Make War, then Love

At the close of the first decade of the 21st century, we find ourselves continuously connecting to one another.  This isn’t a new thing, although it may feel new.  The kit has changed – that much is obvious – but who we are has not.  Only from an understanding of who we are that we can understand the future we are hurtling toward.  Connect, connect, connect.  But why?  Why are we so driven?

To explain this – and reveal that who we are now is precisely who we have always been, I will tell you two stories.  They’re interrelated – one leads seamlessly into the other.  I’m not going to say that these stories are the God’s honest truth.  They are, as Rudyard Kipling put it, ‘just-so stories’.  If they aren’t true, the describe an arrangement of facts so believable that they could very well be true.  There is scientific evidence to support both of these stories, but neither is considered scientific canon.   So, take everything with a grain of salt; these are more fables than theories, but we have always used fables to help us illuminate the essence of our nature.

For our first story, we need to go back a long, long time.  Before the settlement of Australia – by anyone.  Before Homo Sapiens, before Australopithecus, before we broke away from the chimpanzees, five million years ago, just after we broke away from the gorillas, Ten million years ago.  How much do we know about this common ancestor, which scientists call Pierolapithecus?  Not very much.  A few bits of skeletons discovered in Spain eight years ago.  If you squint and imagine some sort of mash-up of the characteristics of humans, chimpanzees and gorillas, you might be able to get a glimmer of what they looked like.  Smaller than us, certainly, and not upright – that comes along much later.  But one thing we do know, without any evidence from skeletons: Pierolapithecus was a social animal.  How do we know this?  Each of its three descendent species – humans, chips and bonobos – are all highly social animals.  We don’t do well on our own.  In fact, on our own we tend to make a tasty meal for some sort of tiger or lion or other cat.  Together, well, that’s another matter.

Which brings us to the first ‘just-so’ story.  Imagine a warm late afternoon, hanging out in the trees in Africa’s Rift Valley.  Just you and your mates – probably ten or twenty of them.  You’re all males; the females are elsewhere, doing female-type things, which we’ll discuss presently.  At a signal from the ‘alpha male’, all of you fall into line, drop out of the trees, and begin a trek that takes you throughout the little bit of land you call your own – with your own trees and plants and bugs that keep you well fed – and you go all the way to the edge of your territory, to the border of the territory of a neighboring troupe of Pierolapithecus.  That troupe – about the same size as your own – is dozing in the heat of the afternoon, all over the place, but basically within eyeshot of one another.

Suddenly – and silently – you all cross the border.  You fan out, still silent, looking for the adolescent males in this troupe.  When you find them, you kill them.  As for the rest, you scare them off with your screams and your charges, and, at the end, they’ve lost some of their own territory – and trees and plants and delicious grubs – while you’ve got just a little bit more.  And you return, triumphant, with the bodies you’ve acquired, which you eat, with your troupe, in a victory dinner.

This all sounds horrid and nasty and mean and just not criket.  That it is.  It’s war.  How do we know that ‘war’ stretches this far back into our past?  Just last month a paper published in Current Biology and reported in THE ECONOMIST described how primatologists had seen just this behavior among chimpanzees in their natural habitats in the African rain forests.  The scene I just described isn’t ten million years old, or even ten thousand, but current.  Chimpanzees wage war.  And this kind of warfare is exactly what was commonplace in New Guinea and the upper reaches of Amazonia until relatively recently – certainly within the span of my own lifetime.  War is a behavior common to both chimpanzees and humans – so why wouldn’t it be something we inherited from our common ancestor?

War.  What’s it good for?  If you win your tiny Pierolapithecine war for a tiny bit more territory, you’ll gain all of the resources in that territory.  Which means your troupe will be that much better fed.  You’ll have stronger immune systems when you get sick, you’ll have healthier children.  And you’ll have more children.  As you acquire more resources, more of your genes will get passed along, down the generations.  Which makes you even stronger, and better able to wage your little wars.  If you’re good at war, natural selection will shine upon you.

What makes you good at war?  That’s the real question here.  You’re good at war if you and your troupe – your mates – can function effectively as a unit.  You have to be able to coordinate your activities to attack – or defend – territory.  We know that language skills don’t go back ten million years, so you’ve got to do this the old fashioned way, with gestures and grunts and the ability to get into the heads of your mates.  That’s the key skill; if you can get into your mates’ heads, you can think as a group.  The better you can do that, the better you will do in war.  The better you do in war, the more offspring you’ll have, so that skill, that ability to get into each others’ heads gets reinforced by natural selection, and becomes, over time, evolution.  The generations pass, and you get better and better at knowing what your mates are thinking.

This is the beginning of the social revolution.  All the way back here, before we looked anything like human, we grasped the heart of the matter: we must know one another to survive.  If we want to succeed, we must know each other well.  There are limits to this knowing, particularly with the small brain of Pierolapithecus.  Knowing someone well takes a lot of brain capacity, and soon that fills up.  When it does, when you can’t know everyone around you intimately.  When that happens your troupe will grow increasingly argumentative, confrontational, and eventually will break into two independent troupes.  All because of a communication breakdown.

There’s strength in numbers; if I can manage a troupe of thirty while all you can manage is twenty, I’ll defeat you in war.  So there’s pressure, year after year, to grow the troupe, and, quite literally, to stuff more mates into the space between your ears.  For a long time that doesn’t lead anywhere; then there’s a baby born with just a small genetic difference, one which allows just a bit more brain capacity, so that they can handle two or three or four more mates into its head, which makes a big difference.  Such a big difference that these genes get passed along very rapidly, and soon everyone can hold a few more mates inside their heads.  But that capability comes with a price.  Those Pierolapithecines have slightly bigger brains, and slightly bigger heads.  They need to eat more to keep those bigger brains well-fed.  And those big heads would soon prove very problematic.

This is where we cross over, from our first story, into our second.  This is where we leave the world of men behind, and enter the world of women, who have been here, all along, giving birth and gathering food and raising children and mourning the dead lost to wars, as they still do today.  As they have done for ten million years.  But somewhere in the past few million years, something changed for women, something perfectly natural became utterly dangerous.  All because of our drive to socialize.

Human birth is a very singular thing in the animal world.  Among the primates, human babies are the only ones born facing downward and away from the mother.  They’re also the only ones who seriously threaten the lives of their mothers as they come down the birth canal.  That’s because our heads are big.  Very big.  Freakishly big.  So big that one of the very recent evolutionary adaptations in Homo Sapiens is a pelvic gap in women that creates a larger birth canal, at the expense of their ability to walk.  Women walk differently from men – much less efficiently – because they give birth to such large-brained children.

There’s two notable side-effects of this big-brained-ness.  The first is well-known: women used to regularly die in childbirth.  Until the first years of the 20th century, about one in one hundred pregnancies ended with the death of the mother.  That’s an extraordinarily high rate, particularly given that a women might give birth to seven or eight children over their lifetime.  Now that we have survivable caesarian sections and all sorts of other medical interventions, death in childbirth is much rarer – perhaps 1 in 10,000 births.  Nowhere else among the mammals can you find this kind of danger surrounding the delivery of offspring.  This is the real high price we pay for being big-brained: we very nearly kill our mothers.

The second side-effect is less well-known, but so pervasive we simply accept it as a part of reality: humans need other humans to assist in childbirth.  This isn’t true for any other mammal species – or any other species, period.  But there are very few (one or two) examples of cultures where women give childbirth by themselves.  Until the 20th century medicalization of pregnancy and childbirth, this was ‘women’s work’, and a thriving culture of midwives managed the hard work of delivery.  (The image of the chain-smoking father, waiting outside the maternity ward for news of his newborn child is far older than the 20th century.)

For at least a few hundred thousand years – and probably a great deal longer than that – the act of childbirth has been intensely social.  Women come together to help their sisters, cousins, and daughters pass through the dangers and into motherhood.  If you can’t rally your sisters together when you need them, childbirth will be a lonely and possibly lethal experience.  So this is what it means to be human: we entered the world because of the social capabilities of our mothers.  Women who had strong social capabilities, who could bring her sisters to her aid, would have an easier time in childbirth, and would be more likely to live through childbirth, as would their children.

After the child has been born, mothers need even more help from their female peers; in the first few hours, when the mother is weak, other women must provide food and shelter.  As that child grows, the mother will periodically need help with childcare, particularly if she’s just been delivered of another child.  Mothers who can use their social capabilities to deliver these resources will thrive.  Their children will thrive.  This means that these capabilities tended to be passed down, through the generations.  Just as men had their social skills honed by generations upon generations of warfare, women had their social skills sharpened by generations upon generations of childbirth and child raising.

All of this sounds very much as though it’s Not Politically Correct.  But our liberation from our biologically determined sex roles is a very recent thing.  Men raise children while women go to war.  Yet behind this lies hundreds of thousands of generations of our ancestors who did use these skills along gender-specific lines.  That’s left a mark; men tend to favor coordination in groups – whether that’s a war or a footy match – while women tend to concentrate on building and maintaining a closely-linked web of social connections. Women seem to have a far greater sensitivity to these social connections than men do, but men can work together in a team – to slaughter the opponent (on the battlefield or the pitch).

The prefrontal cortex – freakishly large in human beings when compared to chimpanzees – seems to be where the magic happens, where we keep these models of one another.  Socialization has limits, because our brains can’t effectively grow much bigger.  They already nearly kill our mothers, they consume about 25% of the food we eat, and they’re not even done growing until five years after we’re born – leaving us defenseless and helpless far longer than any other mammals.  That’s another price we pay for being so social.

But we’re maxed out.  We’ve reached the point of diminishing returns.  If our heads get any bigger, there won’t be any mothers left living to raise us.  So here we are.  An estimate conducted nearly 20 years ago pegs the number of people who can fit into your head at roughly 148, plus or minus a few.  That’s not very many.  But for countless thousands of years, that was as big as a tribe or a village ever grew.  That was the number of people you could know well, and that set the upper boundary on human sociability.

And then, ten thousand years ago, the comfortable steady-state of human development blew apart.  Two things happened nearly simultaneously; we learned to plant crops, which created larger food supplies, which meant families could raise more children.  We also began to live together in communities much larger than the tribe or village.  The first cities – like Jericho – date from around that time, cities with thousands of people in them.

This is where we cross a gap in human culture, a real line that separates that-which-has-come-before to that-which-comes-after.  Everyone who has moved from a small town or village to the big city knows what it’s like to cross that line.  People have been crossing that line for a hundred centuries.  On one side of the line people are connected by bonds that are biological, ancient and customary – you do things because they’ve always been done that way.  On the other side, people are bound by bonds that are cultural, modern, and legal.  When we can’t know everyone around us, we need laws to protect us, a culture to guide us, and all of this is very new.   Still. Ten thousand years of laws and culture, next to almost two hundred thousand years of custom – and that’s just Homo Sapiens.  Custom extends back, probably all the way to Pierolapithecus.

We wage a constant war within ourselves.  Our oldest parts want to be clannish, insular, and intensely xenophobic.  That’s what we’re adapted to.  That’s what natural selection fitted us for.  The newest parts of us realize real benefits from accumulations of humanity to big to get our heads around.  The division of labor associated with cities allows for intensive human productivity, hence larger and more successful human populations.  The city is the real hub of human progress; more than any technology, it is our ability to congregate together in vast numbers that has propelled us into modernity.

There’s an intense contradiction here: we got to the point where we were able to build cities because we were so socially successful, but cities thwarted that essential sociability.  It’s as though we went as far as we could, in our own heads, then leapt outside of them, into cities, and left our heads behind.  Our cities are anonymous places, and consequently fraught with dangers.

It’s a danger we seem prepared to accept.  In 2008 the UN reported that, for the first time in human history, over half of humanity lived in cities.  Half of us had crossed the gap between the social world in our heads and the anonymous and atomized worlds of Mumbai and Chongquing and Mexico City and Cairo and Saõ Paulo.  But just in this same moment, at very nearly the same time that half of us resided in cities, half of us also had mobiles.  Well more than half of us do now.  In the anonymity of the world’s cities, we stare down into our screens, and find within them a connection we had almost forgotten.  It touches something so ancient – and so long ignored – that the mobile now contends with the real world as the defining axis of social orientation.

People are often too busy responding to messages to focus on those in their immediate presence.  It seems ridiculous, thoughtless and pointless, but the device has opened a passage which allows us to retrieve this oldest part of ourselves, and we’re reluctant to let that go.

Which brings us to the present moment.

Hyperconnected Health

I: My Cloud

This is the age of networks, and we are always connected.  If that seems fanciful, ask yourself how often you are parted from your mobile, and for how long?  All of our hours – even as we sleep – the mobile is within arm’s reach for almost all of us.  A few months ago a woman asked me when we might expect to have implants, to close the loop, and make the connection permanent.  “We’re already there,” I responded.  “It’s wedded to the palm of your hand.”  In a purely functional sense this is the truth, and it has been the case for several years.

Connection to the network is neither an instantaneous nor absolute affair.  It takes time to establish the protocols for communication.  We understand many of these protocols without explanation: we do not telephone someone at three o’clock in the morning unless vitally important.  Three o’clock in the afternoon, however, is open season.  Lately, there are newer, technologically driven protocols: I can look at a caller’s number, and decide whether I want to take that call or direct it to voice mail.  The caller has no idea I’ve made any decision.  From their point of view, it’s simply a missed call.  Similarly, I have friends I can not text before 10 AM unless it’s quite urgent, and I ask my friends not to text me after 10 PM for the same reason.  We set our boundaries with technology, boundaries which determine how we connect.  We can choose to be entirely connected, or entirely disconnected.  We can let the batteries run flat on our mobile, or simply turn it off and put it away.  But there’s a price to be paid.  Absence from connection incurs a cost.  To be disconnected is to cede your ability to participate in the flow of affairs.  Thus, the modern condition is a dilemma, where we balance the demands of our connectedness against the desire to be free from its constraints.

Connectedness is not simply a set of pressures; it is equally a range of capabilities.  As our connectedness grows, so our capabilities grow in lock-step.  What we could achieve with the landline was immeasurably beyond what was possible with the post, yet doesn’t compare with what we can do with email, mobile voice, SMS, or, now, any of a hundred thousand different sorts of activities, from banking to dating to ordering up a taxi.  The device has become a platform, a social nexus, the point where we find ourselves attached to the universe of others.  Consider the address book that lives on your mobile.  Mine has about 816 entries.  Those are all connections that were made at some point in my life.  (Admittedly, I haven’t been weeding them out as vigorously as I should, so some of those contact are duplicates or no longer accurate.)  That’s just what’s on my mobile.  If I go out to Twitter, I have rather more connections in my ‘social graph’ – about 6700.  These connections aren’t quiescent, waiting to be dialed, but are constantly listening in to what I have to say, just as I am constantly listening to them.

No one can give their full-time attention to that sort of cacophony of human voices.  Some are paid more attention, others, rather less.  Sometimes there’s no spare attention to be given to any of these voices, and what they say is lost to me.  Yet, on the whole, I can maintain some form of continuous partial attention with this ‘cloud’ of others.  They are always with me, and I with them.  This is a new thing (I view myself as a sort of guinea pig in a lab experiment) and it has produced some rather unexpected results.

At the end of last year I went on a long road trip with a friend from the US.  On our first day, we struck out from Sydney and drove to Canberra, arriving, tired and hungry at quarter to six.  Where do you eat dinner in a town that closes down at 5 pm?  I went online and put the question out to Twitter, then ducked into the shower.  By the time I’d dried off, I had a whole suite of responses from native Canberrans, several of whom pointed me to the Civic Asian Noodle House.  Thirty minutes later, my American friend was enjoying his first bowl of seafood laksa – which was among the best I’ve had in Australia.

A few days later, at the end of the road trip, when we’d reached the Barossa Valley, I put another question out to Twitter: what wineries should we visit?  The top five recommendations were very good indeed.  Each of these ‘cloud moments’, by themselves, seems relatively trivial.  Both together begin to mark the difference between an ordinary holiday and a most excellent one.

Another case in point: two weeks ago today, my washing machine gave up the ghost.  What to replace it with?  I asked Twitter.  Within a few hours, and some back-and-forth, I decided upon a Bosch.  Some of that was based on direct input from Bosch owners, some of that came from a CHOICE survey of washing machine owners.  I was pointed to that survey by someone on Twitter.

As I experiment, and learn how to query my cloud, I have sbecome more dependent upon the good advice it can provide.  My cloud extends my reach, my experience and my intelligence, making me much more effective as some sort of weird ‘colony individual’ than I could be on my own.   I have no doubt that within a few years, as the tools improve, nearly every decision I make will be observed and improved upon by my cloud.  Which is wonderful, incredible, and – to quote Tony Abbott – very confronting.

Let me turn things around a bit, to show another side of the cloud, specifically the cloud of my good friend Kate Carruthers.  Last year Kate found herself in Far North Queensland on a business trip and discovered that her American Express card credit limit had summarily been cut in half – with no advance warning – leaving her far away from home and potentially caught in a jam.  When she called American Express to make an inquiry – and found that their consumer credit division closed at 5 pm on a Friday evening – she lost her temper.  The 7500 people who follow Kate on Twitter heard a solid rant about the evils of American Express, a rant that they will now remember every time they find an American Express invitation letter in the post, or even when they decide which credit card to select while making a purchase.

Hollywood has been forced to take note of the power of these clouds.  There’s a direct correlation between the speed at which a motion picture bombs and the rise in the number of users of Twitter.  It used to take a few days for word-of-mouth to kill a movie’s box office:  now it takes a few minutes.  As the first showing ends, friends text friends, people post to Twitter and Facebook, and the news spreads.  After the second or third showing, the crowds have dropped off: word has gotten out that the film stinks.  Where just a few years ago a film could coast for an entire weekend, now the Friday matinee has become a make-or-break affair.  An opinion, multiplied by hundreds or thousands of connections, carries a lot of weight.

That amplification effect has been particularly visible to me over the last week.   I’ve been participating in a ‘social review program’ sponsored by Telstra, who sought reviewers for the handset du jour, the HTC Desire.  I received a free handset – worth about $800 – in exchange for a promise to do a thorough, but honest review.  This is the first time I’ve ever done anything like this, and when I started to post my thoughts to Twitter, I immediately got a big pushback.  Some of my cloud considered it an unacceptable commercialization of a space they consider essentially private and personal.  I spruik The New Inventors on Twitter every Wednesday.  That’s just as commercial, but Telstra is held out for particular contempt by a broad swath of the Australian public, so any association with them carries it own opprobrium.  I’ve come to realize that I’ve tarred myself with the same brush that others use for Telstra.  Although I did this accidentally and innocently, some of that tar will continue to stick to me.  I have suffered the worst fate that can befall anyone who lives life with a cloud: reputational damage.  Some people have made it perfectly clear that they will never again regard me with the same benevolence.  That damage is done.  All I can do is learn from it, and work to not repeat the same mistakes.

This marked the first time that I’d been ‘chastised’ by my cloud.  I’ve always operated within the bounds of propriety – the protocols of civilized behavior – but in this case I found I’d stumbled into a minefield, a danger zone filled with obstacles that I’d created for myself by presenting myself not just as Mark Pesce, but as Telstra.  I’ve learned new limits, new protocols, and, for the first time, I can begin to sense the constraints that come hand-in-hand with my new capabilities.  I can do a lot, but I can not do as I please.

II: Share the Health

Social networks are nothing new.  We’ve carried them around inside our heads from a time long before we were recognizably human.  They are the secret to our success, and always have been.  We’re the most social of all the of the mammals, and while the bees may put us to shame, we also have big brains to develop distinct personalities and unique strengths, which we have always shared, so that our expertise becomes an asset to the whole of society, whether that is a tribe, a city, or a nation.

Others have been studying these ‘old-school’ human social networks, and they’ve learned some surprising things.  Harvard internist and social scientist Dr. Nicholas Christakis has published a series of papers that illustrate the power of the connection.  In his first paper, he studied how smoking behaviors – both starting and quitting – spread through social networks.  It turns out that if a sufficient number of your friends start to smoke, you’re more likely to begin yourself.  Conversely, if enough of your friends quit, you’re more likely to quit.  This makes sense when you consider the reinforcing nature of social relationships; we each send one another a forest of subtle cues about the ‘right’ way to behave, fit in, and get along.  Those cues shape our choices and behaviors.  Hang out with smokers and you’re more likely to smoke.  Hang out with non-smokers, and you’re likely to quit smoking.

Dr. Christakis also found that the same phenomenon appears to hold true for obesity.  Again, people look to one another for cues about body image.  If all of your peers are obese, you are more likely to be obese yourself.  If your peers are thin, you’re more likely to be thin.  And if your peers go on a diet, you’re likely to join them in slimming.  The connections between us are also the transmitters of behavior.  (It may be the secret to the success of other groups, such as Alcoholics Anonymous.)  This is a powerful insight, one which caused me to have a bit of a brainwave, a few months ago, as I began planning this talk: what happens when we take what we know about our human social networks as behavioral transmitters and apply that to our accelerated, amplified digital selves?

I can take any bit of data I like and share it out through Twitter to 6700 connections, and I frequently do.  I post articles I’ve read, interesting films I’ve watched, photographs I’ve taken, and so forth.  My cloud is an opportunity to share what I encounter in my life.  Probably many of you do precisely the same thing.  But let’s take it a step further.  Let’s say that my doctor wants me to lose 15 kilos, in order to help me lower my blood pressure.  I agree to his request, and perhaps see a nutritionist, but after that I’m pretty much own my own.  I could spend some money to join a ‘group’ like Weight Watchers or whatnot; essentially purchasing a peer group with whom I will connect.  That will work for the duration of the weight loss, but once the support ends, the weight comes piles on.

Instead of this (or, perhaps, in addition to it), what I need to do is to bind my cloud to my intention to lose weight. I need to share this information, but I need to do it meaningfully.  This is more than simply saying, ‘Hey, I need to drop some pounds.’  More than posting the weekly weigh-in figures.  It means using the cloud intelligently, sharing with the cloud what can and should be shared – that is, what I eat and what exercise I get.

When I say ‘my cloud’ in this context, I doubt that I’m speaking about the full complement of 6700 souls.  Although all of them wish me well, this sort of detail is simply noise to many of them.  Instead, I need to go to a smaller cohort: my close friends, and those within my cloud who share a similar affinity – who are also working to lose weight.  These connections – a cloud within my cloud – are the ones who will be best served by my sharing.  I now keep track of what I eat and how I exercise, using some collaborative tool developed an some enterprising entrepreneur to track it all, and everyone sees what kind of progress I’m making toward my goal.  I also see everyone else’s progress toward their own goals.  We reinforce, we reassure, we share both new-found strengths and our moments of weakness.  As we share, we grow closer.  The network is reinforced.  All along, my friends (and my GP) are looking in, monitoring, happy to see that I’m on track toward my goal.

None of this is rocket science.  It’s good social science, and plain common sense.  It needs to be supported by tools.  At this point, I began to think about the kinds of tools that would be useful.  First and most useful would be a food diary.   Rather than a text-based listing of everything eaten, I reckon this will be a bit more up-to-date; there’ll be photographs, taken with my mobile, of everything that goes into my mouth.  As a bit of an experiment, I tried photographing everything I ate from the beginning of this month.  I always got breakfast, mostly lunch, and by dinner had forgotten completely.  My records are incomplete.  That wouldn’t do for any sharing system like this, and it points to the fact that technology is no substitute for effective habits, and those habits don’t develop overnight.  They require some peer support.

As I was beginning to think through the requirements of such a hypothetical system – so that I could share that system with you– I learned that someone had already implemented a real-world system along similar lines.  Jon Cousins, an entrepreneur from Cambridgeshire recently launched a website known as Moodscope.  This site allows individuals who have mood disorders to track their moods daily, and then shares those daily updates with a circle of up to five trusted individuals.

It’s known that individuals with mood disorders can be supported by a network – if that network is kept abreast of that individual’s changes in mood.  I decided to give Moodscope a try, and have been charting my daily moods (which average around the baseline of 50%) for the past 26 days, sharing those results with a close friend.  Although it’s early days, Moodscope is showing promise as a tool that can support people in their struggle for mood regulation and overall mental health, and might even do so better than some pharmaceutical treatments.

In these two examples – one imaginary and one wholly real – we have a pattern for health care in the 21st century, a model which doesn’t supplant the existing systems, but rather, works alongside them to improve outcomes and to keep patient care costs down, by spreading the burden of care throughout a community.  This model could be repeated to cover diabetics, or hypertensives, or asthmatics, or arthritics, and so on.  It is a generic model which can be applied to every patient and each disorder.

We’ve already seen the birth of ‘Wikimedicine’, where individuals connect together to try to learn more about their diseases than their treating physicians.  This is sometimes a recipe for disaster, but that’s because this is all so new.  Within a few years, doctors, nurse practitioners and patients will be connected through dense networks of knowledge and need.  The doctor and nurse practitioner will help guide the patient into knowledge using the wealth of online resources.  That’s not often happening at present, and this means that patients fall prey to all sorts of bad information.  In our near future, medical knowledge isn’t simply locked away in the physician’s head; it’s shared through a connected community for the benefit of all.  The doctor still treats, while the patient – and the patient’s connections – learn.  From that learning comes the lifestyle changes and reinforcements in behavior that lead to better outcomes.

We have the networks in place, both human and virtual.  We merely need to institute some new practices to reap the benefit of our connections.  As the population ages, these sorts of innovations will seem both natural – relying on others is an essentially human characteristic – and cost-effective.  The population will adopt these measures because they find them empowering (and because their GPs will recommend them), while governments and insurance companies will adopt them because they keep a lid on medical costs.  The forces of culture and technology are converging on a shared, hyperconnected future which aims to keep us as healthy as possible for as long as possible.

III:  The Ministry of Love

I have a good friend who was diagnosed with a mood disorder sixteen years ago.  A few months ago he decided his psychiatric medication was doing him more harm than good, and took himself off of it.  Although it’s been a difficult process, so far he’s been reasonably stable.  When I found Moodscope, I told him about it.  “Sounds good,” he responded, “I can’t wait until they have it as a Facebook app.”  I hadn’t thought about that, but it does make perfect sense: your social graph is already right there, embedded into Facebook, and Facebook applications have access to your social graph: why not create a version of Moodscope that ties the two together?  It sounds very compelling, a sure winner.

But do you really want Facebook to have access to highly privileged medical information, information about your mental state?  That information can be used to help you, but it could also be used against you.   Sydney teenager Nona Belomesoff was lured to her death by a man who used information gleaned from Facebook to befriend her.  Consider: If someone wanted to cause my friend some distress, they could use that shared mood data as a key indicator which would guide them to time their destabilizing efforts for maximum effectiveness.  They could kick him when he was down, and make sure he stayed down.  Giving someone insight into our emotional state gives them the upper hand.

Were that not dangerous enough, just last Friday the Wall Street Journal reported the results of an investigation, which revealed that Facebook was sharing confidential user data with advertisers – data which they’d legally agreed to hold in closest confidence.  The advertisers themselves had no idea that this information was provided illegally.  Facebook, the supreme collector of marketing data, simply didn’t know when or even how to restrain itself.

With that in mind, let’s imagine a situation bound to happen sometime in the next few years.  You and your Facebook friends decide that you want to quit smoking.  It’s too expensive, it’s too hard to find a smoking area, your clothes stink, and you’re starting to get a hacking cough in the mornings.  Enough.  So you tell your friends – over Facebook – that you’re thinking of quitting.  And they think that’s a great idea.  They want to quit, too.  So you all set a date to quit.  That’s all well and good, but then an invitation arrives to a very swanky party in the City, an exclusive affair.  You go, and find that the whole space is a smoking area!  All of these elegant people, puffing away.  Because smoking is glamorous.  And you begin to reconsider.  Your resolve begins to weaken.

Or you want to lose weight.  You even add the Facebook ‘Drop the Fat’ app to your account, to help you achieve your weight loss goals.  But, just as soon as you do that, you start seeing lots more Facebook advertisements for biscuits and ice cream and fresh pizzas.  That has an effect.  It weakens your willpower, and makes those slightly-hungry hours seem more unbearable.

This is the friendly version of ‘Room 101’ from George Orwell’s Nineteen Eighty-Four. In that room, you met your greatest fear.  In this one, you meet your greatest weakness.  When a tobacco company has access to a social network which is trying to quit smoking, it will be tempted to disrupt that network.  When a soft drink company has access to a social network which is trying to lose weight, it will be tempted to disrupt that network.  Our social networks are too potent and too powerful to leave exposed to anyone, for any reason whatsoever.  Yet we leave them lying around, open to public inspection, and we allow Facebook to own them outright, to exploit them as it sees fit, to its own ends, and for its own profit.  Hopefully that will come to an end, unless we’re too far down the rabbit hole to pull out of Facebook and into something else that preserves the integrity of our social graph while granting us control over how we share our inmost selves.

This is where you come in.  You’re the policy folks, and I’ve just thrown a whopper into your lap.  Securing the safety and prosperity of our social future means that we need to establish clear guidelines on how these networks can be used, by whom, and to what ends.  As I’ve explained, there is enormous potential for these networks to lead to breakthroughs in public health, disease prevention, and medical cost management.  That’s just the beginning.  These same networks can organize toward political ends.  We got just a taste of that in the Obama presidential campaign, but the next decade will see its full flower, whether in America or in Iran or in Australia.  As social networks become identified with power networks, all of the conservative and power-seeking interests of culture will work to interfere with them as a means of control.

As public servants and policy makers, you will see the politicians, the doctors, and the advertisers come to you crying, ‘Can’t we do something?’  All of them will want you to weaken the protections for social networks, in order to make them more permeable and less resilient.  In this present moment, and with our current laws, social networks have no protections whatsoever.  They used to live inside our heads, where they needed few protections.  Now they live in public, and with every day that passes we come to understand that they are perhaps our most important possession, the doorway to ourselves.  First you must protect.  Then you must defend.

Protection is not enough.  It’s not clear that any commercial interest can be trusted with the social graphs of a community.  There’s too much potential for mischief, particularly right now, when everything is so new and so raw.  Government must play a role in this revolution, encouraging government-affiliated NGOs and other not-for-profits to foster networks of connections to spring up around communities which need the empowerment that comes with hyperconnectivity.  In the absence of this sort of gardening, the ground will be ceded to commercial forces which may not have the best interests of the citizenry foremost in mind.  By doing nothing, we lay the foundation for a new generation of grifters, criminals, and brainwashers.  But if these networks are built securely – by people who believe in them, and believe in what is possible with them – they become hyper-potent, capable of transforming the lives of everyone connected to them.  It’s a short path from hyperconnectivity to hyperempowerment, a path which will be well-trodden in the coming years.

The 21st century will look very different from the century just passed.  Instead of big wars and major powers, we’ll see different ‘gangs’ of hyperempowered social networks having a rumble, networks that look a lot like families, towns, or nations.  We’ll all be connected by similar principles, for similar reasons, and we will use similar tools to rally together and mobilize our strengths.  As is the nature of power, power will seek to use power to undermine the power of others.  Facebook is already doing this, though they seem to have stumbled into it.  The next time it happens it will be more deliberate, and more diabolical.

That’s it.  The future is much bigger than hyperconnected health, but as someone who will be a senior in just 20 years, hyperconnected health means more to me than whatever might happen to politics or business.  I need the support that will keep me healthy long into my sunset years, and I will join with others to build those systems.  If we build from corruption, corruption will be the fruit.  We must be honest with ourselves, acknowledge the dangers even as we laud the benefits, and build ourselves systems which do not play into human weaknesses, or avarice, or megalomania.  This is a project fit for a culture, a project worthy of a nation, a people who understand that together we can accomplish whatever we set our sights upon, if we build from a foundation of trust, respect and privacy.