In my not-so-long-ago bid for medical school, I volunteered in an inpatient rehabilitation facility, including shadowing a physiatrist. This mostly involved the kinds of things you could readily imagine would be involved in physical therapies–in addition to scans and medications, various kinds of stretches, braces, casts, handrails, low-stress exercises for different weakened muscle groups, and so on.
Note that most if not all of these remain relatively low-tech, and for the most part are either outside of the body, or placed in the body with the clear intention of later removal. The stated goal, at least, is to free the patient from dependence on machines, and there’s an immense degree of human contact between the patient and physical therapist as well.
I eventually decided against pursuing medicine any further, for a myriad of reasons–foremost the cost, my age, and hearing one too many apocalyptic accounts from physicians about how miserable and bureaucratized the profession has become. But it still felt very natural, given that background, to try and learn more about the cutting edge technologies in rehabilitation medicine, so I’ve been attending some classes and lectures on the subject. What I have found so far is quite different from my prior experience, for it throws light on the cutting-edge of the field rather than the rank-and-file–and that cutting-edge is a very different world indeed. These are some of my infuriatingly inchoate impressions.
A demonstration lecture. We are introduced (by way of a TED talk) to a special device meant to harmlessly reveal “the wonders of neuroscience” to a large audience. The presenter, Greg Gage, tells us that the marvelous field of neuroscience is uncovering the forces and phenomena that make you, you, including the nature of free will. (“You’re nothing but a pack of neurons”, as the late Francis Crick put it.)
Alas, Gage continues, most people don’t get to see these marvels firsthand, because few people learn about neuroscience in school, which in turn is because the equipment involved in actually doing neuroscience is so onerously expensive and specialized: MRI machines, single-cell recording, calcium imaging, and so on.
Faced with this unacceptable situation, Gage and a few colleagues set out in search of ways to explore the wonders of the brain on a shoestring budget and a mass scale: do-it-yourself neuroscience, opening at last the vault of modern-day understanding of the brain to rich and poor, high-schoolers and PhDs alike.
Gage proceeds to prove his point by electronically taking control of a volunteer’s arm–this is one of Gage et al.’s star products. Two volunteers, male and female, are brought up from the audience. Electrodes are attached, via a small computerized apparatus, from the ulnar nerve of one volunteer’s arm to the other.
“Now”, explains Gage to the male of the pair, “she will take away your free will and you will no longer have control of this hand!”
Hushed awe from the crowd, as the one volunteer moves her arm and, surely enough, with eerie mirror-precision, the other volunteer’s arm imitates it. (It is naturally assumed that there is no deliberate mimicry going on.)
Wrapping up, Gage declares, “We’re going to bring on the neuro-revolution!” Wild applause, end of talk.
Now it’s our turn: as a surprise treat, the lecturer has procured some of these devices to distribute to the audience.
The device comes in a box with a cartoon image on the front which I find striking: there are two figures, one who is working a little remote-control with a knob, while the other has adhesive gel electrodes attached to his arm, which appears to be moving. Above each cartoon figure, in big superhero comic lettering, are titles for each of the two figures: “The Controller” and “The Controlled”.
We break into groups, bust open the boxes and examine the contents. Controller pad, electrodes, remote, connector jacks, all are accounted for, and we set to work on wiring everything up. The connectors are colorful plastic, embossed with the insignia of what appears to be a cockroach or a silverfish missing a leg. (The implication seems to be that we will twitch like insects.)
When all is said and done, the thing barely works—the most we manage is to get a muscle in one girl’s arm to twitch slightly—but resonances of the Milgrom experiment and a thousand sci-fi nightmares seep into my thoughts. Try it, I hear my groupmates say, try it–and for a second I can’t tell if their smiles more resemble the numb enthusiasm of converts to a new cult, or merely the usual enthusiasm of young adults for the latest novel entertainment. In some subtle way, the line between the two seems to have been already blurred, if not erased. I quietly decline.
Meanwhile (in true TED fashion), when all is said and done we’ve learned really nothing about the brain: nothing. The impulses along the ulnar nerve of the arm tell you scarcely more about how the brain really works than a cut on your thumb tells you about cardiology; similarly, the fact that a nerve impulse from the brain can be overpowered by a much stronger artificial one on the skin says no more about free will being “taken away” than does handcuffing someone to a railing. Certainly there has been no elaboration of what that “neuro-revolution” is supposed to be like. Yet none of that seems to matter. Despite knowing these things, I cannot help but feel that something—albeit very different from the stated lesson objective—has been taught or conveyed by this haunting demonstration. What is it, I wonder, as I leave the lecture hall and head for home. What, what, what.
Some time later our lecturer arranges a tour of the rehabilitation center at one of the state’s main trauma centers.
In the hospital, we crowd in a circle in one of the rehab rooms, watching as a nurse turns a knob and a volunteer’s hand slowly opens and contracts, over and over, as if of its own accord, with inanimate smoothness. Many people, though not all, can’t wait to try it.
There seems here to be a craving to unite with and be sheltered by the Machine: whether one is The Controlled rather than The Controller is of little object. The vision is one of people becoming meat-puppets for the technological, not through some horrible extrinsic oppression like in the bad old days of slavery and tribute, or in unsophisticated dystopian fiction, but through their own desiring. One’s own yearning to be healthy, to be current, to be independent, to be whole, paradoxically seems enough to make one ready to hand over control of one’s very body without a second thought.
Stroke victims often lose “sense of insight” into what they are missing, one of the rehab nurses explains to us; they favor one side of their body almost completely, while seeming to totally forget the other side exists. But at once I think, who is there to assure us that normal human beings are not the same way, just in a broader sense? In many ways, we already have strong evidence that they are. What if the entire human race suffers from a “lack of insight”? What if we are increasingly favoring only one side of ourselves, at the complete expense of the other, all with but a faltering awareness that anything is going amiss?
In the hospital I see machines, machines, machines. Vision machine. Cranking machine (a mounted metal box with a crankshaft, plus a promotional chart of 100 “real world” motions it supposedly replicates). Gait machine. Endoscopic swallowing machine. Speech machine. Machines all clamoring to do what we do, even to teach us what we do. The state-of-the-art hospital is an academy for bodies that have forgotten the true path, where machines are becoming the primary teachers.
Many of the instruments surely save lives, and yet somewhere, something has gone too far: from using the machines as an aid to people to using them to define people.
The trend is not only medical: Cathy O’Neil’s “Weapons of Math Destruction” presents the case of mathematical models that have mission-crept from studying human behavior in the aggregate to individually controlling their employment and financial destinies.
The superstructure of mechanism and its countless accretions grows and grows. Where does it go? What is its aim? What is being left out?
I read some recent news releases on climate change. One says that for the first time, global CO2 levels will no longer drop below 400 ppm at any part of the year (pre-industrial level was 270), something unseen in the last 2 million years. Another states that the Paris climate agreement, even if ratified, will be utterly impossible to carry out unless absolutely no new fossil fuel sources are developed. Yet across North Dakota a battle rages for more pipeline, more pipeline—to run more cars, more buildings, more growth.
On the surface, these articles seem to have nothing to do with mechanization in health care, yet like O’Neil’s work, they suggest a common thread. Month by month, the contradictions of our time grow more and more jarring and obvious. Are we having a kind of collective stroke right now, a progressive neglect of what is most essential? In that case, what machines have we yet invented to save us from our own wider folly, from our own rapacious incompleteness?
Through an endoscope, the sight of a man’s tracheal opening as he swallows is shown on one of the hospital monitors. It’s shocking: a ghastly, slimy, bulbous valve, embedded in a dark fleshy space, opening and closing from three sides in a drizzle of mucus, flecks of chewed food and saliva.
Maybe, I reflect, this is what the machines aim to protect us from: seeing the grotesqueness within ourselves. The body, and living things in general, surely are no machines—but suddenly, I have a glimpse of how it could be comforting to think so.
I am unable to decide on the seriousness of the technological as a threat, not simply to the biosphere, but to the spiritual life. Machines and mechanical thinking are of course hardly new–but for them to have such an intimacy with the very substance of our bodies and selves is indeed new. Surely it demands careful thought–far beyond what we are accustomed to, and far beyond what we have done.
Is the technological an autonomous force, an “alien entity from beyond the void which devoured its summoner and is proceeding to eat the rest of the world”, as Scott Alexander so starkly put it not so long ago? Is it thus an entity-unto-itself that is merely using us to establish itself before discarding us, or is it at root something of ourselves, like a parasitic twin, capable of doing little we don’t actually want?
(I am typing this on a smartphone as I walk down the hall, heavily distracted. It’s a marvel I don’t crash into someone. This predictive typing feature is kind of handy, I think to myself.)
A while after the rehab center visit, we are treated to another TED talk. This one is by Hugh Herr, MIT professor, boy-genius rock-climber, and double amputee. After being trapped for three days by an ice storm on the slopes of Mt. Washington—in which he and a fellow climber suffered extreme frostbite, costing him the lower part of his legs—Herr, once mostly known for his superb climbing skills, changed direction, dedicating himself to the development of new artificial limbs and attaining immense academic success.
His voice is soft, timid, slightly halting, very much as if some deep trauma still clings to him. But his words, by contrast, reveal a taste for technological revanchism. Sporting a pair of his own flipper-like prosthetic legs, Herr makes his way smoothly around the stage as he delivers pithy exhortations to the audience:
“Nature is driving design,” he intones, describing some of the new prosthetic limbs emerging from his research. “Design is also driving nature.”
He continues for some time in this gnomic, prophetic vein. “We are bridging the gap between human limitation and human potential”, he explains. “The artificial part of my body is malleable, able to take on any form, any function.” Because of this malleability, he argues, it was possible for him return to rock climbing “stronger and better”.
Yet Herr sees problems crying out for technological solutions not just in the severely injured, but in ordinary craftsmen and the able-bodied. The fact that shirts can occasionally itch or fit badly, for instance, seems to be a cause célèbre to him second only to the development of novel replacement limbs. Some day, he explains, our clothes will no longer be made using outdated “artisan strategies” but using “data driven quantitative strategies”. (He apparently has never seen images of the inside of a textile sweatshop, a triumph of “quantitative strategies”.)
Next he describes new robotic exoskeletons that can be used on healthy persons to amplify their strength, and notes with an edge of contempt that after taking them off, users their own legs feel “ridiculously heavy and awkward”. (What sort of an achievement is it, I wonder, to make your own perfectly healthy limbs seem intolerable?)
Finally, as though summiting his own mountain of overcompensatory hubris, Herr suavely declares: “our humanity can be embedded into electromechanics”. Full stop.
Switching tacks, Herr then frames the question of human-technological augmentation in terms of rights: “Every person should have the right to live life without disability if they so choose—the right to live life without severe depression; the right to see a loved one, in the case of seeing-impaired; or the right to walk or to dance, in the case of limb paralysis or limb amputation.”
This sounds eminently reasonable and even inspirational, especially in dramatic cases like those of amputees. But at the same time something in me doubts it, and wants simply to say with a shake of the head: there is no “human right” not to have awful things happen, no “human right” to dissolve yourself in machines. There are no such rights, however much you may desire them.
Finally, Herr brings up the story of a woman, an aspiring dancer, who was severely injured in the Boston terror attacks. Can we give her a bionic foot so she can dance again? The answer, of course, is yes. The woman is led onto the stage and carefully executes a short number with a male partner guiding her as Herr looks on.
Somehow this comes across as disquieting, much less because of the sight of a woman with a robotic foot rather slowly dancing around the stage than because of the rhetorical arm-twists that Herr has piled one on top of the other to get us to this point. It seems we’ve been led to conclude that any misgivings about the broader repercussions of his technologies are tantamount to an acquiescence to bomb attacks and jihadist intimidation. In short, we should embrace our cyborg future: because otherwise, the terrorists win.
As the talk ends, I begin to think about the strength-augmentation device again, and wonder if someday a point will be reached where people like Professor Herr argue for proactive amputation of natural limbs. Given that they function so poorly compared to the prostheses that could afterwards be installed, and assuming our humanity can truly be “embedded” in wires, chips and steel just as well as in flesh and blood, what ultimate objection could there be?
We are introduced to motion capture systems for gait analysis. A video shows a woman running in a gray metal-and-concrete room, back and forth, with reflectors pinned to her joints and limbs. Cameras throughout the walls track the motion of the reflectors, and processors and software convert the motions into a bio-mechanical model—a digital thumb-print of her musculoskeletal system.
Yet again, like Alexander’s “entity from beyond the void”, there is an uncanny feeling of the technological trying to intercalate itself into the human, to conform itself to it–to engulf it, track it, capture its essence. The woman running in this metal room seems tiny and fragile, all too much like a captured microorganism under intensive microscopic study: and perhaps that is exactly what she is. The goal, the output, is a reduction of that specimen to a vectorial and veridical stick-figure, preserved in silicon, wholly de-animalized: a better self, perfect, rational, and healthy for all time.
Oceans of ink have been spilled on the interaction between man and machine, and the possible integration of the two, yet I cannot resist writing about it in light of these experiences. Somehow a line is crossed, or erased, and I am left to wonder whether it is a line worth defending, a line written in nature or in the essence of the human—in short, something worth being deeply unpopular over.
It is not merely curative or utilitarian any more—for as as often as not it feeds the disease—and so, lacking that, it feels like there must be an agenda at work. I am part of this system, typing upon the keys and looking into the screen of one of its creations, and so am unable to decide if my misgivings are absurd or prescient. Certainly I am not the first person to notice something uncanny about the latest involutions of the technological, their continued penetration and de-differentiation into our very lives. But isn’t this assault on the individual body, its total permeation, surveillance and penetration, something startlingly new?
There are, admittedly, certain precedents. Hearing aids and contact lenses, even wristwatches; going further back, we have even processed foods, chemical additives, drugs—these are not machines precisely, yet still are ingestible, implantable technology of a sort, seemingly born of the desire to unite with our own technical creations till we can literally taste them, till they run through our veins. We long to taste the wafer of communion with these fabricated selves, to have them become ourselves, whether it be by “healing”, “progress”, “wearable tech”, “personal augmentation”, “big data”, “social media”. Or we may call it anything else, as necessary. Even the dumping of carbon into the atmosphere means that we must taste and breathe the technological, and so it, too, is a communion.
I wonder where this longing comes from, for it is clearly a longing, and foremost in many minds of our day. It is not like the longing for connection to the divinity, some cosmic Thou, for that has been frowned upon and deemed simple-minded; nor is it longing of Pygmalion, whose artwork became human, and indeed lovably so. Instead we have the opposite direction of the latter: we create something intended as an antithesis of art and and then aspire that we become it. We less and less insist even that the technological should meet us halfway; we go running, cartwheeling, stimulating and implanting ourselves towards it, with a growing abandon that is however matched by a growing anxiety. (Even the TED blurb describes the “Controller and Controlled” demonstration as a “fun [and] kind of creepy”.)
This anxiety may be the key. Would Professor Herr settle for his “stronger and better”, attachable, variable-size legs, with parts that can fit tiny cracks in a rock in which no natural foot could gain purchase, over getting his “ridiculously heavy” natural ones back? I somehow doubt it. Would anyone fully rejoice at walking on new prosthetics, if it meant losing the myriad sensations and intuitive reactions afforded by the natural limbs? There is a spite in this repudiation of the originals of nature, a need to devalue them so that our own situation will seem more valuable, or at least more negotiable. And so it is our own motivations that we must examine, I believe, not the machine’s.
In that case, the prosthetic in itself is fine; it is well and good to help someone walk who otherwise could not. It is a tool like countless others, born out of man’s cleverness and the frustrations of his body and his finitude. “Rights” are hardly necessary to invoke in defending it; it is enough just to say life is too short to spend struggling on the most basic things of human life, like hobbling to the fridge, to the bathroom, to one’s own bed, all without any source of hope. It must be the mood and rhetoric that are overdone and disturbing–in them, not in any configuration of components or data flows per se, is where the trouble must be found. The monster is not coming for us; rather, the monster is us. “The essence of technology,” wrote Heidegger, “is nothing technological”.
I once got into a heated conversation with a close friend, who was a lover of technology in virtually all its forms. I believe like many Millennials who grew up on the Internet and often perilously little else, she believed in the technological as not a means to achieve some human end, not something that supervenes on the human, but as a completely value-neutral background of being, and so the only form of salvation from an often intolerable life. This extended to her conviction that becoming cyborgs was not a big deal in any way.
“Of course we are Borg,” she once said to me, referring to the implacably expansionist cyborg race from Star Trek. “We are all just part of the collective. We are fooling ourselves to think anything else. We don’t have any free will anyway. Why should we? It would be best if we were all linked together thinking as one and stopped trying to be individuals.”
I demurred, and suddenly finding myself very high up on my high horse, began telling her something about how the struggle for freedom and privacy itself was worth it, that the point of being an individual was not to let the system utterly define you, and so on and so on.
Yet as I watch all of this I have to admit she was right, or at least foresightful: we are cyborgs, perhaps in a Strangelovian sense–How We Learned to Stop Worrying and Love Machine Control.
As these classes and lectures proceeded, several interesting connections presented themselves, seemingly by coincidence. For one, I found myself reading Donna Haraway’s “A Cyborg Manifesto”, which I learned about by an offhand recommendation from someone I met only in passing. In this work, Haraway exalts in the possibilities opened up for feminism by the cyborg’s complete ability to customize itself, its freedom from the “natural/unnatural” distinction and the implicit authority bound up with it. Near the end, she writes,
“Perhaps paraplegics and other severely handicapped people can (and sometimes do) have the most intense experiences of complex hybridization with other communication devices.”
“Why should our bodies end at the skin, or include at best other beings encapsulated by skin? From the seventeenth century till now, machines could be animated—given ghostly souls to make them speak or move or to account for their orderly development and mental capacities. Or organisms could be mechanized—reduced to body understood as resource of mind. These machine/organism relationships are obsolete, unnecessary. For us, in imagination and in other practice, machines can be prosthetic devices, intimate components, friendly selves. We don’t need organic holism to give impermeable whole-ness…”
Haraway’s work is filled with calls for revolution and radical renovation, through the unflinching fusion of biological and machine components in endless diversity, as both are biology and machine are blurred to the point of interchangeability by the conquering advance of digital information as a paradigm for all existence. Yet what is most striking about her essay is how much of it, published in 1985, merely presages a formulation that has become remarkably mainstream today.
On the one hand, cyborgs have become acceptable chic, have become safely heroic; they have become, in many quarters, the latest “inevitable” thing that humanity must do to itself in order to become “fully” human. On the other hand, the relentless “mass-customization” offered by the Internet has created a vast and utterly atomized population of “cyborg-like” people who increasingly do not talk to each other or in some cases even leave their apartments. There is now to be a “cyborg Olympics” in Switzerland on October 8, featuring 80 different research groups, and dozens of “pilots”
participating in challenges ranging from simple manual tasks using their prosthetic hands, to cycling races with bionic legs, to tests of skill in controlling a brain-computer interface in a simple video game.
Also worth mentioning is the late Roger Ebert’s review of “Being There”, about a flawlessly mannered yet eerily mindless gardener, Chance, who arises virtually from nowhere, and with his flawless manners and inane sayings soon becomes the darling of magnates and power-brokers and eventually, the next heir-apparent to the presidency. The review, written around the time of Deep Blue’s huge symbolic defeat of Garry Kasparov, cleverly draws parallels between Chance’s curiously vacant and mechanistic manner with the then-incipient advance of AI, and ends with this curious observation:
“The question is not whether a computer will ever think like a human, but whether we choose to free ourselves from thinking like computers.”
And on Twitter, again by way of Scott Alexander’s blog, I read the cryptic messages of a mysterious aphorist who says: “The people who see the world through the eyes of machines, but do not expect these eyes to have bugs.”
One last image from the lecture: a movie of one of Boston Dynamics’ new robots, which stand uncannily upright on two legs and take careful yet steady steps across rooms and rugged terrain. To demonstrate its ability to recover itself, a human stands beside it and gives it sharp shoves with a broomstick. After the first shove the robot staggers, but impressively recovers its footing. After the second shove, it tumbles to the ground. There is a burst of laughter from the classroom, which surprises me: it seems itself strange that people would find inanimate slapstick funny. Then, with an abrupt sequence of movements, the robot turns till it lies face-down, thrusts forward its arms till its upper body is upright, then extends its legs till it is standing again. The audience goes quiet. A voice says, “It’s almost scary how good they are at getting back up now.” (Google recently sold off Boston Dynamics, citing unprofitability.)
For now, I affirm Heidegger’s maxim: what lies behind technology is nothing technological. But if it’s not really a Lovecraftian Other, but rather in us, is this necessarily a comfort? Don’t human beings contain many powers, and perhaps many gods? Ultimately the threat is not in the technology itself, despite its often alarming appearance, but in the ways we choose to run away from our all-too-human condition, and the gods that may be born as we do so.