From Aron’s Desk

Friends, 

More and more, I think my main job is to be human. 

It is pretty fupid (funny-stupid) that our national conversations about computerization have been reduced to binary questions of support/non-support, savior/curse, opportunity/threat, cheer/boo. As people, shouldn’t we lean into the strengths of analog, which is more subtle and complex than two-bit calculations? Through social media, i.e., the computerized, industrial farming of our thoughts, national conversations trigger us to love or hate that one weird trick/hack/dance in a video short. We’ve moved from shorthand to short thought. 

People have always loved the simplicity of hero-villain stories, but the world is more continuous than that. You can be the villain of Gallipoli in one decade and hero of Britain in another. We need to hang onto the complex, the nuance, the gray zone, the fourth act, and hope we push ourselves to be better and smarter. Our university’s and professions’ struggles with AI has me thinking about this. 

Computerization, including AI, is but another phase in the long historical arc within our infinitesimal corner of the universe. Mechanization, including computerization, and industrialization have resulted in centuries of upheaval, marching on, for good and ill, disregarding policy, religion, or ideology. Wish you could stop it? You might as well try to stupefy plate tectonics.

Regardless of how technology moves, people have continued, adapted, and remained an imperfect, narcissistic species propelling and being repelled by our own technology. Domesticated fire, crops, and animals changed our cultures radically long ago. We change our cultures and societies, and people remain, culturally changed to be sure, but still Homo sapiens. 

Which is to say that the more things change, the more we stay the same - the people are always there with our biological imperatives and weaknesses. We are not always happy, and we often do not treat each other well; but it is people who define the present. Clearly the social and technological engines we create can dehumanize us and amplify our worst and best attributes. Too often we feel like a cog in a machine or that our lives are beholden to some institutional machinery.  

But we can’t stop thinking and planning and trying to do good. Amongst a decade of turmoil abutting the metamorphosis of AI, it feels like the most important thing we do at our health university is protect the place of people in health care; people who are the patients and providers. Big institutions like health systems and universities have always teetered on the edge of being impersonal monoliths in their worst behavior. Now, with AI, how do we know the person is there at all?

Still, it’s worth remembering that, even before AI, people in institutions had to step out and be a person in order to escape the machine. Computerization has and will continue to change our lives: creating opportunities and challenges. We each see and feel both the good and the bad. I owe my career to spellcheck, because I am such a bad speller that I’d have continually, professionally embarrassed myself in the mid-twentieth century. Earlier, before standardized spelling, I might have been fine professionally, but later, when spelling to one’s phant’sy was derided and oppressed, I’d have struggled on my own. I think there were about 100 years during the 4.5 billion years of earth’s history when spelling was an important skill — and I am happy to have missed most of those years. 

Technology that fosters clearer communication does create opportunity, and may well help young people who come from less privileged scholastic backgrounds. As an example, just after generative AI came on the scene, and in a previous part of my life, I took a group of medical students to a conference. After the conference, I asked them to write a reflection paragraph for a weekly newsletter. I knew I was in for some editing, because I had spent enough time with students to know that asking five of them for a paragraph would net me at least two editing challenges. But then I got five structurally and grammatically sound paragraphs, each with their own points and point of view. AI gave at least two of those students the ability to present their thoughts in a clear, professional manner, helping them put their point of view into the public conversation without me unnecessarily spending a bunch of time fixing their stuff. For at least a couple of these students, their thoughts are more useful and engaged because of their interaction with technology. How cool is that‽ 

The balance between mechanization and people has always been fraught and driven society to change. Truly huge cities became possible as efficiencies in farming, transportation, and public health made it possible to feed, water, and move millions of people in urban settings. Cities changed our work, our family life, and our politics. Only one of the European empires survived the 140 years of tumult and industrialization from the dawn of the nineteenth century to World War I, and the sun was clearly setting on the last of them by that point. The upheavals of industrialization brought us the stockyards and Sinclair Lewis, the camera and Impressionism, consumerism and mingei. 

I am dating myself when I say I went to grade school in the era of consternation over calculators. Some folks were in a lather that calculators would stunt our learning, and because learning is about changing your brain, that means calculators would stunt our brains, which in retrospect feels like a big claim. The controversy seems trite now. It turns out that you can ask young students, who cannot do much calculation, to do conceptually harder problems if you let them use a calculator. That’s good. The same can be true with generative AI. Like my students writing their paragraphs, we can take on harder challenges than our skills would usually allow, if we do this correctly. 

But the trick is doing it correctly. What does that look like? Well, for whatever opportunities we have, I think we want there to be people in our health world, and not just machines. No one will doubt that having a neural network review the data generated by a PET/CT scan will help make diagnoses when added to the work of a radiologist, who is limited to signal averaged, false monochrome images. There is so much useful information that people miss and the computer has a chance to catch. But do you want the diagnosis provided by a screen or a person? We all know that AI can be unfailingly, unflaggingly polite, and stories abound about people bonding with their AI companions. Is that what we want as a matter of health policy? Some may, but I just don’t think we want our health centralized and controlled by bots and their corporate overlords.

Much of my job as president of a wonderful university is communicating in person and in writing, and AI is getting pretty good at mimicking what I do. So, I am starting to fight back. I want to make sure you know I am a real person listening to you as real people, working to support you. So now, I take any weapon at hand to prove humanity. The lowly semicolon, eschewed by AI and AP Style alike, is my hand grenade; the portmanteau is my spy; the interobang is my canon. I zero derive as an act of civil disobedience; ribosome that, Claude!

We are a health university: we educate health care professionals, we discover how nature works, we advocate for our neighbors, and we treat patients. Our people work at the intersection of policy and people, clinically and educationally. The key to our success across all of our work is that we show up for each other, and, in proof of the brilliance of the university as an invention, we are successful. Not every day is a good day, but I am immensely proud that more than 400 of our students donate their time to our free clinics, that our Care Coach is there for all people who need it, and that our team figured out how to staff clinics for abused children when the “fancier” institutions down the road did not. 

It is the human work of showing up for each other and preserving and protecting curiosity that only people can do for each other. An interlocking network of algorithms could easily keep us separated and sedated when we need to be curious, seeking, loving, and never quite sure we have found what we are looking for. 

AI will bring more technologies and responses, more advances and tumult. People will find themselves in the midst of the successes and the crashes. It will be up to institutions like ours, universities and other organizations dedicated to the public good, to be the scientific safety net for people when government is overwhelmed or foolish, to provide service to people when others do not, and to provide a path forward by learning from each other, listening to our neighbors’ needs, being useful, and being genuinely and generously curious about the people and universe around us.

Improving the wellness of all people with you, 

Aron