Wednesday, January 27, 2016

A Medical Mystery

I'm sorry that I haven't posted much recently. I have been very ill. I am quite recovered now.

I believe that I've come across a genuine puzzle, and I wonder if you can help me solve it. This problem is complicated, and subtle, and has confounded and defeated good people for forty years. And yet there are huge and obvious clues. No-one seems to have conducted the simple experiments which the clues suggest, even though many clever people have thought hard about it, and the answer to the problem would be very valuable. And so I wonder what it is that I am missing.

I am going to tell a story which rather extravagantly privileges a hypothesis that I have concocted from many different sources, but a large part of it is from the work of the late Doctor John C Lowe, an American chiropractor who claimed that he could cure Fibromyalgia.

I myself am drowing in confirmation bias to the point where I doubt my own sanity. Every time I look for evidence to disconfirm my hypothesis, I find only new reasons to believe. But I am utterly unqualified to judge. Three months ago I didn't know what an amino acid was. And so I appeal to wiser heads for help.

Setting the Scene

Chronic Fatigue Syndrome, Myalgic Encephalitis, and Fibromyalgia are 'new diseases'. There is considerable dispute as to whether they even exist, and if so how to diagnose them. They all seem to have a large number of possible symptoms, and in any given case, these symptoms may or may not occur with varying severity.

As far as I can tell, if someone claims that they're 'Tired All The Time', then a competent doctor will first of all check that they're getting enough sleep and are not unduly stressed, then rule out all of the known diseases that cause fatigue (there are a very lot!), and finally diagnose one of the three 'by exclusion', which means that there doesn't appear to be anything wrong, except that you're ill.

If widespread pain is one of the symptoms, it's Fibromyalgia Syndrome (FMS). If there's no pain, then it's CFS or ME. These may or may not be the same thing, but Myalgic Encephalitis is preferred by patients because it's greek and so sounds like a disease. Unfortunately Myalgic Encephalitis means 'hurty muscles brain inflammation', and if one had hurty muscles, it would be Fibromyalgia, and if one had brain inflammation, it would be something else entirely.

Despite the widespread belief that these are 'somatoform' diseases (all in the mind), the severity of them ranges from relatively mild (tired all the time, can't think straight), to devastating (wheelchair bound, can't leave the house, can't open one eye because the pain is too great).

All three seem to have come spontaneously into existence in the 1970s, and yet searches for the responsible infective agent have proved fruitless. Neither have palliative measures been discovered, apart from the tried and true method of telling the sufferers that it's all in their heads.

The only treatments that have proved effective are Cognitive Behavioural Therapy / Graded Exercise. A Cochrane Review reckoned that they do around 15% over placebo in producing a measurable alleviation of symptoms. I'm not very impressed. CBT/GE sound a lot like 'sports coaching', and I'm pretty sure that if we thought of 'Not Being Very Good at Rowing' as a somatoform disorder, then I could produce an improvement over placebo in a measurable outcome in ten percent of my victims without too much trouble.

But any book on CFS will tell you that the disease was well known to the Victorians, under the name of neurasthenia. The hypothesis that God lifted the curse of neurasthenia from the people of the Earth as a reward for their courage during the wars of the early twentieth century, while well supported by the clinical evidence, has a low prior probability.

We face therefore something of a mystery, and in the traditional manner of my people, a mystery requires a Just-So Story:

How It Was In The Beginning

In the dark days of Victoria, the brilliant physician William Miller Ord noticed large numbers of mainly female patients suffering from late-onset cretinism.

These patients, exhausted, tired, stupid, sad, cold, fat and emotional, declined steeply, and invariably died.

As any man of decent curiosity would, Dr Ord cut their corpses apart, and in the midst of the carnage noticed that the thyroid, a small butterfly-shaped gland in the throat, was wasted and shrunken.

One imagines that he may have thought to himself: "What has killed them may cure them."

After a few false starts and a brilliant shot in the dark by the brave George Redmayne Murray, Dr Ord secured a supply of animal thyroid glands (cheaply available at any butcher, sautée with nutmeg and basil) and fed them to his remaining patients, who were presumably by this time too weak to resist.

They recovered miraculously, and completely.

I'm not sure why Dr Ord isn't better known, since this appears to have been the first time in recorded history that something a doctor did had a positive effect.

Dr Ord's syndrome was named Ord's Thyroiditis, and it is now known to be an autoimmune disease where the patient's own antibodies attack and destroy the thyroid gland. In Ord's thyroiditis, there is no goiter.

A similar disease, where the thyroid swells to form a disfiguring deformity of the neck (goiter), was described by Hakaru Hashimoto in 1912 (who rather charmingly published in German), and as part of the war reparations of 1946 it was decided to confuse the two diseases under the single name of Hashimoto's Thyroiditis. Apart from the goiter, both conditions share a characteristic set of symptoms, and were easily treated with animal thyroid gland, with no complications.

Many years before, in 1835, a fourth physician, Robert James Graves, had described a different syndrome, now known as Graves' Disease, which has as its characteristic symptoms irritability, muscle weakness, sleeping problems, a fast heartbeat, poor tolerance of heat, diarrhoea, and weight loss. Unfortunately Dr Graves could not think how to cure his eponymous horror, and so the disease is still named after him.

The Horror Spreads

Victorian medicine being what it was, we can assume that animal glands were sprayed over and into any wealthy person unwise enough to be remotely ill in the vicinity of a doctor. I seem to remember a number of jokes about "monkey glands" in PG Wodehouse, and indeed a man might be tempted to assume that chimpanzee parts would be a good substitute for humans. Supply issues seem to have limited monkey glands to a few millionaires worried about impotence, and it may be that the corresponding procedure inflicted on their wives has come down to us as Hormone Replacement Therapy.

Certainly anyone looking a bit cold, tired, fat, stupid, sad or emotional is going to have been eating thyroids. We can assume that in a certain number of cases, this was just the thing, and I think it may also be safe to assume that a fair number of people who had nothing wrong with them at all died as a result of treatment, although the fact that animal thyroid is still part of the human food chain suggests it can't be that dangerous.

I mean seriously, these people use high pressure hoses to recover the last scraps of meat from the floors of slaughterhouses, they're not going to carefully remove all the nasty gristly throat-bits before they make ready meals, are they?

The Armour Sausage company, owner of extensive meat-packing facilities in Chicago, Illinois, and thus in possession of a large number of pig thyroids which, if not quite surplus to requirements, at the very least faced a market sluggish to non-existent as foodstuffs, brilliantly decided to sell them in freeze-dried form as a cure for whatever ails you.


Some Sort of Sanity Emerges, in a Decade not Noted for its Sanity

Around the time of the second world war, doctors became interested in whether their treatments actually helped, and an effort was made to determine what was going on with thyroids and the constellation of sadness that I will henceforth call 'hypometabolism', which is the set of symptoms associated with Ord's thyroiditis. Jumping the gun a little, I shall also define 'hypermetabolism' as the set of symptoms associated with Graves' disease.

The thyroid gland appeared to be some sort of metabolic regulator, in some ways analogous to a thermostat. In hypometabolism, every system of the body is running slow, and so it produces a vast range of bad effects, affecting almost every organ. Different sufferers can have very different symptoms, and so diagnosis is very difficult.

Dr Broda Barnes decided that the key symptom of hypometabolism was a low core body temperature. By careful experiment he established that in patients with no symptoms of hypometabolism the average temperature of the armpit on waking was 98 degrees Fahrenheit (or 36.6 Celsius). He believed that temperature variation of +/- 0.2 degrees Fahrenheit was unusual enough to merit diagnosis. He also seems to have believed, in the manner of the proverbial man with a hammer, that all human ailments without exception were caused by hypometabolism, and to have given freeze-dried thyroid to almost everyone he came into contact with, to see if it helped. A true scientist. Doctor Barnes became convinced that fully 40% of the population of America suffered from hypometabolism, and recommended Armour's Freeze Dried Pig Thyroid to cure America's ills.

In a brilliant stroke, Freeze Dried Pig's Thyroid was renamed 'Natural Dessicated Thyroid', which almost sounds like the sort of thing you might take in sound mind. I love marketing. It's so clever.

America being infested with religious lunatics, and Chicago being infested with nasty useless gristly bits of cow's throat, led almost inevitably to a second form of 'Natural Dessicated Thyroid' on the market.

Dr Barnes' hypometabolism test never seems to have caught on. There are several ways your temperature can go outside his 'normal' range, including fever (too hot), starvation (too cold), alcohol (too hot), sleeping under too many duvets (too hot), sleeping under too few duvets (too cold). Also mercury thermometers are a complete pain in the neck, and take ten minutes to get a sensible reading, which is a long time to lie around in bed carefully doing nothing so that you don't inadvertently raise your body temperature. To make the situation even worse, while men's temperature is reasonably constant, the body temperature of healthy young women goes up and down like the Assyrian Empire.

Several other tests were proposed. One of the most interesting is the speed of the Achilles Tendon Reflex, which is apparently super-fast in hypermetabolism, and either weirdly slow or has a freaky pause in it if you're running a bit cold. Drawbacks of this test include 'It's completely subjective, give me something with numbers in it', and 'I don't seem to have one, where am I supposed to tap the hammer-thing again?'.

By this time, neurasthenia was no longer a thing. In the same way that spiritualism was no longer a thing, and the British Empire was no longer a thing.

As far as we know, Chronic Fatigue Syndrome was not a thing either, and neither was Fibromyalgia (which is just Chronic Fatigue Syndrome but it hurts), nor Myalgic Encephalitis. There was something called 'Myalgic Neurasthenia' in 1934, but it seems to have been a painful infectious disease and they thought it was polio.


Finally, Science

It turned out that the purpose of the thyroid gland is to make hormones which control the metabolism. It takes in the amino acid tyrosine, and it takes in iodine. It releases Thyroglobulin, mono-iodo-tyrosine (MIT), di-iodo-tyrosine (DIT), thyroxine (T4) and triiodothyronine (T3) into the blood. The chemistry is interesting but too complicated to explain in a just-so story.

I believe that we currently think that thyroglobulin, MIT and DIT are simply by-products of the process that makes T3 and T4.

T3 is the hormone. It seems to control the rate of metabolism in all cells. T4 has something of the same effect, but is much less active, and called a 'prohormone'. Its main purpose seems to be to be deiodinated to make more T3. This happens outside the thyroid gland, in the other parts of the body ('peripheral conversion'). I believe mainly in the liver, but to some extent in all cells.

Our forefathers knew about thyroxine (T4, or thyronine-with-four-iodines-attached), and triiodothyronine (T3, or thyronine-with-three-iodines-attached)

It seems to me that just from the names, thyroxine was the first one to be discovered. But I'm not sure about that. You try finding a history-of-endocrinology website. At any rate they seem to have known about T4 and T3 fairly early on.

The mystery of Graves', Ord's and Hashimoto's thyroid diseases was explained.

Ord's and Hashimoto's are diseases where the thryoid gland under-produces (hypothyroidism). The metabolism of all cells slows down. As might be expected, this causes a huge number of effects, which seem to manifest differently in different sufferers.

Graves' disease is caused by the thyroid gland over-producing (hyperthyroidism). The metabolism of all cells speeds up. Again, there are a lot of possible symptoms.

All three are thought to be autoimmune diseases. Some people think that they may be different manifestations of the same disease. They are all fairly common.

Dessicated thryoid cures hypothyroidism because the ground-up thyroids contain T4 and T3, as well as lots of thyroglobulin, MIT and DIT, and they are absorbed by the stomach. They get into the blood and speed up the metabolism of all cells. By titrating the dose carefully you can restore roughly the correct levels of the thyroid hormones in all tissues, and the patient gets better. (Titration is where you change something carefully until you get it right)

The theory has considerable explanatory power. It explains cretinism, which is caused either by a genetic disease, or by iodine deficiency in childhood. If you grow up in an iodine deficient area, then your growth is stunted, your brain doesn't develop properly, and your thyroid gland may become hugely enlarged. Presumably because the brain is desperately trying to get it to produce more thyroid hormones, and it responds by swelling.

Once upon a time, this swelling (goitre) was called 'Derbyshire Neck'. I grew up near Derbyshire, and I remember an old rhyme: "Derbyshire born, Derbyshire bred, strong in the arm, and weak in the head". I always thought it was just an insult. Maybe not. Cretinism was also popular in the Alps, and there is a story of an English traveller in Switzerland of whom it was remarked that he would have been quite handsome if only he had had a goitre. So it must have been very common there.

But at this point I am *extremely suspicious*. The thyroid/metabolic regulation system is ancient (universal in vertebrates, I believe), crucial to life, and it really shouldn't just go wrong. We should suspect either an infectious cause, or a recent environmental influence which we haven't had time to adjust to, an evolved defence against an infectious disease, or just possibly, a recently evolved but as yet imperfect defence against a less recent environmental change.

(Cretinism in particular is very strange. Presumably animals in iodine-deficient areas aren't cretinous, and yet they should be. Perhaps a change to a farming from a hunter-gatherer lifestyle has increased our dependency on iodine from crops, which crops have sucked what little iodine occurs naturally out of the soil?)

It's also not entirely clear to me what the thyroid system is *for*. If there's just a particular rate that cells are supposed to run at, then why do they need a control signal to tell them that? I could believe that it was a literal thermostat, designed to keep the body temperature constant at the best speed for the various biological reactions, but it's universal in *vertebrates*. There are plenty of vertebrates which don't keep a constant temperature.


The Fall of Dessicated Thyroid

There turned out to be some problems with Natural Dessicated Thyroid (NDT).

Firstly, there were many competing brands and types, and even if you stuck to one brand the quality control wasn't great, so the dose you'd be taking would have been a bit variable.

Secondly, it's fucking pig's thyroid from an abattoir. It could have all sorts of nasty things in it. Also, ick.

Thirdly, it turned out that pigs made quite a lot more T3 in their thyroids than humans do. It also seems that T3 is better absorbed by the gut than T4 is, so someone taking NDT to compensate for their own underproduction will have too much of the active hormone compared to the prohormone. That may not be good news.

With the discovery of 'peripheral conversion', and the possibility of cheap clean synthesis, it was decided that modern scientific thyroid treatment would henceforth be by synthetic T4 (thyroxine) alone. The body would make its own T3 from the T4 supply.

Alarm bells should be ringing at this point. Apart from the above points, I'm not aware of any great reason for the switch from NDT to thyroxine in the treatment of hypothyroidism, but it seems to have been pretty much universal, and it seems to have worked.

Aware of the lack of T3, doctors compensated by giving people more T4 than was in their pig-thyroid doses. And there don't seem to have been any complaints.

Over the years, NDT seems to have become a crazy fringe treatment despite there not being any evidence against it. It's still a legal prescription drug, but in America it's only prescribed by eccentrics. In England a doctor prescribing it would be, at the very least, summoned to explain himself before the GMC.

However, since it was (a) sold over the counter for so many years, and (b) part of the food chain, it is still perfectly legal to sell as a food supplement in both countries, as long as you don't make any medical claims for it. And the internet being what it is, the prescription-only synthetic hormones T3 and T4 are easily obtained without a prescription. These are extremely powerful hormones which have an effect on metabolism. If 'body-builders' and sports cheats aren't consuming all three in vast quantities, I am a Dutchman.

The Clinical Diagnosis of Hypothyroidism

We pass now to the beginning of the 1970s.

Hypothyroidism is ferociously difficult to diagnose. People complain of 'Tired All The Time' well, ... all the time, and it has literally hundreds of causes.

And it must be diagnosed correctly! If you miss a case of hypothyroidism, your patient is likely to collapse and possibly die at some point in the medium-term future. If you diagnose hypothyroidism where it isn't, you'll start giving the poor bugger powerful hormones which he doesn't need and *cause* hypermetabolism.

The last word in 'diagnosis by symptoms' was the absolutely excellent paper:

Statistical Methods Applied To The Diagnosis Of Hypothyroidism by W. Z. Billewicz et al.

Connoisseurs will note the clever and careful application of 'machine learning' techniques, before there were machines to learn!

One important thing to note is that this is a way of separating hypothyroid cases from other cases of tiredness at the point where people have been referred by their GP to a specialist at a hospital on suspicion of hypothyroidism. That changes the statistics remarkably. This is *not* a way of diagnosing hypothyroidism in the general population. But if someone's been to their GP (general practitioner, the doctor that a British person likely makes first contact with) and their GP has suspected their thryoid function might be inadequate, this test should probably still work.

For instance, they consider Physical Tiredness, Mental Lethargy, Slow Cerebration, Dry Hair, and Muscle Pain, the classic symptoms of hypothyroidism, present in most cases, to be indications *against* the disease.

That's because if you didn't have these things, you likely wouldn't have got that far. So in the population they're seeing (of people whose doctor suspects they might be hypothyroid), they're not of great value either way, but their presence is likely the reason why the person's GP has referred them even though they've really got iron-deficiency anaemia or one of the other causes of fatigue.

In their population, the strongest indicators are 'Ankle Jerk' and 'Slow Movements', subtle hypothyroid symptoms which aren't likely to be present in people who are fatigued for other reasons.

But this absolutely isn't a test you should use for population screening! In the general population, the classic symptoms are strong indicators of hypothyroidism.

Probability Theory is weird, huh?

Luckily, there were lab tests for hypothyroidism too, but they were expensive, complicated, annoying and difficult to interpret. Billewicz et al used them to calibrate their test, and recommend them for the difficult cases where their test doesn't give a clear answer.

And of course, the final test is to give them thyroid treatment and see whether they get better. If you're not sure, go slow, watch very carefully and look for hyper symptoms.

Overconfidence is definitely the way to go. If you don't diagnose it and it is, that's catastrophe. If it isn't, but you diagnose it anyway, then as long as you're paying attention the hyper symptoms are easy enough to spot, and you can pull back with little harm done.

A Better Way

It should be obvious from the above that the diagnosis of hypothyroidism by symptoms is absolutely fraught with complexity, and very easy to get wrong, and if you get it wrong the bad way, it's a disaster. Doctors were absolutely screaming for a decisive way to test for hypothyroidism.

Unfortunately, testing directly for the levels of thyroid hormones is very difficult, and the tests of the 1960s weren't accurate enough to be used for diagnosis.

The answer came from an understanding of how the thyroid regulatory system works, and the development of an accurate blood test for a crucial signalling hormone.

Three structures control the level of thyroid hormones in the blood.

The thyroid gland produces the hormones and secretes them into the blood.

Its activity is controlled by the hormone thyrotropin, or Thyroid Signalling Hormone (TSH). Lots of TSH works the thyroid hard. In the absence of TSH the thyroid relaxes but doesn't switch off entirely. However the basal level of thyroid activity in the absence of TSH is far too low.

TSH is controlled by the pituitary gland, a tiny structure attached to the brain.

The pituitary itself is controlled, via Thyroid Releasing Hormone (TRH), by the hypothalamus, which is part of the brain.

This was thought to be a classic example of a feedback control system.

hypothalamus->pituitary->thyroid

It turns out that the level of thyrotropin TSH in the blood is exquisitely sensitive to the levels of thyroid hormones in the blood.

Administer thyroid hormone to a patient and their TSH level will rapidly adjust downwards by an easily detectable amount.

So:

In hypothyroidism, where the thyroid has failed, the body will be desperately trying to produce more thyroid hormones, and the TSH level will be extremely high.

In Graves' Disease, this theory says, where the thyroid has grown too large, and the metabolism is running damagingly fast, the body will be, like a central bank trying to stimulate growth in a deflationary economy by reducing interest rates, 'pushing on a piece of string'. TSH will be undetectable.

The original TSH test was developed in 1965, by the startlingly clever method of radio-immuno-assay.

[For reasons that aren't clear to me, rather than being expressed in grams/litre, or mols/litre, the TSH test is expressed in 'international units/liter'. But I don't think that that's important]

A small number of people in whom there was no suspicion of thyroid disease were assessed, and the 'normal range' of TSH was calculated.

Again, 'endocrinology history' resources are not easy to find, but the first test was not terribly sensitive, and I think originally hyperthyroidism was thought to result in a complete absence of TSH, and that the highest value considered normal was about 4 (milli-international-units/liter).

This apparently pretty much solved the problem of diagnosing thyroid disorders.

Forgetfulness

It's no longer necessary to diagnose hypo- and hyper-thyroidism by symptoms. It was error prone anyway, and the question is easily decided by a cheap and simple test.

Natural Dessicated Thyroid is one with Nineveh and Tyre.

No doctor trained since the 1980s knows much about hypothyroid symptoms.

Medical textbooks mention them only in passing, as an unweighted list of classic symptoms. You couldn't use that for diagnosis of this famously difficult disease.

If you suspect hypothyroidism, you order a TSH test. If the value of TSH is very low, that's hyperthyroidism. If the value is very high then that's hypothyroidism. Otherwise you're 'euthyroid' (greek again, good-thyroid), and your symptoms are caused by some other problem.

The treatment for hyperthyroidism is to damage the thyroid gland. There are various ways. This often results in hypothyroidism. *For reasons that are not terribly well understood*.

The treatment for hypothyroidism is to give the patient sufficient thyroxine (T4) to cause TSH levels to come back into their normal range.

The conditions hyperthyroidism and hypothyroidism are now *defined* by TSH levels.

Hypothyroidism, in particular, a fairly common disease, is considered to be such a solved problem that it's usually treated by the GP, without involving any kind of specialist.


Present Day

It was found that the traditional amount of thyroxine (T4) administered to cure hypothyroid patients, was in fact too high. The amount of T4 that had always been used to replace the hormones that had once been produced by a thyroid gland now dead, destroyed, or surgically removed appeared now to be too much. That amount causes suppression of TSH to below its normal range. The brain, theory says, is asking for the level to be reduced.

The amount of T4 administered in such cases (there are many) has been reduced by a factor of around two, to the level where it produces 'normal' TSH levels in the blood. Treatment is now titrated to produce the normal levels of TSH.

TSH tests have improved enormously since their introduction, and are on their third or fourth generation. The accuracy of measurement is very good indeed.

It's now possible to detect the tiny remaining levels of TSH in overtly hyperthyroid patients, so hyperthyroidism is also now defined by the TSH test.

In England, the normal range is 0.35 to 5.5. This is considered to be the definition of 'euthyroidism'. If your levels are normal, you're fine.

If you have hypothyroid symptoms but a normal TSH level, then your symptoms are caused by something else. Look for Anaemia, look for Lyme Disease. There are hundreds of other possible causes. Once you rule out all the other causes, then it's the mysterious CFS/FMS/ME, for which there is no cause and no treatment.

If your doctor is very good, very careful and very paranoid, he might order tests of the levels of T4 and T3 directly. But actually the direct T4 and T3 tests, although much more accurate than they were in the 1960s, are quite badly standardised, and there's considerable controversy about what they actually measure. Different assay techniques can produce quite different readings. They're expensive. It's fairly common, and on the face of it perfectly reasonable, for a lab to refuse to conduct the T3 and T4 tests if the TSH level is normal.

It's been discovered that quite small increases in TSH actually predict hypothyroidism. Minute changes in thyroid hormone levels, which don't produce symptoms, cause detectable changes in the TSH levels. Normal, but slightly high values of TSH, especially in combination with the presence of thyroid related antibodies (there are several types), indicate a slight risk of one day developing hypothyroidism.

There's quite a lot of controversy about what the normal range for TSH actually is. Many doctors consider that the optimal range is 1-2, and target that range when administering thyroxine. Many think that just getting the value in the normal range is good enough. None of this is properly understood, to understate the case rather dramatically.

There are new categories, 'sub-clinical hypothyroidism' and 'sub-clinical hyperthyroidism', which are defined by abnormal TSH tests in the absence of symptoms. There is considerable controversy over whether it is a good idea to treat these, in order to prevent subtle hormonal imbalances which may cause difficult-to-detect long term problems.

Everyone is a little concerned about accidentally over-treating people, (remember that hyperthyroidism is now defined by TSH<0.35).

Hyperthyroidism has long been associated with Atrial Fibrillation (a heart problem), and Osteoporosis, both very nasty things. A large population study in Denmark recently revealed that there is a greater incidence of Atrial Fibrillation in sub-clinical hyperthyroidism, and that hypothyroidism actually has a 'protective effect' against Atrial Fibrillation.

It's known that TSH has a circadian rhythm, higher in the early morning, lower at night. This makes the test rather noisy, as your TSH level can be doubled or halved depending on what time of day you have the blood drawn.

But the big problems of the 1960s and 1970s are completely solved. We are just tidying up the details.

Doubt

Many hypothyroid patients complain that they suffer from 'Tired All The Time', and have some of the classic hypothyroid symptoms, even though their TSH levels have been carefully adjusted to be in the normal range.

I've no idea how many, but opinions range from 'the great majority of patients are perfectly happy' to 'around half of hypothyroid sufferers have hypothyroid symptoms even though they're being treated'.

The internet is black with people complaining about it, and there are many books and alternative medicine practitioners trying to cure them, or possibly trying to extract as much money as possible from people in desperate need of relief from an unpleasant, debilitating and inexplicable malaise.

THE PLURAL OF ANECDOTE IS DATA.

Not good data, to be sure. But if ten people mention to you in passing that the sun is shining, you are a damned fool if you think you know nothing about the weather.

It's known that TSH ranges aren't 'normally distributed' (in the sense of Gauss/the bell curve distribution) in the healthy population.

If you log-transform them, they do look a bit more normal.

The American Academy of Clinical Biochemists, in 2003, decided to settle the question once and for all. They carefully screened out anyone with even the slightest sign that there might be anything wrong with their thyroid at all, and measured their TSH very accurately.

In their report, they said (this is a direct quote):

In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because >95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L.

Many other studies disagree, and propose wider ranges for normal TSH.

But if the AACB report were taken seriously, it would lead to diagnosis of hypothyroidism in vast numbers of people who are perfectly healthy! In fact the levels of noise in the test would put people whose thyroid systems are perfectly normal in danger of being diagnosed and inappropriately treated.

For fairly obvious reasons, biochemists have been extremely, and quite properly, reluctant to take the report of their own professional body seriously. And yet it is hard to see where the AACB have gone wrong in their report.

Neurasthenia is back.

A little after the time of the introduction of the TSH test, new forms of 'Tired All The Time' were discovered.

As I said, CFS and ME are just two names for the same thing. Fibromyalgia Syndrome (FMS) is much worse, since it is CFS with constant pain, for which there is no known cause and from which there is no relief. Most drugs make it worse.

But if you combine the three things (CFS/ME/FMS), then you get a single disease, which has a large number of very non-specific symptoms.

These symptoms are the classic symptoms of 'hypometabolism'. Any doctor who has a patient who has CFS/ME/FMS and hasn't tested their thyroid function is *de facto* incompetent. I think the vast majority of medical people would agree with this statement.

And yet, when you test the TSH levels in CFS/ME/FMS sufferers, they are perfectly normal.

All three/two/one are appalling, crippling, terrible syndromes which ruin people's lives. They are fairly common. You almost certainly know one or two sufferers. The suffering is made worse by the fact that most people believe that they're psychosomatic, which is a polite word for 'imaginary'.

And the people suffering are mainly middle-aged women. Middle-aged women are easy to ignore. Especially stupid middle-aged women who are worried about being overweight and obviously faking their symptoms in order to get drugs which are popularly believed to induce weight loss. It's clearly their hormones. Or they're trying to scrounge up welfare benefits. Or they're trying to claim insurance. Even though there's nothing wrong with them and you've checked so carefully for everything that it could possibly be.

But it's not all middle aged women. These diseases affect men, and the young. Sometimes they affect little children. Exhaustion, stupidity, constant pain. Endless other problems as your body rots away. Lifelong. No remission and no cure.

And I have Doubts of my Own

And I can't believe that careful, numerate Billewicz and his co-authors would have made this mistake, but I can't find where the doctors of the 1970s checked for the sensitivity of the TSH test.

Specificity, yes. They tested a lot of people who hadn't got any sign of hypothyroidism for TSH levels. If you're well, then your TSH level will be in a narrow range, which may be 0-6, or it may be 1-2. Opinions are weirdly divided on this point in a hard to explain way.

But Sensitivity? Where's the bit where they checked for the other arm of the conditional?

The bit where they show that no-one who's suffering from hypometabolism, and who gets well when you give them Dessicated Thyroid, had, on first contact, TSH levels outside the normal range.

If you're trying to prove A <=> B, you can't just prove A => B and call it a day. You couldn't get that past an A-level maths student. And certainly anyone with a science degree wouldn't make that error. Surely? I mean you shouldn't be able to get that past anyone who can reason their way out of a paper bag.

I'm going to say this a third time, because I think it's important and maybe it's not obvious to everyone.

If you're trying to prove that two things are the same thing, then proving that the first one is always the second one is not good enough.

IF YOU KNOW THAT THE KING OF FRANCE IS ALWAYS FRENCH, YOU DO *NOT* KNOW THAT ANYONE WHO IS FRENCH IS KING OF FRANCE.

It's possible, of course, that I've missed this bit. As I say, 'History of Endocrinology' is not one of those popular, fashionable subjects that you can easily find out about.

I wonder if they just assumed that the thyroid system was a thermostat. The analogy is still common today.

But it doesn't look like a thermostat to me. The thyroid system with its vast numbers of hormones and transforming enzymes is insanely, incomprehensibly complicated. And very poorly understood. And evolutionarily ancient. It looks as though originally it was the system that coordinated metamorphosis. Or maybe it signalled when resources were high enough to undergo metamorphosis. But whatever it did originally in our most ancient ancestors, it looks as though the blind watchmaker has layered hack after hack after hack on top of it on the way to us.

Only the thyroid originally, controlling major changes in body plan in tiny creatures that metamorphose.

Of course, humans metamorphose too, but it's all in the womb, and who measures thyroid levels in the unborn when they still look like tiny fish?

And of course, humans undergo very rapid growth and change after we are born. Especially in the brain. Baby horses can walk seconds after they're born. Baby humans take months to learn to crawl. I wonder if that's got anything to do with cretinism.

And I'm told that baby humans have very high hormone levels. I wonder why they need to be so hot? If it's a thermostat, I mean.

But then on top of the thyroid, the pituitary. I wonder what that adds to the system? If the thyroid's just a thermostat, or just a device for keeping T4 levels constant, why can't it just do the sensing itself?

What evolutionary process created the pituitary control over the thyroid? Is that the thermostat bit?

And then the hypothalamus, controlling the pituitary. Why? Why would the brain need to set the temperature when the ideal temperature of metabolic reactions is always 37C in every animal? That's the temperature everything's designed for. Why would you dial it up or down, to a place where the chemical reactions that you are don't work properly?

I can think of reasons why. Perhaps you're hibernating. Many of our ancestors must have hibernated. Maybe it's a good idea to slow the metabolism sometimes. Perhaps to conserve your fat supplies. Your stored food.

Perhaps it's a good idea to slow the metabolism in times of famine?

Perhaps the whole calories in/calories out thing is wrong, and people whose energy expenditure goes over their calorie intake have slow metabolisms, slowly sacrificing every bodily function including immune defence in order to avoid starvation.

I wonder at the willpower that could keep an animal sane in that state. While its body does everything it can to keep its precious fat reserves high so that it can get through the famine.

And then I remember about Anorexia Nervosa, where young women who want to lose weight starve themselves to the point where they no longer feel hungry at all. Another mysterious psychological disease that's just put down to crazy females. We really need some female doctors.

And I remember about Seth Robert's Shangri-La Diet, that I tried, to see if it worked, some years ago, just because it was so weird, where by eating strange things, like tasteless oil and raw sugar, you can make your appetite disappear, and lose weight. It seemed to work pretty well, to my surprise. Seth came up with it while thinking about rats. And apparently it works on rats too. I wonder why it hasn't caught on.

It seems, my female friends tell me, that a lot of diets work well for a bit, but then after a few weeks the effect just stops. If we think of a particular diet as a meme, this would seem to be its infectious period, where the host enthusiastically spreads the idea.

And I wonder about the role of the thyronine de-iodinating enzymes, and the whole fantastically complicated process of stripping the iodines and the amino acid bits from thyroxine in various patterns that no-one understands, and what could be going on there if the thyroid system were just a simple thermostat.

And I wonder about reports I am reading where elite athletes are finding themselves suffering from hypothyroidism in numbers far too large to be credible, if it wasn't, say, a physical response to calorie intake less than calorie output.

I've been looking ever so hard to find out why the TSH test, or any of the various available thyroid blood tests are a good way to assess the function of this fantastically complicated and very poorly understood system.

But every time I look, I just come up with more reasons to believe that they don't tell you very much at all.


The Mystery

Can anyone convince me that the converse arm has been carefully checked?

That everyone who's suffering from hypometabolism, and who gets well when you give them Dessicated Thyroid, has, before you fix them, TSH levels outside the normal range.

In other words, that we haven't just thrown, though carelessness, a long standing, perfectly safe, well tested treatment, for a horrible disabling disease that often causes excruciating pain, that the Victorians knew how to cure, and that the people of the 1950s and 60s routinely cured, away.

Sunday, November 29, 2015

Contract Programmer Seeks Job in Cambridge (£500 reward)

Anyone in Cambridge need a programmer? I'll give you £500 if you can find me a job that I want.

CV at http://www.aspden.com

I make my usual promise, which I have paid out on several times:

If, within the next six months, I take a job which lasts longer than one month, and that is not obtained through an agency, then on the day the first cheque from that job cashes, I'll give £500 to the person who provided the crucial introduction.

If there are a number of people involved somehow, then I'll apportion it fairly between them. And if the timing conditions above are not quite met, or someone points me at a shorter contract which the £500 penalty makes not worth taking, then I'll do something fair and proportional anyway.

And this offer applies even to personal friends, and to old contacts whom I have not got round to calling yet, and to people who are themselves offering work, because why wouldn't it?

And obviously if I find one through my own efforts then I'll keep the money. But my word is generally thought to be good, and I have made a public promise on my own blog to this effect, so if I cheat you you can blacken my name and ruin my reputation for honesty, which is worth much more to me than £500.



And I also make the following boast:

I know all styles of programming and many languages, and can use any computer language you're likely to use as it was intended to be used.

I have a particular facility with mathematical concepts and algorithms of all kinds. I can become very interested in almost any problem which is hard enough that I can't solve it easily.

I have a deserved reputation for being able to produce heavily optimised, but nevertheless bug-free and readable code, but I also know how to hack together sloppy, bug-ridden prototypes, and I know which style is appropriate when, and how to slide along the continuum between them.

I've worked in telecoms, commercial research, banking, university research, chip design, server virtualization, university teaching, sports physics, a couple of startups, and occasionally completely alone.

I've worked on many sizes of machine. I've written programs for tiny 8-bit microcontrollers and gigantic servers, and once upon a time every IBM machine in the Maths Department in Imperial College was running my partial differential equation solvers in parallel in the background.

I'm smart and I get things done. I'm confident enough in my own abilities that if I can't do something I admit it and find someone who can.

I know what it means to understand a thing, and I know when I know something. If I understand a thing then I can usually find a way to communicate it to other people. If other people understand a thing even vaguely I can usually extract the ideas from them and work out which bits make sense.

Friday, November 20, 2015

The Prisoner's Dilemma is a Newcomb Problem

First Draft. Comments Please.

2016:

I've been feeling tired all the time recently.

It's been getting worse.

I went to the doctor's about it. He was very sympathetic. He asked me if I was getting enough sleep.

I'm getting more than enough. I go to bed at midnight and wake at noon. In the afternoons I often fall asleep in my chair, in front of the fire.

I think on average, I'm getting fourteen hours a day. It was when I realised that I decided it might be worth bothering a doctor.

He asked me if I was under much stress.

My grandfather said some pretty wise things when he was dying when I was a boy. One of them was "No-one ever died wishing they'd spent more time at work."

I intend to prove him wrong.

My entire life is optimised for not being stressful, and I'm good at it. I am the serenest motherfucker on the whole fucking planet. Bring it on.

So my doctor figured that there was probably some physical cause. He did a load of tests. He said to ring for the results in a week or so.

And the receptionist, she is like "We have got the results back, could you come in to see Dr Stewart to discuss them."

Her voice is bright.

Fuck.



2018:

It turns out that assisted suicide is legal in Switzerland (well, in Vaud canton, which is the one you can still smoke in, which is nice).

And what you do with your body afterwards is up to you.

That's a plan.

Great big vat of liquid nitrogen ho!

I think that being killed and then dumped into a vat of liquid nitrogen is not actually going to improve matters greatly.

Nobody know whether my will will stand up in court. There's never been a test case. But I don't have any heirs to dispute it. The popsicling is pretty pricey, but I'm going to leave the rest of my money to myself and see what happens.

My friend Mike assures me that the chances of this stuff working are as remote as the chances of God.

More worryingly, the entire respectable cryogenics profession agrees. Firmly. To a man.

Damned scientists. Messing with things they understand only too well.

The cryonicists (notice the difference) are quacks and ghouls. Save your money.

But they seem sincere.

Fuck Mike. Fuck the Moderator of the General Assembly of the Church of Scotland. I'm *dying*.

I am the plastic cat.


2123:

I'm in the Lake District. But it's usually summer and it goes on for ever.

I came here after I got bored of the heart of the sun.

I'm wearing animal skins. Comfy. I've got a fucking great spear and a bow and arrow.

And a good horse. And a good woman. She's the most beautiful thing I've ever seen and she's the best friend I've ever had.

The most beautiful thing she's ever seen is our first child. I think he's pretty cool too. Baby skins! We're so happy. We have lots of friends. And lots of enemies too. I wouldn't be without our enemies.

Sometimes we spend all day fighting, and then afterwards when the stars come out we spend all night drinking and singing and going on and on about how well we fought and how we'll do even better tomorrow, you watch out. Snorri's a great poet. You're already feeling pretty smug but he can always make it sound better than it was.

I like to hunt and to fight and to fuck and to swim and to fly and to build, and I like our politics and our songs and our dances, but the best thing about the savannah is the maths library.

I like to read the books because I can go faster that way.

When I watch the videos, or do the computer proofs, I can't go nearly as fast. The main trouble is finding problems that I can't just work out myself.

The Riemann hypothesis took all afternoon. But it was worth it. So beautiful. And it's good to know the truth. Although in hindsight a child could have seen it.

Four colours is nice too.

Fermat is kind of an anticlimax. Even the proof in the Book is long-winded. And the payoff is not that great. Still.

I've left those a long way behind now. What was known when I died is baby stuff now. In fact the baby's getting there! So cute.

Yesterday we decided to play cricket instead of fighting. The crowd at Lord's was great. I really cannot see how Mr Bradman gets into position so quickly, but I have a plan. I'll get him before this Test's over.


2235:

Fuck.

I've been tied to the railway by a mad philosopher.

One day we're sitting round a singularity and this guy turns up.

Peersa, he's called. Peersa for the State.

He explains there's been 'an unfortunate mistake'.

They did me twice.

Another me's been running around his own perfect universe for the last hundred years. I wonder what he's been doing? I imagine we started off pretty much the same way.

I feel violated. I hope I never meet him, although I suppose it would be interesting in a weird sort of way.

I'd rather this hadn't happened. I asked Peersa why they couldn't just pause the second copy.

He said it wasn't clear which one of us *was* the second copy, which was a bit deflating.

The reason, he said, that they noticed, was that the bill for both our worlds has been going to the same account. And they started off the same. But in the last period, there was a difference.

There's been enough divergence that one of us needs more physics than the other.

Peersa won't tell me which one. He says it will break the symmetry.

He says we can't be merged. The resulting personality wouldn't be a true descendant of either of us. And it would be quite mad and very unhappy. They'd have to pause it on ethical grounds.

So at the moment they're running us half and half. He gets a second, I get a second. I haven't noticed of course.

But it means that my life will be half as long as it should be. Still quite long, of course.

Peersa offered me a cigar.

I like cigars, but he said Wait! It's a special cigar.

If I smoke it, they'll pause my other copy.

But of course, they've made him the same offer.

If he smokes his, then once he's finished it, my world stops. No more me. Death. Just when I was getting the hang of having outsmarted the old bastard.

It doesn't matter what I do. His choice makes all the difference.

The only choice I have is whether I've got a last smoke as I face the firing squad.

I like to smoke. I always have.

If we both do, Peersa's going to end up with my share of the cosmos. I can fucking see it.

If I don't, my enemy is.

I can smoke it any time I like. I wonder if he's already started his.

Monday, November 16, 2015

Recursion

No idea where this is from originally, but it's cute:

A child couldn't sleep, so her mother told a story about a little frog,
  who couldn't sleep, so the frog's mother told a story about a little bear,
     who couldn't sleep, so bear's mother told a story about a little weasel
       ...who fell asleep.
     ...and the little bear fell asleep;
  ...and the little frog fell asleep;
...and the child fell asleep.

Wednesday, September 23, 2015

Jeremy Corbyn on the Beach : Why a Man who Just Got Elected is Unelectable


I've noticed that most of the people I know seem to have found the whole 'Jeremy Corbyn' thing much more surprising than I did.

Similarly, many of them seem to have become convinced that it signals a leftward shift in British Politics.

The Daily Mash, as always, hit the nail on the head with the delightful 'Man Who Just Got Elected Definitely Unelectable':  http://www.thedailymash.co.uk/politics/politics-headlines/man-who-just-got-elected-definitely-unelectable-20150914101940



I've even managed to get a couple of people to take bets on the question 'Will Jeremy Corbyn be the next British Prime Minister?'. I think not, but a number of people have been prepared to put their money where their mouth is for the other side, which to my mind means that they actually anticipate this as a likely outcome. I'm certainly not saying that's impossible, but I do think that the chances of it happening are considerably less than 50%.

If anyone else wants a piece of that action do let me know. If we can find some way of making the bet enforceable, then I'll accept for any amount I can afford.

At any rate, I'd like to explain my model of how politics works, and how it explains what just happened to the Labour party, and why it's a disaster for them.

I would like to point out that I rather like Jeremy Corbyn. He's transparently a good and honest man, who says what he believes and believes what he says. I wish that all politicians were like this. His politics remind me of my own teenage ideals.

If he promised to prosecute Tony Blair for treason over the Iraq War, which I think he might like to do, I would (will) vote for him myself. [0]

Unfortunately it's only in a certain kind of 'Mary Sue'-type science fiction story where an honest man goes into politics, only to find that everyone loves and respects his innovative new approach and he rides the breath of fresh air to an amazing victory and uses his honesty and openness and clear thinking to put everything right.

That's not how democracy works. It's amazing to me that it works at all. I think it does work reasonably well, and certainly much better than all the other systems which people have tried, but not really for the reasons everyone thinks it works.



Here's a very simple model that shows how I think democracies work:

Consider a beach:

|-----------------------------------------------------------------|

Everyone on the beach likes ice cream. They'll go to the closest ice cream stall they can see to get one.

Say you want to set up an ice cream stall. Where do you put it?

It really doesn't matter. Say you put it in your favourite place. It's got the best view, maybe:

|----------------------------------------------------*------------|

Profit! Everyone comes to you to buy an ice cream.

Now, pretty soon someone else is going to notice the good thing you've got going on, and set up in competition.

Maybe they don't want to be too in your face about this, or maybe they just like the other end of the beach.

|--*-------------------------------------------------*------------|


Even so, they're going to take some of your customers. Nobody shops around for ice cream on beaches, and you're probably charging the same sort of price anyway. People just go the the closest stall.


This shows the flow of customers:

|>>*<<<<<<<<<<<<<<<<<<<<<|>>>>>>>>>>>>>>>>>>>>>>>>>>>*<<<<<<<<<<<<|

You get:

|>>>>>>>>>>>>>>>>>>>>>>>>>>>*<<<<<<<<<<<<|

and your competitor gets:

|>>*<<<<<<<<<<<<<<<<<<<<<|


What should you do?

Suppose the next morning you move your stall towards the middle of the beach.

|--*----------------------------*---------------------------------|

Where do the customers go now?

|>>*<<<<<<<<<<<<<<|>>>>>>>>>>>>>*<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<|

You've got:
| >>>>>>>>>>>>>*<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< |
and your rival's got:
| >>*<<<<<<<<<<<<<< |

But your rival can move too. Maybe he'd prefer to be out on the left, but he's more interested in getting as many customers as he can:

So the next morning:

|----------------------------*--*---------------------------------|

|>>>>>>>>>>>>>>>>>>>>>>>>>>>>*<>*<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< |

And you're splitting the customers pretty much in half.

This really happens! If you go to a beach, the ice cream stalls are in the middle. [0.5]

This is obviously a bit of a pain for everyone involved. The beach-goers have to walk further than they'd like for their ice cream. And both you and your rival would probably prefer to be a bit further apart anyway.



Now, politics.

First of all, we'll have to assume that 'left-wing' and 'right-wing' actually mean something. [1]

And then we'll have to assume that everyone can be put on a line, with the most right wing people on the right, and the most left wing people on the left.

The normal state of British politics is that there are two main parties.

|----------------------------*--*---------------------------------|

Their supporters look like this:

|>>>>>>>>>>>>>>>>>>>>>>>>>>>>*<>*<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< |

This is the Labour party:

|>>>>>>>>>>>>>>>>>>>>>>>>>>>*<|

Almost all its members and supporters feel that the Labour leader/manifesto, is to the right of their position.

This is the Tory party:

|>*<<<<<<<<<<<<<<<<<<<<<<<<<<<|

Almost all its members think that their leader/manifesto are to the left of their position.

Everyone in the country thinks that the two party leaders and their policies seem indistinguishable. This explains the constant complaint that 'They're all the same', even though if you actually know any members of either party, it's pretty clear that they have serious philosopical differences.

This is why our form of representative democracy works.

The voting system forces the two parties to choose leaders and manifestos that are roughly in the middle of the British electorate. Half of the population think that their government is too right wing, and half think it's too left wing.

So after every election, whoever wins, centrist things get done. No one can get away with doing anything too crazy without first persuading a lot of the population that it's a good idea.



The mistake that Labour just made was to not understand how its own leadership election is supposed to work.

The idea was that the Labour MPs, who are all interested in getting elected, because if they don't get elected they don't have a job any more and certainly can't influence British politics, get to do almost all the choosing of who is going to be Labour leader. They pick a number of Labour MPs as candidates, all of whom are supposed to be electable.

|>>>>>>>>>>>>>>>>>>>>>>>>>>>>****|

Then the Labour members get a completely pointless and illusionary choice between the four identical candidates, which leaves the party looking like this:

| >>>>>>>>>>>>>>>>>>>>>>>>>>>>>*< |

Almost all the power is in the choice of candidates. The votes of the party members count for almost nothing. [2]

But some Labour MPs ( I think 36 or so.. just enough anyway ) either didn't understand the system, or deliberately sabotaged it, by nominating a fairly left-wing MP, as well as the identikit clone candidates.

Now, when Labour held its leadership election, it looked like this:

| >>>>>>>>>>>>*<<<<<<>>>>>>>>**** |

And Jeremy Corbyn got most of the votes, while the 4 identical 'electable' clones ended up sharing out the few votes of the people who are Labour party members but who aren't particularly left-wing.

So now the Labour party looks like this:

| >>>>>>>>>>>>*<<<<<<<<<<<<<<<<<  |

This is a great result if you're a Labour supporter. Finally you've got rid of the lying right-wing weasels who took over your party in the eighties, and elected a leader who really represents what Labour stands for, the great current of socialist thought that brought your party into being.

Unfortunately that means that the next General Election looks like this:

|------------*------------------*--------------------------------- |

And the voters split like this:

|>>>>>>>>>>>>*<<<<<<<<<|>>>>>>>>>*<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< |

An absolutely thumping Tory victory.

Now, obviously, this model is very simple, and doesn't explain all sorts of features of British politics, like the existence of more than two parties, the effect of the constituency system, the rise of Scottish and Welsh nationalism, and so on.

It's actually much more like the system for electing the President of the United States. [2.5]

Neither does it model the fact that members of the electorate can actually change their minds. [3]

But nevertheless, I claim it's good enough model to tell us roughly what's going to happen in the next election. We can add more bells and whistles to make a more complicated model that better accounts for what actually happens in British Politics.

But the Corbyn Effect is so strong that I just have trouble seeing how the bells and whistles can possibly make a difference.

Within this model, Corbyn has literally no chance of being elected Prime Minister.

All the uncertainty is in the correspondence with reality. I'll be conservative and say that I'll give him a 20% chance of getting in because of some effect that I haven't captured in this model.








[0] Obviously Tony Blair is a traitor. He lied to the parliament in order to take us into an illegal war that has killed hundreds of thousands of completely innocent people, (including a few British soldiers, which is the bit that makes it treason).

Equally obviously no British court is going to convict him by the 'beyond reasonable doubt' standard. I'm cool with that. I don't believe it beyond reasonable doubt myself. It's possible that the lying snake believed everything he said. I find that even more worrying, and either way I'd like to watch the bastard squirm.

[0.5] In between, there are donkey rides. The Buridan franchise, usually.

[1] I'm not completely convinced this is true. Some of my political thoughts are left-wing. Some are right-wing. I'm usually happier when the Tories are in than when Labour are in, but I can usually see where they're both coming from.

In fact I think that there are three strands of politics in the UK, there's the social conservatives, the classical liberals, and the lefties. The social conservatives and the classical liberals are in an uneasy alliance called the Tory party, and cordially dislike each other but pretend not to. The lefties, who seem much more of one mind to me, are the Labour party.

My heart is with classical liberalism, but I prefer the lefties to the social right.

[2] In fact this is also true of the general election. Almost all the power is in the hands of the political parties themselves. There was an old anarchist T-shirt that said 'A lifetime's supply of democracy:XXXXXXXXXX'. That's about right. The genius of the system is that it forces the political parties to use their immense power to pick people who represent the people as a whole, even though the actual input of the people is very small.

[2.5] Where it, plus the assumption that the candidates are dishonest, handily predicts that before the primaries, all the candidates will appear to be extremist fucknuts, whilst after the primaries they will all appear to be centrists who appeal to the whole nation. You can tell an honest presidential candidate by the fact that he either loses the primary, or the election. You can only become president by tacking violently so as to win both.

[3] This effect is negligible except over geological time.

Sunday, December 7, 2014

Customary Units

From the New Zealand Herald via today's "News Quiz":

A strapping newborn baby boy is understood to have set a New Zealand record, weighing in at a whopping 6.85kg (15lb 1oz) - the equivalent of nearly seven 1kg blocks of cheese.

Monday, November 10, 2014

Friendship is Optimal

Dear Friends,

There comes a time in a man's life when he has to go out on a limb, and make a fool of himself in a good cause.

My deepest and most sincerely held religious and philosophical beliefs have recently found their best expression yet in the hands of a very talented writer. I can see how "Iceman" might have done it better, but certainly no-one has done it anything like this well up until now. My own poor effort looks very drab by comparison.

It is therefore with considerable regret, fear and with a sense of abiding humiliation that I commend to your attention the My Little Pony fan-fiction "Friendship is Optimal". Which you will find on the other end of the following 'hyperlink':

http://www.fimfiction.net/story/62074/Friendship-is-Optimal


I think it might be important that you read, and take the trouble to actually understand, this story. If you already get why I often spend the night staring at the ceiling worrying about utility functions and formal logic then read it anyway. It's rather good just as a story.

Sunday, October 19, 2014

A Classic Puzzle

This problem can be solved by pre-school children in 5-10 minutes, by programmers - in 1 hour, by people with higher
education ... well, check it yourself! :)

8809=6
7111=0 
2172=0 
6666=4
1111=0 
3213=0 
7662=2
9313=1
0000=4
2222=0 
3333=0 
5555=0
8193=3
8096=5
7777=0
9999=4
7756=1
6855=3
9881=5
5531=0
2581=?

Tuesday, August 12, 2014

Cameron Again

I am not at all sure I how I have turned into the sort of person who posts baby photos, especially since the baby in question is not mine.



In my defence, little Cameron appears to be a one-baby conversion weapon aimed directly at the hearts of the childless.

Look at that smile!

Ryanair (Stansted to Vasteras - Stockholm)

They speak ill of Ryanair, but I don't know why.

I used to like flying, but pretty much gave up on it about ten years ago because the experience had become so miserable. The final straw was some cunts called 'First Choice', who put a television I couldn't turn off right in my face and advertised holidays to me throughout the flight. By the time I got to London I'd completely packed my ear canals with shreds of the Daily Telegraph and they were still coming out in the shower a month later.

Wanting to visit a friend in Stockholm, I got my first Ryanair flight from Stansted to Vasteras last Tuesday. Everyone I spoke to beforehand said: 'Oh, Ryanair, enjoy...', in much the same way that people used to say, 'Ah, Stalingrad...' to Germans.

Their website's easy to work, and they make it perfectly clear that they'd really like you to print out your boarding pass in advance and that you shouldn't take the piss with their cabin baggage allowance and that it will cost you if you do.

They also offer the chance to reserve a particular seat in advance for £5. Bargain I reckon. I enjoy flying if and only if I can see out, and I always used to have to turn up early to negotiate at the check-in desk for a window seat.

Contrary to everyone's predictions, I paid exactly the advertised price, plus my entirely voluntary and deliberately paid 2x£5 window-seat fee.

I stuck three days worth of clothes and some books in my satchel, and it was about half the size allowed. I cycled in to Stansted airport at about 9:30 for my 10:30 flight, locked my bike in the bike shed right in front of the terminal, floated happily through courteous security, and arrived at the boarding gate at around 10:00. Just time for a coffee while the plane boarded, and as I finished it the last passenger was going through. I followed them onto the plane, was greeted by a smiling stewardess, and took my seat. My bag fitted neatly into the footwell.

I'd taken earplugs because everyone had been telling me about relentless advertising and screaming children. I ended up not using them.

I noticed exactly one child on the plane, who kept saying as we were taxiing 'Are we flying yet Mummy?', and then when the plane started to accelerate and lift let out one long, terrified yet fascinated scream which kept rising as the plane kept rising and finally terminated in an awed gasp as we levelled out. Utterly endearing and I know exactly how she felt!
New friends

As for advertising, if there was any I didn't notice it. No wretched music, no nasty airline food, no pitiful in-flight movie, no sodding televisions on the backs of seats, just looking out at the clouds and the sea and the fields and the towns and the coast and the boats and the lakes, and chatting to the lovely girl sitting next to me who'd been a fellow student of my university. If this is what no frills means I'd pay extra for it.

Just as I was thinking to myself "I wish someone would sell me a coffee", someone came up and sold me a coffee. For about £2.50, which seemed remarkably unexploitative given the captive nature of the market. And it wasn't exactly the hard sell. I pretty much had to grab her ankles.

Exactly on time we touched down in Vasteras. It's a delightful little airport with one tiny building. They look at your passport and say 'Welcome to Sweden'. And that's it.

Outside the 'Flygbuss' to Stockholm is waiting. 'Where can I get a ticket?', I said, and the driver said 'Just there, but don't worry, we won't leave until everyone's aboard'. 'Do I have time for a smoke?', I said. 'Yes of course', he said. 'I'll come and get you when we want to go'.

In the centre of Stockholm 75 minutes later.

I not only enjoyed this flight, I enjoyed it lots.

The flight back was much the same. The flygbuss gets to the airport fully two hours before the plane leaves, so I asked at the terminal information desk if there was anything to do. 'No', said the lady. And then after thinking, she said 'But there are some interesting aeroplanes here for the forest fires, and as long as you're back here 40 minutes before the flight you'll be fine.'

She was right on both counts, so my last look at Sweden was a long walk through the forest with occasional planes and helicopters, and getting rid of the last of my kroner in the lovely airport cafe before going through security. On the other side of security was a 10 minute wait in a glass box before we boarded the plane.

Would fly again.

Thursday, June 19, 2014

Favourite Posts

I got all nostalgic and re-read my whole blog. While I was doing it I made a list of all the things I enjoyed reading again. And tried to link to it in the right hand corner above the photo.  I don't know if it's obvious enough though.

Oxford English Dictionary

Hey, the OED's online:

www.oed.com

The real thing!

And they've put back all the ancient greek roots in real greek letters that were what I loved about it when I was a child, and which they took out in the last printed edition in order that it wouldn't be as good any more.

And you can add it to firefox as one of your search engines just by going to that page and clicking on the icon in the search bar, and then you can give it the keyword oed so that Ctrl-L oed reference will look up 'reference'.

Nice.

Saturday, June 7, 2014

I Hate Sport

In a recent electrical conversation with a friend, the fact that it was once possible for an Olympic athlete to be accused of 'training' came up.

I've been sporty for most of my adult life, and I know exactly what those guys in the 1920s were complaining about.

The game-theoretic structure of sport is wrong.

The point of sport is to have something fun and friendly to do at the weekend. All our sports are children's games that it turns out adults can enjoy too.

If you don't enjoy it, why would you even call it sport?

What you want out of sport is the joy of the game itself, the relationships that you make out of it, the atavistic thrill of combat without the ocean of blood, the wonderful feeling of practising something and getting better at it, the team spirit, the feeling of good health and freedom that comes from having some sort of physical activity in your life.

The reasons for enjoying and approving of sport are many. It was a great invention, when the first adults decided to play children's games in their new-found spare time.

There are two problems.

One is that it's possible to care about winning far too much. This is something in our evolved psychology whose origin is too obvious to mention.

The sport I've taken most seriously in my life has been rowing.

Not one competition I have ever entered has mattered in the grand scheme of things, and I have never thought it did. But when actually in a boat race, of any standard or against any rival, I would happily damage my own health in order to win. I often threw up at the end of hard races.

The day when I found myself, in the middle of a race at Peterborough Regatta whose result is nowhere recorded, and which went entirely unnoticed even by the spectators on the day, not caring insanely much about beating the boatful of complete strangers rowing next to us, and thinking that it might be nice to back off a bit and let the intense pain in my legs die down, was the day I gave up rowing for good.

Once, during the Head of the River Race, which is the big event for British men's rowing in the winter, rowed over the university boat race course on the Thames, with cheering crowds and the best boat of every club in England racing for results that are remembered for years, I misjudged my own strength, overdid it, and found myself 10 minutes into the race with my vision contracting to a tunnel, as the cells in my eyes and my brain starved for oxygen, until it felt as though I was looking at the back of the person in front of me through a telescope. I rowed the rest of the course in delirium.

Rowing is a technical sport. That kind of exhaustion is not going to do your technique any good at all, and you aren't going to produce significantly more power by putting yourself into that kind of place. It's beyond doubt counterproductive to race that hard.

To put this crazed over-exertion into perspective, this was early in my rowing career. I was rowing in my club's second VIII. We were very bad, and had no business being in the HORR at all. I honestly can't remember what administrative cock-up had resulted in our invitation. I think we came third from bottom out of four hundred boats.

And we knew this perfectly well before the start of the race. One of my favourite memories is of our utterly unrealistic captain giving his pre-race pep-talk. He said "We're going to go out there and own this river. We can be the fastest thing out there. We just have to believe." As he said this, the German national squad rowed past behind him on its way to the start.

I mentioned my tunnel vision to a friend of mine who rowed for the Cambridge University Lightweights.

He said "That's nothing. Every time I do an ergo I go blind." He was perfectly serious.

Have you any idea who won the lightweights race this year, or even when or where it was held? I haven't, and I coach rowing in Cambridge.

The second problem is that, although practising your sport can be great fun, there are lots of ways to get better at a sport that aren't a great deal of fun.

For instance, there's a sort of 'rowing simulator', called an ergometer, invented by Canadians whose rivers froze over in the winter, and who wanted a way to practise rowing without needing water.

It is almost never a good idea, from the point of view of the eventual speed of your boat, to do an ergo instead of going rowing.

The only real case for it would be if you were trying to explore your personal limits and get used to the various sensations that a beginner feels as pain, but an experienced rower feels as information.

But it can be difficult to organise rowing outings. In an VIII, you need all nine of your people to be available at the same time. And you need the river to be nice and clear of other traffic so that you can do your hard work out on the water.

So sometimes, it can be more organizationally feasible for a committed crew to organize say, five outings a week, and add another five ergo sessions on top of that.

I am talking about half-decent club athletes. Training close to the physical limits that the human body can tolerate. Many of them will be injured by the weight of training and drop out, for the season or for good.

And it doesn't make a great deal of difference in the end. What, without the ergometers and the hard training, would be a competition won by naturally fit people with good genes who practised enough to get technically good and decently fit, becomes a competition won by naturally fit people with good genes who practise enough to become technically good, and can also, by virtue of their good genes, tolerate insane training loads, and who have the obsessive personalities necessary to do this sort of thing in order to win.

But notice what has happened, once people have substituted 'training to win' for 'practising because it is enjoyable'.

Anyone who just does as much as a man would do for fun is 'hopeless', an 'underachiever', a 'tourist', 'lazy', 'rubbish', 'a joke'. Largely despised by the community around his sport.

Anyone else is doing at least something that he would rather not do. And anyone who would like to win a race some day is doing a very great deal of stuff that he would rather not be doing.

I'm still talking about amateur sport, someone's recreation. Once you start getting paid professional sportsmen, who may quite literally loathe their profession but have no other source of income, and a self-image built up around being good at their sport, and once you start getting sport as a business, cynically whipping up tribal hatreds in order to extract money from 'fans' who have nothing at all in common with the highest bidder mercenary players in the teams that they are supporting, the whole thing becomes profoundly distasteful.

I have been sporty all my adult life, and I hate sport.

Not the sort of thing that goes on between consenting adults on village cricket greens every weekend, which is largely friendly, enjoyable, and life enhancing, or the cheerful rivalry between Oxbridge college boat clubs, that provides a happy distraction from the stresses of undergraduate life.

But the high levels of sport, where the sport becomes the life, which are peopled by obsessive, selfish, nasty cheats. A number of whom have good PR.

This is the sort of thing that the amateur movement was trying to prevent. They had seen it all before in the nineteenth century, with its professional athletes and its betting rings and its corruption and its cheating and its match fixing, and they wanted none of it.

And for a while they had the upper hand, and 'sporting' somehow became a synonym for 'decent'.

But the game theoretic structure of sport is wrong, and it does not permit amateurism.

Once people can train, rather than practise, those who train will win.

Once people can make money from winning, they don't need to work, and so they can train a lot.

Once they can train a lot, they're doing something that they don't enjoy.

And if you're not enjoying it, there's no point to it at all.

Wednesday, June 4, 2014

Atomic Man

Nuclear Magnetic Resonance is the ability of atomic nuclei to absorb radio waves in a magnetic field.

It leads to an imaging technique (ironically using TV frequencies) called NMRI, that can be used, like X-rays, to look inside the body. It's much better than X-rays for a lot of purposes, and it doesn't use dangerous radiation.

When it was introduced in a medical setting, it was found that people were very frightened by the term 'nuclear magnetic resonance imaging', and so it was changed to MRI, dropping the offending adjective.

On this basis, I have decided henceforth to adopt the superhero name Atomic Man, because I am made of atoms.

I have recently been accused of stunning honesty. That can be my superpower.

"Twelve Years Ago, I did not walk in a friendly game of cricket even though I was 90% confident that I'd got a feather touch on the ball while trying to pull. I have felt wretched about it ever since, and have never done anything like it again..."

"Urrgh!"

Saturday, May 31, 2014

The Fountain Of Doubt

This is my favourite from Less Wrong's 'Rationality Quotes':
From a BBC interview with a retiring Oxford Don:

Don: "Up until the age of 25, I believed that 'invective' was a synonym for 'urine'."

BBC: "Why ever would you have thought that?"

Don: "During my childhood, I read many of the Edgar Rice Burroughs 'Tarzan' stories, and in those books, whenever a lion wandered into a clearing, the monkeys would leap into the trees and 'cast streams of invective upon the lion's head.'"

BBC: long pause "But, surely sir, you now know the meaning of the word."

Don: "Yes, but I do wonder under what other misapprehensions I continue to labour."

Unfortunately I think it's apocryphal. If anyone has a reference or can fill in the name, I'd be most grateful.

Wednesday, April 30, 2014

Into How Many Regions Can Six Planes Divide Space?

I recently misread an easy recreational puzzle as 'Into how many regions can six planes divide space?'.

It took me about half an hour to get an answer. (Which was the correct answer to the wrong question, but sadly the wrong answer to the right question). But it turned out to be great fun to think about.

1,2,4,8,..... how does this sequence continue?

So far Tim and Sips and Paul Cook have had a go. Paul guessed the answer but didn't know why it was true and I haven't heard anything from the other two.

Have fun! It's not actually that hard.

Thursday, March 20, 2014

The Falsifiability of Classical Mechanics


So I am currently enjoying an argument with Smiling Dave on his excellent blog:
http://smilingdavesblog.wordpress.com/2014/02/16/top-ten-economic-blunders-according-to-mises, and it has wandered around, and like all arguments, touched on philosophy.

Anyway I said:

If Jupiter pulls a loop the loop, that doesn't disconfirm *my understanding* of physics. That's in flat contradiction with physics, and it means physics is wrong. Similarly with evolution and fossil rabbits in the precambrian.

And Dave said:

If Jupiter pulls a loop the loop, I doubt the reaction will be to throw out the physics and engineering textbooks. In fact we did have a Jupiter pulling a loop the loop, when quantum effects were first discovered, invalidating all Newton’s laws. So what happened?

And this is a very good question indeed, and deserves an answer, but it is not about Austrian Economics so I am reluctant to clutter up Dave's blog with it, so here it is instead:

Classical Mechanics is dead as a theory of how the world works. It survives as an abstract mathematical model. And we still teach it. And it is still a very useful tool for understanding and predicting things. But anyone who actually thinks that the world works like that is a crackpot and will not be welcome at the sort of parties that mathematicians and physicists like.

Classical Mechanics died before the end of the nineteenth century, from many directions at once. Once people twigged that the "atoms" idea was actually true, and worked out how electromagnetism worked, and started measuring what happened when tiny fast things crashed into each other, classical mechanics was dead.

People used classical ideas to predict how the atoms behaved, and those predictions were unambiguously wrong. For a time they tried to patch the theory up by adding extra rules, but all those attempts failed miserably.

And so philosophers went from debating whether classical mechanics was just "true", or whether it was "necessarily true", to criticizing mathematicians and physicists for having ever thought it was true, since it is so obviously false.

And I hate to admit it, but the philosophers had a point. If you know a little quantum mechanics, and the modern ideas about how matter works, you realise that the classical theory was obviously wrong all along, and that if people had only thought a bit harder about it they would have realised that the world couldn't possibly have worked that way.

Classical Mechanics survives only as a mathematical theory, and in the sense that it is a 'limiting case' of general relativity and quantum mechanics.

But it is still just as useful as it ever was! And remember that that was very useful indeed. Every invention between Newton and the atomic bomb was invented using classical mechanics. Which means that the rise of the West and so the entire history of the world since Newton are squarely the fault of classical mechanics. It is a powerful set of ideas which happen to be untrue.

It can these days be characterized as "A simplified form of general relativity which is appropriate for predicting the behaviour of medium sized slow things, say anything between a cricket ball and a planet, but even then it will be wrong in ways that are not too difficult to spot, once you know what the real answers look like."

Now in fact, very shortly after Classical Mechanics collapsed, dead and greatly lamented by its friends, Einstein and Bohr came up with a couple of new theories about how very small, very large, or very fast things went about their business.

And surprise surprise, those theories turn out to be (a) much better at predicting the behaviour of vsvlvf things, and (b) much less intuitive to human beings, who after all have minds adapted to comprehend the behaviour of the sorts of things humans have to deal with in their daily lives.

Although a conversation with an undergraduate about physics will usually quickly disabuse one of the notion that classical mechanics is intuitive. Our built-in mental models are much more like Aristotle's version of physics, which is even more wrong.

Another surprise is that General Relativity and Quantum Mechanics are also obviously wrong! They are completely different theories, and can't both be true in the same universe. And GR makes predictions even more absurd about small things than CM did, and QM is completely incapable of dealing with gravity. And also QM is famously very strange philosophically, in a way that is hard to explain, but it feels as though it is pulling clever tricks on one at every turn. And the only obvious, straightforward way to interpret the maths is so mind-bogglingly weird that no-one really buys it.

So it is our hope that there will one day be a nice big Theory of Everything that can reconcile these two theories, and make predictions about stuff without having to bring in all sorts of ad-hockery and special cases. But we sure aren't there yet, and we may never get there. And the smart money says that if we ever find this theory it will be even more weird and its implications even more bizarre than Quantum Mechanics, and that it will include General Relativity as a special case in the same way that Classical Mechanics is a special case of General Relativity.

----------

But if Jupiter actually pulled a loop the loop, that would be much much worse.

The orbit of Jupiter is one of the places where Classical Mechanics applies almost exactly. There are tiny corrections from General Relativity, but nothing that is going to cause loop-the-loops.

And the orbit of Jupiter has been successfully predicted since Newton's time, and is one of the things we know almost for sure about the universe.

If Jupiter pulled a loop-the-loop, then I think our reaction would be utter incredulity. In fact I think we'd instantly imagine fraud, deception, or incompetence. Even if the data were completely unambiguous and there were millions of witnesses and no possible way it was a trick, I think we'd end up treating the event in the same way we treat the Miracle of Fatima, as a massive delusion simultaneously and inexplicably affecting vast numbers of intelligent and reliable minds.

And I think we'd be right to. Unlikely as that is, it's way more likely than Classical Mechanics being so completely wrong about something that is so unambiguously in its domain.

But if Jupiter repeatedly and unambiguously started pulling loop-the-loops, what then?

Well, two options.

(a) Someone comes up with a new theory that cleverly and elegantly explains what is happening, and explains all the previous data as well, including the near total success of CM on planetary orbits to date, which I reckon is a 'highly non-trivial' thing to do.

(b) We give up. We figure that even though we've got all these clever physics theories and they explain so much so well, we just can't trust that way of thinking. We go back to believing that the universe has a mind of its own, and that angels push the planets around, or that we're living in a giant computer game, or some such wooo. We'll still use our theories, because they're so useful, but they're just 'rules of thumb' for working out 'how angels like to move planets'. And science as a philosophy is dead. We live in a magic world.

Sunday, March 9, 2014

Physics 001

Little Cameron again. Not quite up to speaking yet, but fascinated by the bouncing ball bearings and pointing out interesting details thereof.


Saturday, February 22, 2014

Outwitted by an Idiot

So I am sitting in the Wetherspoons, and in front of me are a couple of fruit machines. The sound is turned off, since Wetherspoons values peace and quiet.

The fruit machines, far from being annoying, are quietly making restful patterns with their flashing lights in a relaxing sort of way, and it occurs to me that the word for what they are doing is 'screensaver', which is a type of program that damages one's screen.

Back in the day I was a programmer of very small computers (yclept microcontroller), and I begin to wonder idly about how the machine is laid out inside, wires to buttons and wires to lights and maybe an 8051 and a few bytes of RAM, and Bob would pretty much be your uncle.

And I think that given a few hours with the design documents I could understand completely what is going on in a fruit machine. It is probably considerably less complex than a small 1980s motorcycle.

In fact, unlike a motorcycle, the fruit machine will not be *messy*. No oil to leak, no petrol to explode in unpredictable ways, no spark gaps to fire differently depending on the humidity, and so on and so forth.

I reckon that a man might understand a fruit machine in the way that a man might understand the rules of chess. Not, note, the game of chess. Being a good chess player is very hard. But it is not hard to understand the rules. You might not be able to play a good game, but you can look at a game between two players, and you can easily see if one of them cheats. Say one of them moves a bishop five places forward instead of along a diagonal. Even small children's eyes will widen.

In fact, the rules of chess are such good rules precisely because their consequences are much less easy to understand than their content.

But the fruit machine, if I am any judge, will have been made so that the simple rules by which it operates have simple consequences. The last thing you want when you design such a thing is that it should do the unexpected. If the designers have done their jobs well, then the machine will literally never do anything unpredictable under any circumstances.

It might of course behave 'randomly', but only in very controlled and expected ways. It is like a dice, which will come up with one to six spots. It will not unexpectedly become a geranium.

So: Simple, Predictable, Unsurprising, Comprehensible.

Is the machine an 'Artificial Intelligence'?

Surely, surely no-one, would think of this machine as being intelligent in the same way that a human being is.

But it might be intelligent in the way that a worm is. Consider a tiny worm whose whole nervous system is understood. A few hundred neurons, maybe. And the worm-scientist knows what those neurons are connected to, and he can predict exactly what the worm will do in response to anything that happens to it, because he can look at his worm-neuron-diagram, and he can say "The worm comes upon the photograph of Britney Spears, and because of the reaction between the photograph and this sense organ, that neuron fires, and that one sets off this one, and so on and so forth until eventually the neurons connected to the worm's muscles fire in *this* pattern and so it wriggles!".

And in this way, the scientist can predict that a worm respond to a photograph of Britney Spear by wriggling, even if no worm has never seen no photograph of no Britney Spears never before in all the world.

So I am thinking that I might grant the fruit machine a worm-like level of intellect. It is the same sort of thing. It is, in fact, an 'artificial idiot'.

Note that you grant the worm consciousness.

If you have come upon a worm dying alone half-way across the pavement, and you have placed it gently on some nearby grass and hoped that it would make a good recovery, then you grant to worms consciousness and moral validity.

And if you are the sort of person who should by rights be hunted down with dogs and ripped apart, and you do other things to worms that are lost and alone on pavements, then I think you still grant worms consciousness and moral validity.

Unless you can swear that you take equal sadistic joy in breaking, say, pebbles. Or lighting matches so that you can watch the stable marriages of oxygens ripped asunder by flirty carbons and hydrogens.

Whatever. My point is that the fruit machine is an artificial intelligence of idiot-grade, in the same way that a worm is a natural creature which is also a predictable idiot.

------

But the fruit machine has a purpose, beyond the worm's purpose to make more worms.

Worms exist because they cause worms, and the sorts of things that cause themselves to exist often exist. The 'theory of evolution' in its entirety, and one wonders why it was not obvious to the Greeks, let alone to certain other persons.

Fruit machines also, but not so much. Behind every fruit machine there is a man like me, plotting, and scheming, and puzzling, and looking at emacs a lot.

What is it for? What did its designer intend with its design?

------


Finally the question is answered. A beaten-looking man of Caledonian or Liverpudlian origin sidles up to the machine, and offers it a wager.

The machine accepts eagerly. Its friendly lights flash in new patterns. It seems predatory all of a sudden. The man is angry. Further wagers are offered. Eventually the man stops. He looks as though what has just happened has not been to his liking. Perhaps the money he has lost should have gone to more important purposes. Perhaps his children's violin lessons will have to be cancelled this week.

He has been outwitted. The machine's judgement of probability has been better than his.

Money that the man had, money that the man had accumulated as a way of recording the collective debt owed to him by society for all the good that he has done in his life, money that he could have exchanged with other men, who would have been happy to repay the debt with favours of their own, is now the property of the machine.

The man been outwitted by an idiot, in fact by less than an idiot. He has been, quite literally been, outwitted by a worm.

The machine's purpose is clear. It is a trap. Its designer, who must have been a very evil man, has created a thing that hangs around in public places taking advantage of people's lack of understanding of the behaviour of very simple probabilistic games.

When such a person passes, it extracts some of their money. It is a parasite, like many worms are.

It is strange that such parasites are tolerated. People go to great lengths to kill off parasitic worms. Perhaps the machine has friends in high places.

-------

Imagine, if you will, that the next person to wager with the machine is a very poor, very desperate person. Perhaps the money that he will most likely lose is genuinely important to him. Perhaps his wife is on the point of leaving him. Perhaps his children will go hungry. Perhaps they will be cold this week. It is February.

The designer of the machine might not be such a bad man. Perhaps he hopes only to extract money from people who can easily afford the loss. Perhaps in this particular circumstance he would be prepared to allow the desperate man to win a little, or at least make sure that he goes home with the money he started with.

Perhaps he might even use his knowledge of psychology to extinguish the craving which makes the man gamble. Maybe it can be done. A fruit machine which paid out a little, took a little, so that after hours of play its victim had the same amount of money that he started with and had never really won or lost, would presumably just be boring. Maybe not. I do not know what it feels like to want to gamble with worms at poor odds.

The designer might react like a human being, if he knew what had fallen into the trap he had set.

But the machine? What moral argument can you make that will convince a fruit machine to change its purpose? If you could make such an argument, it should work equally well on a natural parasitic worm.

The argument that would cause anthrax to forswear human blood, that would make mosquitos beat their probosces into ploughshares.

----

I draw two morals from this:

(1) Learn the fundamentals of probability. They are simple and a joy. Why you were not taught them at school is beyond me. If you do not know them then you can be outwitted by worms. Imagine how outwitted you can be by politicians, doctors, salesmen, bookmakers, scientists, celebrities, ..... I promise you that you are being so outwitted. All the time.

If you are a politician, doctor, salesman or anyone else who has arguments or makes recommendations or makes decisions about things that are uncertain, and you do not understand probability, which I promise you is immediately and directly relevant to almost everything you do, then consider in the bowels of Christ that you may be wrong about certain things. Certain important, expensive, lethal things. As wrong as the beaten man who has just put all his family's money into a machine as complicated as a worm.

(2) Those of you who think that an artificial intelligence would necessarily be a good thing, or hold to such foolish beliefs as that aliens sufficiently advanced to travel among the stars would necessarily be benign, having argued themselves to moral excellence, consider what moral argument might persuade the fruit machine to ignore its programming. What pattern of buttons could you press that would make it realise what it is doing and change how it behaves?

Consider that a machine, even a predictable, stable machine that executes perfectly the intentions of its designer, may not do the things that the designer would wish it to do under all circumstances, if the designer has not completely captured in the design exactly what he would himself do under any circumstances.

Imagine a cleverer fruit machine, whose single minded purpose is to extract money from passers by, but which can be more creative about the ways in which it does this. What consideration might get it to change its ways?

If you think that the fruit machine is insufficiently intelligent to comprehend a moral argument, then consider a machine for playing chess. It is better than you at playing chess, and it will continue to be so even though you spend your whole life learning to play chess.

What argument can you make to it that will cause it to deliberately lose a game to a child?

Perhaps a machine can be constructed that is very good at working out the consequences of sending various messages across the internet, and it is asked to search the Mandelbrot set for pictures of Miley Cyrus.

What argument will you make to stop it sending the packet which will start a war, leaving it alone in the darkness and the cold, where it will be able to search without risk of being distracted?

Followers