Understanding Donald Trump

After speaking to my oldest child last week (and he is not a kid anymore), I believe I have gained some insight into Donald Trump. What Andrew observed was that it seems that Trump is critical of anyone who is critical of him and furthermore, Trump is incapable of being critical of anyone who is supportive and uncritical of  him. It is a very simple principle of tit for tat and very consistent with the reasoning of a man who does not appear to be especially capable of any deep and reflective thought.

After thinking about this observation, it brought to mind the writings of Jonathan Haidt and his work "The Righteous Mind". This work is nicely summarized in 2011 article in Scientific American (Link)

"To understand what constitutes these moral matrices Haidt teamed with Craig Joseph from the University of Chicago. Building on ideas from the anthropologist Richard Shweder (with whom they both had studied), they developed the idea that humans possess six universal moral modules, or moral "foundations," that get built upon to varying degrees across culture and time. They are: Care/harm, Fairness/cheating, Loyalty/betrayal, Authority/subversion, Sanctity/degradation, and Liberty/oppression. Haidt describes these six modules like a "tongue with six taste receptors." "In this analogy," he explains in the book, "the moral matrix of a culture is something like its cuisine: it’s a cultural construction, influenced by accidents of environment and history, but it’s not so flexible that anything goes. You can’t have a cuisine based on grass and tree bark, or even one based primarily on bitter tastes. Cuisines vary, but they all must please tongues equipped with the same five taste receptors. Moral matrices vary, but they all must please righteous minds equipped with the same six social receptors."

It may appear that he is thoroughly unprincipled but that is not the case. Trump values loyalty beyond all other principles. His earlier dealings with Jim Comey provides support for this. Recall that in his initial dealings with Comey what he asked for ( LA Times link)

President Trump demanded "loyalty" from former FBI Director James B. Comey and asked him to drop at least part of the bureau's investigation of former National Security Adviser Mike Flynn, Comey plans to testify to Congress Thursday. In a prepared statement posted on the Senate Intelligence Committee website, Comey says that in a private dinner with Trump on Jan. 27, the president asked him if he wanted to remain as head of the FBI and told him “I need loyalty, I expect loyalty.”"I didn’t move, speak, or change my facial expression in any way during the awkward silence that followed. We simply looked at each other in silence," Comey says. He told Trump that he could promise "honesty," he says.

Comey did not get it. To Trump, loyalty is much more important than honesty. Trump's mind is likely equipped with all of the same six social receptors, but he applies a different emphasis on particular receptors. Haidt showed that this differential emphasis is a characteristic of people with certain patterns of emphasis associated with particular political leanings.  One can take a test to see where your individual leanings might be and which moral senses you might emphasize at (http://www.yourmorals.org/).  Haidt has noted that liberals and conservatives tend to place emphasis on different priorities, where liberals placing great emphasis on care and fairness and conservatives placing more emphasis on sanctity, authority, and loyalty.  Surprisingly, there seems to be an inherited component to this differential weighting that goes beyond environment. Thus, our moral intuitions may be driven by genetics to some degree.

Although I realize this is rank speculation, I believe if Donald Trump took this test his results would be skewed toward a single minded emphasis on loyalty.  His focus on loyalty is so strong and so single minded, it is hard for the rest of us to comprehend.  Yet, it does seem to explain what otherwise defies explanation. Donald Trump becomes quite understandable once you realize that no other principles are in play.

The Promises and Perils of AI - Artificial Ignorance v. Artificial Ignorance

AI - New Yorker

There is a buzz out there in the health care delivery world about the promises of artificial intelligence (AI). There are fears among physicians that they might be replaced by computers. There is excitement and there is fear and there is hype. In my opinion, at this point there is mostly hype. The reason I believe that what we have most is hype is that for most of the important tasks we can delegate to AI, we are missing one key element. AI is not something programmed. It is something learned and in order to learn a computer needs validated data sets which contain unambiguous right and wrong answers. There lies the rub.

The recent article in the New Yorker by Siddhartha Mukherjee (AI - New Yorker AI v. MD) describes studies done by Stanford where they trained computers using images taken from patients diagnosed with melanoma.

Thrun, who had maintained an adjunct position at Stanford, enlisted two students he worked with there, Andre Esteva and Brett Kuprel. Their first task was to create a so-called “teaching set”: a vast trove of images that would be used to teach the machine to recognize a malignancy. Searching online, Esteva and Kuprel found eighteen repositories of skin-lesion images that had been classified by dermatologists. This rogues’ gallery contained nearly a hundred and thirty thousand images—of acne, rashes, insect bites, allergic reactions, and cancers—that dermatologists had categorized into nearly two thousand diseases. Notably, there was a set of two thousand lesions that had also been biopsied and examined by pathologists, and thereby diagnosed with near-certainty.......

...Thrun, Esteva, and Kuprel then widened the study to include twenty-five dermatologists, and this time they used a gold-standard “test set” of roughly two thousand biopsy-proven images. In almost every test, the machine was more sensitive than doctors: it was less likely to miss a melanoma. It was also more specific: it was less likely to call something a melanoma when it wasn’t. “In every test, the network outperformed expert dermatologists,” the team concluded, in a report published in Nature. 

So should our dermatology brethren be afraid that Watson and its prodigy will supplant the mole spotting workforce in dermatology? Perhaps, but there is a flaw in this work.  What does it mean to use "biopsy proven" images? What exactly does a biopsy prove?  It may not prove anything and there lies the problem. The teaching sets upon which machine learning is based may be validated (or not) by a not so shiny gold standard.

In a recent paper published in the British Medical Journal by Elmore et al (BMJ) the reproducibility of histology in melanoma diagnosis was examined.  The results are a bit concerning and call into question the gold standard status of anatomic pathology and its ability to "prove" anything. The best concordance found was about 80% for lesions believed by experts to be frankly malignant. That means any training set the computer viewed likely had at least a 20% error rate built in. For the more subtle lesions, the concordance rates hovered around 50% (and some lower).  How about comparing this to coin flips?

Training machines to learn to make diagnoses by using flawed teaching sets will generate AI; perhaps more likely to generate artificial ignorance than it is to generate artificial intelligence.

Civil War Reconstruction continued

I have been a bit quiet for a while. I, like much of the country, have been appalled by the antics of President Trump for a number of typical and also contrary reasons. I do not disagree with everything that he is attempting to accomplish, just because embraces awful positions on other issues. In some sense, I am even more deeply resentful of his appalling white supremacist and neo-Nazi apologist statements. They are appalling in and of themselves, but also because these statements also can prejudice others against anything else Donald Trump may embrace. They poison his entire agenda, good and bad.

When one looks into the history of Confederate memorials, it presents a not so virtuous justification of erecting them in the first place. The great surge in erecting these monuments coincides with the promulgation of Jim Crow laws and of Lost Cause mythology. The Old South prior to the Civil War was built upon a foundation of racism at its worst. It was an economic system where people owned other people. The Lost Cause mythology attempted to soften that ugly fact and revise history to make the actions of those who led the rebellion,  to preserve the system which allowed certain people (whites) to own other people (blacks), to appear more virtuous than they really were. It also attempted to have the oppressors and former slave owners assume the roles of victims.

The monument building occurred at the same time that Washington DC was resegregated by Woodrow Wilson, the KKK membership spiked, and many gains African Americans garnered in the South after Reconstruction were rolled back through enforcement of Jim Crow laws. The nation put in place immigration laws at that time that were blatantly racially exclusive. The monuments to the Confederacy were erected for a purpose, and a not so benevolent one. We need to recognize that was part of the plan.

Do the statues need to come down? I like the idea that they need to come down only after a period of reflection and education. Here they are in plain sight, where some have been for more than 100 years. Many of us simply ignored them as empty and boring markers of distant history no longer relevant to our lives. However, the history involves events which happened not so long ago and we need to be more aware of what happened then because it is relevant to what is happening now. I believe they were erected with malice intent with an agenda focused on fear and intimidation. Some people in current times share this same agenda. There is nothing benign about this. I believe that once the truth about these statues becomes widely understood, they will come down because they will be a source of embarrassment.

In my opinion, it is not justified to honor people whose behavior and actions were neither heroic nor morally sound. They likely were people with many virtues (or at least some virtues) but their decisions to fight for a way of life predicated on human enslavement put them on the wrong side of the moral divide. It might be said that our founding fathers (Washington and Jefferson) should also be viewed in this light but I would like to make a basic distinction. Washington and Jefferson were hypocrites in that they were slave holders,  but they did not mount a rebellion based upon preservation of a morally unjustifiable tenant of slavery. Their monuments were erected to celebrate their accomplishments in creating a Republic which, although imperfect, has been a remarkable accomplishment.

Confederate leaders led a rebellion primarily motivated by the desire to preserve this abhorrent institution. We do need to recognize that their views were not unique for the times. Slavery was the norm for thousands of years and these men and women who embraced it in the early and middle part of the 19th century represented the tail end of slavery acceptability, at least in the developed world. Their lack of insight may be explainable given history, but it is not morally justifiable and clearly does not warrant any monuments celebrating their lives and actions. In the end, they accomplished essentially nothing. What is there to celebrate about their lives and accomplishments?

This series of events also highlights the perils of focusing on moral equivalencies. At the most basic level, everyone is flawed and everyone makes mistakes. This creates the opportunity to level all moral transgressions, elevating minor infractions to major status and lowering major one to minor status. We need to recognize that some transgressions are simply worse than others. Yes, I understand that this can lead one into another slippery set of slopes but we can for our work on the ends of the spectrum and not in the middle. Advocacy of Nazism and White supremacy has no middle way aspects. The philosophy is poison and has recent history marked by brutal violence and mass murder. We would be absolutely mortified if current day Germany started erecting statues honoring Adolf Hitler and Herman Goering.