Sep 18, 2023Liked by Birgitte Rasine, Michael Spencer
I see patients remotely now. Incredibly convenient for … me. But the problem I thought might happen has - a two dimensional emptiness that emphasizes my own evolutionary psychology patient education material.
We are one of countless social species because this basic instinct allowed us to survive through various versions over millions of years. A social instinct has allowed us to find food, protect ourselves and procreate more effectively. We are wired for this at the DNA level - to communicate through affective resonance and pheromones, and to be physically touched. Lives in misalignment with basic genetic wiring become ill … and in this case empty/depressed, like Harlow’s monkeys.
Dr. Hager—David if I may—well said, especially that last line in your comment. From the patient's side, I can share with you that for certain types of doctor visits that involve only talking, like discussing test results and so on, I actually prefer remote calls. It saves the time you spend driving, parking, and goodness, WAITING to be called in. Not to mention that those who might be immunocompromised save themselves the trouble of risking infection in the physical space of a clinic or hospital. And perhaps, in a darkly ironic twist, I can easier justify the $200+ bill for a 15-minute doctor's visit (this is what the doctors charge here) if it gives me an hour or more of my own time.
When the issue is of greater consequence of course, my preference shifts to in-person. I also feel strongly our society needs to return to the days when doctors could spend a good half hour with each patient, and make them feel like a human being again. Perhaps then we wouldn't in fact need all those remote calls, because we might be—gasp—much healthier and better functioning humans.
About half of psychiatrists don't accept insurance anymore to avoid the following problems inherent to 3rd party payers:
1) Across all specialties, reimbursement schedules are designed to pay more $$/minute for shorter appointments. The more time I spend with patients, the less I earn.
2) No diagnosis = no payment, ergo everyone gets a diagnosis.
3) 3rd party payers require compliance with forms and work flow processes that are costly, intrusive and frustrating.
I've heard this from a number of sources, but it's always sobering to hear it from the professionals themselves. Feels like everything that makes us human is being monetized
Some Boomer leaders even called the remote work trend "Tragic". Surprising how differently this is all viewed by GenZ. Consumer tech is conditioning younger people very differently. So where does it all lead? Some companies now are fully distributed globally without an HQ office and without massive meetings even online.
The key word there is "conditioning." Conditioning because it's not innate or inherent. Conditioning because there is intention behind the UX/UI design. While I personally appreciate being able to write and work from home, I do at times miss having a work family, which I've experienced in the different sectors I've worked in previously. At the end of the day it depends on the synergies and chemistry of the people in any given group—your work tribe can be supportive and fun to be with, or it can be toxic and manipulative. But in both cases you gain wisdom and insight from the experience. The point is to have the experience to begin with.
As a poet and nonfiction writer, I can see how frustrated many writers feel. This debate over if we need writers anymore or if poetry is really useful for anyone if a prompt can give you a better poem than a human poet. This adds up to this anxiety of disconnection that Birgitte mentioned in the ssay. I also see some of my advertising clients use AI as an excuse to bargain with writers because "AI can do it faster and better".
However, I myself have been using AI in my work and see how they generate the content for work. They are at average quality, easy to copy and easy to find everywhere on the internet. There is lacking of unique point or strong human touch in it.
By that token, I struggle everyday to write a poem or an essay that helps me to grasp with the reality or to reflect my emotional state with the reality. Those valuable response of writing, just like physical exercise, can't be replaced to AI. Of course, I can ask AI to write me a poem to "show up", but I can't ask it to help me walk through the mental process that helps me expand my living experience. For that, as a selfish (and not so talented) writer, I still write for my own experience, I don't ask AI write me a poem. A tool can take over your daily life if you let it. But if you use it as a tool, it is a tool. I have been using AI for work in the last six months, I don't feel the loneliness of disconnected feeling between my work and myself.
I do feel at odd with some clients' conversations (as the essay said) but I guess that is part of the industry I work in.
Read one of your poems Khải Đơn, before returning here to comment. The one titled "Your Last Miracle." One writer's respect for another.
I have not heard any writers praising the literary talents of the chatbots. Even my engineer friends have texted me how utterly unimpressed they have been with the strings output by ChatGPT. Sure, people are in general struck by the ability of these algorithms to generate anything close to literature, but as you say, there is no "human touch in it."
That's what decouples us from this content, from these strings of text. There is no one behind it. No pain we can share, no wonder we can touch, no dreams we can peek into. No personal history, no journey, no life path, no insights and no realization.
Yes, AI is a tool, and a powerful one. It's no creative soul. It should be easy for us all to accept that, but the lines in our own eyes have been blurred by the way we now interact with the online world. That's our fatal flaw.
Birgitte (and Mike) - this is very timely, and I don't think it can be discussed enough. I live with a weird paradox in my own personal life: I run a jiu jitsu school, where life couldn't be much more intimate. We are in very, very close quarters with one another for extended periods of time.
At the same time, I am a very private, introverted person who appreciates solitude more than most. I'm one of the folks who the internet has unambiguously helped survive and thrive, but I'm also in a very weird spot, and I'm conscious of that tension all the time.
This was even more true as we were beginning to drop covid restrictions at our gym, gradually, cautiously. That's not an experience I want to repeat!
Anyway, thank you for some great food for thought. I hope a lot of folks are thinking about this.
Thanks Andrew for that thoughtful comment. Of all the sports and physical activities we humans participate in, jiu jitsu is certain up there in terms of intimacy. There does seem to be a contradiction, as you say, for those more introverted of us, practicing a sport of that degree of physical closeness, often with complete strangers. And yet you can retain that privacy of mind, that place within which is yours and yours alone, in solitude or in company, and which no one can occupy without your permission.
This is the challenge for us as individuals and as a society: we have granted far too much permission for too many people to occupy our minds.
Well said. It is called "the attention economy" for good reasons, too, which means it's not just people vying for our attention, but also companies (and algorithms). Clarity of mind is paramount, and zooming out so that we can see what's happening is really important! That's why I appreciate pieces like this one.
Yes, and harmfully so, ever more companies and ever more algorithms. Attention metrics should not impact our emotions and well-being, but they do. Until we dig deep enough into the reasons why, we'll never be able to overcome that dynamic. This is why I wrote this piece. We need to establish a foundation before we erect a skyscraper...
I see patients remotely now. Incredibly convenient for … me. But the problem I thought might happen has - a two dimensional emptiness that emphasizes my own evolutionary psychology patient education material.
We are one of countless social species because this basic instinct allowed us to survive through various versions over millions of years. A social instinct has allowed us to find food, protect ourselves and procreate more effectively. We are wired for this at the DNA level - to communicate through affective resonance and pheromones, and to be physically touched. Lives in misalignment with basic genetic wiring become ill … and in this case empty/depressed, like Harlow’s monkeys.
Dr. Hager—David if I may—well said, especially that last line in your comment. From the patient's side, I can share with you that for certain types of doctor visits that involve only talking, like discussing test results and so on, I actually prefer remote calls. It saves the time you spend driving, parking, and goodness, WAITING to be called in. Not to mention that those who might be immunocompromised save themselves the trouble of risking infection in the physical space of a clinic or hospital. And perhaps, in a darkly ironic twist, I can easier justify the $200+ bill for a 15-minute doctor's visit (this is what the doctors charge here) if it gives me an hour or more of my own time.
When the issue is of greater consequence of course, my preference shifts to in-person. I also feel strongly our society needs to return to the days when doctors could spend a good half hour with each patient, and make them feel like a human being again. Perhaps then we wouldn't in fact need all those remote calls, because we might be—gasp—much healthier and better functioning humans.
About half of psychiatrists don't accept insurance anymore to avoid the following problems inherent to 3rd party payers:
1) Across all specialties, reimbursement schedules are designed to pay more $$/minute for shorter appointments. The more time I spend with patients, the less I earn.
2) No diagnosis = no payment, ergo everyone gets a diagnosis.
3) 3rd party payers require compliance with forms and work flow processes that are costly, intrusive and frustrating.
I've heard this from a number of sources, but it's always sobering to hear it from the professionals themselves. Feels like everything that makes us human is being monetized
Some Boomer leaders even called the remote work trend "Tragic". Surprising how differently this is all viewed by GenZ. Consumer tech is conditioning younger people very differently. So where does it all lead? Some companies now are fully distributed globally without an HQ office and without massive meetings even online.
The key word there is "conditioning." Conditioning because it's not innate or inherent. Conditioning because there is intention behind the UX/UI design. While I personally appreciate being able to write and work from home, I do at times miss having a work family, which I've experienced in the different sectors I've worked in previously. At the end of the day it depends on the synergies and chemistry of the people in any given group—your work tribe can be supportive and fun to be with, or it can be toxic and manipulative. But in both cases you gain wisdom and insight from the experience. The point is to have the experience to begin with.
"The spectacle was born from the world's loss of unity, and
the immense expansion of the modern spectacle reveals the
enormity of this loss. The abstractifying of all individual
labor and the general abstractness of what is produced are
perfectly reflected in the spectacle, whose manner of being
concrete is precisely abstraction. In the spectacle, a part of the
world represents itself to the world and is superior to it. The
spectacle is simply the common language of this separation.
Spectators are linked solely by their one-way relationship to
the very center that keeps them isolated from each other.
The spectacle thus reunites the separated, but it reunites
them only in their separateness."
GUY DEBORD - THE SOCIETY OF THE SPECTACLE , 1967
As a poet and nonfiction writer, I can see how frustrated many writers feel. This debate over if we need writers anymore or if poetry is really useful for anyone if a prompt can give you a better poem than a human poet. This adds up to this anxiety of disconnection that Birgitte mentioned in the ssay. I also see some of my advertising clients use AI as an excuse to bargain with writers because "AI can do it faster and better".
However, I myself have been using AI in my work and see how they generate the content for work. They are at average quality, easy to copy and easy to find everywhere on the internet. There is lacking of unique point or strong human touch in it.
By that token, I struggle everyday to write a poem or an essay that helps me to grasp with the reality or to reflect my emotional state with the reality. Those valuable response of writing, just like physical exercise, can't be replaced to AI. Of course, I can ask AI to write me a poem to "show up", but I can't ask it to help me walk through the mental process that helps me expand my living experience. For that, as a selfish (and not so talented) writer, I still write for my own experience, I don't ask AI write me a poem. A tool can take over your daily life if you let it. But if you use it as a tool, it is a tool. I have been using AI for work in the last six months, I don't feel the loneliness of disconnected feeling between my work and myself.
I do feel at odd with some clients' conversations (as the essay said) but I guess that is part of the industry I work in.
Thank you so much for the thoughtful essay.
Read one of your poems Khải Đơn, before returning here to comment. The one titled "Your Last Miracle." One writer's respect for another.
I have not heard any writers praising the literary talents of the chatbots. Even my engineer friends have texted me how utterly unimpressed they have been with the strings output by ChatGPT. Sure, people are in general struck by the ability of these algorithms to generate anything close to literature, but as you say, there is no "human touch in it."
That's what decouples us from this content, from these strings of text. There is no one behind it. No pain we can share, no wonder we can touch, no dreams we can peek into. No personal history, no journey, no life path, no insights and no realization.
Yes, AI is a tool, and a powerful one. It's no creative soul. It should be easy for us all to accept that, but the lines in our own eyes have been blurred by the way we now interact with the online world. That's our fatal flaw.
Birgitte (and Mike) - this is very timely, and I don't think it can be discussed enough. I live with a weird paradox in my own personal life: I run a jiu jitsu school, where life couldn't be much more intimate. We are in very, very close quarters with one another for extended periods of time.
At the same time, I am a very private, introverted person who appreciates solitude more than most. I'm one of the folks who the internet has unambiguously helped survive and thrive, but I'm also in a very weird spot, and I'm conscious of that tension all the time.
This was even more true as we were beginning to drop covid restrictions at our gym, gradually, cautiously. That's not an experience I want to repeat!
Anyway, thank you for some great food for thought. I hope a lot of folks are thinking about this.
Thanks Andrew for that thoughtful comment. Of all the sports and physical activities we humans participate in, jiu jitsu is certain up there in terms of intimacy. There does seem to be a contradiction, as you say, for those more introverted of us, practicing a sport of that degree of physical closeness, often with complete strangers. And yet you can retain that privacy of mind, that place within which is yours and yours alone, in solitude or in company, and which no one can occupy without your permission.
This is the challenge for us as individuals and as a society: we have granted far too much permission for too many people to occupy our minds.
Well said. It is called "the attention economy" for good reasons, too, which means it's not just people vying for our attention, but also companies (and algorithms). Clarity of mind is paramount, and zooming out so that we can see what's happening is really important! That's why I appreciate pieces like this one.
Yes, and harmfully so, ever more companies and ever more algorithms. Attention metrics should not impact our emotions and well-being, but they do. Until we dig deep enough into the reasons why, we'll never be able to overcome that dynamic. This is why I wrote this piece. We need to establish a foundation before we erect a skyscraper...