Index
Philosophy
September 1, 2024
Thoughts of a Retired General/Trauma Surgeon
Chapter 1: Philosophy: this chapter.
Chapter 2: Personal Economics: October 2024
Chapter 3: Medical Economics: November 2024
The odds you were born are so tiny that for practical purposes you can assume you were not.
Yet you are alive, perhaps for a cosmic instant. What are you going to do with your galactic lottery winnings?
These were my thoughts on a resplendent spring day walking to school my junior year of high-school in 1967.
Dear reader, you are well on your way in the great discovery of life. Here are some thoughts.
Every discussion begins with anatomy and physiology though it is seldom recognized as such.
Neurons are vector functions. Functions are equivalent to logic and logic is equivalent to input/output machines.
Every thought has a representation using functions, logic, or machines.
The validity of a statement depends on the axiomatic system within which it exists. A statement is true, fuzzy, or false only within its context.
The same statement with different axioms has different validity.
The Declaration of Independence has an axiomatic method.
''We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights,
that among these are Life, Liberty and the pursuit of Happiness.'
Here the 'unalienable Rights' are axioms.
They generated a country.
Note that some interpretations for the timing of 'created' and 'endowed' are conception, birth, or a point on the cosmic clock.
Since this means different axioms, subsequent arguments are not reconciled.
Familiar to the practice of medicine is 'primum no nocere' or 'first, do no harm.'
It declares itself an axiom with the word 'first.'
Since all interventions have a probability of harm, this axiom constructs a system where nothing should be done.
This is the battle cry of those wishing to avoid vaccinations and evidence the medical profession is not paying attention to what it is saying.
Axioms come in different flavors.
For example, Euclid''s Postulates seem to be natural and immutable with the appearance of existence waiting for discovery.
There is an interesting story that this is not the case for the fifth postulate.
Other axioms have varying degrees of malleability and choosing axioms is the heart of this missive.
Euclid built a system of geometry with his, we build systems of living with ours.
There is also a new perspective. More commonly described as artificial intelligence (AI), the aliens (Aliens Inc.) have already landed.
At present AI has no idea what it is talking about but that will change.
AI is and will continue to be just like us so it would be nice to get it right.
Some 2024 ballpark figures:
A human brain has 10^11 neurons and 10^14 synaptic connections.
A CPU has 10^11 transistors and 10^15 floating point operations per second.
Nerve conduction speed is 2 * 10^2 mph and a frequency of 10^3 cycles per second.
The speed of light 6 * 10^8 mph and CPUs have a clock frequency of 10^9 cycles per second.
Floating point operations are faster than synaptic connections.
The brain and computers have distributed processing.
Computers are evolving faster than brains.
If I had another neuron, I would have enough for a synapse. (Me, relative to AI in 25 years.)
AI will have the same axioms we have and do the same things we do only faster. Forget Asimov""s robot rules.
The best axiom is old and here labeled Axiom A: Love and treat others as you wish to be treated.
Axiom A is deficient without love because otherwise it allows destructive behaviors and does not explicitly take the others into account.
Love is not passive, sometimes tough, but never mean. A corollary to this axiom is that the customer or patient, is not always right. Nor are you.
In contrast is an alternate axiom, also old and here labeled Axiom Alpha: Treat others as they want you to treat them.
This is servitude and self-contradicting making all statements simultaneously true and false.
Suppose person A wants person B to do X and B wants A to not A wants B to do X.
Both cannot apply. Axiom Alpha cultivates dominance of one over another. A corollary to this axiom is that the other is always right and you, if you disagree, are wrong.
On January 11, 1944 President Franklin D. Roosevelt in his State of the Union Message stated
''- these economic truths have become accepted as self-evident - a second Bill of Rights - Among these are - The right to adequate medical care -''.
These are alienable rights or something transferred from one to another as opposed to unalienable rights which everyone has and cannot be removed.
Healthcare as a right means person A controls person B or Axiom Alpha.
Rather, healthcare is a responsibility encapsulated by Axiom A.
Healthcare is about loving and giving others the excellence of care you would like to have.
Our healthcare needs repair with the first step being the selection of an objective which will filter ideas building a desired system of care.
For example: the maximization of access and quality with the minimization of complexity and cost.
Difficult objectives are optimization problems best solved with distributed processing.
However, many challenges are approached top-down which lack the ability for optimum complex problem solving.
For example, the existing electronic medical record, imposed top-down, maximizes charges and uses physicians as data entry clerks.
Medical economics is the subject of the third chapter.
In general AI will be part of solutions. You will also be the future.
You do not need to understand the nitty gritty of AI except that it is axiomatically based.
Consequently, if you do not get the axioms correct you may be treating AI as AI wants to be treated.
Love,
James J. Rice, M.D.
email: first two initials, last name, at comcast dot net (AI could easily figure this out)
Suggested Readings:
Childhood''s End: Arthur C. Clark
Nineteen Eighty-Four: George Orwell
References:
https://spacefillingcurve.com/
A proposal to reroute and reform the healthcare money trail
American Journal of Surgery, VOLUME 207, ISSUE 6, P996-999, JUNE 01, 2014
Index