Is Second Life Just Playing Doctor or What?

You can take Second Life (SL) in a couple of ways: it’s either a grossly over-hyped major 3D time killer for a declining population of people with limited First Life (i.e, the real world) social skills and nothing much else to do, OR a grand and incredibly interesting social experiment in new media, managed and populated by some bright, creative folks that has simply caught the public imagination (SL boast 9 million residents!).

Depending on whom you talk to, people carry strong opinions and their own statistics on both sides of this not so virtual fence.

My job here is not to declare allegiances — at least not yet — since the fundamental research, that of actually entering into this virtual world, has yet to be completed. More on that in a later post. But I’m interested in what’s happening in SL because the crowd in there wants to play doctor.*

So what of it, why should I or you at all be curious about what going down in SL? Well . . .

  1. Some very interesting medical and health education things are said to be taking place in SL. See this description — thanks to Science Roll — of a hematology training simulation or this listing of health related sites in SL.
  2. Some very large corporate, university and charitable organizations are making sizable financial and time investments in health care related virtual projects on the Grid (the geography that makes up the SL world.) See here, here and here, for example.
  3. Some very deep connections exists between what people do in their virtual lives and what they do in their real lives. So when it comes to medical care or health information, that relationship should be understood or at least respected. In this virtual society one can visit the Second Life Medical Library or go to a hospital for example.
  4. And finally, there are some questions of actual virtual life in the SL world that should compel health policy wonks to do a little digging: do avatars (your virtual representation on the screen) get sick — beyond worms and viruses, that is — or injured? Since there’s plenty sex in SL, can they get an STD or HIV? Can they get pregnant? What about mental disorders? Do avatars die? Since they have a functioning economy, do they have a functioning health care system? How’s it organized? Is it expensive? How good is the care there — wherever there is?

You see there may be more here than meets eye and definitely enough to warrant a trip to this metaverse (the synthetic universe of Second Life). So keep an open mind. Maybe we’ll find out what all the digital hubbub is about.

* Second Life is not a game and thus the term playing is somewhat inappropriate. It is a virtual environment in which “residents” interact and create an online virtual society. SL was brought into existence in 2003 by Linden Lab of San Francisco.

WHCB: “China’s Internal Health Care Debate Heats Up”

“Despite all that’s going on in Beijing and the sorry press it suffers these days, we’re starting to get a glimpse of the terms of the internal debate on health care reform as it spill out in the local media. A recent story in the Beijing Review points to the domestic battle over the role of the market when it comes to health care.”

See my complete post over at World Health  Care Blog.

Beijing Announces New Bicycle Campaign

This report from the China Daily hypes a new bike promotion campaign that authorities are hoping will reinforce its status as the bicycle kingdom. From the press report:

“Under the scheme, 50,000 bikes will be available for rent soon throughout the city. They will cost 100 yuan ($13) for a one-year contract or 20 yuan per day. . . It is estimated the rental network will cover some 200 locations by the time of next year’s Olympics in a bid to ease traffic congestion. . . At the end of 2003, Beijing had more than 10 million registered bicycles.”

I’ve been following the bike situation in China for some time (see below). The decline of bicycle use and the dramatically increased hazards of riding in the city are very real. This campaign may be more for domestic use than for foreigners except in very controlled and defined areas of the city. But I congratulate the officials for giving it a whirl.

Previous posts:

A Note from the Bicycle Kingdom

Pedaling Around Globalization

Bicycle Kingdom Under Seige

Globalization Takes Toll of China’s Flying Pigeons

Odd Thoughts on Hospital Theory Reloaded

What do we think, better yet, what fills the public imagination when confronted with HOSPITAL? If a hospital room could speak, what would it tell us? What would it want us to know, what secrets would it share? Covert conversations? Stories of recovery and renewal? Epiphanies on what’s most important? Or disappointments, banality, private embarrassments, and the dehumanization of our demise?

If we go beyond the literary to the philosophical, that is, a philosophy of hospital, would it be riddled primarily with “essentialists” debates on the true nature of hospital? Would it be saddled with a genealogy of hospital moral reasoning or critiques of pure hospital. Would we now be, in this day and age, at the end of hospital history?

What about studies of hospital language? How does a hospital speak? What is its ‘lingua franca’; does it posses a power medical discourse that makes irrelevant any local or native speech that enters its field of influence? In a postmodern deconstruction of the hospital text, would “to hospital” someone invoke a surveillable identity?

And where would Marxists place the hospital in their scientific understanding of social and economic class relations? Or Adam Smith, for that matter, what would a free market hospital look like?

And if this literary exploration, and philosophical backdrop were seen as a reflective and legitimate intellectual pursuit, would we then engender a field of hospital theory with legions of hospital theorists researching change, adaptation or the disenchantment of hospitals? What would the historical fossil records of hospitals reveal to the modern consciousness? Would we have experiments in competing theoretical models of hospitaling?

In other words, how would something that has so ossified in our current scheme of things be different, radically different?

Travels of a New iMac: The World is Indeed Flat

Ordered a new fully loaded iMac a few days ago. Can’t wait. So in tracking the shipping we find this: it ships out of Shanghai, China (from where I don’t know), then to Anchorage, Alaska, then to Oakland, California, and finally to arrive in Honolulu, Hawaii. Seems like the scenic route. Anyway globalization is alive and well at Apple.

By the way if you want to see an iMac seriously deconstructed, check this out thanks to Cult of Mac.

DHHS’s Mike Leavitt’s New Blog: Let’s Not Blow It

Thanks to Bob Coffield at Health Care Law Blog as well as iHealthBeat we now learn that DHHS Secretary Mike Leavitt has started a blog. It’s personal, thoughtful, seems not to written by staff or handlers, and well. . . interesting. So does this mean all us policy wonks will have a direct line to the top? Probably not. But does it mean that when a new administration comes in, a blog from the Sec will be the norm? Maybe it’ll take hold and President Obama (Would Hillary do this?) will write his own behind-the-scenes blog. Hey he could do that right now!

Seriously, the thing to be done now is to make this effort by Mike work. By that I mean to help make it a valuable exercise for both health activists and for the Secretary: to make it a meaningful conversation about where America’s health care is going. This could be an interesting experiment. Mike is taking chance here. Let’s not blow it.

WHCB: “China Continues to Reveal Details of New Urban Health Insurance Plans”

In another speech last week, Vice-Minister of Labor and Social Security Hu Xiaoyi said that by 2010, 240 million non-working urban residents, such as children and students, will benefit from a basic medical insurance scheme now being piloted in 79 cities.

See my complete post over at World Health Care Blog.

How to Read A Blog (With a Nod to Mortimer Adler)

First let us agree that there are at least two strikingly different views on the blogosphere. One (I have discussed before) is that held by people like Andrew Keen. He complains that the internet is transforming our culture into a cacophony of “infinite filibustering”, a noise of “hundred million bloggers all talking about themselves; a place where truth is “flattened”, where “ignorance meets egoism, meets bad taste, meets mob rule … — on steroids.” And more to the point, this “chaos of useless information” is not just pop culture entertainment, but a threat to civil public discourse, “encouraging plagiarism and intellectual property theft and stifling creativity.

Almost polar opposite to that view are those of people like David Weinberger, who argues that “Web conversations look to many like echo chambers because of the nature of conversation itself.” The blogosphere “tells a story of constant conversation, elaboration, and disagreement that is not visible in a simple map of links” and is in fact a “powerful force for democratic institutions and open markets, not a polarizing and simplifying medium. . . This is how meaning grows. . . (and that) the public construction of meaning is the most important project of the next hundred years.”

If the blogosphere is as Keen describes — a pit of electronic ‘nattering nabobs of negativism‘ — then why bother to waste time reading blogs? Well, there is the occasional illicit entertainment value they offer or the niche-group (cult?) information they collect. And of course there’s the simple pleasure of witnessing the decline of civilization itself. Ok. Good reasons all. But if the blogosphere is as Weinberger observes — a postmodern wellspring of democratic practice — then we have a duty to get right in there and do our part for the betterment of the human race.

But seriously, most would agree that the blogosphere is here to stay, at least for a little while (even the two authors above have blogs), and if we say for the moment that the phenomenon is a modern day ‘meaning-construction project’ in process, then why and how should we read blogs?

To get some perspective, I went back to the wisdom of an ‘ancient’ text (paper-based, of course) written by Mortimer Adler in 1940 (a bestseller no less) entitled, simply enough, How to Read a Book. Yes, I know, blogs are not books, — or magazines or newspapers — but we do read (and often listen) to them and want something from them as well. So let’s look at some of Adler’s observations and see how they hold up to today’s demands.

Why Read?

  • Adler: There are two distinct senses of reading: one is the the reading of “newspapers, magazines, or anything else that , according to our skill and talents, is at once thoroughly intelligible to us. Such things may increase our store of information, but they cannot improve our understanding. . . The second sense is the one in which a person tries to read something that at first he does not completely understand.” Through reading, one begins to understand more, and not just remember more information. “There is a sense in which we moderns are inundated with facts to the detriment of understanding.” Adler believes there is a deep difference between reading for information or entertainment, and reading for understanding.
  • Blogosphere: Blogs are great information and entertainment devices. But we often do start to confuse those attributes with understanding. The sheer volume and weight of a voice does not, in itself, mean an enlightened one. The challenge is how do we plunge into this cacophony, using all the intellectual and technical tools at our disposal to build understanding? Readers and their books build understanding one person at a time. Weinberger argues that blogs build shared understandings, because most of us “think by talking with others.” Knowledge “isn’t in our heads: It is between us.” Is Weinberger’s shared knowledge the same as Adler’s “understanding” ? Is a college student’s assemblage of a term paper from snippets of Wikipedia (or any other super-library) the same as the struggle to think through a complex series of intellectual relationships? I don’t think so.

What is reading?

  • Adler: The art of reading is “the process by whereby a mind, with nothing to operate on but the symbols of the readable matter, and with no help from the outside, elevates itself by the power of its own operations. The mind passes from understanding less to understanding more. The skilled operations that cause this to happen are the various acts that constitute the art of reading. “
  • Blogosphere: No problem here except for two points: Adler talks about “no help from the outside” and in another passage talks about the “essentially loneliness of the reader”, a solitary conversation with a solitary author. In the blogosphere, no reader has to be lonely. In fact the ability to be lonely is hard to do and contravenes the cultural and technological everyday social networky machinations of blog world view. Second, the blogosphere rides on the back of a particularly postmodern orientation to reading which Weinberger alludes to in his book. Adler sees that there are authors and readers. In the world of perpetual remix, there is no author, no distinction from the reader, and no content ownership.

What is Active or Good Reading?

  • Adler: Many make the”error of assuming that to be widely read and to be well-read are the same thing.” There are way too many “literate ignoramuses who have read too widely and not well.” Good or analytical reading is a silent conversation with the author. “If . . . you ask a book a question, you must answer it yourself.” But what are those important questions? Adler says four: What is the book about as a whole; What is being said in detail – and How; Is the book true, in whole or part; and finally, What of it? “And that is why,” according to Adler, “there is all the difference in the world between the demanding and undemanding reader. The latter ask no questions – and gets no answers.”
  • Blogosphere: I don’t think anyone would say that these questions and active reading are foreign to the blogosphere. But there are differences in how this all gets acted out. Adler’s silent and solo conversation with the book (implicit and tacit as Weinberger says) is now public, explicit and consequential: private thoughts are now a never ending reality show that has social impacts. “Reading will cease to be a one -way activity. . . All that metadata, and every use of metadata will enrich the context within which we make sense of what we read and learn” (Weinberger) If everything is meta, how do we meta-read that? Do we achieve a meta-understanding? And what the hell is that anyway?

Good Books, Bad Books

  • Adler: Good books must make demands on you. “You must tackle books that are beyond you. . .Only books of that sort will make you stretch your mind. And unless you stretch, you will not learn. . . A good book does reward you for trying to read it. . . (a bad book) is not worth the effort of trying. You receive no reward for your struggle. . . The great majority of the several million books that have been written in the Western tradition alone – 99 percent of them – will not make sufficient demands on you.” As you become a skilled reader, you get better at discerning which are which.
  • Blogosphere: Good blogs must make demands on us as well if we are to view them as Weinberger does. And like Adler, we complain that the blogosphere is clogged with bad blogs. But as we become a skilled blogger and blog reader, we get hints from our RSS feeds, begin identifying the best bloggers for our interests — those that both agree and disagree with our perspective — and throw out the trash. We just have to spend a lot of time and a lot of technology doing just that. It seemed simpler back then.

Arguments

  • Adler: “An “argument begins somewhere, goes somewhere, gets somewhere. It is a movement of thought.” But “you have to recognize an argument when you see one, and there may be some people who are argument-blind!” Authors make propositions. They have personal opinions. Yet authors should have reasons for their views and arguments as to why we should be persuaded to accept them. And then there is arguing. “For the disputatious and contentious, a bone can always be found to pick a quarrel over.” Adler believes in an intellectual etiquette. Something can be learned in good conversation. Disagreements are “arguable matters” taken with the supposition that when all is said and done, the original issue can be “resolved.” A reader must be able “to carry on a civil, as well as intelligent, controversy.” Talking back to an author should focus on four (once again) possible areas of disagreement: “You are uniformed, or misinformed, or illogical or your analysis is incomplete.”
  • Blogosphere: There is a certain pride in the contentiousness of blogs. The blogosphere is often a messy, name-calling, blustering, ideological jungle of bad posts, bad arguments, constant misunderstanding and intellectual laziness. Sure, there is a fledgling blogger’s etiquette of sorts bound to grow as the culture develops and (should I say it) the blogosphere becomes more institutionalized. So there is a lot to learn from the old school, and a history of thoughtful debate that should be appropriated into the blogosphere. The focus should be on the quality of the argumentation and not on the volume. This is definably happening as blogs continue to move from outlaw status to a mainstream form of social expression.

Screenshots of Google Health

Don’t know if these screen shots of Google Health’s personal health record (PHR) are legit, but if they are they give some sense of where they are going with this effort. I’ve seen a lot of PHR products, and nothing here jumps out except the fact that it’s Google and that’s enough to get my attention (see my previous posts here and here).

WHCB: “Rising Chronic Disease in Developing Countries”

In a twist to the usual commentary on disease in developing countries, the latest issue of the Economist features an analysis on the rise of chronic diseases in the developing world. The authors argue that “chronic disease has become the poor world’s greatest health problem” and “that developing countries suffer more from ‘rich world maladies’ than the rich world itself . . . By 2015, says the World Bank, these ailments will be the leading cause of death in low-income countries. They already account for almost half of all illnesses there and impose substantial economic costs.”

See my entire post over at the World Health Care Blog.