Green Light

We’re not going to leave the long and winding path, but SBIR may strengthen and speed our steps.

The National Science Foundation has given Humaginarium a green light to apply for substantial, non-dilutive, SBIR funding. The light came on right after I submitted my Project Pitch, a required first step that gauges whether Humaginarium can “meet the program’s objectives to support innovative technologies that show promise of commercial and/or societal impact and involve a level of technical risk.

The Humaginarium project seemed like a good fit way back in 2010 when I first looked into SBIR. That’s when I began ideation for this venture, years before founding it. I guess this illustrates how serendipitously I approach even things that are important to me, and how I tend to follow long and winding paths with a compass but not a map. Taking me forever!

The manifold innovative technologies I pitched to NSF include computer models of physiology, high-fidelity time-based simulations of morbidity at scale, state-of-the-art medical CGI, cloud-built and cloud-based entertainment that streams to screens everywhere. My pitch is not about inventing these incredible emerging technologies, but rather adapting them (for the first time) to the direct use and benefit of regular folks.

I pitched my belief that the Humaginarium project will have commercial and societal impact. As commerce it operates in the nexus between entertainment, health, and education: three large, fast-changing and fast-growing industries. It caters to strongly-felt consumer needs at the center of each industry – but in this unique case all at the same time, with the same products that we rapidly make and the same business processes that are noncapital intensive. As a social enterprise, Humaginarium promotes health literacy and health equity not for a few who can afford it, but for everybody who chooses to use it. If activists are leading us to a brave new world where health is a right and not a privilege, Humaginarium may become one of the enabling technologies of that world.

The level of technical risk in the Humaginarium project is pretty high. I say the work can be done, but at the same time acknowledge that it’s never been done before. I speak with the voice of a world I’ve imagined, that doesn’t yet exist: one that will deliberately avoid an apocalypse in health care by empowering self-care. I promise to make health science coherent and beautiful and playful and useful to folks who currently know almost nothing about it; and who typically don’t want to know anything about it (until it’s too late). This is truly a moonshot, one that enables “one giant leap” for every individual who takes a ticket.

In order to mitigate this crazy level of risk, I pitched a series of Phase 1 experiments that may define the most promising way forward. Not only to design, build and test an effective solution, but also to commercialize it. I say mitigate, not eliminate risk, because the Humaginarium project is a lion that doesn’t wear a leash. We won’t abandon the long and winding path because that’s where know-how and value are captured. Still, SBIR can speed and mightily strengthen our steps. The green light thrills me like a call to arms on the White Mountains.

Click here to read the Project Pitch.

Scientific Entertainment. Variation on Academic Study, by William Mulready


One Word

We in our time, in our world, can master fate with one unchanging and unfaltering word.

One Ring to rule them all, One Ring to find them, One Ring to bring them all, and in the darkness bind them.

I recalled Tolkien’s incantation during a recent marketing workshop for startups. A facilitator had been lulling me to sleep with familiar bromides about 5 Cs and 5 Ps. Then suddenly she posed a striking question! A really good puzzler that I never before tried to answer and wasn’t sure I could.

“In this challenge,” she said, “you’ll choose one word that epitomizes the difference between Humaginarium and its competitors. One word you’ll coin that others can’t credibly use. One you’ll own that others can’t easily copy. Everything in Humaginarium will sum up to it. Customers will value and love its meaning, because it’s the generative organ of your brand.”

OMG! I expected to struggle for weeks or months and eventually give it up. After all, I’ve used tens of thousands of words to discover, explain, and promote Humaginarium. Distilling my sea of rhetoric into a single sparkling drop felt impossible. I squirmed, “This is ridiculous. Who cares about one word anyway? Why not two or ten or fifty? Why does one matter?”

The incantation reveals why it matters. Follow along here, I’m unpacking an analogy. I pondered: which one of my words can rule all the others and lead inevitably to them? Which corral my verbiage into a pattern or system or way? Which bind my jabberwocky to an elegant purpose that goes deeper and wider over time but never changes or falters? Which become a beacon that guides consumers to harbors they seek? I came to believe, reluctantly, that one word isn’t impossible. It’s crucial, and I need to know what it is.

The usual suspects were plainly wrong. For example, my word can’t be functional – concerned with how Humaginarium works or is made. Words like simulative, complicated, responsive, interactive, educational, streaming, informative, personalized, adaptive, entertaining, or immersive don’t cut it. Everybody has a version of those things. Functional is not experiential; it’s merely procedural. Neither can my word be conceptual – marshmallows like a brand name, an operating principle, a core belief, a price point or business model. Conceptual is not experiential; it’s spongy. And neither can my word be metaphorical – allusive like a symbol, a token, or an invocation. Metaphorical is not experiential; it’s tricky.

My one word had to connote the wondrous thing that happens when people experience Humaginarium that doesn’t happen when they experience my competitors. The word for that is uplifting.

Uplifting is the cumulative effect of improvement. It’s growth in strength and stature, grace and capability. Uplifting manifests in biology as homeostasis; in religion as zen; in behavior as flow; in learning as vision. To be uplifting is to concentrate rather than divert attention like so much entertainment does. To inspire, embolden, make resilient and curious. Uplifting is having less to fear and more to enjoy.

Every way I look it, this word seems appropriately generative. As video game entertainment, Humaginarium is uplifting: rather than facilitate escape or denial, it returns people to the real world with more understanding and appreciation of themselves. As health education, Humaginarium is uplifting: rather than bewilder and frighten people with medical jargon, it endows them with control of a human body that suddenly makes sense and is actually quite miraculous. As a diagnostic tool, Humaginarium is uplifting: rather than outrageously prescriptive and bureaucratic like 99% of health education, it nudges people to make excellent choices in their informed self-interest. Finally above all, as a work of art Humaginarium is uplifting: it’s gobsmacking cool to look at, play with, learn from, and build on.

Thus my one word, and this is where the magical incantation breaks down. In Middle Earth the One Ring belongs to the darkness. In Humaginarium, the one word belongs to the light. I suppose elves, men, and hobbits were unequal to the solemn power of the Ring, but we in our time, in our world, can master our fate with one unchanging and unfaltering word.

Behavior

Without getting to the why there is no getting to behavioral outcomes.

Is scientific entertainment™ an offshoot of behavioral science or behavioral medicine? With the FDA approving video games as therapy for the first time, the question is hardly idle. The answer may explain how Humaginarium achieves meaningful outcomes.

Behavioral science is the study of human behavior through observation, modeling, and experiment. Behavioral scientists investigate why people do what they do, and how they might do better. The scientists have a voracious appetite for meaning, so they stir separate disciplines into a unified mode of inquiry, wrangling diverse epistemology in order to discern and use truth in more holistic and robust ways.

Behavioral medicine is likewise the study of human behavior with a unified mode of inquiry. Practitioners study why people are unhealthy or at risk of illness, prone to injury, difficult to treat, heal, or cure; why they’re frail or short lived, and how they can manage health with more than biomedicine. Having a voracious appetite for meaning, practitioners look beyond clinic to identify environmental, psychological and social dimensions, causes, or palliations of disease – and try to make good use of them.

I now think that scientific entertainment is indeed an offshoot of these correlates; that it’s “behavioral entertainment.” It involves depictions of human behavior derived from observation, modeling, and experiment. It relates why people do what they do, and how they might do better. For example, why they often increase risks rather than avoid or control them; and how they might act differently to produce more desirable outcomes.

Could it be that standup comedy on The Daily Show is also behavioral entertainment; likewise animation by Pixar, theater by Lin Manuel Miranda, painting by Banksy, fiction by Margaret Atwood, movies by Guillermo Del Toro, music by Bob Dylan, and video games by Will Wright? All of these make audiences feel good while moving them to create and use new meaning.

If scientific entertainment in Humaginarium is behavioral, it’s important to remember that behavior is more than how people act; it’s also why. As Robert Sapolsky makes abundantly clear, without getting to the why there is no getting to behavioral outcomes.

In humans, “why” leads through a morass of conscious choices and decisions, through nervous reactions of the senses, all the way to the tremulous molecules that compose our bodies and microorganisms that live in and on us – some keeping us alive and others just the opposite.

I’m claiming to be behavioral, but not behaviorist. I don’t suppose that humans are machines that can be programmed with external conditioning. More in line with behavioral economics, I think people should not be trained, conditioned, or forced to do anything they prefer not to do.

The job of scientific entertainment in Humaginarium is to help them recognize choices and make decisions in what they believe is their own self-interest. That’s our nudge to wellness™.

The nudge is what allows us to generate behavioral outcomes. As I have often heard the butterfly say to the fish, “the best thing in the world you can be is yourself.” People who find themselves in Humaginarium may grow more confident that they’re incredibly beautiful and brave and may become ever more so.

Fantasy

Transforming the body from oozing, sticky humors into a cosmic miracle.

A more explicit way of saying “scientific entertainment” is “biological fantasy.” Both may be rare enough to qualify for trademark protection, provided they actually make sense and are useful. Do they, and are they?

Scientific entertainment and biological fantasy are oxymorons that label customer experience in Humaginarium. Each should negate itself because everybody knows that biology is real and fantasy is fake; that science is momentous and entertainment is merely fun. Add two polar opposites together and logically expect a nil result. Does that mean we’re making zero-sum, inconsequential mind games for customers of Humaginarium?

I don’t think so because, in the context of learning, the whole is always greater than the sum of its parts. Look at it this way. Biology is the aspect of human nature that is real and tangible, but largely invisible and incomprehensible to regular folks. How do we know? Stop somebody on the street and ask a profound question about biology, for example, “What is a stem cell?” In most neighborhoods the answer may range from clueless to ridiculous, though every human life depends on stem cells and our species would go extinct without them. In this way biology is weirdly physical, immediate, deterministic, and largely unfathomable. (By the way, that lovely blob in the illustration below is a stem cell.)

Unlike biology, fantasy purveys intangible figments of the imagination that are nonetheless visible to the mind’s eye and fairly easy to understand. That’s partly why fantasy is a massively popular art form. People get it! To test this distinction, ask somebody on the street what a soul is, and you’ll likely get a devout or convinced or passionate response. Stem cells exist in and around us, yet folks know little if anything about them. Souls don’t exist anywhere, yet they’re a ubiquitous felt presence in real life. How can this be?

Probably because fantasy isn’t fake! Unreal yes, because it’s made up; but fully-conceived fantasy is at least as meaningful and truthful as biology; in fact more so for the vast majority. In scientific entertainment or biological fantasy, consumers confront what for them is unknowable and therefore frightening (the contests of the human body with morbid threats). They confront these threats with beliefs they can grasp and control to suit their longings and needs; and that activity is motivating. Though you may never hear the word fantasy in health care, I’m pretty sure it’s an uninvited guest at every medical procedure and sleepless night of worry. Patients leave the door unlocked because fantasy doesn’t negate science; instead it makes science believable, trustworthy, and useful to them.

What sorts of fantasies are churning in Humaginarium? Obviously science fiction because we picture and animate human physiology; and simulate its progressions with computer models. Like the wings of a fairy, fantasy surrounds and moves with our biology – not in order to falsify it, but to simplify and disarm it; and make it coherent, responsive, and beautiful. The imaginative rendering of scientific subject matter is called reductionism. It’s an aesthetic at the core of all great art (including the medical arts).

Beyond science fiction, Humaginarium presents immersive fantasy that alchemizes the oxymorons into seamless perceptual experiences. Customers don’t experience science and entertainment; instead they experience scientific entertainment with breathtaking epistemic powers. We present liminal fantasy that reframes the human body, transforming it from a pool of oozing, sticky humors into the cosmic miracle that “in fact” it “really” is. We present dark fantasy marbled with infection, inflammation, deterioration, and death that is coming after you and may catch you unawares and unguarded. We present comic fantasy sparkling with cuteness and jokes that ventilate the struggle for survival with the laughter of relief. Our initial visual prototypes did this job with steampunk, which somehow works like fictional nonfiction. There’s another oxymoron for opening doors of perception.

So then, does scientific entertainment make sense? You bet it does. Is biological fantasy useful? Only for certain things, like having a happier and longer life.

Scientific entertainment. Variation on Working in Marble by Jean-Léon Gérôme

Evidence

Consider a review of research on the utility of video games for education.

I’ve just finished a moiling task of compression. Mostly finished actually. I still have to incorporate feedback, but the basic job is complete. If you’re curious you can view the upshot on the Humaginarium website, in the Evidence option of the Resources menu.

Readers of this blog know that brevity is not my forte. Getting straight to the point is difficult. Why do you suppose one of my favorite novels is Tristram Shandy? The other day I dreaded hearing a venture capitalist say he won’t consider pitches that take more than a few seconds to read on his phone. Sadly, it seems easier for a camel to go through the eye of a needle than for a prolix startup to enter the kingdom of unicorns.

Where was I? Ah, compression! My task involved reading 500 pages of scholarship in a book named Computer Games and Instruction, edited by Sig Tobias and Dex Fletcher (2011). This brick-like tome reviews research on the hypothetical utility of video games for learning. More than 30 experts contributed chapters on various types of educational games, for example Jan Cannon-Bowers on games for health.

(By the way the book lacks a chapter about games for industry and commerce. Ian Bogost punted an invitation to write it, perhaps after thinking it over for a while. He asked the editors to invite me, which they did on fairly short notice. I’m not as clever as Ian so I accepted without thinking and tried – but failed – to write a brilliant chapter on video games for business. I knew there were many, believed in their utility, and had myself designed some, but I didn’t find much research to review. Neither could Sig and Dex. I eventually inferred that some companies invest ambitiously in games and gamification but the return on these investments is still uncertain. This despite the Kirkpatrick model of training evaluation.)

I digress. Though my chapter is not in Computer Games and Instruction, I admire the other contributors and consider the book a touchstone. It answers a question I’ve been asked many times, which goes something like this: “I don’t get it. Why video games?” It would be ideal if I could simply hand the book to skeptics. However VCs are not alone in their aversion to plodding. I may be the only general reader the book ever had because it’s a slog to read cover-to-cover, with numbness encroaching the cerebral cortex.

Having studied it though, my next step was to compress the scholarly evidence that is relevant to Humaginarium. I needed to set aside the academic rhetoric, the footnotes, the caveats, the attributions, the anecdotes and examples, in order to succinctly and confidently state that well-designed video games do – in fact and beyond reasonable doubt – promote learning.

I filtered the 500 pages for the gold dust: a couple dozen solid claims. I then asked several scholarly and industry experts to vet the claims, in order to root out confirmation bias and add things I may have overlooked. Each claim occupies one slide: clean black text centered on plain white background. My months of labor takes about five minutes to read and think about, but I didn’t actually create it for reading. It’s for talking.

My pitch for Humaginarium is actually not about the efficacy of video games for education. I doubt investors care about that. Instead it’s about the promise of Humaginarium to return multiples on their investment in a reasonably short period of time. I have only a few minutes to make that case in the language of numbers.

That said, a minority of investors intrigued by the numbers may want to know why Humaginarium promises to improve health literacy and empower self-care with, of all things, exciting video games. That’s when I’ll bring forth the evidence. We’ll talk about it while not looking at our phones.

Visualizing

Our virtual human body looks and acts like an incredible video game.

Members of the Humaginarium tribe are called customers, consumers, patients, users, gamers, players, learners, and (my favorite) eyeballs. Each of the monikers emphasizes a different role. The special role performed by eyeballs is to view.

So what engages eyeballs in Humaginarium? The answer isn’t obvious. After all Humaginarium is scientific entertainment that’s not been done before at scale; has never been done for a mass market of regular folks. Members of our tribe will surely be astonished and amazed by what we show them. Will they like the show and keep coming back for more?

To increase the chances we invented an intriguing visual style in the confluence of medical and fantastical illustration. One depicts a natural, objective world of the senses. The other imagines a make-believe, subjective world of the mind.

Our medical illustration is state-of-the-art CGI of human anatomy (structure), physiology (function), and pathology (abnormality). This kind of digital visualization involves dimensional, colorful, high-resolution, high-fidelity, animated pictures. It looks sophisticated and technical, but the roots of medical illustration trace all the way back to pharaonic Egypt. It informed Classical and Renaissance science and art and continued to evolve in the centuries that followed. Modern medical illustration that leverages technology began with Spanish neuroscientist Santiago Ramón y Cajal and blossomed in American surgeon Frank Netter‘s Atlas of Human Anatomy. These artist-doctors rendered Homo sapiens in elegant and precise drawings that were (and still are) used by clinicians and educators.

New medical CGI renders Homo sapiens as discrete atoms, and complete organisms, and at every scale in between including molecular and cellular. Want to zoom a chromosome? No problem, have a look. Want to strum an auditory ossicle? Right this way, point the light. Our medical CGI prompts folks to view and manipulate every ingredient of a virtual human body without ever cutting into a real one.

This kind of visualizing is naturalistic, but is it realistic? My answer is no, because a realistic picture of anatomy, physiology, and pathology is extremely hard to parse and comprehend; and therefore not as useful. State-of-the-art medical CGI is very useful because it idealizes subject matter. The rendered biology appears true to nature, yet easy to see and experience; moreover it’s beautiful, no less than great works of art and architecture. To encounter awesome new medical illustration is to gaze in wonderment.

The beauty of medical CGI serves as a docking station for fantastical CGI. It allows actual organic matter to dovetail with absurd and ridiculous inventions; together they generate nothing short of visual magic. People have always experienced this kind of magic without thinking much about it. For example as children with a wishbone after dinner, a ringlet of hair in a locket, and a baby tooth under a pillow. In these everyday examples and in Humaginarium, the real body acts like a wardrobe that opens into Narnia.

What does our scientific Narnia look like? Well, there’s a substratum of idealized anatomy, physiology, and pathology; that’s the natural world of Homo sapiens. Pure figments of our imagination populate that world: things like gardens with unmarked paths, caves with cryptic messages etched on the walls, opalescent pools that ripple when they speak, supernatural humanoids and beasts, horrifying monsters, criminals intent on gambling momentary gratification for a lifetime of pain, immanent spirits, enchanting songs. Our fantastical CGI is overlaid on the natural kind and littered with tangible clues like those that Jules Verne created for his adventurers.

Much of the spectacle in Humaginarium throbs with attitude and nervous energy. Members of our tribe don’t stroll through an art gallery but work hard to find their ways through a maze of chronic illness, in an enchained world that yearns to be free. That’s why our virtual human body looks and acts like an incredible video game. It doesn’t invite eyeballs to observe and learn. Instead it challenges them to survive and prosper despite the odds. That is why they like the show and keep coming back for more

Learning

The most desperate problems emerging from chronic illness have a surname: Vulnerability.

Humaginarium is entertainment for consumers who have, risk, or wonder about chronic illness. Participation is voluntary. Nobody is forced or cajoled to join. Like a carnival barker, the only promise we make is fun. It’s important to say this because unlike presenters of classic health education, Humaginarium must offer art that regular folks like and want for its own sake, whether or not it solves their problems.

Thanks to art, Humaginarium probably has more in common with medicine than bland health education does. Truly? Well yes, because medicine historically is a mixture of art and science, with art doing the lion’s share of the job until the mid 20th century. Even today in the technical vanguard of biomedicine, art is a critical component of what matters to most people: healing and wellness. When medical arts are eclipsed by instrumentation and data, health care can begin to seem manipulative and futile, if not ridiculous, to the folks it serves.

Humaginarium likewise is a mixture of art and science. Though we don’t boast about solving problems, that’s actually why we exist. Real-life problems; often unacknowledged, misunderstood, denied, hidden, scorned, or ignored by the kinds of folks who buy video games for escapist fantasy rather than useful information. As they enjoy the experiences we prepare for them, their health issues are pulled through an aesthetic ringer I call catharsis. That’s pretty much the same ringer that doctors and shamans have used for millennia and still use today.

In my view all the most desperate problems caused by chronic illness have a surname: Vulnerability. By that I mean weak defenses against illness and the clueless pursuit of wellness. Vulnerable consumers don’t make themselves better; they let things get worse. They don’t relish the esoteric complexity of the body; they’re obsessed with appearances. They don’t ask hard questions they can’t begin to answer; they delegate that to experts who know everything. Experience eventually shows how little medical experts actually know and how risky and inefficient such delegation can be.

As a problem solver, Humaginarium is not paternalistic. It doesn’t tell consumers what to think or do beyond one simple command: win the game. That’s their mandate. Thing is, they have to figure out how to win. On their own. They can share ideas and experience with peers, but they can’t delegate.

Instead players build their own knowledge and make their own choices in their own self-interest; and health literacy emerges. This learning style is called constructionism. You’ll find it in healthcare simulations for medical students and physicians, but you won’t find it in health education for patients who need it just as much. Why? That doesn’t matter. It’s about to change.

Consumers initially come to Humaginarium not for information or simulation or education of any kind, but to be amused. To enjoy a virtual experience of the human body in its battle with unfair, unfeeling, out-of-control destiny. As in all their favorite video games, players must develop new competencies to win. But this time their gains deliver more than make-believe victories.

Capabilities learned in Humaginarium are wholly transferable. A fight for health in our fantasy prepares people for a similar fight in real life where, maybe for the first time, they’ll deeply understand and strive to control existential threats like diabetes, cancer, or heart disease. We want them to bring better defenses against illness and longings for wellness to the battle. Ones that fit their own circumstances more or less perfectly.

When that happens, Humaginarium may perform like a magical healing art of the 21st Century.