Monday, December 20, 2010

Apologies, Echo Chambers, Open Minds, Learning, & Health Care

I have a confession to make. I sometimes overstate things to try to get people to read my blog posts and tweets. I really do not think that avatars and video games are going to replace doctors any time soon (

I felt a little guilty today when I read Irene Greif of IBM saying, “I do think of computers as augmenting people, not replacing them. We need help with the limits of the brain, but there are some things that our brains can do that computers can’t do.”
(htt:// I felt guilty because I agree with Greif, but my blog headline blared out about avatars and video games replacing doctors.

This guilt reminded me of my reaction to a tweet from @neuroconscience chastising me for retweeting one of his posts with the label “Brain wars.” “@KentBottles Hi, not exactly 'BRAIN WARS', and please don't retweet so sensationally. At least, don't make it look like I said it! Thnx” I was so ashamed and taken aback that I never apologized to @neuroconscience until now. The link I was trying to draw attention to was a blog by LSU graduate student Gary Williams in which he defended Antonio Damasio from criticism by Ned Block at the New York Times Book Review and by Allison Gopnik over at Slate. “Block and Gopnik level the exact same argument against Damasio: he has conflated the minimal self with the reflective self and mistakenly claimed that the minimal self depends on the reflective self.” (

What struck me today was how fortunate I am to be able through twitter to interact and learn from others who think differently than I do. @neuroconscience is listed on the twitter profile as Micah Allen from Arhus, Denmark, and I got in trouble by labeling as “brain wars” a thoughtful essay by Gary Williams who obviously understands the minimal self and the reflective self I lot better than I do. It goes without saying that I have never met either Williams or Allen, but I used to work with Damasio at the University of Iowa College of Medicine.

Many of the people in my twitter tribe (@e-Patient Dave, @Susannah Fox, @healthythinker, @murzee, @maggiemahar come immediately to mind) share the same opinions I do about many things and usually understand my sarcasm and exaggeration. Or at least I hope and think they do. Micah Allen is a Danish academic, and I thank him for making me think more deeply.

I, like IBM, am “trying to break out of the standard way people use social networks to navigate the flood information. Typically, people interact with generally like-minded friends and thus create an ‘echo chamber’ where prejudices are reinforced. Such a posture also helps flatten the culture – reduces the culture to memes if you will; we float along the same YouTube clip everyone else is passing along. Treat serious news as gossip, and vice versa.” (htt://

I do not want to exist in an echo chamber; I want to learn and grow. I try to read the Wall Street Journal and The New York Times every day, and I enjoy seeing how the right and the left view the same stories differently. I follow @mparent77772 and @pharmaguy on twitter because they often do not see things the same way I do. I try to read John C. Goodman’s conservative Health Policy Blog ( as much as Maggie liberal Mahar’s Healthbeat blog ( I need all the help I can get to understand health care and patients and doctors and tests and myself.


  1. You used to work with Damasio???? Wow, impressive!

    (You can tell that's the greatest impression on me your post has ;0

    The echo chamber is a big problem, but it has its merits.

    The merits: helping to initiate and maintain relationships.

    The downside: reinforcement of biases and a sealing off from alternative and more expansive views of the world.

    Don't feel bad about how you RTd. Things like this are part of the Web.

    BTW: I posted this morning about the echo chamber:

  2. Kent you are one the kindest, wittiest, brilliant, thoughtful and fair-minded people I've found. This post just proves what I've always thought about you. You and I probably don't agree nearly as much as you'd like ;-) but I always respect your opinion and hope you'll keep making me smile. Those that don't share our strange sense of humor are missing out...

  3. Yeah, one must be careful when retweeting. A big part of growing one's social media network is realizing that *all* your new readers will have no context for the first tweet or first post they see.

    I've enjoyed the conventions that continue to evolve to distinguish original from the RTer's addition, all within 140 chars. I might have done it "Brain wars?" or "Heh, looking like brain wars?" or some such. Others append, with a clear marker "|" or "<". But you know dat.

    Then there's the art of promoting responsibly: how do we arouse interest without distorting?

    Anyway, as a former marketing analytics guy who's now committed to building a movement (*if* anyone wants to come along), I'm pretty sure that the path to a solid audience is to be genuine - post content that has genuine value. Sure, you can polish it up so it catches people's eye, but the content itself is the sine qua non.

    And if it turns out nobody wants to come along, then any traffic I drew would be pretty hollow anyway.

    Show us your soul, man. Talk about what matters. :) And keep being the best curator in all tweetdom.

  4. I was a professor at the University of Iowa where Damasio was head of neurology; I knew him, but I never worked on any scientific projects with him.

  5. Kent: You summed it up well with your statement "I want to learn and grow" (and I whole heartedly agree). Another statement (or two) comes to mind, "If it is to be, it is up to me" or "If we are not part of the solution than we are part of the problem"... so true and to your quest... To question ourselves and the solutions is what it is all about...


  6. Brian hit the nail on the head. You, Brian, Dave, and Phil have been generous with your time helping me learn what is needed in healthcare. Without you and many others, I would still be trying to decide if healthcare is one word or two.

  7. I am trying REALLY HARD to think of a way to sensationalize this post, but am failing. Nearest go: Really genius kind blogger writes incredibly sensible post and just gets it.

    And y're right. Twitter can create an echo chamber. But its capacity to rapidly show us a diversity of angles is stunning. Good on you for tacking advantage of it.

  8. Bravo Kent!

    First up was the 'fixed' v. 'growth' mindset per Dweck contribution; now we get the 'minimal self v. reflective self' prism.

    Either way, you model context building for personal integrity in a way not often seen in this medium. There are many sincere pretenders in the mix....

    As far a the 'echo chamber' is concerned, I hear you and agree. It's pretty easy to orchestrate an agenda via an handful of participants who have a common (though perhaps opague) interest. Here the 'things may not be as the appear rule', may apply.

    None-the-less, you are a trooper and one of my mentors in this tribe.

    As far a 'Camp Goodman' is concerned; you are a better man than I (though I too, appreciate an eclectic and diverse thought gene pool). Ideologue 'echolalia' is a disease which John, obvious grey matter notwithstanding, practices, rather well IMJ.


  9. DotWonder
    RT @alyankovic: Ouch. A Beth Melby post that summarizes why we really do need to try to see both sides of all arguments

  10. As a relatively new blogger myself, it's tough to "get discovered"...regardless of the quality of your content. Not whining here...just stating a fact.

  11. I'd just like to comment as someone who is not interested in being 'on' Twitter, but who reads the tweets of several of those here, including Kent and Dave. I find them very educational, specifically the links - and I often look up the tweeps with whom you converse, and thus learn more and more educational things.
    So, though I couldn't care less about tweeting, following, or building a network; nonetheless you provide a very valuable service, and I bet there are many like me. Thanks!

  12. This was excellent. One of the reasons I like following you is you have such a wide range and seem to have an open mind. I try to be like you and read WSJ and NYT to get different takes, and I try always to be willing to change my mind when I get new information. Here's to balance! -Jackie Fox

    P.S. I really liked your gratitude post too but had technical difficulty posting a comment.

  13. Great post and wonderful comments as well -- I only wish I could disagree to add flavor to the discussion :). Yet, there is nothing that you say that is not true. I have been on web sites where it almost feels like a bunch of psychophantic followers armed with brooms and pitchforks are there to run out any dissenters. This edifies no one and diminishes our potential to arrive at the viable common group

  14. Kent--

    I've allowed a few days for reflection before commenting, but didn't want the holiday to arrive before doing so. Also, I'm procrastinating on "one last thing" that my boss asked me for at the end of last week.

    I want you to know how much I appreciate your postings and tweets. You are a reliable--and yes, imperfect--curator of a community that matters to me. I count on your comments and links to offer useful content.

    As an emergency physician I'm quite familiar with decision-making in the face of uncertainty, yet I've come to trust you because while imperfect in your commentary, your intent as I experience it as a user seems constructive to me.

    It's been said that the only human who likes change is a baby with a wet diaper. Others have pointed out that societal constructs only change when the generation holding them dies out and is replaced by a new generation with a new construct. Advertisers and propagandists point to a necessity for overstatement/exaggeration and repetition to change minds and actions.

    I'm not sure what the right mix is for you. I surely don't know what it is for me either--As a paid monthly columnist for five years (in my past, fortunately) I surely "jumped the shark" on occasion.

    As a user of your writing, I find you mostly get it right. A bit of reflection and reconsideration from time-to-time may be useful. Rumination rarely is. Warm regards and best wishes for peace in the world and contentment in your life in 2011.

  15. Adults who cultivate gratitude have more energy, more optimism, higher earnings, more social connections, more happiness, more sleep, more exercise, and more resistance to viral infections than those who do not.

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