Near-Misses in History

In the late 18th century, something strange occurred: a revolution in medicine that should have happened did not.

It started in 1772, when Joseph Priestley, an English theologian, philosopher and chemist, synthesized nitrous oxide. The compound followed two very different trajectories. Within the scientific community, a few researchers followed up on Priestley’s discovery. One, Humphry Davy, noted that nitrous oxide “appears capable of destroying physical pain” and recommended that “it may probably be used with advantage during surgical operations.” The British upper class had a different idea. The laugh-inducing compound became a popular recreational drug; laughing gas parties were commonplace. Yet for nearly half a century, Davy’s suggestion was ignored. Not one doctor—or any of those giggling British aristocrats—thought of using nitrous oxide to dull the pain elicited by surgery. Thousands suffered in vain.

That changed in 1845 when a dentist and surgeons from Boston connected the dots. On October 16th, 1846, a team of surgeons administered an anesthetic gas to remove a larger tumor from a woman. She experienced no pain, survived, and modern anesthetics were born. “Gentle, this is no humbug,” declared John C. Warren, a dentist at the Massachusetts General hospital.

It’s difficult to ignore near-misses in history. In his early teens, Blaise Pascal constructed the first mechanical calculator, ideal for a 17th century accountant, yet ignored for 250 years. Mendel’s famous pea experiments were overlooked for decades after his death. Sanctorius Sanctorius invented the thermometer in the 17th century, but it did not become a standard tool for clinicians until the mod 19th century. Davy saw the benefits of nitrous oxide, but doctors ignored him. Why?

To think about progress, you must first understand what stands in the way of progress.

IV Aphorisms

A good aphorism ignites the mind more than classroom learning, and in a fraction of the time.

The true altruist would never be ashamed to reveal his motives; his insincere counterpart, the opposite.

Nothing prevents us from being natural as much as the attempt to be natural.

Avoid italicizing to make your point; self-discovery is the most powerful form of learning.

The World Is Not Flat, Creativity Clusters.

One of the most enduring themes of creativity is that it clusters. Think Elizabethan England, ancient Athens, Silicon Valley, and Renaissance-era Florence. People with good ideas are attracted to each other.

In a 2005 interview with Dan Pink, Thomas Friedman, author of The World is Flat, argued that “Several technological and political forces have converged, and that has produced a global, Web-enabled playing field that allows for multiple forms of collaboration without regard to geography or distance – or soon, even language.” Yet at least with respect to collaboration, Friedman has it backward. The world is not getting flatter—we’re clustering.

Consider this. In 2010, Isaac Kohane and colleagues discovered a correlation between the quality of academic papers (as measured by the number of citations it had) and the geographic location of the authors. The closer together the co-authors lived, the better the research. A recent paper by Stefan Hennemann and two collaborators who examined scientific collaboration likewise found that across “six distinct scientific fields… intra-country collaboration is about 10–50 times more likely to occur than international collaboration.” As Edward Glaeser notes in his book Triumph of the City, “Cities speed innovation by connecting their smart inhabitants to each other… proximity makes it easier to exchange ideas or goods.”

Years ago—around the time The World is Flat was published—commentators were predicting the demise of cities as cheap communication was flourishing. With Skype, why would anyone need to commute? Yet at no other point in the history of the United States have more people flocked to cities. For the creative class, at least, the ideating mind craves collaboration and abhors the suburban and rural vacuum. And as the cost of living in a city like New York or London increases, the barriers to entry are strengthening, not crumbling.

Two Aphorisms

The attempt to conceal an insecurity usually reveals an insecurity. In life, only those trying to lose a few pounds announce, without prompt, how many miles they ran, just as only miserable single people announce, without prompt, how much they love being single.

The more reasons I invent to justify something the more I known to avoid it, just as I know to avoid meetings with many people, but not few.

We Are Epistemic Hypochondriacs

If you want to witness one marvel of the human body, smack your thumb with a hammer. A precise, coordinated self-healing process will immediately rush in for repairs. “Blood platelets secrete clotting factors that soon stem the bleeding,” writes Randolph Nesse and George Williams in their book Why We Get Sick. “Other cells secrete a complex variety of substances that cause inflammation, thus raising the temperature of the tissue and making it harder for any invading bacteria to grow. They also keep the thumb painful, thus protecting it from minor stresses that might disrupt the healing process. Simultaneously, the immune system rushes specialized infection fighters to the site. They either attack any bacteria that the injury might have introduced or take them to lymph nodes, where they can be more easily destroyed.”

What’s remarkable is how we humans disrupt this process. First, we’ll use an ice pack to reduce the swelling, even though 1) swelling is an effective repair strategy and 2) no empirical evidence suggests that reducing swelling is helpful. Second, we’ll rush to the pharmacy to look for pills, bandages, etc, instead of simply allowing the immune system from preforming a fairly routine procedure.

The mind is preoccupied with the need to do something, even when inaction is the optimal strategy, and even when we are perfectly healthy. Let’s call this epistemic hypochondriasis – our obsessive urge to generate an explanation and search for a cause, even when none exist, of an unfavorable event (and a favorable one, but to a lesser extend) and then doing something to about, even if it’s counter productive. I recently returned to portions of Nietzsche’s Twilight of the Idols and realized that he captured this bias precisely:

We want to have a reason for feeling as we do – for feeling well or for feeling ill. It never suffices us simply to establish the mere fact that we feel as we do.

To trace something unknown back to something known is alleviating, soothing, gratifying and gives moreover a feeling of power… First principle: any explanation is better than none.

This is most obvious, perhaps, in medicine. Here is my favorite quote from Druin Barch’s Taking the Medicine:

To this day, little in medicine is so difficult as doing nothing at all. Medicine is founded on the desire of patients to be helped and of doctors to help. These desire outweigh sense. The difficult of doing nothing, or of admitting that there is nothing to be done, is overwhelming.