Talking Trees Are Smarter Than Computers

 

Late one night in my third year of medical school, I was following the senior resident around, and we got a call for a 98-year-old white female in the ER, short of breath. He interviews her, finds that she’s always been pretty healthy, but she started having more trouble breathing a few days ago.

He asks what she means by “pretty healthy.” He asks if she’s ever been in the hospital before, she says she had her appendix out when she was a little kid, maybe four years old or so.  The resident doesn’t even look at me and says, “Get records on that, Bastiat.”

I look up at the ceiling and shake my head as I’m doing math:  “Let’s see.  It’s 1993, she’s – what – 98?  So that would have been – what – 1896?  1898?  Holy %#$@.  I’m sure that will be right on the front rack in medical records…”  After the resident left, I asked her what hospital she was in when that happened.  She said she was in this very hospital, but in the old building, before they tore it down.  I though, “Well, ok, maybe there’s hope here.”

So I stomped downstairs to medical records as I cursed my luck getting no sleep again.  I walked through medical records, past the ladies at the front desk, past all the rolling shelf systems, past the fixed shelves, and found stacks of cardboard boxes back by the heating and air equipment.  The boxes were pretty well organized, since apparently nobody ever went back there.  And after some rooting around, I actually found her chart.  I sat down on a box and read about her hospitalization in 1898.  It was fascinating:

Her father carried her into the hospital – she was too sick to walk.  The surgeon immediately diagnosed appendicitis and removed her appendix less than three hours after she got to the hospital.  Unfortunately, it had already ruptured, and her abdominal cavity was full of pus.  They had real problems with her BP – she was presumably septic, and they presumably had only ether for anesthesia.  Somehow the surgeon and the anesthesiologist got her through it.  How, I have no idea.

Remember, this was decades before antibiotics came out.  The surgeon put in a couple of drains, and did some lavages, and over the next month in the hospital he kept moving drains, etc., to try to deal with the diffuse infection.

One of his notes made me stop and read it again:  “I moved a drain yesterday.  Today she is much worse.  I fear I may have made a mistake.”

My first thought was, “Ok, now there is a note you would never see in a chart today.  The lawyers would jump all over that.”  But my next thought was, “On the other hand, that’s a really important piece of information.  Anybody working on that kid on that day would really need to know that.  But today, that very important thing would be the one thing we couldn’t say.”

Anyway, she was extremely sick and nearly died twice, but somehow the surgeon used the primitive tools he had available and somehow saved the girl’s life.  How he performed such miracles with his presumed lack of racial diversity, I’ll never know.

Anyway, I went back up to her room and looked at all the scars on her belly, from all the drains the surgeon had described in his notes – touching those scars made me feel connected to a surgeon who had probably been dead for 80 years.  But his four-year-old patient had lived a full life of 98 years now, with a few scars on her belly, but with children and grandchildren and such.

Nice work, buddy.

After having read the chart, I felt like I had been there with the surgeon, and I understood every decision he had made.  And what was amazing about that was that her entire chart was on one piece of paper – the full front side, and about two-thirds of the way down on the back.  And she was in the hospital for a month.

A couple months ago, I sent a patient to the hospital to have his appendix out.  It went well, he was discharged the next day.  I got records from the hospital, and it was over 100 pages.  Imagine that.  Over 100 pages for a 24-hour hospitalization.  And before I even started to read it, I knew that if anything important happened – like, if anything went wrong – I knew ahead of time that that would not be in there.  100 pages of nothing.

Why wasn’t the chart from the late 1800s hundreds of pages long?  Because that surgeon had to write every word by hand.  So he wrote what was necessary and important.  And nothing more.

Now that computers can generate huge piles of billable paperwork, why not?

A nurse gives the patient a Tylenol, clicks a box on the computer, and it generates a two-page note with the exact time and date, the lot number of the pill, the patient’s complaint at the time, and lots of other stuff.  Twenty minutes later, another nurse checks the patient’s temperature, enters that into another box, and another two-page note is generated automatically.  And on and on.

Part of this is due to Medicare, of course.  If the patient was paying for the pill, you’d just bill them for the pill.  But when some computer at Medicare is paying for the pill, the more you document, the more you get paid.

But still, computers are partly to blame.  When we talk about “paperless computer systems” what we really mean are computer systems that are capable of generating simply enormous amounts of paper.

Imagine what ChatGPT is about to do.  And all the other “artificial intelligence” is about to do.  Not just in medicine, but in every field you can imagine.  Everything.  Just imagine what’s about to happen.

We are about to drown in a sea of words.  Words that no one will read.  Words that are no good to anybody.  Well, no good to any humans, anyway.

In “The Lord of the Rings,” the Hobbits become impatient with the Ents (large old talking trees) when they take too long to discuss their next move.  The hobbits want to act now, but the Ents are talking slowly and deliberately.  The Ents respond to the impatience of the Hobbits:  “You must understand, young Hobbit, it takes a long time to say anything in Old Entish.  And we never say anything unless it is worth taking a long time to say.”

I’m starting to think that the talking trees have a point.

I spent an hour last night in bed surfing Facebook.  I read for an hour – one post after another – on and on and on.  When I finally foolishly thought I might be able to actually fall asleep I realized that I couldn’t remember anything I had just read.  It was all just a series of words and pretty pictures.  I didn’t know anything that I didn’t know before.

This is why search engines are so important now.  Trying to find the one thing on the internet that is relevant to you right now is becoming more and more challenging.

If the information on the internet is limitless, and if the search engines are good enough, then this could be very powerful.  Potentially.  Right?  And that is pretty much the idea behind artificial intelligence.

Of course, if the information on the internet is not limitless (like if they edit out the less desirable information like the doctor’s ‘mistake’ above), or if the information is otherwise somehow even slightly unintentionally biased, then this goes from helpful to grossly misleading.  And Lord help us if the search engine is biased even a little bit – then it’s all just propaganda.

Imagine the 1898 surgeon’s note after being filtered by Google, CDC, modern media, and a team of lawyers.  I would no longer have any idea what actually happened.

In fact, what actually happened would be less prominent than whatever message those filters were trying to get across.  A message I would question at my own professional and personal peril.

So I wouldn’t question it.  In fact, it wouldn’t ever occur to me to question it.  Why would I?

But still.  But still, the potential of artificial intelligence is huge, right?

Right.  Of course.  Obviously.

But I don’t know.  I really don’t.

In fact, the potential for abuse in this system is so obvious that I’m skeptical even of the motivations of whoever designed it.  There’s no way for humans to design such a system without including subtle biases that will make the results somewhere between unhelpful and pure poison.  So why build it?

To me, there is only one reason to build such a system.  And George Orwell and I think it’s not good.

I’d rather read notes from an old surgeon from 100 years ago, who was choosing his words carefully.

Perhaps it’s better to never say anything, unless it is worth taking a long time to say.

Perhaps those old boxes of charts are pretty well organized, since nobody ever goes back there.  Perhaps you can learn a lot from carefully composed and carefully organized ideas, from people you respect.

Perhaps mass production of concrete blocks is helpful, but mass production of ideas is dangerous.  In fact, perhaps the mass production of ideas is pure poison.

We’ll see, I guess.

Thank you for reading this long essay.  Perhaps there was a shorter way to get to this point.

I’ll let you decide if it was worth taking a long time to say.

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  1. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    I am with you 100%.

    My notes for insurance clients have more words to meet requirements in case I am audited. My Self Pay clients have less words that are easier for me to follow. 

    • #1
  2. namlliT noD Member
    namlliT noD
    @DonTillman

    Wow!  This is enlightening.

    • #2
  3. Chowderhead Coolidge
    Chowderhead
    @Podunk

    Specifications for a simple pump station are hundreds of pages long. This is what it should say:

    Water is high turn pump on. Water goes low turn pump off.

    • #3
  4. Hoyacon Member
    Hoyacon
    @Hoyacon

    Let’s check in with Blaise Pascal:

    I have only made this letter longer because I have not had the time to make it shorter.

    • #4
  5. Dr. Bastiat Member
    Dr. Bastiat
    @drbastiat

    Chowderhead (View Comment):

    Specifications for a simple pump station are hundreds of pages long. This is what it should say:

    Water is high turn pump on. Water goes low turn pump off.

    Ronald Reagan, in a press conference, was once challenged by a reporter:

    “But Mr. President, there are no simple answers!”

    Reagan:  “Yes, there are simple answers.  But there are no easy answers.”

    • #5
  6. TheRightNurse, radiant figure of feminine kindness Member
    TheRightNurse, radiant figure of feminine kindness
    @TheRightNurse

    Dr. Bastiat: Why wasn’t the chart from the late 1800’s hundreds of pages long?  Because that surgeon had to write every word by hand.  So he wrote what was necessary and important.  And nothing more.

    He wrote what was out of the ordinary.  The typical functions of daily life, eating and drinking, excreting were expected and wouldn’t be anything to note.  Today, these are called “WDL” or “WNL”: within defined(normal) limits.  Difference is that now we note everything. 

    Heart rate was normal.  Blood pressure was normal.  Patient eats a standard diet.  Patient is able to void and defecate normally in frequency and quality.  Patient walks and talks normally.  Patient’s pupils are equal and reactive. 

    Theoretically, we’re charting WDL except and then we’re charting only what is out of the normal.  But that’s in the top of each body system.  Then we’re charting exactly what the heart rhythm is, if the waves are normal, any abnormalities.  But then we’re also charting education.  If the patients know what medications they’re taking, why.  Do they have questions?  Do their family members?  Was anyone updated *this shift* about their care and updates in care?  How did that go, exactly?  Who was it who was updated?  When they were in bed, were the rails up?  One rail or two?  Or three?  Or more?  Was the remote near the patient?  What position were they laying in?  On which side?

    All of these things were unnecessary back then.  Who cares where they were laying or what they were eating unless it was a problem?  It was expected and granted that the people providing care were doing so to the best of their abilities and that the patients were relatively normal unless someone said something otherwise.  Whatever they came in for (appendicitis) had an expected course and that’s how it was expected to go… unless someone said otherwise.

    Now everything has to be charted because god forbid someone falls out of bed, someone gets a pressure ulcer from refusing to move in bed, someone doesn’t poop for 5 days and has to stay for two more days until they poop…. etc, etc, etc.

    With more intervention comes more that can go wrong.  The expected course is less routine.  With more information, we know so much more about what happens when we’re sick.  With more information comes more documentation burden.

    …but you’re right.  It’s mostly because people are litigious and regulators like to nitpick that something was left as WDL and they can’t for the life of them figure out what that means so even though you can click on it and it’ll tell you the definition, they need it to be spelled out exactly and with all the words.

    I can’t even tell you how often I’m told to document things in three different places on The Best System Ever ™ because regulators can’t find information.

    Ugh.

    • #6
  7. Ekosj Member
    Ekosj
    @Ekosj

    There is a great vignette from the baseball book Moneyball…

    The author talks about how the enormous amount of baseball statistics fail to capture what actually happened on the field….

    Consider the following situation … runner on third base, two outs.   The pitcher makes a good pitch and the batter lifts a soft fly ball to left.   It ought to be out #3.   
    But
    Out in left field is power hitting but notoriously immobile Albert Belle.  Because it’s Belle out there, and he can’t get to balls most other outfielders could handle with ease, the can-of-corn drops in for a single.   The runner scores.   What really happened?   The pitcher succeeded.   He induced the batter to hit a lazy fly ball.    The batter failed.    And Albert Belle’s lack of speed cost his team a run.

     What do the stats show?   The pitcher gets dinged for giving up a hit and an earned run.  The batter gets credit for a hit and an RBI.   And Albert gets off Scot free.

    • #7
  8. Mad Gerald Coolidge
    Mad Gerald
    @Jose

    During my USAF career I was tasked to investigate the loss of communications equipment in Qatar during Desert Storm.  Since I had never been to Qatar, and everyone who had gone claimed they didn’t remember, it was obviously a waste of time.

    I filled out the form with a terse conclusion that there was no way to determine what happened and the issue should be closed.  The form came back to me with the message to do it over.

    I spent a week documenting worthless information, including proof that the equipment hadn’t been properly documented for 15 years, and possibly had never gone to Qatar. I cited regulations that contradicted my instructions although I didn’t point that out.  I filled the form and attached multiple pages of addendums.  It was accepted.

    The idea that medical records are worse is horrifying.

    • #8
  9. Mad Gerald Coolidge
    Mad Gerald
    @Jose

    A word of warning!  If your medical records ever get mixed with someone else’s, request copies of everything before you report the mixup.

    If you report the mix up first, you won’t be able to access your information until everything is sorted out.  It could take years.

    • #9
  10. Percival Thatcher
    Percival
    @Percival

    Dr. Bastiat:

    Imagine what ChatGPT is about to do.  And all the other “artificial intelligence” is about to do.  Not just in medicine, but in every field you can imagine.  Everything.  Just imagine what’s about to happen.

    We are about to drown in a sea of words.  Words that no one will read.  Words that are no good to anybody.  Well, no good to any humans, anyway.

    It may be a little while.

    ChatGPT ‘may make up facts,’ OpenAI’s chief technology officer says

    The bot “may make up facts” as it writes sentences, OpenAI’s chief technology officer Mira Murati said in an interview with Time magazine, describing that as a “core challenge.” ChatGPT generates its responses by predicting the logical next word in a sentence, she said — but what’s logical to the bot may not always be accurate.

    Garbage in still equals garbage out. But it’s fast garbage.

    • #10
  11. Arahant Member
    Arahant
    @Arahant

    So, what happened with the 98-year-old woman?

    • #11
  12. Clavius Thatcher
    Clavius
    @Clavius

    Dr. Bastiat:

    Perhaps you can learn a lot from carefully composed and carefully organized ideas, from people you respect.

    Perhaps mass production of concrete blocks is helpful, but mass production of ideas is dangerous.  In fact, perhaps the mass production of ideas is pure poison. 

    I think you are correct on both points.

    A lot to think about here.

    Thanks.

    • #12
  13. Miffed White Male Member
    Miffed White Male
    @MiffedWhiteMale

    Ekosj (View Comment):

    There is a great vignette from the baseball book Moneyball…

    The author talks about how the enormous amount of baseball statistics fail to capture what actually happened on the field….

    Consider the following situation … runner on third base, two outs. The pitcher makes a good pitch and the batter lifts a soft fly ball to left. It ought to be out #3.
    But
    Out in left field is power hitting but notoriously immobile Albert Belle. Because it’s Belle out there, and he can’t get to balls most other outfielders could handle with ease, the can-of-corn drops in for a single. The runner scores. What really happened? The pitcher succeeded. He induced the batter to hit a lazy fly ball. The batter failed. And Albert Belle’s lack of speed cost his team a run.

    What do the stats show? The pitcher gets dinged for giving up a hit and an earned run. The batter gets credit for a hit and an RBI. And Albert gets off Scot free.

    On the other hand, a fielder can make a simple error with two outs, followed by the pitcher giving  up 12 home runs in a  row, and none of those 12 runs will be considered “earned”.

    • #13
  14. Miffed White Male Member
    Miffed White Male
    @MiffedWhiteMale

    Arahant (View Comment):

    So, what happened with the 98-year-old woman?

    It was 1993.  I’m guessing she’s died by now.

     

    • #14
  15. Arahant Member
    Arahant
    @Arahant

    Miffed White Male (View Comment):

    Arahant (View Comment):

    So, what happened with the 98-year-old woman?

    It was 1993. I’m guessing she’s died by now.

    Sure, but how much further did she go?

    • #15
  16. Blondie Thatcher
    Blondie
    @Blondie

    I worked evenings and nights when I first started nursing. My notes were usually some version of “patient resting quietly” or “walked down the hall with assistance”. No CMS mandates. 

    • #16
  17. Clavius Thatcher
    Clavius
    @Clavius

    Arahant (View Comment):

    Miffed White Male (View Comment):

    Arahant (View Comment):

    So, what happened with the 98-year-old woman?

    It was 1993. I’m guessing she’s died by now.

    Sure, but how much further did she go?

    Yes, and were the surgery notes from way back helpful in her treatment?

    • #17
  18. Douglas Pratt Coolidge
    Douglas Pratt
    @DouglasPratt

    What a splendid essay. Thank you. It’s a fascinating story in itself, and you told it beautifully. You held me as you spun out your conclusions. I need to consider them to respond, but I didn’t want to wait to express my appreciation. Posts like this are why Ricochet won’t be replaced by Facebook. 

    • #18
  19. GPentelie Coolidge
    GPentelie
    @GPentelie

    This post made me think of (bolding mine) …

    “The explosive component in the contemporary scene is not the clamor of the masses but the self-righteous claims of a multitude of graduates from schools and universities. This army of scribes is clamoring for a society in which planning, regulation, and supervision are paramount and the prerogative of the educated. They hanker for the scribe’s golden age, for a return to something like the scribe-dominated societies of ancient Egypt, China, and Europe of the Middle Ages. There is little doubt that the present trend in the new and renovated countries toward social regimentation stems partly from the need to create adequate employment for a large number of scribes. And since the tempo of the production of the literate is continually increasing, the prospect is of ever-swelling bureaucracies.”

    … and …

    It has often been stated that a social order is likely to be stable so long as it gives scope to talent. Actually, it is the ability to give scope to the untalented that is most vital in maintaining social stability…For there is a tendency in the untalented to divert their energies from their own development into the management, manipulation, and probably frustration of others. They want to police, instruct, guide, and meddle. In an adequate society, the untalented should be able to acquire a sense of usefulness and of growth without interfering with the development of talent around them. This requires, first, an abundance of opportunities for purposeful action and self-advancement. Secondly, a wide diffusion of technical and social skills so that people will be able to work and manage their affairs with a minimum of tutelage. The scribe mentality is best neutralized by canalizing energies into purposeful and useful pursuits, and by raising the cultural level of the whole population so as to blur the dividing line between the educated and the uneducated…We do not know enough to suit a social pattern to the realization of all the creative potentialities inherent in a population. But we do know that a scribe-dominated society is not optimal for the full unfolding of the creative mind.”

    — Eric Hoffer, The Ordeal of Change, … 1963

    • #19
  20. Blondie Thatcher
    Blondie
    @Blondie

    Your story about going to medical records and searching through boxes reminded me of one of my favorite anesthesiologists. He was a “seasoned” doc and we all loved him. We hadn’t been all electronic records long when he came up to me and said, “Psst. Come here. I’ve got something to show you.” He pulled a paper anesthesia record out of his pocket. He had found a willing accomplice in medical records to make a copy for him to have. He was so excited to have that paper record from the patient’s previous difficult intubation. It was just one page, but told so much more than that ridiculous record we use now. 

    • #20
  21. Dr. Bastiat Member
    Dr. Bastiat
    @drbastiat

    Arahant (View Comment):

    So, what happened with the 98-year-old woman?

    We diuresed her & sent her home in a few days.

    I’m not sure what happened after that.  I was on to other things.

    I hope she did well.  But she had a weak heart, so I don’t know… 

    • #21
  22. John H. Member
    John H.
    @JohnH

    This story was great the first time, and it is still great now. Ordinarily I object to repetition in posts, but this story needed to be told again, this time with a slightly different message.

    • #22
  23. Dr. Bastiat Member
    Dr. Bastiat
    @drbastiat

    John H. (View Comment):

    This story was great the first time, and it is still great now. Ordinarily I object to repetition in posts, but this story needed to be told again, this time with a slightly different message.

    As I was writing this, I kept doing searches.  I could’ve sworn I wrote about her before.  But I couldn’t find it.

    Nice work!

    Different message this time.  I was trying to make as different point.  But I used the same patient.

    Thanks for finding that! 

    • #23
  24. MikeMcCarthy Coolidge
    MikeMcCarthy
    @MikeMcCarthy

    Perhaps you can learn a lot from carefully composed and carefully organized ideas, from people you respect.

    Ricochet!

    • #24
  25. TheRightNurse, radiant figure of feminine kindness Member
    TheRightNurse, radiant figure of feminine kindness
    @TheRightNurse

    Blondie (View Comment):

    I worked evenings and nights when I first started nursing. My notes were usually some version of “patient resting quietly” or “walked down the hall with assistance”. No CMS mandates.

    Remember paper charting?  One paragraph summary.  No line breaks, just the signature at the end and the date/time at the beginning. What happened today?  Well: pt is oriented, no c/o pain. Ambulated in hallways. Refused all medications. Resting in bed at end of shift. Report to be given to oncoming staff. 

    Donesies.

    What was important was noted.  The patient was oriented, didn’t have pain, walked around and was oriented enough to refuse all meds.  They were left in bed, report was given.  The End.  Done.  With a flowsheet that showed the vitals in graph form.

    Ah, the old days!

    • #25
  26. Mark Camp Member
    Mark Camp
    @MarkCamp

    Doc, this was one of your best. Thank you.

    I have a fond connection with two young anaesthesiologists, and if I could let them read this right now by clicking “Share this article with immediate family members for $1.00. Your Ricochet account will be automatically charged” I would.

    • #26
  27. Ekosj Member
    Ekosj
    @Ekosj

    Miffed White Male (View Comment):

    Ekosj (View Comment):

    There is a great vignette from the baseball book Moneyball…

    The author talks about how the enormous amount of baseball statistics fail to capture what actually happened on the field….

    Consider the following situation … runner on third base, two outs. The pitcher makes a good pitch and the batter lifts a soft fly ball to left. It ought to be out #3.
    But
    Out in left field is power hitting but notoriously immobile Albert Belle. Because it’s Belle out there, and he can’t get to balls most other outfielders could handle with ease, the can-of-corn drops in for a single. The runner scores. What really happened? The pitcher succeeded. He induced the batter to hit a lazy fly ball. The batter failed. And Albert Belle’s lack of speed cost his team a run.

    What do the stats show? The pitcher gets dinged for giving up a hit and an earned run. The batter gets credit for a hit and an RBI. And Albert gets off Scot free.

    On the other hand, a fielder can make a simple error with two outs, followed by the pitcher giving up 12 home runs in a row, and none of those 12 runs will be considered “earned”.

    Either way,  the statistics, voluminous though they are, can still fail to convey the truth of what happened.   Which is the fascinating double entendre of the whole Moneyball idea … basing the entire strategy of the game on  the intricate analysis of statistics known to be … flawed(?) … inadequate(?) … I’m not sure of the right word.    It it’s that double entendre that  I think, gets to the heart of Doc’s post.    Instead of creating better records, we try to make up in volume what they lack in clarity.   Why?   Because we can.   And it’s waaaay easier than looking for genuine explanations.  Take Progressives’ statistics-based analysis of anything involving race in America as cases in point.

    • #27
  28. kedavis Coolidge
    kedavis
    @kedavis

    Mad Gerald (View Comment):

    During my USAF career I was tasked to investigate the loss of communications equipment in Qatar during Desert Storm. Since I had never been to Qatar, and everyone who had gone claimed they didn’t remember, it was obviously a waste of time.

    I filled out the form with a terse conclusion that there was no way to determine what happened and the issue should be closed. The form came back to me with the message to do it over.

    I spent a week documenting worthless information, including proof that the equipment hadn’t been properly documented for 15 years, and possibly had never gone to Qatar. I cited regulations that contradicted my instructions although I didn’t point that out. I filled the form and attached multiple pages of addendums. It was accepted.

    The idea that medical records are worse is horrifying.

    But at least you cited actual stuff, apparently ChatGPT just makes up sources too.

    • #28
  29. kedavis Coolidge
    kedavis
    @kedavis

    GPentelie (View Comment):

    This post made me think of (bolding mine) …

    “The explosive component in the contemporary scene is not the clamor of the masses but the self-righteous claims of a multitude of graduates from schools and universities. This army of scribes is clamoring for a society in which planning, regulation, and supervision are paramount and the prerogative of the educated. They hanker for the scribe’s golden age, for a return to something like the scribe-dominated societies of ancient Egypt, China, and Europe of the Middle Ages. There is little doubt that the present trend in the new and renovated countries toward social regimentation stems partly from the need to create adequate employment for a large number of scribes. And since the tempo of the production of the literate is continually increasing, the prospect is of ever-swelling bureaucracies.”

    … and …

    It has often been stated that a social order is likely to be stable so long as it gives scope to talent. Actually, it is the ability to give scope to the untalented that is most vital in maintaining social stability…For there is a tendency in the untalented to divert their energies from their own development into the management, manipulation, and probably frustration of others. They want to police, instruct, guide, and meddle. In an adequate society, the untalented should be able to acquire a sense of usefulness and of growth without interfering with the development of talent around them. This requires, first, an abundance of opportunities for purposeful action and self-advancement. Secondly, a wide diffusion of technical and social skills so that people will be able to work and manage their affairs with a minimum of tutelage. The scribe mentality is best neutralized by canalizing energies into purposeful and useful pursuits, and by raising the cultural level of the whole population so as to blur the dividing line between the educated and the uneducated…We do not know enough to suit a social pattern to the realization of all the creative potentialities inherent in a population. But we do know that a scribe-dominated society is not optimal for the full unfolding of the creative mind.”

    — Eric Hoffer, The Ordeal of Change, … 1963

    Sounds like the old Mandarins, doesn’t it?

    • #29
  30. kedavis Coolidge
    kedavis
    @kedavis

    John H. (View Comment):

    This story was great the first time, and it is still great now. Ordinarily I object to repetition in posts, but this story needed to be told again, this time with a slightly different message.

    I knew it was familiar!

    • #30
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