. And, from both points of view, “they seem to work,” even though they don’t work any better than a placebo.

So what’s the harm in that? Everyone’s happy aren’t they? Well no, they’re not. Doctors are performing an operation that does no better than a placebo so there’s no upside. However, there’s a significant downside in the complications from the operation.

Or take another example from a cruise I went on. Cruises offer Wi-Fi on the ship with tiny data limits (50MB for the whole trip). This is so small that just opening my phone will go over this limit. So a cruise director offered, “Give me your phone and I’ll make it work on the boat.” So I gave him the phone and he starting turning off these data hogging applications. A few months later I realized that one of the things he turned off was my iCloud backup. So the decision that the cruise director made, without telling me, was to give me very limited internet functionality on the boat while turning off my critical backup capability.

Another way of looking at iatrogenics is overvaluing of short term gains vs. long term risks. Take the example of Thalidomide, the poster child for drug overuse. Thalidomide was a sedative that was prescribed around 1960. While it helped women with morning sickness (a relatively minor problem) it caused tens of thousands of serious birth defects.

Indulge me with one more example. When George Washington had left the presidency he’d taken ill. His treatment was the standard for the day — bleeding. However, taking 5 to 7 pounds of blood from Washington’s body is now widely believed to accelerate his death. Bleeding stayed around for a while after that. It was still recommended by leading doctors as late as 1909.

Taleb tells one story of how this problem goes beyond medicine and into finance:

One day in 2003, Alex Berenson, a New York Times journalist, came into my office with the secret risk reports of Fannie Mae, given to him by a defector. It was the kind of report getting into the guts of the methodology for risk calculation that only an insider can see—Fannie Mae made its own risk calculations and disclosed what it wanted to whomever it wanted, the public or someone else. But only a defector could show us the guts to see how the risk was calculated.

We looked at the report: simply, a move upward in an economic variable led to massive losses, a move downward (in the opposite direction), to small profits. Further moves upward led to even larger additional losses and further moves downward to even smaller profits.

At its core, this was what caused the financial crisis. It was people adding more and more risk for smaller and smaller gains. They failed to look at the downside risks which kept growing larger and larger because they couldn’t imagine that they would occur.

Oddly enough, people don’t get in trouble for doing this. There’s a general sense that the people causing the problems were doing the best they could. The idea of “this is the best modern medicine (or modern finance) has — even if it doesn’t work” is well accepted. This is true even when the procedure is successful but the patient died or the economy collapsed.

A lot of this happens because the people making the decisions don’t have skin in the game. They get the upside benefits without being exposed to the downside risk. Taleb mentions that when Roman engineers built a bridge, they were required to sleep under it. Then, if the bridge fell down, the engineers would feel the pain (or death in this case) of the people who were hurt by the bridge.

So what can you do about all this? Try to get your doctor to put a little skin in the game. The next time you have an important medical decision to make, don’t ask your doctor for her medical opinion, ask her what she would do if she were in your place. This changes her mindset from a “disinterested professional” to someone with a personal stake in the game. You might get a very different answer.

Read this along with my story on back pain.

Prospect Theory in Real Life OR How Losing Feels Bad More than Winning Feels Good

I’m going to do a magic trick with a number. I’m going to take a number 1700 and by doing nothing more than raising and lowering it, I’m to show how the interpretation of the number can dramatically change.  Let’s see how that can happen and then I’ll explain how that works.

When my wife was pregnant with our second son, we had a test for Downs Syndrome. This test had three parts:

  1. A “Nucal” sonogram that measured some key ratios. This was the most important test and sets the baseline.
  2. A blood test that measured blood proteins in the mother.
  3. A test of “soft markers” that refined the initial estimates based on other sonogram features.

So we had the initial test. The chance of an issue was 1 in 1700.

“Is that good?” We asked the doctor. “It sounds good to us.”

“Well, in order to be certain, you’d need to have an amniocentesis which has a 1 in 400 chance of serious problems,” said the doctor.

So 1 in 1700 is pretty darn good. Then we got the blood test back. The numbers were even better. Our chances now were 1 in 6800. That was 4 times better than we’d had before!

So we’d finished 2 or the 3 tests. Then, things got tough. We went in for a sonogram and the technician stopped at one point and said, “I need to get the doctor.” That’s never a good sign.

When the doctor came back he said, “Well, your child had 2 soft markers for Downs.”

“What does that mean?” we asked.

“Well, it means that your child has a higher chance of having Downs Syndrome. Maybe you should see a genetic counselor,” he said.

“Before we go down that route, how does this really alter our chances?” we asked.

“Well, we’re not really sure. One soft marker could double the chance of having Downs Syndrome. So 2 soft markers might increase the chance by as much as 4 times but it’s probably less than that,” he said.

“So you’re saying our chances are back to 1 in 1700.”

“Yes.”

See. Magic.

How did this happen? Behavioral Economics has an answer. In contrast to typical economic theory, Behavioral Economics looks at situations and sees how people really react — not how they would react in theory. The situation above is an example of Prospect Theory — the finding that losing something causes about twice as much pain as the pleasure you get from gaining something. So gaining and then losing the same amount still feels like a net loss.

“Saving Money” by Paying More for Netflix

In an earlier piece, I talked about how NetFlix’s move to a subscription model. Why was this subscription model so important?  It made me think of some research that I did on how people think about money about 10 years ago.

One of the big findings was that people have good and bad ways to spend money. For instance, spending money on the house and paying it off every month is a good thing. Having credit card debt every month is a bad thing. But you can get people to make credit cards bills into good payments when you show them how many airline miles they have “earned.” Notice how credit card companies use the word “earned” as opposed to “purchased.”

Getting back to NetFlix, I remember talking to a middle class couple about their finances about 10 years ago. We were in suburban Chicago and sitting on their back porch on a warm spring day. We talked about how they were saving money. They started with normal things like eating out less and spending less money on clothes. But then they said, “We have Netflix so we’re saving money that way too..”

So I asked, “Do you watch a lot of movies?” figuring that they had calculated the cost of renting from Blockbuster vs. their Netflix subscription. This was before streaming. You got one DVD at a time but you could exchange it as many times as you wanted over a month.

“No. Not really,” they said. “But having Netflix means that we don’t have to rent DVDs anymore so that saving money.”

That always stuck with me because I bet they paid a lot more for their Netflix subscription than they ever paid renting videos at Blockbuster. But to them, this was saving money.

When AI Get’s Personal OR You’re Not Supposed to Talk About That!

A few months ago Microsoft released Seeing AI. This is a tool created by a blind product manager to help blind people. It’s trying to using computer vision to replace lost sight.

The most interesting piece is the person functionality. This is a fairly transparent implementation of Microsoft’s Face API. The Face API has a number characteristics that it can determine including hair color,  emotion,  glasses, facial hair, makeup, smiling, gender, and age. Computer geeks, take a look at Face API, it’s pretty awesome. Here’s an example of the person functionality from Seeing.ai showing off Face API.

It’s a great party trick to show your friends how AI can figure out all this stuff. The most interesting characteristic is age. Microsoft thinks so too and created an entire website called how-old.net.

It’s a great party trick so I started bringing it out at parties. But there was the problem. People who skewed older than they really were started saying “Hey, that’s not cool.” I started to realize that the app didn’t have a lot of tact.

It was like a little kid saying, “Mommy, that lady looks 45.”

And the woman saying back, “My Lord! Don’t you have any manners!”
This is similar to a scene in the Netflix series Atypical about Sam, a character with Autism Spectrum Disorder (formerly called Aspergers Syndrome). Sam doesn’t read emotions very well and is often too honest — not taking into account other people’s feelings.

At one point Sam made a list of the Pro’s and Con’s of Paige, his prospective girlfriend. Paige found an imprint of the list and used a pencil to read it.

Paige with Sam’s list of Pro’s and Cons about her.

To paraphrase their conversation:

“Why would you do that? You called me bossy and said I’m always interrupting people,” said Paige.

“But I also said that you had very clean shoes and had a nice neutral smell. So there were some good things in there,” said Sam.

“Ugh. You’re just not supposed to write that stuff down. It’s rude.”

And that’s the inherant problem with the way Face API displays people’s age. Making these things too transparent is just rude.

From all this, I’ve learned 3 things.

  1. It’s kind of creepy how AI can take things from the real world and “know” things about you.
  2. When building a computer program, features like “age” are useful in doing things like matching or making predictions but should generally be hidden from the end user.
  3. It’s much better to use this data for a different purpose, like figuring out which piece of artwork you look like.

 

Questions from a Reader

Hi Everyone!

In this email, I’m answering some questions from a reader.

Rob,

I really like what you put on this site. I’ve tried to blog myself but could use your advice on the following topics:

  1. Why write about something when you know that there’s bound to be someone on the internet that has written the same thing – likely better than you? Wouldn’t it make more sense to just link to that?
  2. How do you decide what to write about?
  3. How can I do what you do? Whenever I sit down to write something, I find that I want to write a treatise and I never get finished with it.
  4. How do I subscribe to your blog?

Best,
Dave

I’ll answer these questions one at a time.

Why write about something when you know that there’s bound to be someone on the internet that has written the same thing – likely better than you? Wouldn’t it make more sense to just link to that?

That’s a good point Dave. Here are a few reasons why I write rather than link:

  1. It’s not worth comparing myself to others. There’s always someone in the world who’s doing something better than me. But if I’m writing about something personal that means something to me, hopefully, I can bring something new to the conversation.
  2. Some people (like you) seem to be interested in what I write.
  3. To paraphrase Maria Popova from Brain Pickings, “I’m writing for myself. If other people want to read this that’s great. But I’m writing for me and not them.”
  4. It’s fun to write.
  5. The best way to become a better writer is to write more. Jeff Atwood, co-founder of Stack Exchange, has some great advice on how to be a great blogger. He says “If you can demonstrate a willingness to write, and a desire to keep continually improving your writing, you will eventually be successful.”
  6. Having a blog becomes a personal record of your thoughts and ideas. It becomes a record of who you are – hopefully of your best self.
  7. Think about your readers. If you look at my first posts I had a lot of links and quoted a lot of sources. This makes it difficult for your readers who just don’t have a lot of time. Paradoxically, by writing a little more, you’re having your readers read a lot less.
  8. You need to be confident in yourself that you have something useful to say. But you need to have your own ideas – not just parrot the ideas of others.

How do you decide what to write about?

I don’t decide what to write about as much as it finds me. I know it sounds corny but it’s true. I have a post a few weeks ago about the process I’m using.

I keep a prioritized list of ideas. When I look at the top of that list, I find a few things that are really exciting and fun to write about. I generally say, “Wow, that’s a really fun idea I’ve put on my list.”

How can I do what you do? Whenever I sit down to write something, I find that I want to write a treatise and I never get finished with it.

Going back to my previous post about writing, I’ll pick a topic that seems pretty exciting and try to figure out how I can get it across in the shortest amount possible. That keeps the boring stuff a minimum and lets me get done with pieces faster. Then I only write about things while they are still interesting. That’s what keeps it fun.

Another way to think about this is the Feynman Method of understanding:

  1. Describe the topic on one sheet of paper
  2. Simplify it so that it can be read by a non-specialist reader
  3. Repeat until you have gotten it simple enough

By the way, there’s a pretty cool and short video about Feynman’s view on what it really means to understand something.

Can I get notifications of your latest posts?

Yes you can! Just go to the bottom of the right column (on a desktop) or the bottom of the page (on mobile).

Thanks for your questions!

What Makes a Great Consultant OR the Best Appliance Repairman Ever

What makes a great consultant? It’s someone who get’s the job done quickly,  teaches me instead of selling me and gives me the advice for the future. I’ve also got a great example of a bad consultant. The best consultant that I’ve met recently was the guy that fixed my refrigerator.

The Issue

Our Viking refrigerator was broken. The water filter was stuck. It was so badly stuck that in the act of trying to get it out, I broke the holder for the water filter. At this point, we needed to call in an expert before my “home improvement” project became a “buy another fridge” project.

Calling for help

So I called Len’s Appliance in Brooklyn (718) 238-3200. In the past, I’ve learned its useful for me to be there when the repairman comes rather than trying to rope someone else in. If it’s a bad repairman, I can avoid the damage. If it’s a good repairman, there’s a lot I can learn.

 

Get in Quick, Get It Done and Get Out

He came in and fixed the problem within 10 seconds. He grabbed the filter, disengaged it from the holder and twisted to remove the filter. The filter holder itself was made horribly. Not only is it very flimsy but it requires a lot of force in an awkward position to remove it. This is not a good combination. The force needed to take the filter out of the refrigerator stresses the holder so every time I change the filter, it’s always on the verge of breaking it. Once he removed the filter from its holder he could easily apply enough force to remove the filter. Wow that’s bad design.

Teach Me to Fish Rather Than Selling Me a Fish

Now remember, I called Len’s because of the broken filter holder.  After removing the filter he told me where I could go to buy a replacement. It was fairly easy to install myself and it wouldn’t be worth the $125 service call for him to reinstall it. Then he paused. “On second thought,” he said, “you don’t actually need this piece at all.” He explained that the poorly designed holder that made it difficult to remove the filter was only in use DURING the filter change process. So it actually wasn’t necessary at all.

Give Me Advice for the Future

Then he told me about the refrigerator itself. We’d bought this Viking fridge because we were under the impression that this fridge was unique in its size. This is a tiny Manhattan kitchen where space is a premium. He mentioned that the fridge was actually a standard size which is great! He also said that it’s out of production now and that spare parts are more expensive and will continue to go up in price.  Eventually, the parts will be impossible to buy.

Did you know that refrigerators are only meant to last 7 years? That’s what he told us. That big expensive kitchen appliance that you thought would last forever goes out of production every 7 years and you’ll need to buy a new one when it breaks. He told us that if the refrigerator breaks badly, it’s probably worth just buying a new one.   Oh, and from what he’s seen, the cheaper models like GE break less often than the Viking ones.

He felt bad that he was charging me $125 for the visit when he was only in my apartment for 15 minutes. But this was the best repair visit that I’d ever had.

Now read about a really bad consultant.

 

The Power of Checklists OR I Don’t Care How Many Years You Went to School, You Still Have to Follow the Process

A few years ago when I was meeting with the head of compliance for a large bank. I know you’re thinking, “This is going to be fascinating.” But surprisingly it was.

Compliance is in many ways the quality assurance function of a bank. At big companies, making sure that things are done correctly is brutally difficult. The temptation is to demand that everyone double check everything and focus on each piece of work to make sure it’s right. And that’s what was happening here.

However, what you find out is that people aren’t very good at focusing on “everything” — especially the smart people who are really good at doing the hard stuff. Smart people aren’t very good at doing the boring stuff. That’s why they’re really smart people. They want to be challenged. So her team was good at doing the complicated things but missed quite a few boring items that people overlooked. 

So what should she do? I immediately thought that she should split up the mundane work from the actually difficult work and mentioned The Checklist Manifesto by Atul Gawande. I asked her if she’d ever heard of the book. With a flourish, she opens up a cabinet with a pile of books and says I give this book to everyone. Read more about the book and the manifesto in this post.

Oh, and for those of you that like this sort of thing, The Checklist Manifesto is one of Jack Dorsey’s favorite books. It’s sometimes referred to as The Big Red  Book.

Click Here to Kill Everyone. A Security Expert’s View on the Internet of Things.

There are a lot of articles about Artificial intelligence and what it will mean to the world. People are asking questions like Where is Technology Taking The Economy? and Where Machines Could Replace Humans?. One thing that’s clear is that computers have become an integral part of our life.

Computers used to be ancillary items that would help us get things done. For example,  a GPS system was just a better map. If the GPS failed, we could always go back to a map to find our way home. Today, we can’t live without computers. Take driving for instance. We don’t drive our cars anymore. When we turn the steering wheel or press a gas pedal we are actually sending a signal to the computer that that drives the car.

Bruce Schneier, one of the world’s top security experts, just published an article about the dangers of this new environment called Click Here to Kill Everyone. With the Internet of Things, we’re building a world-size robot. How are we going to control it?

Giant robot? What is Schneier talking about? He says:

Broadly speaking, the Internet of Things has three parts. There are the sensors that collect data about us and our environment: smart thermostats, street and highway sensors, and those ubiquitous smartphones with their motion sensors and GPS location receivers. Then there are the “smarts” that figure out what the data means and what to do about it. This includes all the computer processors on these devices and — increasingly — in the cloud, as well as the memory that stores all of this information. And finally, there are the actuators that affect our environment. The point of a smart thermostat isn’t to record the temperature; it’s to control the furnace and the air conditioner. Driverless cars collect data about the road and the environment to steer themselves safely to their destinations.

You can think of the sensors as the eyes and ears of the internet. You can think of the actuators as the hands and feet of the internet. And you can think of the stuff in the middle as the brain. We are building an internet that senses, thinks, and acts.

This is the classic definition of a robot. We’re building a world-size robot, and we don’t even realize it.

This reliance on computers changes the way we should be thinking about computer security. Security has three components: confidentiality, availability and integrity. In the past, when people were thinking about security, they were most concerned about confidentiality (e.g., someone was reading their email, someone stealing their identity). But today there’s a far bigger problem in availability and integrity. Shutting down your car (availability) is a far bigger problem than someone knowing where you are all the time (confidentiality). And modifying your car (integrity) to prevent your brakes from working on the highway is the biggest problem of all.

But even cars aren’t the biggest problem. It’s all these smaller things that we’re connecting to the Internet — the Internet of Things. Last year we saw some enterprising hackers marshal together millions of DVRs and webcams to attack the core infrastructure of the internet and bring websites like Twitter, Amazon and Netflix down. Here’s the basic problem:

  • Prioritizing functionality and cost over security. While companies like Apple and Google spend hundreds of millions of dollars on security and pushing out updates, there are many smaller companies making connected devices that don’t care much about security. They often aren’t made in a way to update this security. And because consumers don’t really care if their DVR or refrigerator has good security, it’s unlikely that this will change. So now you have devices connected to the internet that are vulnerable both as victims and coopted attackers. Because these devices are all connected in an ecosystem, a failure of one seemingly unimportant piece can cause far bigger consequences like how an unsecured fish tank connected to the internet let hackers infiltrate a casino.
  • Connecting everything to the internet. Now because all these devices are connected to thet internet, you’ve got to protect against the best hackers in the world. Just look at how North Korea is trying to finance the country through ransomware. I’m not convinced that I’m going to win a hacking battle with a nation — are you?

So how do we fix this? Schneider doesn’t have great solutions but he has a couple:

  • Regulation. While regulation is normally anathema to computer programmers, for cybersecurity it is needed. There are a few ways to look at this. First of all, the internet as a whole is a utility. In order to maintain the availability of the utility and protect against catastrophe, it’s reasonable to regulate it. Secondly, you can view security as a public health system. In order to maintain the health of the internet, we need to ensure that there are a limited number of viruses on it and we take those viruses seriously. Otherwise, these viruses can imperil the health of the entire system. Schneir’s point is that regulation is inevitable so we should start thinking about it now.
  • Disconnection. Why are we connecting everything to the internet?! Everyone is so excited about connecting everything to the internet without thinking about the risks. How much do we lose by disconnecting a power station’s controls from the Internet? It’s probably a little more expensive to have a person or two stationed directly at the plant. But if we leave them connected, there’s the real danger that they can be attacked by a hacker and brought down or destroyed. 

In the excitement over all the possibilities that Artificial Intelligence and the Internet of Things can bring, we need to be vigilant about protecting the ecosystem. But people remain far too optimistic about the future. Just today I saw an article titled Cyber Attacks on U.S. Power Grids Can Be Deterred With Password Changes that should have been titled “US Power Grid Has Multiple Security Holes.” Oh, and taking down a power grid is already being tested in Ukraine.

The Halo Effect by Phil Rosenzweig

Have you ever had a thought that the whole world was crazy? That there was something so painfully obvious that you couldn’t believe everyone was missing? For me, it was the idea that all business books had the same plot:

  1. Let me tell you about this new business theory I have!
  2. I will prove this new theory about business by showing that it applies to great companies like Wal*Mart, Apple, etc.!

I kept wondering why it was only me. Then I came across the book The Halo Effect (with great summary here) by Phil Rosenzweig.

Rosensweig’s key point is that companies only have one independent variable that can be measured — how good it’s doing financially. Companies that are doing well have all these awesome attributes: great leadership, great culture, etc. And companies that are doing poorly have all these horrible features: poor leadership, poor strategy, etc. He uses the example of Cisco:

As an example, when Cisco Systems was growing rapidly, in the late 1990s, it was widely praised by journalists and researchers for its brilliant strategy, masterful management of acquisitions, and superb customer focus. When the tech bubble burst, many of the same observers were quick to make the opposite attributions. Cisco, the journalists and researchers claimed, now had a flawed strategy, haphazard acquisition management, and poor customer relations. On closer examination, Cisco really had not changed much—a decline in its performance led people to see the company differently. Indeed, Cisco staged a remarkable turnaround and today is still one of the leading tech companies.

This isn’t an exercise in analysis or science — it’s an exercise in storytelling. People look at how well the company did and create a story retrospectively to explain it. Rosenzweig quotes Eliot Aronson who says “people are rationalizing beings rather than rational beings.”

But how can these books be so off when they do so much analysis? They talk about going through tens of thousands of pages of financial reports and business press. But maybe this is just theater to make the findings seem more valid than they really are. The less we know about a topic the more we need to dress it up. I remember when I asked a math professor “Why don’t you see very many well-dressed mathematicians?

Math is different from other fields in that you don’t have to prove you’re an authority in math. Your math does it for you. You can solve the problems, they can’t. In English and the Humanities, it’s much more subjective, and so you need some extra way of establishing yourself as an authority figure.

The core problem in analyzing great companies is that there isn’t any good data. Criteria like leadership, customer orientation and culture are subjective. And the financial success of the business leads directly to the contagion of the other metrics.  Rosenzweig says:

The halo effect is especially damaging because it often compromises the quality of data used in research. Indeed, many studies of business performance—as well as some articles that have appeared in journals such as Harvard Business Review and McKinsey Quarterly and in academic business journals—rely on data contaminated by the halo effect. These studies praise themselves for the vast amount of data they have accrued but overlook the fact that if the data aren’t valid, it really doesn’t matter how much was gathered or how sophisticated the analysis appears to be.

The upshot is that business books are telling you stories about great companies and rationalizing the greatness of those companies.  For managers who are looking to improve their companies, these books won’t be helpful. The books are peddling quick fixes and “one size fits all” strategies. But these strategies certainly won’t work for all companies. Managers and leaders need to understand that their role is to be agile and do what’s best in their specific role. They need to look at their company and their environment and determine what strategies will have the best chance of success.

The Epistemology of Google

e·pis·te·mol·o·gy — the theory of knowledge, 
especially with regard to its methods,
validity, and scope
— Google Definitions

“Daddy, what is the meaning of life?” says the child.

“It’s complicated,” says the dad.

“Why don’t you ask Google?”

Laugh if you will but the question makes perfect sense to kids. Google knows everything doesn’t it? “What’s the weather?,” “How do I get to San Francisco?”, and even  “Why is the sky blue?” The big question is: “What doesn’t Google know?” Or, stated another way, “What knowledge can’t we outsource to Google?”

Knowing Facts vs. Gaining Understanding

It really comes down to two different kinds of knowledge: knowing facts and gaining understanding. The Farnam Street blog has a good description of this  and there’s a great video of Richard Feynman explaining it.  In summary:

  • Knowing Facts. You know what something is called and what it looks like. This is the type of information that Google is very good at.
  • Gaining Understanding. Taking various bits of information and really making it your own? This is the type of thing that you can’t ask Google because it’s about changing who you are (i.e., learning).

One good way to know the difference is the difficulty of what you’re reading or watching. If you can read it quickly you’re probably reading for facts. Reading for understanding requires you to sit down at the foot of the author and realize that things may not make sense in the beginning. I think of true learning as fundamentally changing myself. Kind of like in the Terminator 2 movie where the T-1000 changes his shape in the face of adversity.

Knowing Facts

So what does Google know:

  • Define a word (like epistemology)?
  • What’s happening in the news?
  • Who starred in the princess bride?
  • When is Mothers Day?
  • How many teaspoons are in a tablespoon?

Rad Bradbury had a great section on knowing facts in Fahrenheit 451. The book is a metaphor on how books can be explosive with ideas. But the government can provide so many facts that people don’t have room for ideas:

“Give the people contests they win by remembering the words to more popular songs or the names of state capitals or how much corn Iowa grew last year. Cram them full of non-combustible data, chock them so damned full of ‘facts’ they feel stuffed, but absolutely ‘brilliant’ with information. Then they’ll feel they’re thinking, they’ll get a sense of motion without moving. And they’ll be happy, because facts of that sort don’t change.”

Filling in the Gaps

Data and facts can be useful but you need a framework to use them. William Poundstone has a great book on the topic called Head in the Clouds: Why Knowing Things Still Matters When Facts Are So Easy. Poundstone’s key point in the book is that Google can’t teach you what you need to Google. In order to do that, you need a framework of understanding.  Facts are like bricks in a wall of knowledge. There can be some gaps and the wall will maintain its structural integrity. But if we remove too many, you have bricks hanging in midair and the wall collapses.

Gaining Knowledge

Gaining knowledge is about more than gathering facts. The best guide to gaining knowledge is from How To Read A Book by Mortimer Adler and Charles van Doren. The book was written in 1940 and revised in 1972 and it holds up incredibly well. The key idea is that to read a book well, you don’t just read the words or learn the key points. You need to understand the knowledge inside that book and let it change you — which takes effort. For a summary of the key points, the Farnam Street blog does a good write up. But if you really want to learn from these guys, you really have to read the book.

In short, the book says that an engaged reader needs to ask the following questions:

  1. What type of book am I reading? What do I hope to gain by reading it?
  2. What is the author’s high level points / argument?
  3. How does the author make this argument? At this point you don’t agree or disagree with the author by bringing any predefined prejudices to the argument.
  4. After reading the whole argument, going back and asking “Is it true in whole or in part?”
  5. For the pieces that you find true, “What are you going to do about it and how does it change your world view?”

In Fahrenheit 451, Bradbury talks about what makes an engaged reader. These are the people the government is concerned about. As one of the rebels says, there are three things needed to engage with a book:

  1. Quality Information: “What does the word quality mean? To me it means texture. This book has pores. It has features. This book can go under the microscope. You’d find life under the glass, streaming past in infinite profusion. The more pores, the more truthfully recorded details of life per square inch you can get on a sheet of paper, the more `literary’ you are. That’s my definition, anyway. Telling detail. Fresh detail.”
  2. Leisure: “[When] you’re not driving a hundred miles an hour, at a clip where you can’t think of anything else but the danger, then you’re playing some game or sitting in some room where you can’t argue with the four wall televisor…. It tells you what to think and blasts it in. It must be, right. It seems so right. It rushes you on so quickly to its own conclusions your mind hasn’t time to protest, ‘What nonsense!'”
  3. Action: “The right to carry out actions based on what we learn from the inter-action of the first two. “

If this all sounds difficult, that’s the point. You can’t expect to have other people do your thinking for you. You need to pose questions and answer them. You need to argue with the author once you’ve understood him or her.

Why is this Important?

Google in many ways is like the world’s most awesome encyclopedia or your friend with a photographic memory who watches TV all the time. He’s  a great guy to have around but not someone you should trust with important decisions. In an age when you can type a few keystrokes and feel like you’re changing the world it’s hard to put in all that effort.

But getting back to the original question, the reason that Google can’t answer “What is the meaning of life?” is that it needs to be figured out by living. It’s a question that’s only answered by learning and discussion. Basically, it requires gaining knowledge throughout your life.