Anomalisa and Medicine

The Movie: Anomalisa

I was lucky enough to preview the movie Anomalisa early this month. I urge any adult who is interested in how our modern economy changes us to go and see it. Adult because it does have explicit sex scenes albeit with stop-motion animation, nevertheless it is sex that is so honestly portrayed that parents should be cautioned. 

  This movie gave voice to much of my dissatisfaction with modern living. In this case by modern living, I mean dealing with large businesses or organizations and the commodification of friendship. Obviously the big bad they have not been able to bribe or blackmail my actual friends into being false friends. However they have clearly infected every single sales or customer service rep with a virus causing them to imitate friendship. In a similar way casual games have been set up expressly to seduce me into one more level or more disturbingly into one more hidden object scene. There now my ugly secret is revealed.

So go, now, see Anomalisa, do not stop at go, don't wait til you have $200, go now to your local art movie theater and see Anomalisa. While you still can.

And Medicine

  So what has this got to do with medicine? Now that I am no longer a practicing doctor, I can express my dismay about what I will call algorithmic medicine. I was thinking about this quite intensely after seeing the film and attempted to put it all into words. My efforts were not pleasing.

  Then I saw an article in the New England Journal of Medicine (Jan. 14 2016, pp. 109-111). It compared industrial efficiency (aka Cheaper by the Dozen's Taylor) to the push to electronic medical records and a number of other regulations recently imposed on doctors.  Most of the comments about the article were outraged rants about how LEAN and six-sigma efficiency practices had been misrepresented. Yet for those outside of a hospital administrator setting, there is no real opportunity to give feedback, "Hey medicare! This isn't working for me, or for patients x, y and z." I mean there is opportunity, complaints, protests, appearing before committees and so forth, but not immediate, actionable opportunity.

  In brief, this is the message. Efficiency experts and pursuers of lowered health costs are trying to turn physicians and other health professionals into robots who churn through check-lists and algorithms to provide the best care that evidence-based medicine can provide. The problem is that people are not identical, neither physicians nor patients are robots with the same instruction and repair manuals. We are each wonderfully, fearfully made with our own amazing uniqueness as well as our common humanity. Let us never forget that. 

  Now go, see Anomalisa!