Animals can fake their evolutionary fitness in a number of ways. Humans do it too. While this may seem like we’re corrupting our gene pool it might not be so bad.
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Hacking Evolution: Fitness Faking
Category: Ideas
I used to love Honest Tea. It made me feel so good. The company was the brainchild of Barry Nalebuff and Seth Goldman. It was based on an idea that we could have healthy, great-tasting, and ethically sourced tea. They even wrote up the history of their company, Mission in a Bottle, as an engaging graphic novel.
When they were bought by Coca-Cola in 2008, I thought, “Good for Seth and Barry. They made some money, and Coca-Cola will take the company forward.” I didn’t pay attention to the company for a while, thinking that Coca-Cola was being an attentive steward to the brand. After all, Coca-Cola had the resources to expand Honest Tea’s reach and keep the company alive. That’s why I was so surprised to see the brand Just Ice Tea on the shelves looking exactly like Honest Tea. And when I looked at the back of the bottle, I saw the same message from Seth and Barry I used to see on Honest Tea.
It’s time to go back to the office. Some of us are already there and others, like me, will be back sometime in 2021. A lot has changed since 2019. Now we all know what a fully remote workforce looks like and most of us know how to host a Zoom meeting (though it’s still surprising how many times I need to tell people to mute their phones).
In his annual letter to JP Morgan shareholders, Jamie Dimon says that he learned that “Performing jobs remotely is more successful when people know one another and already have a large body of existing work to do. It does not work as well when people don’t know one another.” I learned these lessons over years of working in hybrid environments. When I was at AIG, my entire team, including my boss and my teammates were all based in Charlotte North Carolina while I was based in New York. We learned that we needed to meet in person a few times a year to build trust and agree on what to do. These conversations were imperative to getting everyone on the same page. These were the times to have disagreements about what to focus on and what could be postponed. We left these meetings with a plan. Then we could all travel to our own locations and get our work done.
Note: You can watch the speech I gave based on this material here.
I remember the first time it happened to me. It was the first year of business school and we were working on an economics problem set. My friend Yugin had just arrived from Korea and she was correcting an answer for her economics homework.
She asked me “What’s the English word for after you erase something?”
I thought this was a philosophical question like, “What’s left of an image after you remove it?” Something like the way Robert Rauschenberg erased a drawing by William de Kooning to push the boundaries of art.
So I answered, “When you erase something there’s nothing left. You’ve erased it.”
“No, that’s not what I’m asking. Those little pink things that come off the eraser. What do you call that?”
“Hmmm … eraser shavings maybe. We don’t have a word for that in English.”
“Huh,” she said, “that’s odd. We have a word for that in Korean.”
Focusing on the right thing is key to being successful in work and life. If you focus on one thing, you can accomplish anything. But, as a mentor once told me, “If you have 12 apples, don’t take one bite of each.”
But figuring out what to prioritize can be tricky. At my college reunion, my friend Lutz and I were spending the day with our families. We’d jam-packed the day with great activities. As we were walking down the street, I saw a sign for Ashley’s Homemade Ice Cream.
I said, “Lutz, I’d really like to buy my family some ice cream.”
Being the logical German, he said, “Yes. That would be nice but there’s no time left in the day. We need to go hear the President of the University speak.”
“Lutz,” I said, “you have to prioritize. You can always watch the video of the President’s speech or read a transcript. But how often are you able to spend time with your family on a beautiful spring day, sitting on the college lawn eating ice cream?”
He said, “You’re right. Let’s get the ice cream.”
And it was the best decision we’d made that weekend.
This year Professor Laurie Santos created Yale’s most popular class of all time. The class is titled Psychology and the Good Life but it’s really a course on how to be happy both in the short and long term. I was excited to hear that Yale was offering the course but even more excited to see that the class is available online. She expanded on the class with her Happiness Lab Podcast. While there’s little I hadn’t heard before, it did a great job of focusing me on what’s important and helped me get into the practice of being happier.
I spotted a technology executive walking down the street. He used to wear expensive tailored suits. Now he’s coming to work in high-end jeans and a polo shirt. Then it hit me. Jeans and a turtleneck or jeans and a polo shirt (or really jeans and anything) is the new innovation wardrobe. On one level, it makes sense because everyone wants to dress like Steve Jobs. But when you dig a little bit deeper, using Silicon Valley clothes as a status symbol doesn’t make any sense at all.
In the class The Science of Well-Being, Professor Santos focuses on how we often look at our happiness not in an absolute way but by comparing ourselves to those around us. These thoughts about absolute vs. relative comparisons got me thinking about strawberry ice cream.
Whenever I eat strawberry ice cream, I think is pretty wonderful. It’s light, sweet, and just a little bit tangy. If I like strawberry ice cream so much, why am I surprised at this fact every time I eat it. I feel like I’m carrying some sort of bias against strawberry ice cream — but why?
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.(1)The story of homeopathy is particularly interesting in the story of iatrogenics. Homeopathy involves a dilution of a substance until all you’re left with is water. It’s currently viewed as a pseudoscience but at one point, it was good medicine. When homeopathy was in its heyday, it was far more effective than the iatrogenic alternatives of the day, like bloodletting. The relative success of homeopathy actually forged a path to science based medicine.
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.
Footnotes
| ↑1 | The story of homeopathy is particularly interesting in the story of iatrogenics. Homeopathy involves a dilution of a substance until all you’re left with is water. It’s currently viewed as a pseudoscience but at one point, it was good medicine. When homeopathy was in its heyday, it was far more effective than the iatrogenic alternatives of the day, like bloodletting. The relative success of homeopathy actually forged a path to science based medicine. |
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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:
- A “Nucal” sonogram that measured some key ratios. This was the most important test and sets the baseline.
- A blood test that measured blood proteins in the mother.
- 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.
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