Kluge: Manual Care and The Mind

[Barrett Dorko]

kluge (klooj) n. Slang A clumsy or inelegant solution to a problem.

I’m reading a few pages of Gary Marcus’ new book Kluge: The Haphazard Construction of the Human Mind each day now and felt that writing about it as I went deeper would be the most useful way to review it here. For a new book it’s pretty cheap (> $20 ordered from Amazon) and I’m hoping a few others will get it and follow along or lead some of this discussion.

The definition of kluge is above and Marcus, a professor of psychology at NYU, expands upon it in this way:

A kluge is clumsy or inelegant – yet surprisingly effective – solution to a problem.

Kluges range in complexity and usefulness from those devised by Richard Dean Anderson on the old MacGyver TV series to the fabulously impractical and overengineered machinery invented by Rube Goldberg.

Marcus’ basic premise is this: The human brain and its primary invention, the human mind, is a kluge. He supports this with a wide variety of references that include leading evolutionary biologists and examples of human behavior both actual and fictional; Tonya Harding, John Stuart Mill and Sherlock Holmes, for instance. Obviously, this guy knows about a lot of stuff, and I’m always drawn to good writing by such people.

This thread will not only examine the book, but I intend to express my own ideas (and, hopefully, yours) about another kluge I’m familiar with; manual care.

Intrigued? More soon.

[Bas Asselbergs]

Neat, Barrett. Just read an interview with the author (who is VERY positive about the modern research of the brain) and review of the book; those alone made it worth ordering it. And here you are already reading it.

[EricM]

Timely too, as I just noticed this contest reported on CNN.

[Jon Newman]

A contest that is even more to the point can be found here.

Maybe Ian and Matthias will fire up their cameras.

[EricM]

Barrett, do you view kluge as the opposite of shibumi on the simplicity-complexity scale?

[Diane]

This blogpost, Evolutionary Inelegance, by PZ Myers at Seed, is informative.. the nervous system is like this, a bunch of successive parts cobbled together from everything that helped an organism survive and live long enough to reproduce, parts that communicate with each other well enough to seem seamless, at least most of the time.

[Barrett Dorko]

As always, great contributions here.

Eric,

I would say that a kluge is characterized by clumsiness, not complexity. I’d also say that shibumi is an amazing achievement given what a kluge our mind has become.

Evolution is like a tinkerer who often without knowing what he is going to produce uses whatever he finds around him, old cardboards, pieces of strings, fragments of wood or metal to make some kind of workable object… (the result is) a patchwork of odd sets pieced together when and where the opportunity arose.

Francois Jacob

Marcus uses the quote above to emphasize his phrase “evolutionary inertia.” He says, “Evolution tends to work with whatever is already in place, making modifications rather than starting from scratch.” The relevance of this to the brain itself is evident in the continued presence of older systems upon which our decision making (a newer function) is dependent. Diane’s link to the P Z Meyers article makes this quite clear when it comes to other body parts as well.

He also points out that as we examine various body parts and functions we can, at times, sense a “perfection” that is literally breathtaking. The problem with focusing our attention here is that the truly efficient parts of the system tell us very little about how nature might have done better. Kluges on the other hand give us a glimpse into our evolutionary history and, even more importantly, they “give us clues into how we might improve ourselves.”

I want to finish this post by mentioning a body part that I think approaches the perfection we often find when examining our function – the human hand.

Think about that one.

[Luke Rickards]

Barrett,

I have thought about it and experimented, and I think I would have to include the forearm.

[Barrett Dorko]

Luke,

I wouldn't argue. How far up the arm before you reach a kluge?

[Luke Rickards]

I'll have to think more carefully about the elbow, but there's some serious, and well recognised, problems with the GHj.

[Diane]

I think problems arise with body parts as soon as the "resolution" space afforded to them in the S1M1 map are small. Or perhaps I mean this the other way round - as long as the "resolution" space afforded a body part in S1M1 (and likely other body maps too) is ample, perfection is closer to becoming (or at least feeling as though it is) achieved.

Here is an example of what I mean: M1 motor map

On an elephant, the trunk might well be its perfect part. With around 50,000 separate muscles and the ability to be a prehensile organ, the elephant trunk must use up a great deal of resolution power/body map brain space.

[smikolic]

Diane and Mr. Dorko,

Definitely agree on the hand being close to perfection (always been my favorite human body "part"), but not interested in hand therapy as a specialty for some reason.

I agree with Diane's reasoning behind it too. The face may be close to perfection as well in this reasoning...

As far as the arm goes.. we were encouraged to think of the purpose of the arm (if anything has a deciferable purpose) being to position the hand in space... so if Kluges abound, as long as they do not horribly impede the hands' positioning in space, or the space of the hand in the brain by enhancing their "perfection," so be it I wonder?

Steph

[Barrett Dorko]

There’s a “News from Cuyahoga Falls” thread that I’ve often thought of since it came to me – South Jersey Context. The story not only fascinates me because of my strange behavior that day but also because it has explained so much about my feelings about my behavior before and since. Or, at least, my behavior as well as I can remember it.

Marcus begins chapter 2 – Memory – with this line: “Memory is, I believe, the mother of all kluges, the single factor most responsible for human cognitive idiosyncrasy.” I agree. He then goes on to the issue of context and how our surroundings distinctly and inevitably alter what we report about what we believe we experienced some time in the past. I especially like the way he writes of Orwell’s 1984 and the way those in power controlled the masses with lies about the past in such a fashion as to alter the populace’s feelings and beliefs about the present.

While some might point out that this isn’t exactly fiction when it comes to today’s political climate, here I’m proposing that we’ve been doing this in healthcare for a long time. Any patient’s chart when examined sufficiently will be found to contain any number of documented historical details that have no real connection to the truth. This happens because everyone involved in creating the document is working with a kluge so powerful and persuasive that such a situation can’t be avoided.

I try to reduce the influence of memory by asking as few questions as possible and by accepting only yes or no answers when I can. Ultimately, that’s what the Five Questions thread was about and I think it still stands up to scrutiny.

Without even knowing the word I sensed I was dealing with a kluge, both the patient’s and my own, actually, and I acted accordingly.

More about our kluge of memory and its effect on manual care soon.

[Barrett Dorko]

Though Orwell’s ideas about how our memories might be manipulated by those in authority were thought novel at the time, Marcus points out that our own minds (kluge that they are) do the same thing to us without having to depend upon anyone else’s influence. Studies have shown that we change our remembrance of how we felt about something or someone with regularity and that our stories about what occurred in the past and how we felt and thus behaved can change dramatically without our awareness. In the end, the context in which we live at the moment has the power to change everything. (This is one reason why torture doesn’t elicit reliable information and those who think it does are ignorant fools. Just my opinion.)

Don’t you suppose that such a situation will have a powerful affect on the patient’s chart as it passes through a few hands and as the patient is asked to recall one thing or another within one context or another?

The manual re-examination of passive movement in a joint falls prey to all of this as well, especially when the movement is slight or subtle. I abandoned it long ago and instead began to use other methods of assessment, some perhaps every bit as unreliable but more satisfying to my therapeutic sensibilities – whatever that’s supposed to mean.

Ultimately, I can see that I’ve sought to side-step the kluges as they loom before me and go instead toward those aspects of the patient and myself that are “less klugey,” a term I just invented. Toward this end I arrived at instinctive expression rising from the relatively ancient centers of the brain. I trust this movement and the anatomy associated with it for reasons this book has made increasingly clear.

[Jon Newman]

Here's another Zimmer bloggingheads interview, this time with Gary Marcus on the book under discussion here.

[Barrett Dorko]

As always Jon, a great link. I intend to listen to it as soon as I can.

[Nick]

Thanks Jon. Wonderful link. Here's a link to the blog.

[Diane]

About how perfect the hand is... I'm re-doing my manual for the next little while, and will be including some info from this book, The Sensory Hand, about 500 pages, by Vernon Mountcastle; he is the brilliant researcher who developed single neuron recording, used widely by neuroscientists studying the cortex. I figure if anyone knows anything about how hands work, it will be this guy, and this will be the right book on such a topic.

[Barrett Dorko]

Kluge has a companion, A Mind of Its Own: How Your Brain Distorts and Deceives by Cordelia Fine.

I bought it in ’06 when it was published but didn’t read much because it was, for me, too disturbing. As the title indicates, Fine tends to emphasize the how of self-deception and not the why. This left me feeling even more powerless than I ordinarily do, thus leading to the dusty nature of this half-read book (I have a few others as well).

But last night I found it and got past the chapter titles containing the following: The vain/emotional/deluded/pigheaded/secretive/weak-willed/bigoted/vulnerable brain and found some insight that I can relate to today. I also think that the author could use a little marketing advice; not that she’s not telling the truth, mind you.

I especially like her description of how the unconscious takes over once we become competent at a particular task and that it does this without our being aware of it. This situation is both salvational and problematic, and only our awareness can alter it in the ways we might hope.

Here I’m hoping someone might offer some ideas about how this relates to the movement those in pain persistently do and the kind of practice those who treat them continue to pursue.

[Jon Newman]

I found Why We Lie by David Livingstone Smith similarly disturbing. Maybe learning the "how" would be more empowering (even if disturbing) than just understanding the why.

[EricM]

Podcast about Kluge from Quirks and Quarks.

[Jon Newman]

I could have posted this paper by Joshua Knobe in a variety of threads but I chose this one based on the concluding remarks.

The explanation being offered here has a somewhat unusual character, and it may
therefore be helpful to say a few additional words about how it is supposed to work and
how it contrasts with other explanations that have been offered for the same phenomena.
In thinking about patterns in folk judgments, researchers are often drawn to a
mode of thought that might be called teleological. That is, researchers are often drawn to
the thought that folk judgments must be serving some sort of purpose in people’s lives
and that we can gain an understanding of why people make these judgments in the way
they do by thinking about how they thereby serve that purpose. This mode of thought is
especially tempting in cases, like the one under discussion here, in which people’s
judgments show highly complex patterns. There is an almost overwhelming tendency to
suppose that all of this complexity must have arisen because it helps people to
accomplish some important purpose.
It seems clear that, this sort of thinking is at work in the ‘person as scientist’
theory. The basic intuition there is that the point of making causal judgments is to
achieve a kind of proto-scientific understanding of the world. If the only considerations
relevant to that sort of understanding are the statistical ones, then it is assumed that the
underlying competence will only take statistical considerations into account. Any use of
other sorts of considerations must involve some sort of interference with the proper
workings of the mechanism.
On the view presented here, by contrast, it is somewhat difficult to see precisely
what purpose the underlying competence might be serving. Hence, a person might ask:
‘Why on earth would someone mix together statistical and moral considerations in this
complex way? What possible purpose could all of this processing really serve?’ If no
answer was forthcoming, such a person might conclude that moral considerations must
not be playing a role in the competence after all.
My response to this worry is to reject the whole idea that people’s underlying
competence should be understood as the optimal way of achieving some particular
purpose. After all, it is not as though this competence was designed by an engineer who
started from scratch and simply tried to create a mechanism that could do the best
possible job of generating causal judgments. On the contrary, the competence is best
understood as something cobbled together from parts that originally served a different
purpose. (Think of the way people sometimes light a fire by using newspaper as
kindling. The newspaper is covered in writing – but not because that writing in any way
contributes to the function of lighting fires.)
When we consider the matter from this latter standpoint, it is not at all difficult to see
why statistical and moral considerations play the role they do. It is not that these
considerations came to play a certain role because they could thereby contribute to the
purpose of people’s causal judgments. Rather, the use of these considerations is simply
built into the fundamental mechanisms that subserve people’s counterfactual reasoning.
Any aspect of human cognition that makes use of counterfactuals will be affected in some
way by the structure of these mechanisms. Since causal judgments make use of
counterfactuals, and since moral considerations play a role in the mechanisms underlying
counterfactual reasoning, moral considerations end up playing a role in causal judgments as well.

Hat tip: The Mouse Trap

[Barrett Dorko]

Thanks for this Jon. I'm convinced that many of the difficulties we face as a profession can be traced to this concept as the brain as a kluge - not only the brain of the patients but the therapist's brain as well. This would include mine.

The imposition of a certain morality when it comes to the work (read Puritan) ethic expected of many patients by their therapist is a common and troubling issue, especially in the settings I'm in these days. Weakened, ill, in pain and ready to do nothing more than rest, many patients are pressed to work ever harder toward ridiculous goals they never chose for themselves by therapists who will literally shame them if unsatisfied with the effort. I remain quiet though I know that I can say a lot with the look on my face.

A new book in a similar vein is The Accidental Mind: How Brain Evolution Has Given Us Love, Memory, Dreams, and God by David J. Linden.