Biology as a Second Language

We understand the body about as well as we understand my first paragraph.

When the amygdala perceives sensory information from the thalamus to be threatening, it engages the paraventricular nucleus in the hypothalamus resulting in the stimulation of corticotropin-releasing hormone (CRH), which begins the stress hormone cascade. This hormone then stimulates the pituitary to release another hormone called adrenocorticotrophic hormone (ACTH). This hormone travels down to the adrenal cortex gland, which produces the stress hormone cortisol. Cortisol in turn will feedback to the hypothalamus and the pituitary.

I’m quoting above from a book named The Science of Stress. The authors explain to the general reader how the HPA axis responds to internal and environmental stressors of the human body. I bring this up here for two reasons.

First, the axis is implicated in metabolic syndrome and diabetes mellitus type 2, the subject of our prototype projects Diabetes Agonistes and Metabolic Genii. The HPA axis is a kind of tripwire: the cause of and the mechanism for incredible biological activity in our bodies: every body, every hour of every day. The axis keeps us healthy or makes us sick depending on forces that we, rather than it, control. If the axis didn’t work properly, with phenomenal speed and precision, we would suffer and even die. Yet most of us willfully undermine the axis with some of the behavior typical of our personalities.

Personality is a vague concept, but I think it’s fair to say that personality or self (ego, id, superego) is neither inherited nor determined by environment. It’s a product of the individual imagination – a creative projection of the mind – that tends to take the body for granted. “I think therefore I am.” Until – inevitably – the body breaks down and it’s hard to think straight. We choose to behave as we please, often dangerously, because we understand the body about as well as we understand my first paragraph; i.e. we’re clueless.

My second reason for quoting The Science of Stress is to make a point about health literacy. We know that literacy is the ability to write and read language. And in our society, basic literacy is purportedly equivalent to eighth-grade communication skills. In other words, to be nominally literate in America, in 2019, is to communicate like an adolescent.

That is why my first paragraph is a challenge for regular folks. It is written in English that a scientist or clinician, with abundant education, easily understands. It is not written in the English that the vast majority of their fellow Americans can even read, and none could ever write. For that reason, the meaning of the paragraph doesn’t exist for them. They can’t interpret or use it, and that’s a problem.

You could say those scientists and clinicians are certified BSL: biology as a second language. They’ve been trained to read and write the language of biology. Not for its own sake of course, but in order to use biology in their professions. The humanities majors among us, and the greater number who never got past high school, are literate in that adolescent way. We are not BSL certified. We can’t understand and use biology because it’s wrapped in esoterica.

Or can we? Of course we can’t teach BSL to the masses. We could however extricate biology from its language wrapper and render it in forms that regular folks can easily understand – and even enjoy. That’s what Humaginarium is doing with the biology of chronic illness. Making it animated and visual with symbols and pictorial narrative. Making it tangible so folks can touch it, play with it, fight with it, figure it out and master it. Not biology as a second language, but biology in a visual language of color and shape that folks are already fluent in, and capable of probing for meaning.

Now, some would say that regular folks cannot understand biology, not because they’re baffled by the language, but because biology is way too complicated. This may be why most promotions of health literacy avoid science like a plague and focus on behavioral adherence to rules. I’m betting those promoters are wrong. Based on my experience as a parent, a patient and an educator, there is nothing in or about biology that is beyond the capacity of an average adult to understand.

All those average adults are organisms at the top of the food chain. They are outcomes of billions of years of evolution. Their minds are the most wonderful things that nature has ever made. They are not stupid! They certainly have the capacity and the motivation to understand, interpret and use science to fight chronic illness. Only first, they have to take off the gloves, and we have to take off those bewildering, jargony wrappers.

Scientific entertainment. Dante and Virgil in Hell, by William-Adolphe Bouguereau; pictured with histology of the pituitary gland.

Green Light Redux

Two federal agencies have invited us to request SBIR Phase 1 funding.

I’m taking a break from game design this week to talk about progress on another front.

Back on April 10, I announced that the National Science Foundation approved Humaginarium’s Project Pitch. Today I’m announcing that the National Institute of Diabetes and Digestive and Kidney Diseases has approved our Specific Aims. Two US federal agencies have thus invited Humaginarium to apply in 2019 for substantial, non-dilutive, SBIR Phase 1 funding. In my opinion, that’s cool!

Specific Aims is a single page argument that our groundbreaking idea for biomedical innovation is a good fit for NIH support; and that it’s a good candidate for commercialization. I dubbed the idea Metabolic Genii.

In popular culture, a genie is Robin Williams magically springing from a bottle to make jokes and grant wishes. I’m fine with that; it fits our brand well enough, but the word genie is actually more meaningful. It’s a variant of genius, and a genius (plural: genii) is an attendant spirit: a force that influences actors for better or worse.

Metabolic genii are digital affordances that empower folks who have or risk developing metabolic disorders. The genii enable them to inquire what’s up with their bodies and gain a bit more control over their medical outcomes.

Like any genius worthy of that moniker, metabolic genii are extremely creative. Ours are creative like scientists rather than sorcerers. They intelligently pan for the personal gold in every individual they meet, ultimately enabling users to feel a little like Aladdin, with wishes that now make a lot more sense and eventually may come true.

The terminal objective of our Specific Aims is a set of six precise, repeatable techniques that reliably convert basic health literacy (acquired in a separate project) into resolute behavior. These six techniques are drawn from a social science palette that includes situational awareness, choice architecture, scenario planning, nudge theory, decision science, and reinforcement theory of motivation. According to my reading of research literature, these powerful and accessible affordances have never been synced to produce sustainable medical outcomes. We’re about to sync them in order to discover what happens next.

What do we expect to happen next? Empowerment. Users will demonstrate their ability and desire to make evidence-based decisions about illness and wellness; and furthermore make those decisions as sticky as flypaper. Sound easy? Sorry, it’s never been done before. That may be why health education mostly doesn’t work. At all.

Who is going to benefit from this project? Of course Humaginarium and its investors will benefit, but more importantly 60% of the adult population stands to benefit. That is the proportion who already have a poorly controlled chronic illness (the numbers are increasing). That’s also the proportion who play video games, the medium we are using to generate basic health literacy (and yes, those numbers are increasing too).

What will our R&D be like? It begins with a re-review of secondary research that bears on our terminal objective. From there it takes the form of agile discovery. We are not going to think this problem to death. Instead we shall design activities that a large number of experts and ordinary consumers can experience and comment with feedback. Each of these activities generates data that indicate efficacy and flow into other parts of the Metabolic Genii system.

Our Phase 1 research and development yields proof-of-concept of this system; and verifies its theoretical efficacy. If results are encouraging, we will migrate our hardening techniques into a Phase 2 design-build-test-deploy project. At that point, our world begins to resemble an oyster.

Metabolic Genii and it’s counterpart Diabetes Agonistes are now as two horses pulling a chariot named Humaginarium. Our chariot isn’t racing against competitors; there is none working at our level. We’re racing against time. We want to stymie metabolic disorders and other chronic illnesses as quickly and as soon as possible.

Click here to read the Specific Aims.