Some MLK Day thoughts about evolution, teachable moments, and being human

Maybe my favorite episode of Northern Exposure is the one where Maurice Minnifield (played by the great Barry Corbin), the bigoted, pompous, ex-astronaut is surprised to discover he has a son, Duk Won, conceived during service time in Korea. After grudgingly admitting that Duk Won’s claim is real, Maurice has a conversation with Chris, the town’s DJ and amateur philosopher, about how difficult this is. Their conversation concludes something like this:

Maurice: I wouldn’t have had such a problem with this if only…

Chris: If only he were white?

Maurice: …Yeah…

Chris: Well, that’s a reason for hope.

Maurice: What? What are you talking about?

Chris: Because racism is a learned behavior. And that means it can be unlearned. Continue reading

Is Opower the model for getting us to wellness and health?

This is a post about nudges. And optimism.

There’s a story I read a long time ago by David Brin. It’s called “The Giving Plague,” and the protagonist is a virologist and epidemiologist who describes his life working on viruses and vectors. The Plague of the title is a virus that has evolved the ability to make infected people enjoy donating blood. Recipients keep giving blood, leading to an exponentially expanding network of people who find themselves giving blood regularly and even circumventing age and other restrictions to make sure they can give their pint every eight weeks.

The central twist of the story is that the protagonist’s mentor, who discovers this virus, realizes people who donate blood also perform other altruistic acts–that the act of giving blood changes their own self image. Makes them behave as better people. And so he suppresses the discovery, for the greater good of society. The protagonist, a rampant careerist, begins plotting murder to allow him to take credit. But before he can act, more diseases strike, the Giving Plague moves through the population, and the protagonist forgets about it in his efforts to cure newer diseases.

And if anyone thinks something like this is too outlandish, I encourage you to read this piece about Toxoplasma gondii and how it makes infected mice charge at cats, the better to be eaten so that T. gondii can spread. Yeah.

But what does this story have to do with the future of wellness and health?

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Trying to figure the way through a 401(k) life

Thomas Friedman’s thoughts on how we’re becoming a 401(k) nation have been kicking around the back of my mind for about a year. His Op-Ed piece described the shift in how retirement plans in the US have largely shifted from pensions to 401(k)s and used that transition to make a point about the changing nature of work.

In a pension plan, a defined input (so many year of work) leads to a defined output (a regular payment that starts upon retirement until the day you die) with the risk assumed by the employer. In a 401(k), there’s still a defined input (regular deposits into a managed investment account) but how much a person gets at the end carries no guarantees and the risk sits squarely with the employee.

Friedman’s insight was that work itself is following that same path. Where once the defined achievements of education and learned skills were enough to guarantee continued employment and a good, middle-class career (at least), that’s not really the case anymore.

The news a some months back that Amgen will be closing its Seattle site this year really drove that point home. It was a reminder that biopharma, like so many other industries, isn’t immune to the implications  of the 401(k) life.

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Big Data and Public Health: An interview with Dr. Willem van Panhuis about Project Tycho, digitizing disease records, and new ways of doing research in public health

All opinions of the interviewer are my own and do not necessarily reflect those of Novo Nordisk.

One of the huge and perhaps still underappreciated aspects of the internet age is the digitization of information. While the invention of the printing press made the copying of information easy, quick and accurate, print still relied on books and other printed materials that were moved from place to place to spread information. Today digitization of information, cheap (almost free) storage, and the pervasiveness of the internet have vastly reduced barriers to use, transmission and analysis of information.

In an earlier post I described the project by researchers at the University of Pittsburgh that digitized US disease reports over the past 120+ years, creating a computable and freely available database of disease incidence in the US (Project Tycho, This incredible resource is there for anyone to download and use for research ranging from studies of vaccine efficacy to the building of epidemiological models to making regional public health analyses and comparisons.

Their work fascinates me both for what it said about vaccines and also for its connection to larger issues like Big Data in Public Health. I contacted the lead researcher on the project, Dr. Willem G. van Panhuis and he very kindly consented to an interview. What follows is our conversation about his work and the implications of this approach for Public Health research.

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Dr. Willem van Panhuis. Image credit: Brian Cohen, 2013

Kyle Serikawa: Making this effort to digitize the disease records over the past ~120 years sounds like a pretty colossal undertaking. What inspired you and your colleagues to undertake this work?

Dr. Willem van Panhuis: One of the main goals of our center is to make computational models of how diseases spread and are transmitted. We’re inspired by the idea that by making computational models we can help decision makers with their policy choices. For example, in pandemics, we believe computational models will help decision makers to test their assumptions, to see how making different decisions will have different impacts.

So this led us to the thinking behind the current work. We believe that having better and more complete data will lead to better models and better decisions. Therefore, we needed better data.

On top of this, each model needs to be disease specific because each disease acts differently in how it spreads and what effects it has. In contrast, however, the basic data collection process that goes into creating the model for each disease is actually pretty similar across diseases. There is contacting those with the records of disease prevalence and its spread over time, collecting the data and then making the data ready for analysis. There’s considerable effort in that last part, especially as Health Departments often do not have the capacity to spend a lot of time and effort on responding to data requests by scientists.

The challenges are similar–we go through the same process every time we want to model a disease–so when we learned that a great source of much of the disease data in the public domain is in the form of these weekly surveillance reports published in MMWR and precursor journals, we had the idea: if we digitize the data once for all the diseases that would provide a useful resource for everybody.

We can make models for ourselves, but we can also allow others to do the same without duplication of effort. Continue reading

Big Data provide yet more Big Proof of the power of vaccines

All opinions are my own and do not necessarily reflect those of Novo Nordisk.

Time for another screed about the anti-vaccination movement.

Well, not about them per se, but rather about another study that demonstrates how much of a positive difference vaccines have made in the US. The article, from researchers at the University of Pittsburgh and Johns Hopkins University, describes what I can only imagine to be a Herculean effort to digitize disease reporting records from 1888 to 2011 (article behind a paywall, unfortunately).  Turns out there are publications that have been collecting weekly reports of disease incidence across US cities for over a century.  I have not been able to access the methods, but I can’t shake the image of hordes of undergraduates hunched over yellowed clippings and blurry photocopies of 19th century tables, laboriously entering numbers one by one into a really extensive excel spreadsheet.

All told, 87,950,807 individual cases were entered into their database, including location, time, and diseases.  Not fun, however it was done. Continue reading

When business takes a stand

All opinions are my own and do not necessarily reflect those of Novo Nordisk.


So much of what happens in the US seems to revolve around Texas.  It’s a huge, rich, diverse state, with influence that stretches far beyond its boundaries.  I mean, you rarely hear about how the politics of Rhode Island affect the nation.  I’m just saying.  Don’t hate me, people of Rhode Island! All eight of  you! Which is still about six more people than read this blog…

That’s why, for example, when Texas experiences outbreaks of whooping cough and measles, it makes the news.  The state is a bellwether for certain cultural and societal trends like the anti-vaccination movement.  And it’s in this context that two recent developments in how businesses are interacting with Texas are fascinating.

Let’s talk textbooks and the death penalty.

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One small, wistful story about the shutdown

Seattle, like San Francisco, like New York City, is a city of water and bridges.  I remember reading Winter’s Tale by Mark Helprin back in college. I think it’s a book that I’d benefit from reading now, again, but one of the concepts that struck me even in my callow youth was his observation about cities that have bridges as part of their fundamental being.  He described how a city, to be magnificent, must “project, extend, fling itself in all directions–over the water, in peninsulas, hills, soaring towers, and islands linked by bridges.”

Seattle is that kind of city.

And it made me sad when I heard that one of our bridges, albeit a small and specialized one, was closing because of the government shutdown. Continue reading