Twin Peaks

They are mountains of the mind

What an ordeal, but it’s over now. I have ascended two snowy peaks that were long troubling my eastern horizon. Casting their chilly shadows at sunrise, glinting stubbornly as the sun set, and murmuring, “You’ll never do this, Bob; go find a nice round hill that’s more your speed.”

Damn it, a nice round hill is not my speed! When I walked the Hill of Tara, despite its fabulous history, I felt tired. When I walked the South Downs, with the Channel sparkling in the dips, I felt lost. I don’t find my meaning in soft, green, sun-dappled hills.

I don’t because they’re easy, and when something is easy, that generally means it’s customary. When something is customary, that means others — many others — have done and enjoyed it, are no longer thinking about it, are taking it in stride. That’s not my thing.

I don’t want to walk to my destination; I want to climb, and I want the climb to be difficult. I prefer forbidding peaks, shimmering in the white radiance of eternity, looming under a canopy of frozen, black cosmos. I prefer slopes that are practically vertical, factories of perilous scree, veneered with a thin layer of redoubtable ice covering rock that is rotten and patiently waiting, like a predator, for its next satisfying kill.

That captures the essence of my twin peaks. They are mountains of the mind rather than earth. In fact they are grant applications: one to the National Science Foundation, the other to the National Institutes of Health. Written in parallel, nearly suffocating me with stress. Why were these grant applications predatory?

Because they attract people like me, to come a little bit closer, to view a delectable feast, to find a comfortable seat at the banquet, only to discover that — oh no! — I’m on the menu. The table has been set, not for me, but for a coterie of peer reviewers, the gourmands of esoterica. To them, I’m not a climber making an inconceivable first ascent, but a contestant in a cooking show. I concoct my new recipes, source my rare ingredients, roast and plate my novel thinking and writing…

And then? Then the gourmands sniff it, nibble it, finger it, turn it in the light, contemplate it, and instantly judge it. Mostly their judgments are superficial and harsh, because peer review is a fast, furious, anonymous, and competitive business; neither leisurely, cordial, nor philosophical. It is as subtle and nuanced as a high-stakes horse race: years in the making, thundering out of the gate, over in a few minutes.

However, in a small fraction of reviews, the peers are impressed, their judgements are profound, or at least have profound implications. And that is why these grant applications are worthy endeavors. They are hard and the probability of success is vanishing. Who could ask for anything more?

What makes an application hard? To begin with, it’s “the ask.” The NSF publishes their ask in document called the Solicitation. The NIH publishes their ask in a document called the Funding Opportunity Announcement (FOA). These documents can be hard to find for the uninitiated, but once found, they are seriously hard to read and interpret. Each is supported by hundreds of pages of PAPPG (NSF) and Applications Instructions (NIH).

Why so labor intensive? A hint of passive aggression at the agencies? Don’t be ridiculous! The ask is hard because it’s written for myriad climbers, each of whose routes and peaks are quite awesomely different. One document guides thousands of different aspirants, so it is inevitably confusing to each of them. Many applicants hire a professional Chingachgook, for a hefty fee, to show them how to plan a route and provision their expedition. I didn’t. After all I trained as a textual scholar back in the Jurassic period, so I know how to parse a damned sentence, even if it’s written by a cabal of technocrats.

Reading the Solicitation and FOA, with accompanying instructions, is followed by writing, which in my case is more aptly described as nit-picking. I rewrote my Project Description (NSF) and Research Strategy (NIH) maybe 400 times. Before getting to the summit, I felt dead certain I would fall off the mountain and end up lying in a ditch.

After writing and nit-picking, the last traverse of the perilous journey is a portal for submitting an application online. NSF has Fastlane and NIH has ASSIST. These portals are supported by, and dependent on, other portals including Research.gov, Grants.gov, eRA Commons, and NCBI. Writing in them is comparable to digging your ice pick and crampons into the aforementioned veneer. As often as not, you fly off the pitch and have to call the HelpDesk to pull you back up.

I cannot say enough good things about the HelpDesk. Nicer, more patient, more helpful people than the telephone agents do not exist, of that I feel sure. If you are one of the livestock who’s been oinking about the “deep state,” I have a suggestion for you. Go write a grant application to fund your nutty worldview. Like most others, you may not be funded, but the experience will fill you with tenderness and respect for the gracious civil servants on a HelpDesk, and for the agency that employs them, and for the state that makes it all possible.

North Face of the Eiger, the “Wall of Death” (photo credit)

I always take the same perspective with each new adventure. I put myself in the position of being at the end of my life looking back. Then I ask myself if what I am doing is important to me.” Reinhold Messner

Lineage

We don’t have lineage among our bona fides?

Lineage is a product of continuity, and continuity is a product of evolution. Lineage has history, pedigree, familiarity, assurance. It reinforces our mental model of how good things happen and work. Because we like what we know and we know what we like, usually.

Innovation is a product of disruption, and disruption is a product of revolution. Innovation lacks history, pedigree, familiarity and assurance. It’s risky and uncomfortable. It may satisfy needs, but it takes a lot of getting used to and learning to trust. We usually don’t like what we don’t already know.

I hold these truths to be self-evident, but like most truths of that sort, they’re fraught with tension. That’s because people typically want to have their cake and eat it. They want lineage and innovation at the same time though the two may be diametrically opposed.

If you have attained lineage or you value and reward it, you probably don’t do innovation. You are less interested in the new than the known. Clayton Christensen coined the term “sustaining innovation” in order to connect the opposites — to argue that some innovators make incremental rather than transformational improvements, but that’s a mare’s nest. Making something better is a process of extending its lineage; it’s not an organizing principle of innovation.

The people who want to have their cake and eat it, those are individuals like ourselves, but also organizations such as employers and federal agencies like the National Science Foundation (“Where Discoveries Begin”) and the National Institutes of Health (“Turning Discovery Into Health”). Those agencies are much on my mind at present, because I’m sending SBIR (“America’s Seed Fund”) proposals to each.

The charter of SBIR is to promote innovation in part by selecting for lineage. That’s why most SBIR funds are given to nicely situated academic teams. Wait, let me clarify. SBIR funds are for corporate entrepreneurial teams, but in reality most of them are led and staffed by academic stakeholders who want to commercialize their previously funded academic research. Such stakeholders provide a project with lineage whereas scrappy inventors have only their wit and passion to recommend them, usually.

Unless memory fails me, as a former academician I’m pretty sure that college professors are generally risk averse. They are conservative, self-centered, they don’t like to put skin in the game, in fact they don’t like playing games with their career but prefer the certainties of job security, organizational hierarchy and the comforting sameness of job responsibilities that change only a little from season to season. The ubiquitous tenure system ensures that innovators are largely excluded from academia because they are disruptive.

That is why SBIR requirements for both lineage and innovation are an unacknowledged oxymoron. Unacknowledged because both are explicitly and unapologetically written into NSF solicitations and NIH funding opportunity announcements.

The best way to qualify for SBIR with these agencies is to derisk a project by summoning lineage as evidence that it’s a sure bet. And yet the best way to qualify for SBIR is to explain that the project is so risky that private investors won’t touch it with a ten-foot pole; therefore taxpayer money should finance it.

Humaginarium is one of those scrappy inventors born of a garage rather than an ivory tower. We have an innovation that is damned risky, and we don’t have lineage among our bona fides. What would you do in our place?

Well, we can’t become less innovative. Innovation is what makes our project meaningful and fun. And we can’t borrow lineage, can we?

Actually we can. Because the technologies we are bringing together have been developing for decades, in many cases with government funding, only not for our purposes. System dynamics, computer modeling of health, bioinformatics, biochemical engineering, predictive simulation, adaptive experiential learning, instructional technology. These are the cross threads of our invention, forming a new fabric of impact and consequence.

Precisely what consequence I can’t reveal here, not because it’s a secret but because I’m out of space. For now, suffice it to say that pretty soon you’re going to love what you don’t already know. That goes double for people with chronic illness.

A griffin of classical antiquity combining the eagle (innovation) and lion (lineage) into a mythic animal that embodies an impossible ideal. (Image courtesy of Pixabay.)

Solace of Art

People do what is good only when they want to.

Last week, when I found myself in times of trouble, Mother Mary didn’t come to me. She was in a different neighborhood of Minneapolis with other matters to attend.

The trouble I found that day was not racist murder in the street, but mass murder in the air. Not perpetrated by four deranged police officers, but thousands of passive-aggressive shoppers and sales associates at The Home Depot. Most of whom were utterly indifferent to Covid-19. I watched as they crowded into and out of the big box emporium, with checklists and parcels, without face coverings or hand sanitizers — NIH and CDC be damned! I watched and wondered: have I witnessed a more convincing demonstration of ingrained stupidity? Ever? I have not.

I sometimes refer to regular folks like those at The Home Depot as Joe and Ms. Sixpack — thus trying to dignify a condescending meme coined by a political moron more than ten years ago. I have claimed — without much evidence — that the Sixpack clan will overcome their acute health illiteracy and risky habits, their blimpy form factors and medication maladroitness, and they will take better care of themselves and their families, if only they are better informed about the science of the body and nudged to wellness. My self-appointed job is to inform and nudge; their job is to be happy and live in peace.

As a passionate health promoter, I have watched for months as governments and the fourth estate flooded the entire population with health information (scientific and otherwise), across all media, at all times of the day and night, from every conceivable point of view. A sentient adult cannot by now be ignorant of the incurable and unpreventable Covid-19, nor of the potentially mortal consequences of being infected or infecting others, nor of the ONLY ways to control it: social distancing and personal hygiene. According to my understanding of the Sixpacks, this worldwide tsunami of health promotion delivered more than enough information to warrant their high health literacy and acumen from coast to coast, at least when it comes to communicable disease.

To judge by my observations in Minneapolis, I was wrong. The Sixpacks were blithely committing mass murder in public and private spaces like The Home Depot in Minneapolis, where coronavirus can freely swirl into faces and smear onto the hands of every incautious person who happens to be present, and afterwards into and onto everybody else they meet. Given the quality of health promotion that preceded this dreadful historical moment, the pandemic should not be continuing now. Yet more than 100,000 deaths and more than a million infections later, with dire predictions of a nasty resurgence coming in the autumn, the evidence so far seems to show that health promotion doesn’t work and doesn’t matter in the United States.

I don’t accept that conclusion, but at the same time concur that it’s reasonable. After all, Humaginarium was founded on a premise that traditional health promotion — including health education — doesn’t work and has never worked well; that a different approach is needed to produce a different outcome. The rationale being that people will do what is good for them and others only when they want to. This new approach is conditioned by the solace of art.

Art is using the imagination to create and experience beautiful things. Art has existed as long as Homo sapiens; it is arguably what makes us human. Solace is the comfort we give or seek in grief, the alleviation of pain or fear or anger or anxiety. As a word for being cheered up and amused despite sorrow, solace has been around since the 12th century.

A few hundred years after solace entered the Middle English lexicon, a poet named John Donne wrote his Devotions Upon Emergent Occasions (1624). In these lines, he both defined and exemplified the solace of art: its power to heal and encourage, no matter what the circumstances are.

How does art do this? By writing a prescription? No. By telling the Sixpacks what to do? No. By making them oblivious or stupid? No. By improving their healthcare? No. Art works by facilitating understanding, choices and decisions to do what is right and good for ourselves and for others we rely on, and who rely on us.

I’m giving you a particular Devotion below without further explanation; you’re an adult, you’ll figure out what it means without my help, if you want to. But I’m giving it to you with an earnest request in these times of trouble: that you read it slowly and slowly think about its meaning. What it means not to me or to society or history or Ernest Hemingway, but to you individually and personally, right now.

Because believe it or not, you yourself are the most beautiful and wonderful thing in all of creation, and you deserve to be happy and healthy, and you have the right to demand it, and the power to achieve it. And now in memory of George Floyd and with love for every person who will someday come to Humaginarium with an illness that may never end, I declare and insist that no person is an island; and that even one person’s needless suffering or death diminishes us all.

For Whom the Bell Tolls, by John Donne
No man is an island,
Entire of itself.
Each is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manor of thine own
Or of thine friend’s were.
Each man’s death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.

Writing

George Mallory had similar thoughts, standing at the foot of Mount Everest.

One year to write 20 pages! That is how long they took. Even for me — the slowest of the slow, the latest of the late — this is a personal best. How did it take so long?

Easier question: why didn’t it take longer? Answer: because there was a time limit imposed by somebody else. A timer was set in April 2019, giving me no more than one year to finish or be damned. Not liking the eternal-infernal option, I finished my writing with precisely four days to spare (phew).

Same sort of thing happened in 1975, when I “finished” (i.e. stopped) my doctoral dissertation in English Letters at the end of a fifth year living in the UK. There is evidently something about limits that makes me want to exceed or at least ignore them, as long and as much as possible.

My recent year of writing was an NSF SBIR Phase 1 proposal. Together with documentation it turned out to be 10 x 20 pages, but the Pareto principle applies to just those measly 20 pages comprising the Project Description and Technical Discussion of a game changer known as Diabetes Agonistes.

The National Science Foundation does very nice things for aspirants and martyrs who want to cross the chasms of technical innovation. They carefully publish an explicit Solicitation telling applicants how to write a proposal; and they reinforce the Solicitation with a Proposal and Award Policies and Procedures Guide that kind of “tells ‘em what you’re going to tell ‘em” — with more detail in different words. They further reinforce those helpful documents with myriad web pages of procedural, referential, social and historical information that strikes aspirants with awe and turns some of them into martyrs. Reading this stuff feels a bit like gazing at a Himalayan summit from a safe distance and thinking, “it’s not that tall after all.” All told, there are hundreds of fact-packed government pages that are not only helpful, but also debilitating. Even for me, a person who loves reading for its own sake, that textual mountain was a lot to take in. Consequently much of my year spent writing was actually devoted to getting ready to write and then afterwards checking to make sure that my text was complete and compliant with standards. Even now I’m not sure that it is. The summit is shrouded in mist, and there is a throbbing red glow within it.

As usual with anything related to health care (e.g. Diabetes Agonistes), there is a way to leapfrog the labor by delegating it, with cash. You can hire a consultant, one who is well versed in government documents, as your sherpa. The consultant tells you what to write, and when to write it, and how to revise it until it is ready for primetime. Alternatively, you can hire a consultant as your ghostwriter and project manager: a magus who will use you as a subject-matter expert, write a splendid proposal for you to sign, and afterwards (if successful) manage the entire project for a reasonable fee.

I considered consultants. I attended a two-day workshop hosted by one of the best, and interviewed four others who came highly recommended. I chose not to engage one because (idiot that I am) I wanted to learn and master this writing process myself. I felt there is no text in the English language that I can’t wrestle to the mat (hubris), and if I don’t do the heavy lifting myself, I won’t do all the necessary thinking either. Then I would lose an ineffable chance to experience something new: crossing one of the wider chasms of technical innovation. I’m sure that George Mallory had similar thoughts, standing at the foot of Mount Everest.

Apart from reading and processing freight cars full of documentation, another cause of my slowness was poetics (so-called). Hard as it may be for readers of this blog to believe, I am very careful about every word I write, often writing them over and over in different ways until they sort of chime in my ear and look good to my eye. For this reason, what I want to express is perhaps 30% of my writing. Wordsmithing is 70%. The nutty thing about that is, my subject matter here for the most part is technology, and literary style is certainly not one of the criteria for evaluation of my proposal. Nonetheless, I can’t help myself. My muse insists.

As soon as my writing job was done a few days ago, I turned to (what else?) more writing. I quickly wrote a Project Pitch for educational technology that may bend the curve of COVID-19. Fascinating proposal which will go nowhere, of course, but deserved to be written. Then I started writing an SBIR Phase 1 proposal for the National Institute of Diabetes and Digestive and Kidney Diseases, one of the National Institutes of Health. And also began writing a series of briefs for the NSF project team, in case that proposal isn’t kicked out like a stray dog.

Will I set a new record for slowness with NIH? I think not. Having practiced and sort of mastered the process of parsing technical documentation with NSF, I am likely to cross the next chasm like a hare rather than a tortoise. I will certainly let you know when that happens.

Scientific entertainment. Female nude, back view (1831), by Alexandre-Jean Dubois-Drahonet. Pictured with coronavirus on the prowl.

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.