When Life Imitates Art Imitates Digital Health

You know how they say life imitates art and, also that art  imitates life?  Well, I have recently seen a great example of both: the Netflix movie “Don’t Look Up” demonstrates this concept to perfection.

For those who haven’t seen the movie, it’s about what might happen if a giant asteroid were headed towards the earth and how different people would handle the anticipation and the outcome.  The basic questions contemplated in the movie, among other, are:  Would people be able to acknowledge it? What could be done about it? What’s more powerful – science or technology and are they the same?  Would FOX News still be broadcasting even if the earth was crushed by an asteroid? You know, the usual stuff.

The movie, and if you haven’t seen it, spoiler alert!, is about many things that imperil earth, actually.  It’s about the potential clash of meteor and planet, but also about the culture clash of society and technology and the weird as hell clash between science and politics.  Sound familiar?  It’s a real barn-burner of art-imitates-life-imitates art. It’s also a bit scary in a “yikes this feels too real” kind of way and also hilariously funny in a “I may go to hell for laughing at this” kind of way.

In case you think meteorite risk isn’t one you have to worry about, you’re apparently wrong.  In an glaring example of reality, there have been numerous actual stories in my news feed lately about large objects hurtling towards earth.  One flew right past Pittsburgh.

Another one zinged over the UK, drawing, for a moment, everyone’s eyes off Boris Johnson’s party plans.

On January 18^th, a monster meteor – bigger than the Empire State Building, went flying by. According to NASA, it wasn’t too close a call, but it was close enough to get noticed by the scientists that stare skyward and worry on our collective behalf.

Because of these threats, NASA is developing a spacecraft known as DART that will be deployed to deliberately crash into threatening asteroids with a goal of changing their trajectory.  (spoiler alert – if you haven’t seen the movie, you may want to skip the rest of the article).

In other words, DART is seeking to test whether it could change the ending to the Don’t Look Up movie.  This is actually truth, by the way. And this is where the line between art and science gets hard to discern.

Which brings us back to why I wanted to write here about the movie.  There is a character in the film, Dr. Peter Isherwell, an emotionally disconnected billionaire technologist who traffics in space travel, is a major conservative political donor and who gets tapped to build robots to launch into space to take out the threatening meteor.  If you haven’t guessed who this guy is modeled after, you probably have been hiding in a barrel the last few years.

What really struck my funny bone about the movie was not Isherwell’s robots, but his phone-based AI system.  It purports to know everything there is to know about your state of health, state of mind and likely demise long before you do.  And to me, it was so very digital health 2022.  I could barely think about the asteroid as I giggled about how our current digital health hype was playing out on screen.  The word “algorithm” features heavily in the movie, which is not typical for a Meryl Streep vehicle.  Granted, Jonah Hill, who stars as her son, trafficked in algorithms when he starred in Money Ball, but this is a whole different level of AI.  Jonah Hill is, by the way, the funniest part of the movie, full stop.

As those of us who follow the current health tech tsunami know, at least $5 billion zillion dollars has been invested in mental health-related digital first companies in the last 3 minutes, er, I mean years.  Isherwell’s BASH Liif product has got them all beat (motto:  Life without the stress of living).  Isherwell notes that his ”life’s work has been driven by the inexpressible need for a friend who would understand and soothe me,” which is no surprise given his personality in the movie.  Thus he creates the perfect companion: the BASH Liif 14.3 phone.

“By just having the phone on your person,” Isherwell says, “it fully integrates into your every feeling and desire without you needing to say one single word –  if I feel sad, afraid or alone, the 14.3 Set-To-Life setting instantly senses my mood through blood pressure, heartbeat…”  For me, the best part of this scene is how the screen shot of the product’s dashboard shows all sorts of metrics that would have quantified-selfers shivering with delight: glutamate and dopamine levels, mood metrics – the works!

Here’s what the algorithm tells Isherwell: “Your vitals show that you are sad.  This will cheer you up.”  And with that, the phone automatically sends Isherwell a quick Tik Tok video of an adorable puppy riding on the back of a rooster saying “you are my best friend.”

http://www.youtube.com/watch?v=calxvvSuDx8

Notably, Isherwell points out, the help doesn’t end there.  It also schedules a therapy session with a nearby professional to make sure the sad feelings never ever return. I swear I have read some digital mental health business plans that read not too far from this set of claims.  I am not sure if the rooster is getting click fees or is in a shared revenue arrangement with Isherwell, but at this point nothing would surprise me.

To put an even finer point on it, Isherwell speaks of his predictive modeling prowess.  There’s a great scene where he is challenged by an actual scientist, played by Leonardo DiCaprio in a tweed jacket to make him look science-y rather than Titanic-y.  Referring to Isherwell’s development of robots to take out the potential earth-killing asteroid, DiCaprio’s Dr. Mindy character says, “I just want to make sure you’re open to scientific peer review and not approaching this project as a businessman.” Oh, irony!  How I love thee!

https://www.youtube.com/watch?v=r-VjkVDbmDI

And rather than respond directly by saying, “sure, peer review me baby,” Isherwell goes into a rant that concludes with, “Do you know that BASH has over 40 million datapoints on you and every decision you have made since 1994?  I know when you have colon polyps months before your doctor does- you have 4-5 of them at the moment. They aren’t of concern but I’d check with your doctor as soon as you can.”  He goes on to say, “Our algorithms can even predict how you’ll die within 5% accuracy – I looked you up when we met.  Your death was so unremarkable and boring – I can’t remember details but I can remember one thing – you’re going to die alone.”

http://www.youtube.com/watch?v=QD3FEFCf_o8

It’s suggested by the scene that Isherwell is being rude to Dr. Mindy because he is offended; Isherwell stands by his work, peer review be damned. But of course, the real truth is that he doesn’t want to be challenged, so he is convincing as a few too many health tech CEOs 🙂

Isherwell also predicts that the President of the US, played by Merrill Streep, will die from being eaten by a Bronterac, to which he adds, “I don’t even know what that means.”

And then you come to realize that Isherwell may be a jerk, but he may also be pretty good at the technology stuff, at least sometimes. Hell, even a broken clock is accurate twice a day, as they say. And in the best movie ending in years, we find out whether his death prediction algorithms were right all of the time, some of the time, or never.  Inkeeping with our field, I bet you can guess that the answer is….the middle one.

Because I live in the world of predictive/prescriptive analytics and engage every day with people who flaunt their algorithms like people used to flaunt jewelry, I was howling laughing during these scenes.  They were way too close to real life – especially the unwavering commitment to product promotion without evidence, and the unabashed claims by some that their product is, for all intents and purposes, a healthcare “easy button” that will solve all of life’s deep dark problems with the flick of a keypad.

But then again, there are some people who really do the hard work in this field and show us that there is an occasional pony in the this tech-enabled pile of healthcare crap – sometimes it can actually do what it’s supposed to do.  Some in the field are committed to actual science and, even, peer review!  A few have even gone to the trouble of real clinical trials, comparing their product to the so-called gold standard and living to tell about it.  As a result, current phones and tablets may not quite be able to figure out how you’re going to die in 20,000 years, but they may soon be able to give you the high sign when you should call your doctor about those potential polyps or be able to deliver targeted digital treatment without resorting to chemistry, even if no insurance company intends to cover it.

I guess it’s the promise of the real that keeps us going in this health tech field, even when the delivery of the goofy takes up way too much mind space.  And the tenuous but very live connection between the real and the goofy is captured beautifully in the art of Don’t Look Up.

FYI: beware of Bronteracs.