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Has India Lost Its Way?

By Shlomo   Maital   

Indian dancer 

   I am very fond of India. I’ve visited it several times, have a dear friend there, and chose to publish my recent textbooks there.  This is why I am saddened and perplexed by what is happening to India. I fear India has lost its way.

  During 2003-8, India’s economy boomed, because private capital spending rose from 10% of GDP to 17% ! (source: The Economist, Dec. 1).  New factories and infrastructure dotted the land.  Then, after the global crisis began, capital spending slumped to only 10-12% of GDP.    India has two deep-seated problems: debt and graft.  As one senior Indian boss told The Economist, “most business houses have whole departments dedicated to getting things done no matter what the cost (in bribes)”.    Investment projects are backlogged, but any attempt to fast-track them leads to cries of corruption. 

    India’s capital-intensive firms are highly leveraged.  Between 2007 and 2012, net debt among India’s biggest firms doubled as a per cent of operating profits.  There are zombie firms, alive legally but dead in practice owing to heavy debt.

   India’s image abroad has suffered greatly, with the horrifying rape and murder of the young 23-year-old medical student.  A nation’s image does impact its ability to attract foreign businesses and foreign investment. 

    Doing business in India is very difficult. I know this first-hand from those who have tried.   According to the World Bank, India ranks 132nd in overall ‘ease of doing business’ (2012).  Everything related to doing business there is tough.  Registering property, trading across borders (rank 109), getting a construction permit (181st!), enforcing a contract (182nd!), paying taxes (147th), even getting electricity (rank 98th).   There is no reason for this.  The young women who was raped and beaten was sent to Singapore for medical care.  Let India benchmark Singapore, one of the easiest places in the world to do business. 

    India’s Prime Minister Manmohan Singh is a brilliant economist, whose reforms in the early 1990’s provided the foundation for India’s economic boom. Today, he seems tired and dispirited, defeated by a moribund political system.  The possibility that a Gandhi scion will take over, simply because his name is Gandhi, is simply unbelievable. 

     I grieve for India, which gained independence around the same time as my country Israel.  I love India’s resilient people, and their spirituality.  I wish a leader would arise who could cut through the Gordian knot of India’s deep-seated problems and start afresh.   

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Stories That Heal: On Narrative Therapy

By Shlomo   Maital  

Rita Charon 

   Stories, we know, inform, entertain and convey the lessons of an entire culture from one generation to another.  Stories have evolved from stories told around a campfire, or a village square, by a journeyman storyteller, to printed books and magazines and now, more commonly, to film and video.

   But stories can not only entertain, they can heal.  The brilliant British neurologist Oliver Sacks has been writing fascinating books about single illnesses (starting with Migraine, in 1970), books that tell stories about illness and overcoming it.  Sacks’ latest book is called Hallucinations.   Sacks, according to Siri Hustvedt (writing in today’s International Herald Tribune), is “part of a long tradition of descriptive, narrative, case-oriented medical writing Sacks calls ‘romantic’ “.

    But it is also leading to a new approach to healing, known as narrative medicine. Take for instance the narrative medicine department at Columbia University, headed by Rita Charon.  In this approach, “doctors draw insights from and explore forms of literature, for their work with patients.”   Charon is very unusual.  In addition to her MD degree,  she also has a Ph.D. in English literature. 

    Here is how one reviewer summarizes her 2006 book *:

  Charon defines narrative medicine as “medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness”   She calls this a “new frame” for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess “narrative competence” are able to bridge the “divides” of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.   Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon’s own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.

 As I see it, we understand our ill health by telling a story that explains and interprets it, to ourselves.  Doctors like Charon (who are rare) can help.  Then, we heal ourselves, by telling ourselves another story, in which our ill health diminishes or disappears.  This healing story is powerful, because we know there is a strong physiological connection between the brain, neural pathways and the body’s functioning organs.  Narrative therapy counteracts the growing, and distressing, trend toward mechanical medicine, which analyzes illness solely through tests, data, symptoms and research.   Illness is about people.  Narratives and stories return the individual person to the scene.  By honoring their stories, we can heal the sick.    

* Rita Charon. Narrative Medicine: Honoring the Stories of Illness  Oxford Univ. Press, New York:  2006

Dance Your Way to Creativity

By Shlomo   Maital

                                                    Pilobolus         Pilobolus

    A Bloomberg Business Week article * tells about a group of dancers who believe that “the path to creativity begins with discovering your “groupness” through movement”.  The group is Pilobolus, based in Washington, Connecticut, two hours’ north of NYC.  They’ve existed for 40 years.   In most dance companies, there is a dictator, known as a choreographer.  The dancers struggle to fulfill the dictators’ wishes and vision.   Pilobolus works differently.   Here is how:

      “Pilobolus, by contrast, believes productivity is the only measure of creativity. And productivity begins with groups working well together. “Everyone in the world makes everything the same way,”   says Itamar Kubovy, the group’s CEO. “The group throws ideas down. Then it shifts gears and evaluates the ideas, to sort wheat from chaff. Then there’s some process of assembling the things that survive. Then the results of that action must be sent out into the world.   …Every dancer is expected to help develop the routines that add up to a performance. Pilobolus believes this theory of creativity, based on mingling cultures and collaboration can be used by businesses. 

    “On the morning I watch Pilobolus rehearse, eight dancers are at work before a brightly lit white screen to prepare a shadow dance for a German television show. They start with one move, add another, then try something else and piece by piece it is assembled. Matt Kent, artistic director of this performance, and Mr Kubovy interject with ideas but the dancers mostly figure out what to do themselves. Orchestrating their movements into a visually precise and interesting dance is a form of organizational magic. ”

 Pilobolus is now teaching its approach to companies and to management. I believe the structure of this approach is similar to other proven innovation methods.  First divergent thinking — zoom out, toss ideas out.  Then, stop!  Converge!  Sort and sift, toss out ideas that don’t work, narrow down the range of choice.  You may have to open the process again, several times, until the final convergence occurs, to the final version of the dance. 

  I always believed that creativity and the ideas it spawns are born inside individual brains; only then are ideas developed into innovations through teamwork.  But with Pilobolus, apparently there are ways to spawn ideas right from the outset, in a group setting.

     It works for dance.   Can it also work for innovating goods and services, processes and business  designs?

 

* Philip Delves Broughton,  “A group approach to corporate creativity” Bloomberg Business Week,  December 26, 2012  

How to Innovate: Lessons in Life from a Nobel Laureate

By Shlomo   Maital      

 Hershko

   I had the privilege of interviewing Technion Nobel Laureate in Chemistry (2004) Prof. Avram Hershko, for our book Technion Nation.  After a year of fame and travel, in the wake of his Nobel, Prof. Hershko was back at his lab bench, nose to the grindstone, doing what he loved – solving the innermost mysteries of Nature inside the human cell.  When I interviewed him, he told me he had bowed out of a prestigious ceremony – in order to attend his grand-daughter’s ballet performance.  I thought then that this captured this modest and brilliant man, who knew what truly counts.

    Recently, Hershko’s breakthrough (done with his student Aaron Ciechanover, who shared his Nobel) in discovering how and why cells die (based on a protein called ubiquitin) has returned to the headlines, because a crucial gene p53 related to ubiquitin has been shown to be related to the spread of cancer (see my previous blog).   

    Hershko has shared some of his life lessons in the first issue of Rambam Hospital’s medical journal (2010).*   They are worthy of study by everyone keen on innovating.

    Hershko explains that in one of his first experiments after finishing his Ph.D., he observed that the degradation (destruction) of a protein inside the human cell required energy.  Why? asked Hershko.  After all, protein degradation outside of cells (e.g. digesting food) does not need energy.  Why?  There must be a new kind of energy-dependent mechanism that degrades proteins in cells, he concluded. But what is it?  “All my subsequent work was influenced by this one experiment,” Hershko observes.  This work led to the discovery of ubiquitin, which is attached to proteins and labels them for destruction, which won Hershko the Nobel. “It might have been mere luck that I chose to do this experiment early in my career,” he observes, “but luck by itself would not have steered me toward further achievements. I had to embark on serious scientific work to pursue this unique finding.”  This echoes Pasteur’s famous statement:  “chance favors the prepared mind”..and the mind willing to work hard to follow up on a lucky discovery.  Hershko chose to study how and why cells die, when others wanted to learn only how cells live and divide.  It was a fortunate choice, and may lead to a cure for cancer.

  Here are a few of Hershko’s Life Lessons: 

1. It is very important to have good mentors, you cannot learn how to do good science just from reading the literature.

2. Find an important subject that is not yet interesting to others, otherwise the big guys will get there before you!  Do not go with the mainstream.

3. Accidental observations may be the most important ones. Grab your luck!

4. Use whatever experimental approach is needed for your objective; it may not necessarily be the most fashionable (“state-of-the-art”) technology.

5. Have a lot of excitement and fun in science – this is how discoveries are made!

6. Never leave bench-work, and you shall continue to get a lot of excitement and fun.

  In short,  find good mentors,  pick big challenges others are not tackling, leverage luck, have fun, and keep at it. 

 

* Prof. Avram Hershko, “Science as an Adventure – Lessons for the Young Scientist”,  Rambam Medical Journal, 1(1), June 2010.

Curing Cancer:  Persuading Cancer Cells to Commit Suicide

By Shlomo   Maital     

p53 (p53 protein attaches to DNA) 

   There is a huge number of varieties of cancer.  Each one seems to need its own specific treatment and drug, if one exists.

   But – what if creative researchers found a way to disable or destroy ALL cancer cells, regardless of their type?  How great would that be!

    Today’s Global New York Times carries an article by Gina Kolata,   headlined “Drugs Aim to Make Several Types of Cancer Self-Destruct”.

   Here is the essence of it: 

   “Normal healthy cells have a mechanism that tells them to die if their DNA is too badly damaged to repair. Cancer cells have grotesquely damaged DNA, so ordinarily they would self-destruct. A protein known as p53 that Dr. Gary Gilliland of Merck calls the cell’s angel of death normally sets things in motion. But cancer cells disable p53, either directly, with a mutation, or indirectly, by attaching the p53 protein to another cellular protein that blocks it. The dream of cancer researchers has long been to reanimate p53 in cancer cells so they will die on their own.   …Roche, Merck and Sanofi persevered, testing thousands of molecules.   …At Sanofi, the stubborn scientist leading the way, Dr. Debussche, maintained an obsession with p53 for two decades. Finally, in 2009, his team, together with Shaomeng Wang at the University of Michigan and a biotech company, Ascenta Therapeutics, found a promising compound.  …The company tested the drug by pumping it each day into the stomachs of mice with sarcoma.  A week later, Cedric Barriere, the scientist conducting the experiment, went to his boss, Dr. Debussche, saying, “Laurent, I have a problem.” He confessed that he had treated some of the mice only once. And their tumors had vanished.  Dr. Debussche was stunned. “We have to reproduce it,” he said. They did. …. there are encouraging hints that the drugs might be working. In biopsies and scans, cancer cells appeared to be dying. Rigorous efficacy studies are next. If they are successful, they will be followed by clinical trials across cancer types.”

  In short, cancer cells disarm the DNA time bomb, p53, that makes damaged or dangerous cells self-destruct.  New compounds reactivate p53, thus (hopefully) killing any and every cancer cell.

   If you know those who have cancer, pass this on.  I realize clinical trials will take years – especially because they have to be done on a wide variety of types of cancer, which complicates matters a lot.  But there is hope.  And let’s also hope the FDA and its European equivalent ‘fast track’ these trials…in fact, super-fast-track them!       

Why the World May Well End (Though Not on Dec 21)

By Shlomo   Maital    

evolution 

   The world did not end on Dec. 21.  But for humans, given current trends, the world may indeed end some time in the next 10,000 years.  Here is why.

    Humans gained supremacy in the food chain, through five evolutionary accidents:  large brains, walking upright, the human thumb, cooking their food with fire, and giving birth to babies very early in their development. 

  *  The first human beings,   who appeared 2.5 million years ago, had extra-large brains. The average brain size for a 55 kg. (121 lb.) mammal  is 180 cc’s.   For a human, it is 6-7 times larger:  1,200 – 1,400 cc’s.   At rest, these large brains consume about 25% of the body’s energy consumption.   It is not entirely clear to biologists what advantage these large brains conferred on early humans, enabling them to survive to reproduce. 

*  Human babies enter the world through the relatively narrow pelvis of women (narrower than that of female mammals). As a result, so that their large heads can get through the narrow passage, human babies are born at an earlier stage of their development than other mammal babies. (Baby zebras can run soon after birth, for example. It takes human babies about 18 months).  This implies a longer infancy for humans, during which human babies learn a great deal from their parents and family.

 *  Humans walk upright.  This is relatively inefficient,  because it takes more energy to support the enlarged human head, and is partly why female humans have narrow womb passages.  But it has advantages.

 *  The human hand is another advantage. The opposing thumb enables many delicate operations, including the use of tools. 

  *   Humans cook their food.  This enables them to eat a very wide variety of foods.  Perhaps the enlarged human brain made this possible, and also made possible agriculture, growing our own food in order to cook it.  This required humans to tame and domesticate the use of fire. 

     And here is the irony. It is that same fire, the burning of fossil fuels, in internal combustion engines, that may end the dominance of humans at the top of the food chain.  Climate change may doom us.   It may have been a happy accident that made us humans, weaker than other mammals, clumsy, with needlessly big brains, dominate the food chain.  That accident may be  short-lived, only 80,000 years or so.  We may have huge brains, but we were not smart enough to use them, to learn how to live on our planet in harmony with Nature and other creatures.  We kill mammals and eat them, wasting six of every seven calories needed to do so. We ruined our planet and homo sapiens may pay the price. 

     In his wonderful 2012 book  From Animals into Gods: A Brief History of Humankind,  Israeli historian Yuval Harari notes that about 100,000 years ago, Homo sapiens was still an insignificant animal minding its own business in a corner of Africa. Our ancestors shared the planet with at least five other human species, and their role in the ecosystem was no greater than that of gorillas, fireflies, or jellyfish. Then, about 70,000 years ago, a mysterious change took place in the mind of Homo sapiens, transforming it into the master of the entire planet and the terror of the ecosystem.  

     Will humanity survive for another 10,000 years, after wrecking the ecosystem?  Stay tuned.    

The Easy Way? Or the Right Way? Les Miserables

By Shlomo   Maital    

Hugh Jackman 

 Hugh Jackman in Les Miserables   

   Innovators search for new options, new ways to do things. In this choice, there is often the tough dilemma between the old acceptable way to do things, and the right way, which is risky, difficult, challenging ..and superb.   Take for instance, Les Miserables.  The Victor Hugo five-volume novel, with the gripping tale of Jean Valjean, was a surprisingly successful musical, starting in 1987 and enjoying global success, despite the critics.  After a very long time, it has finally become a movie, to be released at Christmas.  The star is Hugh Jackman.  The director is Tom Hooper.

  One of the innovations of this risky undertaking (the age of the musical film was thought to have ended in the 1950’s) is that the singers actually sing the songs, in real time, rather than have them dubbed in later, after mouthing the words on film.  This is done by having a tiny radio earpiece in, for instance, Jackman’s ear, with a piano accompaniment.  It is the orchestra that is later dubbed behind the voice, rather than having the voice dubbed. 

    Jackman told the CBS program Sixty Minutes that singing in real time was crucial.  It greatly improved the acting, he felt. 

     Other filmed musicals have taken the easy route of dubbing.  The director of Les Miserables, Tom Hooper (who also directed The King’s Speech)  insisted on having the singers sing their songs in real time, while filming.  Watching Jackman, in short segments shown on Sixty Minutes, I was convinced that the innovation of singing the songs in real time was important, giving the actors real conviction and emotion.

     Often, innovative choices involve the old way, the easy way, and the hard, risky, right way.  Pick the latter, no matter what.  Even if you fail, you know you’ve tried your best.    

Guns, Kids and Sanity

By Shlomo   Maital   

Noah Pozner Noah Pozner 

    America leads the world in guns per capita, by far. (See Table).  It leads even lawless Yemen, or Iraq.  (Switzerland scores high, mainly because its citizens are in the reserve army and store their weapon at home). 

 

Country

Guns per 100 residents (2007)

Rank (2007)

 

United States

88.8

1

 
Serbia

58.2

2

 

Yemen

54.8

3

 
Switzerland

45.7

4

 
Cyprus

36.4

5

 
Saudi Arabia

35

6

 
Iraq

34.2

7

 

 

  Here are a few questions, in the wake of the tragic deaths of 20 small children in Newtown, CT.     Do Americans feel personally safer when so many pack weapons, or less safe?   Guns diminish personal safety.  When a household has a gun, there is much higher probability of death by suicide or death when one household member shoots another.   Some gun advocates like the National Rifle Association urge arming teachers.  Perhaps U.S. teachers’ colleges should now have curricula that include target practice as well as pegagogy.    Should every school have an armed guard?   This is the National Rifle Association’s suggestion, expressed by its President.   There is a country where this is the case: Israel.  Israel faces terrorism.  By law every coffee shop, restaurant, shopping center, and school, must have an armed guard.  But this is to protect people and children against an external threat. What if the threat is from Americans themselves? How do you protect a society from itself?  By more arms?  Or by fewer arms?    What can America learn from other countries?   Brazil has a great many shooting deaths, though far fewer per capita than the U.S. Brazil has a lot of firearms, though far far fewer than America (one-tenth).  Brazil has acted to limit firearms.  According to Wikipedia, “all firearms are required to be registered with the state; the minimum age for ownership is 25 and although it is legal to carry a gun outside a residence, extremely severe restrictions were made by the federal government since 2002 making it virtually impossible to obtain a carry permit.”  This is key.  There are 300 million weapons in America, about one per person. The NRA fights to allow people to pack a gun whenever and wherever they wish.   The first step in gun control should be to ban ‘carrying’.  Leave the guns locked, at home.   Does America benchmark other countries, like Brazil, and learn from their experience?  Simply: no!    Is gun control in America (like everything else) about money?   Here are the data – you draw your own conclusion.  “This year, the [gun] industry is expected to rack up a steady $11.7 billion in sales and $993 million in profits, according to analysts at IBIS World. Gun makers churned out nearly six million guns last year — double the number that they did a decade ago.”   If you had a $12 b. industry, would you spend fortunes on lobbyists to protect your business?  Guns, like so many other things in America, are in the end about money.  No effective action will occur until the political system puts some chains on ther high-paid lobbyists, including those of the NRA.

The haunting photograph of 6-year-old Noah Pozner, killed at Newtown, should be on the wall of every Congressperson and Senator.  

    

Dr. Pawash Sinha: Our Miraculous Brains

By Shlomo Maital

 Dr Pawash Sinha

   The Dec. 12 issue of the APA Monitor has a fascinating interview with MIT Prof. Pawan Sinha and his Project Prakash (“light” in Sanskrit).

     His research question was this: Over 300 years ago, an Irish philosopher named William Molyneux asked, ‘does the brain come prepared with knowledge to interact with the world?’, (nativism), or ‘does the brain have to acquire that knowledge through experience’? (empiricism).

   Dr. Sinha studied Indian children born with cataracts, to families too poor to pay for surgery. These children grew up sightless, until 10-14 years later, for a happy few, cataract surgery restored their sight. Some 440 children were treated; Dr. Sinha thinks there are 200,000-300,000 who are still untreated, and hence blind.

  Molyneux observed, if you have a person blind from birth, who has learned to distinguish between, say, a cube and a sphere, by touch – and then suddenly restored their sight – then show them a cube and a sphere, but without TOUCHING either — would they be able to tell them apart just by sight? If they can at once: then, nativists are right. If not, then empiricists.

Sinha tried this on some of the children whose sight was restored. Children who had just regained sight were presented with pairs of objects. They would feel one object, hidden under a bedsheet; then, that object, and a distractor object, were placed in front of the child. The child was asked, “which of these two objects were you just touching?”

  Immediately after surgery, children could not “transfer knowledge from touch to vision”. They could not by sight alone identify the object. But when the children returned for a follow-up, a week after surgery, they showed almost perfect ‘transfer’ (ability to transfer seeing by touch to seeing by seeing)! The brain learned rapidly, in a matter of just a week or so.

   Once again, we learn how amazingly flexible and rapid the brain adjusts. But we must be infinitely sad there are so many blind children in India, when a simple operation could restore their sight.    This is unacceptable.  Do you know that world military spending in 2011 was $1.7 trillion, back to 1988  Cold War levels?   A tiny fraction of that spending would give sight to many thousands of Indian children.  This is simply unacceptable!

To learn more about Project Prakash, see www.apa.org/monitor/digital/Prakash.aspx

 

The Lemon That Aspired to Be a Pear

By Shlomo   Maital

Lemon as Pear 

 

  Remember the Peter Paul & Mary song, Lemon Tree:

 When I was just a lad of ten, my father said to me,

“Come here and take a lesson from the lovely lemon tree.”

“Don’t put your faith in love, my boy”, my father said to me,

“I fear you’ll find that love is like the lovely lemon tree.”

Lemon tree very pretty and the lemon flower is sweet

But the fruit of the poor lemon is impossible to eat.

 

 

We have an amazing little lemon tree in our front yard. It yields unbelievable crops of lemons yearly, and asks for nothing in return, just a bit of water.  And from its lemons, we make lemon chicken, lemon meringue pie, lemon squares, and a blizzard of stuff all of which is great to eat!  

  But our little lemon tree aspires to more.  It wants to be a pear tree.

   So it produced a lemon that looks like a pear.  (See photo).

   You’re an inspiration, lemon tree.  And we apologize for the lyrics of that dumb song.  If love truly were like the lemon tree, it would have high aspirations, be highly productive, and go sour only if you let it. 

Blog entries written by Prof. Shlomo Maital

Shlomo Maital
December 2012
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