The book is a quick read if you are familiar with Doctorow’s other writings, and/or have listened to a few of his interviews. He is nothing if not consistent and, in the case of AI, consistently correct.
You may, if you feel particularly carmudgeonly, argue that this is a book that could have been a blog post. You would be off by only a degree: each chapter does in fact resemble a piece or three from Pluralistic, his decades-old blog. You may notice that each daily article there starts off with an appropriate picture collage of Doctorow’s own making. “Reverse Centaur’s Guide” is his blog post collage. But he is so good at hiding the seams.
No arguments there. AI of the day, which is to say LLMs, are a real technology with real uses that is overhyped beyond any reason. Unless Anthropic and/or OpenAI do great a general supper-intelligence — which they won’t — we will witness (if we are lucky) or suffer their fall.
There are now material ways in which LLMs have improved my life.
At work, it is mostly by transcribing the first patient visits so that I can focus on listening to the person in front of me rather than scribbling in a notepad or staring at a screen while nodding my head pretending I am paying attention. [Note: It is not that you get worse at multitasking with age, it is that you realize you were never particularly good at it so you stop pretending. ] Occassionally, for someone recently discharged and with a million notes, tests, and imaging data in the aftermath of their hospitalization, I may use EPIC’s crude but useful built-in summarization tool. I will even use OpenEvidence in preparation for a visit, but I maintain that free and unrestricted search through NCCN, NEJM and JAMA archives would have yielded the same result, and with fewer linguistics tics.
Personally, I have barely moved from my original use case, which was solving household problems. Having installed Meta’s Muse, sandboxed, locked out of any personal information, I do understand agents have their uses:
In other words, infrastructure-of-life stuff, the exact opposite of what the big mind of Muse espoused. Plans for self-hosting are in progress.
If your reaction to the above was largely negative, you should read the book. Doctorow makes a much better case than I ever could for why it is not morally abhorent to use this new technology. After all, are you boycotting the interstate system because Hitler championed the first autobahn?
May I propose “BSI”, for Bullshit Intelligence?
🍿️ Ferris Bueller’s Day Off (1986) was available on Apple TV and heavily referenced in Ted Lasso, and not having watched it before it was a natural choice for the family’s Saturday night viewing.
🍿️ The Dead Don’t Die (2019) looked exactly like you would imagine a zombie movie made by Jim Jarmusch to look, especially if you knew that he spent his childhood watching matinee double features. Not his greatest, but it hit the right spot: between the fracking references (the apocalypse came about because some brilliant minds decided to frack the Earth’s poles), Murray and Driver’s deadpanning, Tilda Swinton’s out-of-this-world turn and the Iggy Pop cameo, there was much to love.
🍿️ The Last House (2026) was pitched, or so I would like to imagine, as a blend of Home Alone and a Lovecraftian apocalypse. Instead of Macaulay Culkin you get a whole picture-perfect nuclear family; Joe Pesci becomes Cthulhu. No surprise, then, that the ending is a soppy, schmaltzy mess.
📚️ Six Memos for the Next Millennium by Italo Calvino helped me clarify why I liked some authors and not others. [Note: Incidentally, M. John Harrison’s latest book is on the short list for the Booker prize this year. I eagerly await October 13 and its US debut. ] There are in fact five memos, named in order Lightness, Quickness, Exactitude, Visibility and Multiplicity. The final one, Consistency, was not to be: Calvino died, aged 61, before finishing.
Dictated the first draft of this from an Index 01. Integration with Micro.blog isn’t there yet but at some point I might be “writing” blog posts with only my left index finger.
Without having seen this week’s Apple event, I can feel it in my bones that the future of pocket devices is something small that can on demand turn into something big. No, I’m not preordering — for reasons — but surely the matte screen and other crease-hiding trickery will at some point trickle down to a sub-$1,000 inflation-adjusted level.
I can wait.
Clayton Davis for Variety:
The smartest defense is baked into the movie’s DNA. This is not a redemption tour. It is a study of the impossibility of ever knowing what is real, which is either the perfect subject for a branch that fetishizes authenticity or a provocation aimed straight at it.
Max Fisher for Newpress:
China quietly saved the world last month.
Max Kozlov for Nature:
The NIH is quietly restricting funding for research that evaluates how public policy impacts human health.
Ba-dump.
Frequent Infinite Regress linkee Ruxandra Tesslo wrote an op-ed for The New York Times about why we can’t get new cancer cures. Unsurprising for those who have read her past work, she places the bulk of the blame on the glacial speed by which clinical trials are designed, set up and run, at least in the US. Biotechs are looking at other countries — yes, including China — for their next first-in-human trial. All the cures we need are right there in the lab, you see, it is these darn trials that are too slow, keeping patients away from life-saving medicines. There is a nice n-of-one story about a patient with KRAS-mutated lung cancer who received a RAS inhibitor in a phase 1 trial to set the tone.
Vinay Prasad calls out a few big omissions in Tesslo’s article, and the number one point he brings out is the number one point I have issue with as well: the science is, in fact, lacking. There are no miracle cures locked in a drawer somewhere, not reaching patients because of government bureaucracy or a big pharma conspiracy.
But how can that be, with all the money thrown into cancer research ever since Dick Nixon’s War on Cancer? Well. Though I don’t know this for a fact, I have a strong suspicion that the answer to the curious lack of cancer cures is the same as the answer to that other question no one dares ask: if trials being so slow and expensive is a huge bottleneck, why are they so slow and expensive in the first place? It’s also the reason why a discerning reader of this blog may have noticed that my writing has taken a slight but unexpected anti-market turn.
Financialization, once the great enabler of garage-based startups, has turned every field of American endeavor into a casino and given one too many a bullshitter enough money to choke the competition. Biomedicine is particularly susceptible to bullshit large and small. Even if decently financed, the honest players — of which there are quite a few — have to fight for other limited resources in the ecosystem, from PhDs to do the actual research and clinical trial sites to attention. The result is hyperinflation of trial costs and a veritable bullshit bonanza in the biomedical literature, and this is not even taking into account the more personal motives of academics to fill the field with dreck.
My big fear is that no one is talking about the negative impact of financialization because it is water. Kudos to Tesslo for not talking about billion dollar drugs, but that seems to be the default, even among science journalists. Mr. Market will give you cheaper 4K TVs — surveillance comes for free — what it won’t give you is cancer cures.
A note on the title: I have come to detest The NYT’s two-sentence titles that go out of their way to dumb down the subject matter while piquing people’s interest, but thought it would be fun to write one for a quick post that’s a comment on a NYT article. Promise it won’t happen again.