We Could've Had it All

Retro-Viral

Have you seen this meme popping up around the internet?

It’s a screenshot from the “educational” computer game called The Oregon Trail.

For millenials of my vintage, it’s the perfect meme: topical, cynical, and nostalgic.

It’s topical because there has been a rise in cases of dysentery, caused by the Shigella bacteria, in Multnomah County, Oregon.

A Golden Age for Preventable Diseases

Dysentery is just one of the “blast from the past” diseases making a comeback in American life.

Notably, Measles continues to spread despite the availability of a highly effective vaccine that helped us eradicate the disease in this country decades ago.

Pertussis is both vaccine preventable and also on the rise. Cases have been reported around the country (NC, OR, WY, ID) but Oklahoma has been particularly hard hit. The state is now facing its largest outbreak in 69 years.

Kansas has been experiencing one of the largest TB outbreaks in a one-year period of the last several decades. Both preventable and treatable, TB is a leading killer globally, but (usually) a relative rarity in the United States. Our ability to treat the disease is now imperiled.

There’s reason to believe these medical disasters are just the tip of the spear, as other individual and public health decisions portend rising rates of unnecessary disease:

• Drinking raw milk, a habit promoted by HHS Secretary Kennedy (sigh), can cause outbreaks of e. coli, listeria, Rift Valley Fever, and bird flu (H5N1).

• Utah will be the first state to ban fluoride from public drinking water. Scientists predict this will lead to increases in cavities and other sequelae of tooth decay.

… and boy could I go on.

Back to the Future

While #WellnessInfluencers try to bring back times when men were men and lungs were iron, we’re also living through an age of fanatical futurism.

It’s disorienting and, in many cases, mind-numbingly dumb. For example, several carmakers are trying to radically redesign the gear shifter for seemingly no reason.

Customers are confused: “I didn’t even know how to drive this damn car.”

You may have also seen the Salesforce Super Bowl commercial, “Dining Al Fiasco”, in which world-famous actor Matthew McConaughey is forced to sit at a table outside in the pouring rain and eat foods he dislikes because… he didn’t use Salesforce’s proprietary AI to decide what and where to eat?

As one critic puts it, “It is simply wild that Salesforce has this opportunity to highlight to a mass audience, even indirectly, their best and most promising use-case for AI, and here they are aggressively pitching an inscrutable solution to a non-existent problem.”

Some of the “future-is-now” gambits are more dystopian than others. For example:

• McDonald’s is testing facial recognition in their drive-thru lanes, and it’s not the first fast food chain to do it.

• The LA Times had to decommission a new AI-powered “Insights” tool designed to generate summaries to articles because it defended the KKK.

The healthcare system is far from immune. A recently published study in Health Affairs reports that 65% of U.S. hospitals use AI-assisted predictive models, most commonly to anticipate inpatient health trajectories, but only 61% of those have evaluated their model for accuracy with local patient data, and only 44% have evaluated their model for bias.

The failure to evaluate for accuracy and bias is dangerous. Just this past week, a team out of Virginia Tech reported that, when tested, current medical machine learning models missed a whopping 66% of injuries related to patient mortality within hospital settings.

If that doesn’t give you the heebie-jeebies, maybe this will:

Hippocratic AI, a company founded in 2023 to address the global healthcare workforce shortage, is touting its AI Agents as a replacement for expensive nurses and allied health professionals. They’ve got more options than Baskin-Robbins:

I am sure that these predictive machine learning models and AI bots were designed by good-hearted people trying to improve healthcare. But I can’t help but think they are being deployed—like the other futuristic fixes above—as ways to cut costs, charge more, or both.

Michelle Mahon of National Nurses United seems to agree: “Hospitals have been waiting for the moment when they have something that appears to have enough legitimacy to replace nurses. The entire ecosystem is designed to automate, de-skill and ultimately replace caregivers.”

If It’s Not Broken, Fix It

Whether we’re trying to find an “alternative cure” to measles or design the gear shift of the future, we seem hellbent on reinventing all of the wrong wheels.

If it’s tried and true it’s tired. If it’s widely accepted it’s suspicious. If it involves human-to-human interaction, it’s inefficient. If it doesn’t come with an AI co-pilot, you can bet one is on the way.

We are all Matthew McConaughey sitting in the rain with our sad shrimp cocktail. Menus and indoor dining are too ‘woke’ now, I guess.

This is Not a Game

Back to dysentery (a sentence no one wants to read or write).

There is a reason dysentery is spreading in Oregon. Portland has a large homeless population, with 1 in 165 Portland residents homeless on any given night. There are not nearly enough beds for homeless residents (0.61 per unhoused person), in either emergency or permanent housing.

There are also far too few public restrooms. The roughly 116 public restrooms in Portland are predominantly located in parks and libraries. About 61% of public park toilets are closed in the winter to avoid freezing pipes, and libraries are only open during the day.

Dysentery and other communicable diseases are bound to spread when people live in crowded encampments without access to sanitary toilets, clean water, and soap.

Working on public restroom infrastructure and housing policy is decidedly unsexy. It won’t be fixed by an AI chatbot, memecoin, or seed oil ban.

Improving the situation will require substantial investment and individual sacrifice for the greater good. It’ll be about handwashing education and zoning rules. Reliable, boring solutions to serious problems.

I’m afraid we’ve lost our appetite for that kind of large-scale civic response.

We could’ve had vaccines for cancer, energy-efficient affordable housing, and litter-free hiking trails. Instead, we’ll get tooth decay, 18th century plagues, and cars we don’t know how to drive.

I guess that Oregon Trail meme isn’t so funny, after all.

Around the Internet

• Federal Revenue Tool

  An interactive data dashboard that shows how much educational funding your state could lose due to federal cuts.

• What is an Infodemic?

  A nice primer on infodemics, including strategies to help you navigate them and stop the spread of misinformation.

• The FDA is Cracking Down on ‘Poppers’ Producers

  This week, the FDA went after companies manufacturing poppers, a type of inhalant drug. As this article points out, RFK Jr. has argued that use of poppers, not HIV, causes AIDS.

• The right dominates the online media ecosystem, seeping into sports, comedy, and other supposedly nonpolitical spaces

  I knew the right wing media ecosystem was formidable, but I didn’t know the half of it. This Media Matters study should be a massive wake-up call for anyone interested in political discourse and democracy in America.

Living Rent-Free in My Brain this Week

I’m not saying this is anyone’s plan… but I’m having a hard time unseeing it.

Quote I Like

Thanks for reading. Hang in there, everybody.

Ky

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