Wishing for the Day “The Machine Stops”

Forrest Gump got it wrong.  It is not life that is like a box of chocolates where you never know what you gonna get.  A box of chocolates always makes it clear what kind of chocolates have been packed inside.  There is no surprise whatsoever.  It is, instead, in reading that we never know what we gonna get, which is a big reason why reading becomes so rewarding.  Of course, reading while eating chocolates is heavenly ;)

So, there I was reading Atul Gawande's homage to Oliver Sacks in the New Yorker, of course.  Gawande is a medical specialist like Sacks was, and a writer like Sacks was.  Gawande writing about Sacks is, thus, to be expected like knowing you are going to taste milk chocolate if the box said it contained milk chocolates.

But, I did not know what Gawande's comments might include. And therein lies the beauty of reading.  In his essay, Gawande writes "Sacks had asked me whether I’d read Forster’s “The Machine Stops.”  I remembered a reference to this, but in a different context.  It was more than four years ago in an interview with Jaron Lanier, which I watched after reading a lengthy profile of him in the New Yorker.

Lanier is often described as “visionary,” a word that manages to convey both a capacity for mercurial insight and a lack of practical job skills. In the nineteen-eighties, he helped pioneer the field of virtual reality, and he is often credited with having coined the term. He has also dabbled in film. In 2001, he advised the writers of “Minority Report,” Steven Spielberg’s film about a dystopian future. Since 2006, he has worked as a consultant at Microsoft Research.
More recently, he has become the go-to pundit for people lamenting the social changes wrought by modern technology.

Lanier is a technology guru who worries about the dehumanizing effects of a rapidly evolving technology, and the profile essay highlighted our collective struggle on this issue:

[Part] of what Lanier finds most regrettable about Facebook—the way it mediates social contact—is precisely what makes it so appealing to most people. “We use technology this way all the time,” Andy van Dam, a professor of computer science at Brown University, notes. “To create a layer of insulation. We send an e-mail so we don’t have to call someone on the phone. Or we call someone so we don’t have to go over to their house.” Many of us also use technology, he might have added, when we’re too isolated: when someone wants to find a new friend just because he’s feeling alone—or because he’s living with his father in a freezing tent in the desert.

It was after reading that profile essay that I decided to watch an interview with Jaron Lanier, where he referred to Forster--the same reference that Sacks had made when talking with Gawande.  You se how reading makes life so fascinating?

Gawande ends his essay with a reference to Forster's "The Machine Stops":

It’s about a world in which individuals live isolated in cells, fearful of self-reliance and direct experience, dependent on plate screens, instant messages, and the ministrations of an all-competent Machine. Yet there is also a boy who, like Sacks, saw what was missing. The boy tells his mother, “The Machine is much, but it is not everything. I see something like you in this plate, but I do not see you. I hear something like you through this telephone, but I do not hear you. That is why I want you to come. Pay me a visit, so that we can meet face to face, and talk about the hopes that are in my mind.”

We live in a world that Forster wrote about back in 1909.  Screen time of all kinds.  Instant messages.  Tweets and Facebook status reports and blog posts like this all passing of as knowledge, just as Forster had feared.  We have replaced real human interactions with virtual ones.  So "satisfied" with the virtual interactions, and thinking that the virtual even eliminates the need for real interactions, we seem to believe that visiting with parents, children, friends, is not needed anymore.  We live in our own cells.

Through his writing and his own life Oliver Sacks reminded us all about us humans in the flesh, writes Gawande:

He was drawn to the homes of the sick, the institutions of the most frail and disabled, the company of the unusual and the “abnormal.” He wanted to see humanity in its many variants and to do so in his own, almost anachronistic way—face to face, over time, away from our burgeoning apparatus of computers and algorithms. And, through his writing, he showed us what he saw.

Like I said, you never know what you gonna get when you read.

The patient is not an object. The physician is not a technician.

A year ago, it was the death of Robin Williams, who played the role of Oliver Sacks in Awakenings.  And now Oliver Sacks has also died.

I reviewed my own posts in which I was sure I would have referred to Sacks.  I have, yes, but I am shocked that there was only one post.  Shocked because I have read quite a few essays by him and every one of them was profound.

Like many, I too read more than one obituary piece on Sacks.  In this one, at the New Yorker, I found something especially insightful:

 He resisted the powerful current of modern practice that seeks the generic. He rejected a monolithic mindset, and retrieved the individual from the obscuring blanket of statistics. This put him outside of the academy, exiled to chronic-care institutions. Through his writing, Sacks ultimately received recognition for advancing a unique form of clinical scholarship that was largely abandoned: the study of the single person within the context of his own life. Ever the acute observer, his case histories confirmed that under a single diagnostic term was a spectrum of human biology. No two patients are ever the same, he emphasized. ...
Every dimension of the patient was meaningful in his thinking.

 Against the generic.  No two patients are ever the same.

Powerful ideas.  Ideas that are relevant not only to the medical practice alone and, instead, they are applicable to every walk of life.  We often forget that no two people are the same.

In any professional practice, there is a reason, I suppose, that we go with the generic--it is "cost efficient."  But then, I have problems getting even the best fitting shoe because my feet are not the generic 7.5 size!  If that is the problem with the feet, then think about the brain, the biochemistry, the ... In the modern economy, we value and prize "efficiency" so much that we have even begun to forget that every individual is different.

In my own profession, education, this generic approach is leading us deeper and deeper down the rabbit hole of "cost savings."  Students are no longer individuals but are mere products to be shaped in a Fordist factory.  We put them in larger and larger classes, without any consideration of the differences between John and Jon, leave alone John and Jane.  At "prestigious" universities, we pile students in classes of 300 and 500, oblivious to the 300 and 500 different individuals that they are.

As I recall the faces of students with whom I have interacted, and whose stories I know at least a little bit, every one of them is so different.  I can see how I customized my feedback to them, even if the questions were the same.  But, of course, being in small classes, to talk with students, not to use the generic and standardized test formats, are not consistent with the favored "cost efficient" practices and, for all I know, I will soon be without a job.  It will not be "efficient" to retain me on the payroll.  How easily many educators and politicians seem to have have forgotten why they liked and appreciated and loved listening to Another brick in the wall!

Even though Sacks kept the individual patient in the front and center,

This did not mean Sacks was a Luddite. He was an avid reader of scientific journals, fascinated by scientific advancements in imaging the nervous system at work. He engaged in dialogue with Nobel laureates and lab scientists about the nature of consciousness, providing what they lacked—the insights of a naturalist, a field worker.

Indeed.  Sacks showed us that being an "artisan" didn't therefore automatically mean being opposed to scientific and technological advancements.  He made it seem easy how to use those advancements in order to make his individual-centered approach that much more rewarding to his patients.

I saw Sacks in person, and heard him, when he was in Portland on a book tour, which was soon after the publication of Uncle Tungsten.  Even from the back rows of the auditorium, it was clear that he was full of energy.  I had no idea at that time about the complicated and miserable life that he had lived in his younger years; reading about those made me appreciate his energy and commitment all the more.

His own words, from a couple of weeks ago, seem to be the best way to end this post, especially because of the references to the meaning of life and inner peace and happiness, about which I often blog:

And now, weak, short of breath, my once-firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual, but on what is meant by living a good and worthwhile life — achieving a sense of peace within oneself. I find my thoughts drifting to the Sabbath, the day of rest, the seventh day of the week, and perhaps the seventh day of one’s life as well, when one can feel that one’s work is done, and one may, in good conscience, rest.

"Face to face with dying."

I read the news today, oh boy!  Oliver Sacks has terminal cancer.  He is dying :(

Of course, he is not a young man.  At 81, well, one is expected to be closer to the end than is a 21-year old, yes.  But, death at any age, and the process of dying, is not easy to deal with.  "I cannot pretend I am without fear" Sacks writes in that piece.

It was in graduate school that I came to know about Sacks.  Through a fellow-Indian student, who was doing his doctorate in the engineering school.  He told me about The Man Who Mistook His Wife for a Hat and Other Clinical Tales.  I then read it as much as I could understand the intricacies there.  (Even sweeter was that he--the student, that is--met a friend of mine, at a gathering at my place and they remain married to this date!)

And then, of course, was the movie Awakenings.  A few years ago, Sacks was in Portland, on a book-tour-lecture.  About his childhood and science and experiments.

He is dying.

my luck has run out — a few weeks ago I learned that I have multiple metastases in the liver. Nine years ago it was discovered that I had a rare tumor of the eye, an ocular melanoma. Although the radiation and lasering to remove the tumor ultimately left me blind in that eye, only in very rare cases do such tumors metastasize. I am among the unlucky 2 percent.

The very reflective person and writer that Sacks has always been, well, it is no surprise when he writes:

It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can.

For many of us, it might be a neat way to spend time at a party pondering over "if you knew you have only six months more to live, what will you do?"  But, in Sacks' case, as is the story with many others, it is a real deal. The timer is on.  A timer than cannot be reset.

I feel a sudden clear focus and perspective. There is no time for anything inessential. I must focus on myself, my work and my friends. I shall no longer look at “NewsHour” every night. I shall no longer pay any attention to politics or arguments about global warming.
This is not indifference but detachment

As much as I think about death and dying and about how I am mindful of the remaining third of my life, I know I will feel sad to exit this stage.  I like being in this wonderful play, even if sometimes the roles I get to act simply suck.  But, I hope to have that combination of "full of life" and "detachment" that Sacks writes about.

But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers. Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

It is, indeed, an enormous privilege to be a thinking animal, an animal with feelings, especially "on a mote of dust suspended in a sunbeam."

Thank you, Dr. Sacks!