Monday, June 20, 2016

More episodes regarding nurses - I

When they first arrive, most nurses will be intimidated by the sight of my condition and will wonder whether they will be able to do the job. They will be relieved to know that Jaya will be with them at every step till I feel confident that the nurse can do the job on her own. After a week of learning the various procedures and getting to know my communication methods, the nurses start becoming more confident. The problem is that many then quickly traverse to the other end of the spectrum and become over-confident.

They take longer to call Jaya and try to find out what my dumb charades could mean. But their guesses would naturally be confined to what I had indicated in the week or two since the nurse had come while this will be a new issue.. So they will rarely be able to guess the problem and finally they will have no option but to call Jaya to whom I will dictate what needed to be done.

******

Many nurses think that all movements are voluntary whereas most of my movements are involuntary, This sometimes causes misunderstanding. For instance, my hands will keep bending at the elbow in response to cough, itch, pain, laughter, etc. The nurse will straighten them and in a few minutes they will again become bent. When this happens a few times, the nurse will say in exasperation, 'I am listening to you so why can't you listen to me? You are becoming stubborn! Keep your hands straight like this.' Of course, the advise will be in vain. I will feel like saying, 'It is my hands that are disobedient, not me!'

******

Many nurses, once they get used to me, seem touchy when I call Jaya. They think I am complaining to her about them. Actually, I will just be telling Jaya to show the nurse an easier way of doing something (which they will eventually ignore but I will try telling them anyway) or it may be to tell them to avoid some movement that was causing me some pain. In most such instances, I will have no option but to convey such instruction via Jaya.

Perhaps they have no other word to express this and they will sometimes ask me, 'Any complaints to Jaya?' After we realised this problem, we started using another tactic. I will wait for Jaya to come into my room when the nurse is not present and tell her the problem. She will tell the nurse later in some roundabout way about it without letting on that I had told her about it. But in the case of some pain, I will call Jaya immediately.

Many times when I ask a nurse to call Jaya, she will say, 'Why call her? You can tell me what you want.' I will start getting irritated and rail silently, 'It should be obvious to you that I am not able to convey it to you which is why I want you to call Jaya. This does not require rocket science, does it?' It is a bit unfair but it is said that in anger, you will make the best speech that you will regret. I escape this fate since I can't make that speech. Sometimes  the reason for calling Jaya might have nothing to do with the nurse - maybe I just want to remind Jaya about a bill that has to be paid, which I will obviously not be able to tell the nurse.

For a while, I will maintain a forced smile and try to indicate with vigorous movements of my head that there is no option but to call Jaya. Some nurses are stubborn and will persist in telling me that I should tell them the reason. I will start getting impatient and this makes clonus set in after which things are outside my control. My muscles will start stiffening and it will look as if I am having fits. The beneficial aspect of developing clonus is that the nurse will call Jaya immediately without waiting.

Sunday, June 12, 2016

Strength in simplicity

This is the time of bluff and bombast - A 'path breaking' budget that will 'transform' India, a policy is a 'game changer', an agreement is 'historic', a product will 'revolutionise' communication', some product will 'change the world' (Steve Jobs said that about all his products), something will be a 'landmark' decision...I heard an anchor in a Malayalam channel called Kappa TV, which most people wouldn't have heard of, say, "When we were conceptualising this remix, we didn't know the impact it will have on 'the whole nation'".

Every state will have a much-hyped investor summit where huge investment promises will be made but one will never hear about the actuals. The prevailing wisdom seems to be that one has to shout and make tall claims in order to be successful. There is an emphasis on bright-siding everything irrespective of what the reality indicates. I was thinking about this culture of what Arun Shourie called, 'Jo hyperbole so nihal' while reading Gandhi before India by Ramachandra Guha.

In 1909, Gandhi spoke to a mixed gathering of Indians in London where he shared a platform with Savarkar. At that time, the Indian freedom movement was divided into two camps: moderates and extremists. Moderates believed in incremental, constitutional change while extremists wanted rapid change with violence if necessary. Savarkar was in the extremist camp and Gandhi was in the moderate camp. Ramachandra Guha describes how a student remembered the meeting 40 years later:
Savarkar was 'by far the most arresting personality' at the meeting; for 'around him had been built a flaming galaxy of violent revolutionism'. Gandhi, on the other hand, seemed shy and diffident; the students had to 'bend their heads forward to hear the great Mr. Gandhi speak'. His voice and speech were of a piece with his manner - 'calm, unemotional, simple, and devoid of rhetoric'.
A friend of Gandhi said that in  Johannesberg itself, there were 'several of his countrymen whose elocution, natural and unaffected, is far superior to his', that he spoke in a monotonous voice, he 'never waves his arms' and 'seldom moves a finger'. A shy, soft-spoken man who was an indifferent public speaker with speech devoid of rhetoric could move more millions than any other person in India's political history without the aid of arms or an army backing him. I think there is a lesson in it somewhere. (Watch this talk by Dr. Apoorvanand Jha - explaining the relevance of Gandhi's strong anti-majoritarian stand in his final days. The talk is in Hindi.)

Gandhi's philosophy of non-violent resistance to unjust laws made him ' a strategist of slow reforms, of protesting by stages, of systematically preparing himself and his colleagues rather than spontaneously  (or, as he would have it, haphazardly) rushing into confrontation.' This is in sharp contrast to what is popular today: a person who is aggressive, has a no-nonsense attitude, takes quick decisions...In other words, in order to be successful, one is supposed to be a pain in the neck.

Another friend says that while a student in London, Gandhi learnt that 'by quiet persistence he could do far more to change men's minds than by any oratory or loud trumpeting'. He was one of those rare individuals who was reflective as well as firm when he finally took a decision. And importantly, he had high moral standards. His followers were sure that he would be the the first to do what he asked others to do. Guha quotes an admirer, the Chinese Nobel Laureate, Liu Xiabao:
Compared to people in other nations that have lived under the dreary pull of Communism, we resistors in China have not measured up very well. Even after so many years of tremendous tragedies, we still don't have a moral leader like Vaclav Havel. It seems ironic that in order to win the right of ordinary people to persue self-interest, a society needs a moral giant to make a selfless sacrifice. In order to secure 'passive freedom' - freedom from state oppression - there needs to be a will to do active resistance. History is not fated. The appearance of a single martyr can fundamentally turn the spirit of a nation and strengthen its moral fibre. Gandhi was such a figure.
PS: During his first visit to the US, Modi made a big splash. Listening to the audience reactions after one of his 'rock star-like' appearances, I heard a gushing NRI say, 'It was like listening to Gandhi.' I almost had a heart attack.

Thursday, June 2, 2016

Luck - VI

In The Shiva Trilogy by Amish Tripathi, there were some statements that I disagreed with, one of which was that 'nothing is random; everything has a cause'. (Of course earthquakes, for example, have reasons but those reasons have nothing to do with us.) Humans have evolved to notice patterns and ascribe significance to them. English philosopher and scientist Francis Bacon said that humanity has a proclivity to “suppose the existence of more order and regularity in the world than it finds.” Zodiac signs, Roscharch test and paredolia are examples of the human tendency to find patterns where none exist.

Human beings make up stories that sound convincing to them. There is an experiment by the psychologist Richard Nisbet which shows this.They placed several stockings on the table. Many women were then allowed to examine the stockings and choose the one they liked best. The women gave all sorts of reasons for their choice but actually the stockings were identical. People are often mistaken about their feelings and give reasons from social conventions, from how things normally work or plain guesses. You can see this habit of trying to spot patterns in randomness in the stock market.  Phil Rosenzweig writes in The Halo Effect:
...take the stock market, whose fluctuation , edging higher one day and a bit lower the next, resemble Brownian motion, the jittery movement of pollen particles in water or gas molecules bouncing off one another. It's not very satisfying to say that today's stock market movement is explained by random forces. Tune in to CNBC and listen to the pundits as they watch the ticker, and you'll  hear them explain, "The Dow is up slightly as investors gain confidence from rising factory orders,"or, "The Dow is off by a percentage point as investors take profits,"or, "The Dow is a bit higher as investors shrug off worries about the Fed's next move on interest rates." They have to say something. Maria Bartiromo can't exactly look into the camera and say that the Dow is down half a percent today because of random Brownian motion.
In Fooled by Randomness, Nassim Taleb gives an example of how a perfectly random process can produce a result that mimics what happens in the real world. Suppose there are 10,000 fictional investment managers who play a perfectly fair game: each has a 50% chance of winning $10,000 at the end of the year and a 50% chance of losing $10,000. Once a manager loses money, he is thrown out of the sample.Thus, each year half the managers lose their job.

At the end of the first year, we can expect 5000 managers to survive, after two years, 2500 will have won 2 years in a row and so on. At the end of the fifth year, there will be 313 managers who would have won money five years in a row in a game akin to a coin toss. The number of survivors depends only on the initial number who play the game. If one of these survivors is in the real world, what will the reactions be? Taleb writes:
...we would get very interesting and helpful comments on his remarkable style, his incisive mind, and the influences that helped him achieve such success. Some analysts may attribute his achievement to precise elements among his childhood experiences. His biographer will dwell on the wonderful role models provided by his parents; we would be supplied with black and white pictures in the middle of the book of a great mind in the making. And the following year, should he stop outperforming (recall that his odds of having a good year have stayed at 50%) they would stat laying blame, finding fault with the relaxation in his work ethics, or his dissipated lifestyle. They will find something he did before when he was successful that he has subsequently stopped doing, and attribute his failure to that. The truth will be, however, that he simply ran out of luck.
To understand successes, the study of traits in failure need to be present. For instance, some traits that seem to explain millionaires, like appetite for risk, only appear because one does not study business failures. If one includes bankrupt people in the sample, then risk-taking would not appear to be a valid factor explaining success. The Halo Effect also contributes to making a coherent story by making our view of all the attributes of an individual match our judgment of one attribute that stands out. As Philip, the protagonist in Somerset Maugham's Of Human Bondage muses:
 He did not know that he had ever done anything but what seemed best to do, and what a cropper he had come! Other men, with no more advantages than he, succeeded, and others again, with many more, failed. It seemed pure chance. The rain fell alike upon the just and upon the unjust, and for nothing was there a why and a wherefore.
Or as it says in Ecclesiastes: 'I returned, and saw under the sun, that the race is not to the swift, nor the battle to the strong, neither yet bread to the wise, nor yet riches to men of understanding, nor yet favour to men of skill; but time and chance happeneth to them all.' In this speech, Michael Lewis describes how luck played the key role in putting him in the right place at the right time.

Tuesday, May 24, 2016

Luck - V

You can say that successful people are intelligent, hardworking, persevering and driven but the reverse is not true - all intelligent, hardworking, persevering and driven people are not successful. The difference between the smaller set of successful people and the larger set of people with similar qualities to those associated with successful people is luck or what is commonly called 'being in the right place at the right time'.

The reason why only successful people attract attention is because of the survivorship bias - you tend to look at only the survivors of a process, not at the failures. A statement by Walt Disney seems to be popular - 'if you can dream it, you can do it'. Well, the number of people who dreamt something and didn't do it is far greater than those who did. You can't tell the difference between the two groups till you study both groups. But those who failed didn't write autobiographies. As Amitabh Bachchan says in the film Deewar, 'sapne samundar ki lahron ke tarah hoti  hain, woh hakikat ki chattanon se takarah kar toot jati hain.' (Dreams are like the waves on the ocean; they  hit the rocks of reality and break up.)

In the 1982 book In Search of Excellence (more than three million copies sold), Tom Peters and Robert Waterman identified eight common attributes of 43 “excellent” companies. Since then, of the 35 companies with publicly traded stocks, 20 have done worse than the market average. People are reluctant to acknowledge that the world is more messy than their models suggest. It is tempting to think that successful people have the controls in their hands and can tame Lady Luck. Success looks neat and tidy in hindsight.

The evaluation of the strategies and qualities of companies and individuals depends on the perception of their outcomes. As Phil Rosenzweig says in The Halo Effect: . . . and the Eight Other Business Delusions That Deceive Managers (highly recommended), 'if a diversification strategy succeeds,  it will be described as 'deftly maneuvering into new areas'; if it fails, it will be described as ' drifting' or 'straying from its core'. (Perhaps the failure was  due to 'causal ambiguity'. Maybe it was caused by ''idiosymcratic contingency'. The above-mentioned book says that it is the way PhDs say 'I don't know'.)

In The Black Swan, Nassim Taleb tells a story to illustrate survivorship bias, a story that had been related by the Roman orator, Cicero. One Diagoras was shown painted tablets bearing the portraits of some worshippers who prayed, then survived a subsequent shipwreck. The implication was that prayer protects you from drowning. Diagoras asked, “Where are the pictures of those who prayed, then drowned?” Those drowned believers are ignored in the analysis. Taleb writes:
Consider the thousands of writers now completely vanished from consciousness: their record does not enter analysis. We do not see the tons of rejected manuscripts because these writers have never been published...Consider the number of actors who have never passed an audition but would have done very well had they had that lucky break in life.
There is a graph called Socio-economic status (SES) gradient. The poorer you are the greater your chances of suffering from respiratory disorders, ulcers, psychiatric diseases etc.There are obvious possibilities like lack of health-care access, dangerous working conditions, lack of education etc. But the main reason seems to be due to the stress of poverty caused by psychological factors. It is also caused by  being made to feel poor.

The survivorship bias can make people feel poor. Consider a group of millionaires. They will compare themselves to over 99% of the people and feel pleased with themselves. Now put a few billionaires among them. They will start comparing themselves to the minuscule group of survivors and stop feeling so pleased. Your happiness seems to depend on your neighbour's wealth.

Saturday, May 7, 2016

Luck - IV

Nassim Taleb makes a distinction between two types of occupations. Non-scalable occupations are like those of a dentist, baker,cook, etc.  where you need to invest additional time and effort for each unit of production. Scalable occupations are like those of an author, movie star, equity trader etc. where the the amount of work required doesn't increase with production. A writer, for example, has to put in the same amount of work to gain one or a million readers.

In a non-scalable occupation, the element of skill is more easily discernible. A scalable occupation is more dependant on luck and produces huge inequalities where a few can earn a lot leaving others with the crumbs even though there may not be such a wide difference between the two groups. In any individual case, it will be more difficult to decide how much of luck and how much of skill contributed to the success.

Every year, the literary agent John Brockman asks several public intellectuals to answer some question or another, and posts it on the Internet to provoke discussion. One year he asked many scientists to give their favorite equation. Daniel Kahneman gave the following:
success = talent +luck
great success = a little more talent + lot of luck
I will just add that even the skill that one possesses is a matter of luck - it depends on the combination of genes that you are born with and the environment you are born into, both of which you cannot control.

There is also the contingency that  the society that you are born into values the talents that you process.For eg. if Tendulkar had been born in Mali with the same talent for hitting with a wooden implement a leather missile thrown at speed, he would not have become a star. He would also not have become as good as he did because he would not have had the motivation to improve his skills.He worked hard because he knew that the skills that he possessed were honoured and rewarded in the society in which he lived. (A school student said that he needs to study only till Std. X and he will become a crorepati. Why? Tendulkar studied only till Std X! This is is another type of delusion similar to thinking that if you drop out of college and have a garage, you will become a billionaire!)
Michael Sandel writes in Justice:
The successful often overlook this contingent aspect of their success. Many of us are fortunate to process, at least in some measure, the qualities that our society happens to prize. In a capitalist society, it helps to have entrepreneurial drive. In a bureaucratic society, it helps to get on easily and smoothly with superiors. In a mass democratic society, it helps to look good on television, and to speak in short, superficial sound bites. In a litigious society, it helps to go to law school, and to have the logical and reasoning skills that will allow you to score well on the LSATs.
[SNIP]
So, while we are entitled to the benefits that the rules of the game promise for the exercise of our talents, it is a mistake and  a conceit to suppose that we deserve in the first place a society that values the qualities we have in abundance.
You may say that life is unfair, that nature distributes talents unequally and the luck of social circumstances cannot be helped. Well, nature is neither fair nor unfair; it just is. In the words of the poet A.E. Housman, it 'neither  knows nor cares'. As the philosopher John Rawls said, 'What is just and unjust is the way that institutions deal with these facts.' You cannot derive values from facts. Making this error is called naturalistic fallacy.

The philosopher John Rawls considered what formal principles of justice rational and mutually disinterested persons would choose in the original position of equality behind the veil of ignorance unaware of the talents and status they will inherit at birth. If you didn't know your own place in society, there is always the chance that once the veil is removed, you might find yourself among the least advantaged economically and/or a persecuted minority.

According to Rawls, two principles of justice would emerge from such a thought experiment. The first would be that the person would choose a society which would provide equal basic liberties for all which would take priority over considerations of social utility and general welfare. The second choice, knowing that you could be dealt a lousy hand, would be to be born in a society where the most disadvantaged are cared for.

Rawls is not suggesting a levelling equality of the type parodied in Harrison Bergerson, a short story by Kurt Vonnegut.The sociologist Andre Beteille makes a distinction between equality and universality. Universality is the idea of providing primary education and health care to all citizens irrespective of merit. It is concerned with providing the basic necessities and not with everything that human beings may desire at any point of time.

All this does not mean that hard-work, determination, punctuality, etc are not important.  What it indicates is that these qualities are not sufficient attributes for ensuring success. Many successful people have an attribution bias - they attribute their success to their skill and their failures to randomness. It is a wonder that many people seem to  be  convinced of the absurd notion that success is a simple function of individual effort. In The Blank Slate, Stephen Pinker writes about the trade-off between freedom and material equity:
The major political philosophies can be defined by how they deal with the trade-off.  The Social Darwinist right places no values on equality; the totalitarian left places no value on freedom. The Rawlsian left sacrifices some freedom for equality; the libertarian right sacrifices some equality for freedom.  While reasonable people may disagree about the best trade-off, it is unreasonable to pretend there is no trade-off.

Wednesday, April 20, 2016

Luck - III

According to the economist Sherwin Rosen, inequality comes about because of a tournament effect where a person who is only slightly better gets the entire jackpot while others get next to nothing. The effect of asymmetric results can also come from an initial arbitrary push ultimately giving that person cumulative advantage even when no initial skill difference is involved. The sociologist Robert Merton also showed how an initial advantage can follow a person through life which he called the Matthew effect.

The idea of cumulative advantage is that once a person gains a small advantage over other persons, that advantage will compound over time into an increasingly larger advantage. This idea applies to anyone who benefits from past success - individuals, companies, actors, etc. Disadvantages are also cumulative with an initial failure due to random reasons stalking the person for the rest of his life.

When stock markets collapsed following the bursting of the housing bubble many fresh graduates in the US got caught in the ensuing recession. They had to take up lesser paying jobs in industries that were not their first choice. When the economy started recovering a few years later, these people had to start at the bottom of the ladder if they wanted to go back to their preferred sectors and had to compete with younger fresh graduates because their experience was not relevant for the new job. Hence an event entirely outside their control has saddled them with a disadvantage that will dog them throughout their lives.

In Outliers, Malcom Gladwell writes about the concept of the 'self-fulfilling prophecy' by Richard Merton. Here is how Merton put it in his original essay:  “The self-fulfilling prophecy is, in the beginning, a false definition of the situation evoking a new behavior which makes the original false conception come ‘true’.  The specious validity of the self-fulfilling prophecy perpetuates a reign of error.  For the prophet will cite the actual course of events as proof that he was right from the very beginning.”

For example, for admission to kindergarten, a child has to have completed a certain age so there will be a few months difference between the oldest and youngest child in the class. At that age, a few months of extra brain development is significant. The older children will be able to grasp things better and therefore perform better. The cycle of achievement and underachievement, encouragement and discouragement, adds up to a significant advantage over the years. I am quite sure such a process worked to my advantage.

The self-fulfilling prophecy is related also to what Karl Popper called “The Oedipus effect” - an idea that he had discussed in The Poverty of Historicism - the influence of a prediction upon the event predicted.  He called this the ‘Oedipus effect’, because the oracle played a most important role in the sequence of events which led to the fulfillment of its prophecy.

Path dependent processes are those where initial decisions and conditions almost irreversibly affect subsequent decisions which ultimately produce an outcome. It explains how the set of decisions one faces for any given circumstance is limited by the decisions one has made in the past, even though the situation may have changed. Here the future success is determined by the past success. Thus Microsoft or QWERTY keyboard enjoy disproportionate success even though superior products exist. Economists also call it 'network externalities'. Nassim Taleb writes in Fooled by Randomness:
...Brian Arthur, an economist concerned with non-linearities at the Santa Fe Institute, wrote that chance events coupled with positive feedback rather than technological superiority will determine economic superiority - not some abstrusely defined edge in a given area of expertise. While early economic models excluded randomness, Arthur explained how "unexpected orders, chance meetings with lawyers, managerial whims... would help determine which ones achieved early sales and, over time, which firms dominated."
As this Hindi song shows, some people believe that life is all about luck while some believe that life is all about planning. The truth is that both play a role in deciding one's life chances. The successful vastly underestimate the role that luck has played in their lives. Tom Peters, one of the authors of In Search of Excellence , writes in an article TOM PETERS'S TRUE CONFESSIONS, 'In McKinsey's world, all of life is one of two things: strategy or organization.' If everyone had the same opportunities that I had, I would not have got into IIMA.(No doubt you are muttering what Sherlock Holmes told Doctor Watson, 'Your grasp of the obvious amazes me.' )

Wednesday, April 6, 2016

Luck - II

Although both genes and environment both interact and influence behavior, there are some situations when a powerful influence from one side of the interaction can overwhelm the influence of the other. Take for instance the side of genes. Whatever splendid environment you are born in, it will not compensate for the catastrophic consequences of a genetic disease like Tay-Sacks.Conversely some environmental effect can overcome genetic influence. Even the best possible combination of genes is not going to help if you are subjected to a prolonged period of severe protein malnutrition during childhood.

Psychologists say that birth order has an effect on effort and striving - apparently, the first-born has a stronger work ethic, makes more money and achieves more conventional success than their younger siblings. In Justice, Michael Sandel says that when he asks his Harvard class how many are first born, about 75-80% raise their hands. The results have been the same every time he has held the poll.

I would have liked to conduct such a poll in the classes I studied in if I had known about it at the time. (The study is controversial and there is no scientific consensus about it.) For the record, I am first-born. Nobody can claim that he or she can influence the order in which one is born. If something as arbitrary as one's birth order has an influence on one's tendency to work hard then even the hard work one puts in is a matter of chance.

I heard a BBC podcast which suggests that social conditions a couple of generations ago could affect your health. How? The egg that formed you was formed in your mother's ovary when she was a foetus in your grandmother's womb. The health of this egg depends on your grandmother's diet. So your health depends on how women were treated in your society a couple of generations ago.          

Not only the economic capital but also the social capital of family members - the relationships that they have built over the years - aid in one's education and career.  The social capital of a plumber is less influential than that of a doctor in any part of the world so which social stratum you are born in is by no means immaterial even in the most meritocratic societies. The social and economic conditions that you find yourself in matter big-time.

In his retirement speech, Tendulkar talked of the large number of people who helped him in various ways. In the absence of such a nurturing and supportive environment he would not have achieved as much as he did. Jeb Bush, whose father and brother were US presidents and whose grandfather was a  rich Wall Street banker and a US  senator, once said about having such a family lineage, 'I think overall its a disadvantage.' Most people would give their right arm to have such a disadvantage. As Malcolm Gladwell says in Outliers:
People don't rise from nothing.  We do owe something to parentage and patronage.  The people who stand before kings may look like they did it all by themselves.But in fact they are invariably the beneficiaries of hidden advantages and extraordinary opportunities and cultural legacies that allow them to learn and work hard and make sense of the world in ways others cannot. It makes a difference where and when we grew up.  The culture we belong to and the legacies passed down by our forebears shape the patterns of our achievement in ways we cannot begin to imagine.
A report in the NYT says that a large-scale research study found that social mobility hadn’t changed much over time. When you look across centuries, at social status broadly measured — not just income and wealth, but also occupation, education and longevity — social mobility is much slower than many thought.  This is true whether you consider capitalism, democratization, mass public education, the decline of nepotism, redistributive taxation, the emancipation of women, or even, as in China, socialist revolution.

Then there are the unexpected accidents that keep happening. You may fall sick before an exam or interview. A trivial injury may turn into a life threatening condition as happened to this journalist. You may be standing on the side of the road and a vehicle may hit you. (There are maniacs on Indian roads so this is by no means rare.) There is a long running study of Harvard graduates extending over decades which shows chance events changing lives in unexpected ways.