Should you get your DNA sequenced and show it to your doctor?

After FutureMed this year, I sent my spit to 23andme to have my DNA sequenced.  They told me that my mom had Tibetan origins and my dad had Andamanese origins - fascinatingly I've traveled to both these regions.  They told me stuff I knew - that my eyes were brown and hair curled a little.  The most discomforting (at least initially) was my disease risks that varied from atrial fibrillation to prostate cancer to Alzheimer's.

I was skittish when I first logged on to find out my results (it took six weeks after I shipped my spit).  There was a prompt that asked something like, Do you really want to see it?  What the heck, I thought and clicked on ahead.  Then I went through a phase of omg, how could I have all this going on inside?  And then I realized this had to be everyone's story.  All our bodies are likely to have something broken inside with the kind of mutations our DNA has been through (consider, interbreeding with Neanderthals).  We just didn't have a means of learning about it, up until now.  For a long time, I did nothing about these results.  I was busy preparing for a trek and work - I just let it lie.

Around my 21st birthday, because of a chance incident, I was diagnosed with genetic hypertension and put on a 50mg daily dosage of Atenolol.  I simply took the tablet for several years and life went on.  More recently, I started exploring ways to get over hypertension to give me the flexibility to trek more freely.  Interestingly, my DNA didn't talk of hypertension as a risk factor.  I decided to show my data to doctors and see what they say.

What doctors say when they see DNA data

I met two types of doctors - one is an allopathic doctor who originally diagnosed me with hypertension and the other a natural therapist who works on the body systemically.  

The natural therapist (also a physician) studied my entire history (family, medical and lifestyle) and over an hour long discursive diagnosis told me that I had what might be essential hypertension.  He explained that when a body has essential hypertension, its systems simply rev faster - it's not a disease but more an internal behavior.  He fixed my diet - from cutting out milk and wheat to other food that made my intestines work harder, therefore requiring the heart to pump more blood.  He curiously looked at my DNA results for a long time and said that it reaffirmed his thinking - I need to fix what I put in my mouth.  He kept reiterating that the essential systems of our body are interconnected - a problem in one area sooner or later affects another - for e.g. the liver affects the lungs that affect the heart.  Our general understanding was to explore getting me off medications slowly to curtail the toxins accumulating in my liver.

In the interim, I had mild wheezing that wouldn't go and a lung doctor suggested I shouldn't be taking Atenelol that may have side effects.  When I met my allopathic doctor (a well experienced general practitioner who also thinks systemically), I told him that - interestingly, he felt the same and took me off the medication altogether.  It's been over 10 days now and when I check my blood pressure daily - the readings are very normal.  Looking at my DNA results (I'm sure I was his first patient to show him that), his alerts went off on the risks it pointed to (e.g. prostate cancer) and he prescribed tests that I must do every two years to keep a watch on my insides.  

What I think as a patient

When doctors see patients in episodes of time and make decisions, they can be flawed.  As with everything, the body is changing all the time and so is its data.  DNA data provides very basic clues on where the problems might be - these are flaws in our machines.  Lab data (such a Lipid profile) only provide data at specific points in time.  What we really need is data that constantly flows - similar to what a cockpit in a plane gets when it flies.  This isn't possible yet but will in the future.

As patients, we see doctors (and specialists) for specific medical problems.  Each doctor fixes his side of the story, often adding problems to other systems of the body.  There are very few doctors who are able to think (and have the patience to think) of the body as a whole and see the interconnectedness of systems.  But we do so as patients (our body is talking to us all the time) and therefore it becomes our responsibility to channel the care our body needs.

I wonder now if I really ever had hypertension or was that an episode in time.  Or did it gradually go away because I took control of it (I eat moderately, exercise, meditate)?  Or is this an episode in time and would it recur?  I'll never really know the answers to these questions.  My job is to track my data continuously - just as a pilot does for his plane.

I realize that I need both the types of doctors that I see - I need to fix the symptoms when they occur through medication but I also need to fix the system.  Systemic problems require systemic correction - largely involving diet, activity and state of mind that mere medication will not fix.

Should you sequence your DNA?

The answer is yes.  Every other disease becomes a symptom as we learn more about it.  In the past, fever was possibly a disease requiring various cures.  We now know that it's actually a symptom - an indicator that our body is showing to let us know that something is not alright inside.  You can fix the fever by popping Tylenol but you gotto fix the systemic problem for the fever to really go away.  Just as a thermometer gives us insight into fever, our sequenced DNA gives us insight into few other indicators that our body is talking about.  

It took me a few hours, after I first saw my results, to accept that health risks exist for me and for everyone and I'd rather know than not know about them.  If anything these results have helped me give focus to areas that need attention - for e.g. what I eat, how I eat, when I eat (I still haven't fixed it but am more aware).  It also helped me prioritize things in general and be more conscious of how I spend my time.  I worry less about what other people think and focus more on doing things that I really want to do.  I was usually reticent about my health in the past but have surprised myself now by being open about it - thinking that if I talk, it'll help other people.

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But the human DNA is just 10% of us.  90% of our body is the microbiome - bacteria and other microorganisms that reside in us.  Sequencing the microbiome (startup ubiome does it) will tell a whole new story.  Now, I just can't wait to ship my poop.

Messing with Google Glass (and How To Cat-Enhance Your Pics)

Yes, we got one.  We've had hardware, software, middleware...now let's welcome Glassware that will help you make cats appear in front of the Taj Mahal.

A Mirror API on Google's servers connects the development environment to the Glass environment, always keeping Google in the loop.  Google let's you develop in a choice of five languages - Go, Java, .NET, PHP and Python.  This allows developers to create timelines/ cards and menu items that users can access by swiping, tapping and speaking.  Google does a nice job of showing how it feels here but here's how it looks when you un-box.

Cat-enhance your pics

I found this wonderful programming story on how to send users facts about cats by the hour.  Below is a short bit from the Glass developer website on how to cat-enhance your pictures.

1. Your user visits your web application and installs Add a Cat to That by authenticating with OAuth 2.0.
2. Your service creates a new contact on your user's Glass called "Add a Cat to That."
3. As your user takes photos, they share them with Add a Cat to That.
4. Your service composites a random image of a cat on to the shared photograph.
5. Finally, your service delivers the cat-enhanced photo to your user's Glass.

Where do we go from here?

I shudder at the glut of Glassware apps that will soon come our way.  Most of them will be photo/video-based consumer apps - with may be you and me in it.  Our perception of what is real and virtual will blur several notches than it is now.  There will be apps that can alter your life's experience (think seeing cat images everywhere you walk on Times Square).  We will focus even less in the real world - we won't have to reach our phones now, we will simply get notifications in front of our eyes.  People will absurdly touch the side of their heads all the time and keep talking to themselves, activating different functions (remember when you first saw someone using Bluetooth).  Employees will walk in with Glass creating confusion about BYOD policies and confidentiality.  Gamers will get to play even while they sit for dinner with you.  There will be porn (though Google restricts) on the street but you won't know it.

But we will still use it anyways.  Plus we will love it.  "Ok, Glass," let's get started.

The Unimportant Maketh The Important

We need light to recognize darkness.  We need to be sick to understand what it means to be healthy.  We need short people to identify the tall ones.  We need to be far to feel close.  We need to be old to miss youth.  We need failures to distinguish success.  We need to be silent before we speak.  We need the unimportant to know what's important.  But if the unimportant is so important as to make the important so - then isn't it more important than the important?

Is Apple Getting Uncool?

I usually tolerate spam from Apple - it's white and colorful at the same time.  But today I got an email that had please-please-buy-me writ all over.  The subject line said, "We spoke too soon."  I clicked to see Apple showing off a prize from J.D. Power and Associates, a company best known for blessing new automobiles.  Ahem.  Ahem.

As a quick-and-dirty survey, I checked traffic sources for this blog.  Here's how it looks:

Macintosh 57% Windows 31% iPad 4% iPhone 3% Android 2% Linux <1% BlackBerry <1% Other Unix <1%

There you go.  More people are on Macs than Windows.  Apple is edging to become a producer of mass consumer products used by everyone.  What must be happening here?

When we obsess about something, we become that obsession.  Apple is more outwardly focused now than it ever has.  It used to be about ignoring customers and thinking differently from within company walls.  Now the focus is less on the inside but more about grabbing market share and protecting its turf.  In its pressure to meet Wall Street's expectations, the company needs an ever increasing growth curve.  While there must surely be a healthy pipeline of products, it needs a churn at a piping hot frequency - not just version changes.  The only alternative for Apple is to find ways to sell more and more.  That's what it's doing, gradually trading exclusivity for quicker bucks.

Samsung, Microsoft and others are getting hipper - diluting Apple's difference.  We are now officially in the tooth-paste phase of computing products, a state of mind-blur where every product is only as interesting as the other.  Differentiation is marginal - not real.  And an iPhone becomes just a smart little phone.  There's a worm lurking in Apple.  Steve must be squirming...somewhere.

The Power of Not Wanting

I want things all the time.  I want sales.  I want money.  I want resources.  I want to build things.  I want people to pat on my back.  I want to be liked.  I want respect.  I want time.  I want to be useful to society (I like this one because it makes me fool myself as a good samaritan).  What if I don't want - even if it is just for a few moments.  Not wanting sets me free.  In that freedom lies great power to do things exactly the way I want because I really don't want.  

Wanting makes me desperate and weak.  Not wanting puts so much faith in my ability to make things happen that I feel heady.  Instead of resisting something that I think shouldn't be happening, I simply say yes and move forward.  This somehow opens doors that I didn't know existed.  Not wanting puts me in a position of saying yes or no.  Wanting puts me in a position of waiting for someone to say yes or no.  Not wanting makes me think of myself as unique and the world as an abundant place full of undiscovered resources.  Wanting makes me competitive, hungry with a hopeless world view that there's not enough out there.  Not wanting triggers that part of my brain that gives me ideas.  Wanting puts emotions at the forefront.  

Not wanting somehow gives me all the things I would think I want.  It gives me time.  When I'm playing with my son and think of that time as his and not mine, it makes me desperate for time.  But when I don't care about time then that time becomes mine and I seem to have infinite time.  When I'm desperate to close a sale, it never closes.  I come across as needy.  When I don't care about the sale, somehow I speak more truthfully and it takes its natural course to closure.  When I don't care if someone likes my work, the focus becomes the work and not useless externalities that dilute it.  

Try not wanting.  Now would that make you want to try it or not want to try it?  Go figure.

Being Okay With Not Knowing

The more I know, the more I seem to get a glimpse of what I don’t.  When I know what I don’t, I soon find that the I-don’t-know part expands and expands.  I don’t seem to know much about the past or the future.  Even better, I don’t seem to know anything about the present.

Let’s travel to our past.  5 years, 100 years, 1,000 years - how about 50,000?  Scientists recently sequenced a Siberian girl’s DNA from her pinkie bone.  Much like me, she had dark eyes, skin and hair but she got to hang out in the Altai mountains back in the days.  They call her kind the Denisovans.  Denisova hominin are an earlier species of humans and Neanderthals - suggesting interbreeding between the two.  What’s more intriguing is that 2.5% of my DNA (and that of most living Asians and Europeans) might be Neanderthal-laced.  This means that my ability or inability to fight diseases today may be the result of sexual choices of my prehistoric grandparents.  Ahem.  Do we really know our past?  How much past is good enough to call it so?

Let bygones be bygones - the present should be more in our grasp.  But time, even in its present moment, is wide and deep.  What we see is not usually what we think it is.  Fungus on old bread isn't just fungus on old bread.  Learning a little about mycelium, I now know that fungus serves as the Internet and circulatory system of our ecology - transferring food and intelligence.  Molecular communication in the environment occurs through cellular mats of fungus, sometimes spreading over thousands of acres.  I'm hardly aware that my lunch is a product of this network that has been in the works for generations past.  So is the present moment really about now?  I don't know.

That leaves our future.  When I think of the future I'm reminded of Sonmi-451, a genetically re-engineered waitress in Cloud Atlas - a deliciously chaotic movie by the Wachowskis and Tom Tykwer.  In the year 2144, Sonmi starts a revolution when she discovers that bodies of her species are “recycled” into food to produce future waitresses.  Centuries later, most humans are destroyed and the tribe that remains worships her as a fearful deity.  This amusing take of the future makes me wonder about the reality of today that embeds unknown influences of the past.  It also makes me wonder about the future that will borrow from an unreal today.  What is future then?

When we only see the red dot on a white board, we miss the vast nothingness that stares at us.  Time is expansive and cannot be contained.  I don’t think Time thinks of itself as linear dots neatly arranged as past, present and future.  In fact, Time possibly thinks of itself as a repetitious sphere going round and round - think night and day, season after season, yearly revolutions, solar and lunar eclipses, water cycles and so on.   Why should our time be any different?

We love the false sense of security that I-know offers.  But in reality I-don’t.  The more immersed we are in I-don’t-know, the more we may indeed know.  May be.

Takeaways from FutureMed (Day 2)

Here are a few of my takeaways (and thoughts) from yesterday at FutureMed 2013.

We are full of sh*t

Just as gene sequencing took off these past couple of years, we will soon see analysis of microbes break new ground.  Companies like uBiome are mapping the microbiome (the sum total of microbes, their genes and the environment).  I learnt during Larry Smarr's lecture that 90% of our cells and 99% of our genes aren't human (whatever human is) but microbes!  Our gut alone harbors 100 trillion bacteria.  Depending on what species are most dominant inside us determines our physiology.  So we are indeed what we put into our mouth!  Read this fascinating article on how Larry quantified himself to the extreme to take control of his health.

Watson is learning about cancer at Kettering and will go live by the end of the year

IBM's Watson is at Kettering devouring knowledge from millions of its encounters.  Senior oncologists at the hospital are spending 50% of their time teaching Watson.  By the end this year, it'll start assisting doctors with therapeutic options for cancer.  Marty Kohn said that IBM has no decision yet on their business model for Watson.  Would this be a big cloud or several mini-clouds?  We don't know this yet.

An inflection every 50 years

Back in 1870, there was germ theory.  In 1920, advances based on medications (example is penicillin).  By 1970, medicine evolved into a science (evidence based).  Fast forward to 2020 and we could possibly be working in a healthcare world that's driven primarily by data.  These thoughts were from Daniel Riskin, MD whose company actively culls out data from EHRs and creates meaning out of it.

A machine is possibly better than 50% of MDs (who are below average)

Vinod Khosla reflected on insights that possibly stare at us in our face.  The most uncomfortable of them was the fact that half of the doctors out there are below average and could possibly provide much better medicine with assistance from a machine.

Elegant visualization and avatars

Among several other things, John Mattison, MD from Kaiser talked about elegant visualization in the world of big data.  As a case in point, a recent study generated 5 terabytes of data for every patient.  To put this in context most of the world's data has been created in the past two years and is unstructured (Mary Kohn).  A better way to make sense of such data would be to use for example heat maps to visualize what's going on.  What if you combined such visualization and connected it with actionable outcomes using avatars?  If your grandma heard from your avatar in your voice, would she be more willing to get active everyday?

4 predictions for health IT

Christopher Longhurst, MD made the following interesting predictions:

1) EMR vendor consolidation and increasing federal regulation will pose challenges to rapid innovation

2) Health IT focus will shift over the next 3-5 years from EMR implementation to analytics-enabled clinical decision support

3) Over the next 5-7 years, we will see a shift from "evidence-based practice" to "practice-based evidence" through the creation of national learning healthcare systems (could HIEs be those hubs?)

4) Personal health records will evolve into personal health advisors

Trusted recommendations at the right time change behavior

Julia Hu from Lark showed the new Lark.  Their approach to development involved capturing and automating expert coaching and providing behavioral alerts to users at the right time.  For example, if Lark noticed that you didn't sleep well last night, have been running around all day, are still in the office at 7PM and have been sitting for two straight hours then it knows you possibly need a push to de-stress for a few minutes.

New age of innovation

Here's 16-year old Jack Andraka's video where he's screaming away joyously when he became the grand prize winner at the Intel Science Fair last year.  He developed a new way to detect pancreatic cancer and is talking to Quest and other labs to commercialize his method.  He closed his presentation talking about how the Internet has no cognition of who you are, your age, your gender and so on but mainly about what you have to say.

More later.

Amazon must invest in bio-data centers

For all the scramble that we've had over cloud computing the past few years, there could be a gentle evolution underway.  Last August, George Church's Regenesis became the first book to be stored in DNA and was replicated 40billion times (it was fun am sure).  It cost about $1,000 to print onto the first DNA chip and then another $50 to replicate via polymerase chain reaction (PCR).   

How it's done

A book constitutes words and images that fit into an HTML file (Church's book has 53,246 words and 11jpeg images).  The file itself occupies a few hundred KB in traditional information storage terms.  Broken down, the file represents a series of 0s and 1s that can be encoded into ATCG equivalents (primary nucleobases found in DNA).  Church's team assigned 0 to As and Cs and 1s to Gs and Ts.  When we do this, we get a few million base pairs and a few thousand DNA segments.  Once the ATCG equivalent of the book is available on a computer, it can be taken to a lab to synthesize.  The result is an extremely compact storage mass with massive capacity to store - an oligonucleotide chip.  But direct encoding of AT, CG into 0s and 1s provides errors and hence newer experiments use a ternary system (not binary) with 0,1 and 2 that try not to confuse DNA readers.  However, we must just remember that the book in our hands will now be all sticky and gooey.  

A DNA Kindle

Just as we need a Kindle for books (basically a hardware device with software capable of interpreting 0s and 1s in a human-readable form), we will now need rapid DNA-readers (sequencers).  Cost of sequencing is expected to drop to less than $1,000 but scientists are still working with humans in mind, not books and other data that we may wish to store and read.  

A device that can take gooey, sequence it to get the ATCGs and then present it in human readable form could soon be a much needed Christmas toy.  Without stretching my imagination too far, I see a possibility where we have bio-printers and readers at home.  We would get our gooey in a dark box in the mail (it has to be protected from sunlight), we pour it, sequence it and print it (from tissue to book to whatever!).

Data centers with a 10,000 year shelf-life

Our current storage systems have poor shelf-life.  A book has wear and tear.  A CD breaks and scratches.  Data servers heat up and die and require expensive backups.  And DNA?  DNA stays.  Think that every DNA base pair in our cells has had an original existence tying us right to the very beginning of life (some 3,900 million years ago when single cell organisms first discovered that sex was a good idea).  It's always been there - not in its current diversity but in its base forms.  I learnt that we now have the complete DNA code of our brethren neanderthals - a genome consisting of 4billion nucleotides.  Read this fascinating scientific study that also explores whether we (humans) messed around with them.

It's possible therefore to foresee the advent of an entirely new industry to store humanity's data in biological form.  Instead of large physical data centers housing hundreds of thousands of servers, coolers and other goodies, we will have micro-scale biological storage systems in cold, dark places.  It's so micro that a single gram of DNA holds 2.2million gigabytes of data.  The Economist says that you can fit the world's data in a lorry (truck for some).

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Amazon Web Services started with a small group of people in South Africa who imagined a brave new world running storage and computing off the Internet (AWS today is an est. $3.8B business).  Amazon hopefully knows it's time to let its engineers mess with biology.  Hopefully Facebook doesn't.  

There's enough time for what you love

Over the past hundred years, we have been conditioned to think of ourselves as responsible industrious citizens when we make time for all things official.  We easily take time from family for important meetings, urgent conference calls, networking events and so on.  But we find it more difficult to take time from work for interesting movies, going to the museum, walking by the beach, meditation and so on.  This oddly dichotomous behavior is so ingrained in our consciousness that we don't even realize it.  We divide life into compartments such as personal and professional lives when it's really referring to the same person.

A field guide to happiness

Happiness has a real simple formula.  It's got nothing to do with what we possess but everything to do with what we experience (sometimes with what we possess).  When we get over our mental hang-ups, we eventually gravitate towards doing things versus owning things.  Desmond Morris who studies animal behavior puts it well in his 1977 classic, Manwatching: A Field Guide to Human Behavior.  If we could return, by time machine, to an early cave-dwelling, we would no doubt hear the same kind of laughter, see the same kind of facial expressions, and witness the same sorts of quarrels, love affairs, acts of parental devotion and friendly co-operation as we do today.  We may have advanced with abstraction and artifaction, but our urges and our actions are probably much the same.  When examined closely, technology can usually be found to be serving one or other of our ancient action-patterns.  The television set, for example, is a miracle of artifaction, but what do we see on it?  Mostly we watch simulations of the quarrels, love affairs, parental devotion, and other age-old action patterns.  Even in our TV armchairs we are still men of action, if only at second hand.

Regardless of our advances as a society, we love to do the same things that we used to do as neanderthals.  We dance, run, swim, have sex, eat, talk, fight and laugh.  These things make us happy.

A really simple exercise 

When you distill your experiences to the essentials (whether it's during a single day or a period of time), you'll come up with the same 4 or 5 things that excite you.  Things that engage you and make you lose track of time...make you happy.  I've conducted a simple exercise with several people to help them discover what they LOVE.  I simply have them ask themselves: What do I really love?  People love the most random things when not under self-created pressure: to listen to people, to trek, to share knowledge, to play table-tennis, to negotiate, to create, to read and so on.  It ALWAYS ties to their natural talents and is invariably action-oriented.  In fact, people are so sure about what they love (when asked) that they can easily prioritize amongst what they love more and what they love less.  

Now the problem

The problem is people never ask themselves what they love.  Even if they ask, they are too afraid to listen to the answers.  Even if they listen, they hesitate to act on it.  Even if they do act, they worry about extracting commercial value soon.  Finally, they focus on creating material goods that they exchange for time. Then they exchange time to do what they love.  It's funny but this is how the cycle goes.

When we actively don't create space in our days for what we love, we resort to distractions that we well know are purposeless but do them anyways.  Think smoking, Facebook, TV, the regular drink, checking news websites, coffee, more coffee, LinkedIn updates, phone-a-friend, BBM, Skype, idle office banter, stock prices and several other fillers that help us getaway.  How come everything else seems to get our time except what we love?

Eventually, we change our work but end up in the same cycle again until we finally finish up.  The problem isn't the work, it's us.

There's time for love

Here's a simple way out.  It's so simple that you'll feel silly reading it.  Make a short list of things that make you happy.  Do them.  That's it.

In fact, do them everyday - at least one or more of these.  When you act on them, you are happy and your days are more fulfilled.  Don't question them.  Act in spite of the seeming loss of everything else.  There are two ways this would go.  You know what you love but don't act and splurge your time on everything else.  You know what you love and act on it at the cost of other things.  The former will give you momentary practical satisfaction but long-term hell through mediocrity.  The latter will give you short-term angst but long-term bliss in having spent your time usefully.

Making space

A friend recently asked me how I compartmentalize my activities (prompting this article).  The reality is I don't.  All I do is trade every hour carefully with something that I love doing.  And when I'm doing that I subtract everything else and create a lot of space around that activity.  Whether it's a client phone call or playing with my son or painting or scoping a new market - it's the same for me.  I love them all and I create space around it.  I don't let my phone, email, Skype, people, Internet dilute this precious space.  It's very difficult with our modern day distractions but I constantly try.  Creating space around an activity brings greater joy.  You are truly respecting the activity or the people associated with it by being fully there.  In its own way, it helps you move forward with ease.

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When you ask most people what they want out of life, they say they want to be happy.  That's really simple.  Find what you love, do it and make space.

Print me a liver, darling

I recently ran into a computer programmer who was tinkering with what looked like a stripped down printer with a whitish blob that looked like hardened you-know-what.  Curious, I asked him what he was up to.  He was printing what would be or could be biological tissue.  Here's a suboptimal explanation of what I saw.

On one side of this bio hackerspace was an area to cultivate cells.  The interesting thing about cells is you just need one.  If it's a bacterium like E. Coli there's so much love going around that they multiply rapidly...1 becomes 2 becomes 4 becomes 8 becomes 16, 32, 64, 128, 248...you get the idea.  f(x) = 1 + 2x + 4x^2 + 8x^3....something...who cares, just fit any exponential equation you jive with but know that you can culture blobs of love.  They are usually found in our gut and smell like poop (don't try).  I also saw white-pink stem cells on a carrot that looked like the unshaven face of a friend I won't name.

Back to the printer.  What I saw was a combination of an undressed laser-jet printer with a cartridge full of cells, an Arduino micro-controller, a CD-disk drive with a slider and a petri dish to catch the droppings.  The micro-controller was programmed to control the print head and spit out cells on an array.  That's basically a printer printing cells according to design.  See it in action.

These are very early days.  So let's fast forward this a bit and imagine what could be printed.  If you print layer upon layer, you could be building a 3-D organic structure.  That structure could be skin or even a part of a much ethanol-laced liver.  That's what Organovo does and I learnt that Autodesk is developing CAD tools to help us print body parts.  Now the good news is unlike ink you don't need to waste much cell to print.  Print a bit and allow the rest to multiply.  Wonder what Mrs. Bobbit would do now.  Ahem.

Travails of Mister and Miss Furrow Face

Try this experiment.  Take a fresh trash bag, squish it and let it go.  It immediately displays a series of lines that didn't exist before.  These lines simply won't leave whatever you try.  It seems to have memory.  If you think about it, our face behaves much like a trash bag.  A thin layer of skin packing physical and emotional baggage.  Just like the bag, a face develops and maintains lines based on memory.  

About 43 muscles and 14 bones interplay to make the face express a variety of emotions: sadness, anger, disgust, fear, surprise and happiness.  Here's an easy tutorial of what goes into a face: bone, muscle, fat, and skin.  Muscle is indeed like rubber.  I learnt that people have been comparing biological tissues and rubber since 1880.  Skim through this amusing scientific paper comparing the two on a variety of physical properties such as nonlinearity, anisotropy, inelasticity, thermoelasticity and age-dependency.  Simply put, know that muscles stay flexible when used and stiffen when not.  As a tissue gets older, it tends to harden more easily.  And when a tissue dies, the muscle pretty much hardens up.  Think rubber tires.

Try another experiment.  Watch people on a street (zoologist Desmond Morris has the most interesting views on the topic).  You'll see people with singular facial expressions even when they are doing nothing.  The older people get, the more set are these expressions.  This is basically muscles and memory in action.  Every time you scowl/ twitch/ smile/ laugh, you are flexing your muscles well and creating memories for your face.  The longer the dominant expression, the longer its physical manifestation.  

So what do you do?  The next time you have an urge to create a line (unknowingly of course), take one slow breath (knowingly of course) and reset the expression.  Try it and you'll also notice that a physical reset actually causes an emotional reset - providing your system with a reboot.

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Screw all this.  Just dab some skin cream and pump a memory-erasing toxin called Botulinum when needed.  That's what Cameron seems to do.

Blur your vision to get clarity

There's a simple tool I use while painting.  I blur my vision.  Try it.  Yes, that.  When you blur your vision, you can only see the essentials.  You see forms of objects, primary tones of colors, simple light and shadows.  You can't see details.  In a face for example, you can see the smudge of eyes, bridge of the nose, shape of the mouth, contours of the face, a hint of ears, and tufts of hair but not details such as the color and shape of eyes.  If you get these essentials wrong then whatever else you may try will not allow your painting to achieve its moment of truth.  I see several works of art that focus on details but get the form wrong including some very famous ones.  See this painting by Travancore artist Raja Ravi Varma - the detail is exquisite but the perspective of hands is simply wrong (why are both hands the same size when one is closer than the other?).  

I also see several businesses and products do the same.  For the longest time, I made the same mistakes in both art and business.  I was in a hurry to complete and therefore rushed to add detail.  More clients, more employees, more sales...just more without meaning.  Adding detail keeps you busy and creates a notion of success because you seem to be working hard.  However, if you introspect it slowly becomes clear that that success has no meaning.  Of course, someone out there will say good things about your painting but so what?  Your business will have growth but no meaning.

The benefit of getting the form right is that you create something that has a genuine shot at disrupting the norm.  Adding detail at that point pushes the model further and differentiates it strongly creating competitive advantage.  But this is hard, not just hard work.  It sometimes takes forever.  The exercise itself may appear futile and purpose-less because incomplete work is well...incomplete.

And then every so often we come across creations that get both the form and detail right to a surreal level - from Bang & Olufsen to the Seed Cathedral.  They are eons beyond the norm, super-achieving on both functionality and design.  Each element of detail brings out more meaning.  Overall, it creates a Hallelujah effect.  Its every experience makes you realize that it's all been worth it.

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Blur away and get clarity.  Again and again.

Beginning of the end of MBA education

It'll be interesting to see if I'll get a black eye or a grin from fellow alumni board of governors for what am about to write.  Business Week says that the number of MBA applicants in 2012 were flat or down at top schools.  So why is demand for MBA education flat when there's an ever greater need of better management?  Let's explore.

MBA education is more than a 100 years old.  Tuck was the first school to offer a graduate management degree in 1900.  This was a time when the industrial age was in full swing - teddy bears were mass produced and there was massive job growth for typewriter secretaries.  The original MBA constituted a two year program covering accounting, statistics, banking and languages.  Other parts of the world followed quickly after World War II to be as industrialized as America.  A curriculum of core courses with electives became the norm during the second half of the century and since then we've mass produced MBAs (we manufacture about 100K MBAs a year) for humanity to consume.  

Today, differentiation among MBA schools is blurred.  Everyone talks much of the same thing - globalization, China, ethics, outsourcing, technology and so on.  Everyone offers similar outcomes - higher paying jobs in consulting, investment banking and other industries (for the rest of us).  If you don't believe me, do this experiment.  Go to the websites of top 10 schools and ask a 12 year old to spot easy differences other than colors.  Each business school tracks the other based on the hierarchy that Business Week buckets them in and tries to out-do the other.  I'm somehow reminded of toothpastes in a grocery aisle - there are more and more nuanced toothpastes but all I do with it is brush my teeth.  On why I think of toothpastes - read Different, an excellent book by Youngme Moon (an MBA professor who gently stepped out of the herd).

[STOP READING HERE if what am saying is offensive because I'm now planning to sound really stupid]

Spending time at NY Studio School and Singularity, made me wonder what I was doing there and eventually reflect on the future of MBA education.  Grounding in management fundamentals is important but I think it's time look ahead.

Diversity of disciplines

Managers of the future will need to be interdisciplinary to the point that they are as comfortable with grasping biology as they are with computer security.  This means that business schools will need to intersperse engineering, medicine, humanities and other disciplines into the curriculum - not as core courses but as points of departure to expose MBA students to real life.  Exposure to robotics will change perspective on inventory management.  Exposure to 3D printing will change perspective on China.  Exposure to synthetic biology will change perspective on disease management.  Exposure to sculpture will change perspective on business models.  Exposure to poetry will change perspective on human resources.  Aren't we supposed to learn all this at school?

I know what you are saying.  People go to business school to study business.  My only response is - then why do we end up doing all the other stuff after school?

A lot more in a lot less

Life used to change every 20-25 years.  Most of the stuff that our lives depend on today (smart phones that talk to you, tablets that you don't eat, intelligent learning thermostats, Star Trek-like video calls and so on) didn't exist 10 years ago.  Given the exponential growth of technologies, I foresee that life will now change every 5 years.  

In this context, think about what we do in business schools.  We teach case studies that can't really compete with a live wiki on the topic, leave alone a Bing search.  Can't we talk about Boeing's Dreamliner mess versus Southwest Airlines happy employees all the time?  When MBAs complete their education, they are already not relevant.  Plus they expect high salaries to pay off their high student loans.

This university condenses 300 lectures into an intense 10 week program.  Their executive programs have 25% new information every few months.  The programs are run by 5 core people (not a typo).  At business schools, we need to be able to provide a lot more in a lot less time to stay relevant.  While the case study method is fine for teaching fundamentals, I think it's time to move on. 

ExOs

I first heard the term Exponential Organizations (ExOs) from Salim Ismail.  He showed several examples of organizations run by a small groups of multi-skilled people managing enormous scale with the help of technology.  What if there's no role of a CEO or CFO in the future?  What if there is a small group of people executing diverse tasks?  What if micro-tasking tools like CrowdFlower help managers engage millions of workers globally on demand?  What if organizations don't have a mass of employees but become smaller, agile groups of individuals with real names?  Will MBAs be equipped to swallow their egos and handle ExOs?  

Doing and failing

I visited TechShop where regular people were building extraordinary things by tinkering - the world's fastest electric motorcycle and a flying jet-pack are indeed extraordinarily ripe for business.  At Biocurious, I met a computer programmer who used a laser-jet printer, a CD disk drive and an Arduino processor to print cells on an array.  The teachers in both these environments allowed students to constantly tinker and fail.  This allowed people to fearlessly build interesting things without a business objective.  We don't let students fail in business school - we give them a Low Pass.  

Managers of the future need "doing and failing" experience earlier on because a lot more has to be done with a lot less.  Business schools will need a lab of sorts that let people "do" things versus sit and learn.  I see a lot of managers who are scared to get their hands dirty.  They can run analyze numbers, conduct meetings and provide insight but can they "do-and-fail" directly?  Would they think of prototyping differently by using 3D printers?  Would they balk at printing skin?

Invest in the right brain

I met Jeremy Howard who built this ultra-cool company called Kaggle that hosts competitions for data scientists.  The gods of algorithms are pushing heavy weight out there to solve complex business problems.  It'll become more important for managers to ask analytically interesting questions than being able to run numbers themselves.  Artificial Intelligence is advancing at such a rapid pace that machines will soon do whatever we want them to do.  MBAs need to know what they want done.  To get those ideas, their creative brains need to be nurtured.  We've done an excellent job churning out reams of analytically-oriented people during the last 100 years.  What we now need are also right-brained people who can tame AI beasts.

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[ARE YOU STILL THERE?]

Before an evil spreadsheet comes calling, feed your brain with something vague and interesting.

What my DNA tasted like?

One day back at Singularity U, we had a visit from the wonderful folks at Biocurious (a bio hackerspace) to help us extract our own DNA.  Ever since I read a note by Richard Preston (who also climbs redwood trees) on how his DNA tasted several years ago, I've been oddly curious to slurp my own gooey.

The process of extraction is simple.  You lyse the cells in your cheeks and degrade the protein with protease (a salty mixture).  Pour the now cell-adulterated mixture into a test tube and invert it a few times.  Baby-it by warming the tube with your hand for a few minutes, which breaks down proteins.  Add ethanol to the mixture and sit still for 5 minutes.  Your DNA will begin to precipitate.  Inverting the tube again will help DNA blobs get together.  You can then use a pipette to suck your white gooey out.

So how does it taste anyways?
Insipid but on the side of salty.  Vaguely sharp.  I felt a bit shy putting it in my mouth publicly.  So I found a quiet spot where no one was looking, extracted some gooey with a pipette and put the stuff in my mouth.  It was slippery and moved around and disappeared before I knew it.

More than the taste, it was screwy to think that my DNA - genetic instructions passed down to me by who-knows-who from eons ago were sucked out and put back in.  And where did it finally go, I wonder?  My gut of course.  

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Here's a wonderful document on how to extract your DNA.  You can buy a Genes in a Bottle kit here and play with your kid or yourself.  Just don't leave the stuff lying around...unless you'd love to see a Mini-Me somewhere in the future.  Of course, you can put it in your mouth.

A litmus test to find what you love

Often there are more questions about what we love than what we don't.  We seem to be very sure of what we dislike - things, people, habits, situations and so on.  But we are less sure about what we like.  

Here's the simple litmus test to know whether something has any hope of your love.  It has the innate ability to pause all your other thoughts.  That's it.  Even for a few moments, if you are able to get into a zone where nothing else exists then you've just met what you love.  

There are two main variables that skew this: time and space.  Time affects all things.  What we used to love, we now don't and what we now love, we didn't before.  Similarly, how close or how far impacts your interest.

Things that pause you

There are certain things that have the power to overcome all variables and simply bring the chatterbox inside to a halt.  

These experiences engage you and draw you in more and more.  You can't stop yourself.  You never have to justify to yourself why you are doing it.  You almost never think about time.  For me, it's usually when am creating something.  It doesn't matter what am creating or where - a product, a team, a painting, a write-up.  I almost never know the time - it flows like water.  I get restless when someone interrupts me.  I want to get back to it again and again.  The days I create sincerely are my happiest and I sleep very well at night.  Everything feels a little light.  You know exactly what am talking about because we all have those days.  

The funny thing is these things happen every other day but our mind tends to overlook them.  When we do notice them, we constantly question them.  We even educate ourselves to be a little practical because it doesn't exactly fit into our grand plan.  Others tell us that we are irrational because it doesn't fit into our plan.  Moreover, if you did the impractical stuff then other people would feel very lonely out there.  Very rarely do we question the grand plan itself because most of the time the plan has borrowed ideas of other people.  It would be too silly to admit to ourselves but inside we know this. (How many of us (leave alone countries) realize when it comes to measuring money that the concept of GDP - a whole country's money - is only 75 years old?) And when it does happen - the grand plan that is - it's not exactly what we want.  So what's the problem?  If this were a mathematical equation, now's the time to say hence proved - your little grand plan didn't include what you love.

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So the next time you pause just become aware without questioning it.  Because these are exactly what you are searching for whether in a job or in people or even in a book.  Often people change situations to find things when all they have to do is conduct this litmus test.  However, even the pH balance of a litmus paper has to be first neutral before using it to test for acidity.  Therefore, neutrality must apply to our brains before we try pouring something on it.  Meditation is an interesting start and at another level it can pretty much pause all variables making you find love in the most mundane.  Ok, at least go for a run.  If all else fails simply do the activity that you think paused you.  You'll be surprised, it'll pause you again and perhaps you'll smile uncomfortably now because one little part of you will tell you, you are stupid.  Bingo.  You've found what you need.

Relax.  For now, just know that there's an easy way to find what you love.

Why Facebook will be the new Yahoo! unless...

I got off Facebook permanently this week.  Ahem.  I thought it'll be fun to disconnect with some flare and therefore, I created an event inviting people to delete their accounts along with me on a given day.  About 4% said yes and another 2% said may be.  I don't know who finally did but it was an interesting experiment that demoed that there were people who had had enough.

Back in 2007 with a prod from my chaddi dost Ram Papatla, I envisioned a world of mega platforms - such as Google, Amazon, Yahoo! and Microsoft - converging Social and Business Collaboration, Telecom and Internet Connectivity and Do-It-Yourself and Architecture Computing.  This model was published in the book New Age of Innovation (by C.K. Prahalad and M.S. Krishnan) in 2008.  Today, everyone has entered everyone else's bedrooms and Google, Apple, Amazon have become these mega platforms.  Yahoo! is busy fixing household issues and Microsoft seems to be figuring things out now.  

Today, I see a different world where Facebook will be the new Yahoo! and or even AOL (which has more interesting acquired businesses such as The Huffington Post and Moviefone than a core business) unless it does things differently.  Let's see what this means.

Around but with no meaning

People may not get off Facebook like I did but they will use it more as a login tool, an address book and a photo log - exactly the way they use Yahoo! now.  AOL makes $2B in revenues and Yahoo! makes $5B but we can't say that these companies really have sustained impact.  (Just fyi, FB makes $3.7B).

Think of the time that we first had a phone connection, an email, a cell phone.  What did we do?  We got in touch with everybody we knew because we could.  My parents still have a brown leather diary that has everyone's phone numbers in it with a few addresses.  It's fat with all kinds of other papers and notes in between.  It reminds me of FB and its friendly apps.

Social media is for your grandpa

I don't know any of my teenage cousins who use Facebook like they used to.  Why?  Because all their grandpas are in there (no offense grandpas - my dad is one).  When we were kids we used to have our own hangouts that other people never frequented.  When they finally did, it became uncool and we eventually found a new dig.

More importantly, the world has changed in the last five years.  There has been a grotesque amount of useless content that's been created just because we could.  90% of it makes you barf.  What people want is less and less.  And once the early adopters who actually make life so cool have moved on, the rest of us will follow.

See Path - a new kind of social/ location mobile network that helps you remember life in a more close-knit way.  Or see Pair for just the two of you (you can even thumbkiss - whatever that is).  If you want to hangout with a small group of friends then perhaps there's Ourspot.  All these are early experiments but it's clear that the shift has occurred.

Design is a niche.  Ya, right.

Ok sorry FB - your design is blue.  I appreciate all the neat little features like hitting enter to post something but the overall design - it's not Fab.  And Fab, Tumblr and Airbnb is where the world has moved on to and global aesthetics have shifted to better design expectations.

Yes I know you'll say you bought Instagram - it's nice but it's like doing what AOL did by buying The Huffington Post.  When Huffington became the first online-only daily to win a Pulitzer - they did, really not AOL.  If people know that AOL owned Huffington Post, they would read it less.  AOL knows this and therefore you don't see it on the home page.

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So what should Facebook do now?

Thank its stars for the mega database of people and their lives while it has it and make a dramatic shift in a new direction.  Inorganically, it must continue to buy other interesting companies with the money it has and while it has it.  These don't need to be in social media.  If it buys Whatsapp, which all Blackberry grandpas (again, no offense to grandpas or Blackberry users or both) got on to when they realized that no one's really on BBM anymore.  What do you think will happen when FB buys Whatsapp?  Exactly what happens when everybody and their cousin shows up at your pool party.  FB must buy companies in disconnected areas.  While investors would cry hoarse saying it lacks a unified strategy, it would create assets that will keep it safe and less desperate.  

FB needs to accept that social media has changed forever and it will never have the run that it has had thus far.  It's like being excited that everyone's now got a phone.  Ok, get over it - they do and that's that, life moves on.  It must stop coercing others to write apps and games on it.  They won't.  Not so much because, I mean...c'mon, who wants to play Farmville.

Facebook needs to also move in other directions that are different but aligned with its technical and cultural strengths.  For example, FB must build augmented intelligence tools to make things more intelligent and connected - a social network of things versus a social network of people.  It has the DNA - all it needs is the balls.

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So what am I using to poke friends now?  Email.