Author: GETAWAYTHEBERKSHIRES

Home / Author: GETAWAYTHEBERKSHIRES

Happy gnu year, and welcome back to The Monitor, WIRED's roundup of the latest in the world of culture, from box-office tallies to casting news. In today's installment: A final look at the money-making movie titans of 2018; Coachella announces its headliners for 2019; and a reminder that Hollywood is still an institutionally corrupt patriarchy struggling to keep up with the times!

Ticket Masters

The box office reached an all-time high in 2018, earning nearly $12 billion in revenue in the United States alone—and eclipsing a previous record set in 2016. Last year's big winner, not surprisingly, was Disney, which released 2018's three top-grossing films—Black Panther, Avengers: Infinity War, and Incredibles 2—as well as Ant-Man and the Wasp and, uh, Solo. Overseas, foreign box office totals were also up over the previous year, reaching nearly $30 billion, thanks in no small part to such worldwide smashes as Venom and Bohemian Rhapsody. And though an official tally for attendance isn't available yet, it's expected that the number of North American ticket-buyers in 2018 increased as well—which is good news for 2019. However, a different new data set is far less optimistic about the state of the industry…

Hollywood's Gender Disparity

A new study by San Diego State University's Center for the Study of Women in Television and Film finds that, despite increased coverage and awareness of Hollywood's woefully out-of-whack approach to gender equality, women are still underrepresented in filmmaking. The study notes that 20 percent of 2018's top 250 films featured women in roles characterized as "above-the-line"—an admittedly imperfect term used to describe the work of directors, writers, producers, and other key creatives. That number is up slightly from 2017, but it still amounts to "radical underrepresentation", according to Martha Lauzen, the study's author, who notes that, without equally radical steps to correct the issue, "we are unlikely to see meaningful change."

Coachella Gets a Grande Lineup

Coachella released the lineup for its April festival on Thursday, and this year the multi-weekend gathering will be headlined by Childish Gambino, Ariana Grande, and Tame Impala. (There are also reports that Kanye West was going to land a top-billed spot, but that negotiations broke down when the festival's organizers wouldn't let him mess with the design of the desert venue's main stage. Perhaps he wanted all of the lights on at once?) Also on the lineup: Solange Knowles, Bad Bunny, the 1975, and Kacey Musgraves, among 2,386 others. Sadly, neither One of Pig nor Smushy Twin made the cut.

It took a while, but Russia finally got body-checked out of the Olympic Games. The road to ruin began in 2015, when two Russian track athletes-turned-whistleblowers raised suspicion about widespread state-sponsored doping at the 2012 London Games, followed by an independent report about problems at the 2014 Sochi Winter Olympics. Now, the International Olympic Committee has slammed the door on Russia's Olympic dreams, accusing the country of running a state-sponsored program involving more than a thousand athletes since 2011. The Russian team and all of its sports officials were banned from the upcoming winter games in PyeongChang, South Korea, in February, although individual Russian athletes who prove they are clean could compete under a neutral flag.

IOC president Thomas Bach announced the ban at a press conference in Lausanne, Switzerland Tuesday, citing a 17-month investigative report by Samuel Schmid, Switzerland’s former president. “The report clearly lays out an unprecedented attack on the integrity of the Olympic games and sport,” Bach said. “As an athlete myself, I’m feeling very sorry for all the clean athletes who have suffered from this manipulation.”

Despite the earlier warnings of Russian foul play, Bach said Tuesday the IOC didn’t have all the information needed back then to make its decision. The Schmid report detailed the structure of the Russian sports bureaucracy and how it is intertwined with the Russian government. It also gave interesting details about how Russian intelligence agents were able to unlock tamper-proof urine sample bottles—using a dental instrument and a lot of hard work.

Swiss forensic investigators spent two months to unlock the secrets of the supposedly impregnable BEREG-KIT bottles. These Swiss-made bottles are considered tight after five clicks of the sealing ring, with a maximum closure of 15 clicks. But by using a long, thin pointy metal instrument, the investigators were able to jimmy open the seal by carefully inserting it into the plastic ring and pushing it up. The process left tiny scratches on the inside of the bottle—though they were only visible under a microscope. That's how they were able to identify tampering in the Sochi samples.

More than a quarter of the Russian urine samples were likely tainted or swapped out with clean urine collected from the same athletes months earlier. The report also found that suspect Russian urine samples contained high levels of salt, several times higher than found in the human body, which was used to reconstitute the urine.

The Russians didn’t invent any new performance enhancing drugs for Sochi. “They just bought them from the pharmacy,” says Mark Johnson, a San Diego-based author who has written about doping in sports. “It shows that where when you take the resources of a government, both the scientific and financial resources and their research resources and apply it to a problem, they can find a solution,” Johnson says. “If it is one athlete trying to pry open a bottle, you can’t do it.”

The culture of doping in Russia and the Soviet Union goes back to the 1960s, when success in sports brought glory to the nation. Between 1968 and 2017, Russian athletes were stripped of 50 Olympic medals—including one third of their 33 won at the Sochi games.

The IOC’s Bach said that international athletes that finished behind the Russians who doped will have a special ceremony in South Korea. “We will do our best to reorganize ceremonies in PyeongChang in 2018 to try to made up for the moment they missed on the finish line or the podium,” Bach said. “The IOC will propose or will be taking measures for a more robust anti-doping system under [the World Anti-Doping Agency] so that something like this can not happen again.”

    More on the Olympics

  • Eric Niiler

    Olympic Drug Cops Will Scan for Genetically Modified Athletes

  • Chelsea Leu

    It’ll Be Really Hard to Test for Doping at the Rio Olympics

  • Emma Grey Ellis

    What Would Happen if the Olympics Banned Russia?

But Johnson and other critics are skeptical that the IOC’s Russia ban or a new testing system instituted will make a difference in future Olympic games. He notes that record-breaking athletic performance—regardless of whether it is the result of drugs, or perhaps soon through gene-editing techniques—is part of what draws TV viewers, advertisers, and national prestige.

“The objective of pro sports is to entertain and push the boundaries of performance, it’s not to be a moralistic teacher or imposer of values,” says Johnson. Of course, Olympic officials beg to differ. They point to the stated "Olympism" values of fair play, ethics. and hard work.

But sports and national prestige will always go together, and Russians have long since decided doping is worth the risk. Vitaly Murko, Russia’s former minister of sport, was implicated in having a direct role in the doping program by the Schmid report and an earlier 2015 investigation by WADA. On Tuesday, the IOC gave him a lifetime ban. But even though Murko can’t go to the Olympics, he won't be leaving sports behind. Now the country’s deputy prime minister, he is also president of the Russian football union—and next summer, he will be an official host of Russia’s World Cup soccer tournament.

Related Video

Sports

New Technology At The Olympics

This new technology is changing the Olympic Games.

Early on in Mortal Engines, the forthcoming movie based on Philip Reeve's book, a small Bavarian population gets consumed by the moving metropolis of "London." (The movie, like the book, is set in a future where roving "predator cities" ingest smaller towns for their resources.) As its citizens are forced to resettle in their new home, voices on loudspeakers tell them where to go and what to do. Most of the instructions are commonplace for authoritarian dystopias: stay in line, no weapons are allowed, etc. But then there's this one: "Be aware, children may be temporarily separated from parents."

The line wasn't always there—it wasn't in the book, or the original script. But earlier this year, as the Trump administration's zero-tolerance immigration policy led to detentions and child-separations at the southern US border, the loudspeaker announcement found its way in. The movie, says director Christian Rivers, isn't meant to be a "message film," but since it deals with life after a catastrophic war and the ever-repeating cycle of human nature, the line seemed fitting, and adding it amounted to little more than an extra voiceover.

Related Stories

"We thought it was worth making a little comment about that," says Peter Jackson, who produced the film and co-wrote the screenplay, referencing the "horrific" acts of American immigration authorities. "They’ve become the Child Catcher of Chitty Chitty Bang Bang, really."

That line may be the most politics-focused the film gets, but it's definitely not the only moment in Mortal Engines during which the past haunts the future. The premise is that a "60 Minute War" has ravaged Earth, destroying most of humanity, and their history along with it. The survivors have been left to roam in moving cities, looking for resources. What artifacts they've been able to recover from the 20th and 21st centuries don't offer many clues, other than the fact that people were consumed by TV, computers, and smartphones; the period is referred to in the film as the "Screen Age." (Also, based on large statues of the Minions, survivors think the Despicable Me characters might have been worshipped like gods.) Those things, like the immigration line, "make this futuristic world more relatable," Rivers says.

And audience relatability is important. Mortal Engines hits theaters on December 14, fighting for audience attention against films like Transformers flick Bumblebee and Spider-Man: Into the Spider-Verse. Not being a known franchise, and coming from a book series that doesn't have the following of The Lord of the Rings, it's got an uphill battle. "We're surrounded by franchise films or sequels or whatever—Aquaman and Mary Poppins Returns—and there's all this stuff surrounding us that's got pre-determined audiences," Jackson says. "We're this sort of little orphan film that no one knows anything about."

And just like that, humanity draws one step closer to the singularity, the moment when the machines grow so advanced that humans become obsolete: A robot has learned to autonomously assemble an Ikea chair without throwing anything or cursing the family dog.

Researchers report today in Science Robotics that they’ve used entirely off-the-shelf parts—two industrial robot arms with force sensors and a 3-D camera—to piece together one of those Stefan Ikea chairs we all had in college before it collapsed after two months of use. From planning to execution, it only took 20 minutes, compared to the human average of a lifetime of misery. It may all seem trivial, but this is in fact a big deal for robots, which struggle mightily to manipulate objects in a world built for human hands.

To start, the researchers give the pair of robot arms some basic instructions—like those cartoony illustrations, but in code. This piece goes first into this other piece, then this other, etc. Then they place the pieces in a random pattern front of the robots, which eyeball the wood with the 3-D camera. So the researchers give the robots a list of tasks, then the robots take it from there.

“What the robot does is to first figure out where exactly is the original position of the frame,” says engineer Quang-Cuong Pham of Nanyang Technological University in Singapore, “and then calculates the motion of the two arms automatically to go and grasp it and transport it.”

As one arm grasps, say, the back of the chair, the other arm picks up one of those infernal wooden pegs and tries inserting it into a hole at the joint. That 3-D camera only has an accuracy of a few millimeters, so the robot has to feel around. The robot makes swirling motions around the hole, and when it feels the force pattern change, it knows the peg has dropped in slightly, then will apply more force to fully insert the thing.

This, though, is where the robot tends to have problems. If it hasn’t scanned the hole accurately enough, it might start swirling too far away—all the way over the edge of the piece. “Then the changes in force pattern are the same, so it would think that it has found the hole and it would go and insert in the void,” says Pham.

Matters grow more complicated when the robot arms have to grip either end of a larger piece of the chair. Not only does each robot arm have to calculate its own grasping and lifting motion, but it has to do so in consideration of the other arm. Think if you grasped the ends of a baseball bat and swirled it around—each arm is restricted by the movements of the other.

The stakes are even higher for the robot because it’s making calculations as it’s eyeballing the pieces, and has to commit to the plan it works out. “If there is a small error, for example in the modeling of the object, then the arms would fight each other, pulling this direction and the other pulling in another direction,” says Pham. “If that happens the robot will break the object.”

The solution is the force sensors. “When we sense that the force is too much, then it would change the motion of the robot to accommodate the errors,” Pham adds.

Pretty impressive stuff, but the fact remains that the researchers have to do a good amount of hand-holding. "This is a nice result,” says UC Berkeley’s Ken Goldberg, who works in robotic manipulation. “The big challenge is to replace such carefully engineered special purpose programming with new approaches that could learn from demonstrations and/or self-learn to perform tasks like this."

Which is exactly what the researchers are now working on. The next level of autonomy could be something called imitation learning, in which a human either joysticks the robots to learn to do the tasks in the right sequence, or the robot watches the human do it and then mimics.

The ultimate goal? “The final level is we show the robot an image of the assembled chair and then it has to figure it out,” says Pham. “But I would envision this last step not in the next probably five or six years or so.”

This kind of advanced learning will be essential for robots going forward, because there’s just no way engineers can program them to manipulate every object they come across in the complicated world of humans. That means facing challenges including but not limited to bringing down the tyranny of flat-packed Ikea furniture.

Curse you, Stefan. Curse you.

More helpful robots

  • Over at UC Berkeley, engineers have taught Brett the robot to teach itself to master a children's game by failing over and over.

  • As far as imitation learning is concerned, a startup called Kindred is helping picker robots learn to manipulate products in fulfillment centers.

  • Journey inside the Panoptic Studio, which is giving robots the super senses necessary to explore our world.

Related Video

Science

How Brett the Robot is Learning by Failing

Brett, a robot at UC Berkeley, is learning to put a square peg in a square hole the same way that a child does. Slowly and with trial and error.

It's impossible for me to tell you whether you're going to like Kingdom Hearts III. I also can't tell you whether it's good. What I can say, though, is that it means something to me.

I still remember beating the first Kingdom Hearts. I remember being sick, home from school, my body aching as my fingers slid over the controller. I remember white winter light peeling in through my bedroom window. I remember that, at the time, I didn't actually own the game. It was rented, and I would insist my mom or grandmother check it back out from the video store for me every week.

Related Stories

Personal narratives about playing videogames are a little passé at this point, I know. So many people grew up playing videogames that almost everyone has a story like this. But Kingdom Hearts is a series that was there for me at the precise time I needed it, the exact presence I required in my life at that moment. Since age 11, the long, winding, bizarre Kingdom Hearts series has been with me. Playing the third numbered title, after all this time, isn't just playing another game. It’s a sort of homecoming.

For those who didn't spend their childhood with this series, a rough recap: Kingdom Hearts is primarily the story of Sora, an adventurous and happy young boy who teams up with Donald Duck and Goofy (yes, the Disney characters) to explore a universe full of isolated Disney-themed worlds in order to fight monsters and find their friends. It gets more complicated than that—indeed, over the course of nearly a dozen titles of various sizes since, it has gotten a lot, lot more complicated—but that's the core of it. Sora is just trying to help his friends in a vast, confusing world of anime villains, monsters born of pure darkness, and cartoon characters.

Something about it fascinated me on a deep, personal level. When I beat the original Kingdom Hearts, I wanted to know what happened to Sora next. I wanted to learn the fate of his brooding, long-haired rival/best friend, Riku. I was tantalized by the mysteries of the Keyblade, the magic sword/key hybrid that, yes, long-time Final Fantasy creative Tetsuya Nomura definitely came up with on his own.

So I joined an online message board for hardcore fans. We crafted stupid theories. We bonded. A series about the power of friendship, filtered through the lens of Japanese role-playing-game eccentricity, became a pathway to real friendships. I grew up, and my relationship to Kingdom Hearts changed, matured, and gained nuance, but those friendships remained. They influenced my choice of college. They helped develop me into a full person. I don't speak to those people much anymore, but their presence in my life fundamentally changed it and improved it.

I can't possibly separate Kingdom Hearts from what Kingdom Hearts has meant to me. But I can tell you a few things about Kingdom Hearts III. I can tell you that it manages to complete the story started in that original game in 2001 with the sort of goofy, nerdy elegance that's come to define the series, weaving together nearly two decades of complicated, insular plot lines to create moments of sincere, heartfelt connection between its impossible characters and their Disney friends.

I can also tell you that it feels great to play, the simplistic button-mashing of the earlier titles replaced by a system that resembles previous ones but transcends them, with transforming Keyblades and special moves meant to imitate Disney theme park rides that can be optionally sprinkled into the combat, making the player a sort of symphony conductor of brightly colored chaos.

And, like the other games, this one awkwardly mixes in levels that are recaps of Disney movies with an original plot that's like a Final Fantasy game if Final Fantasy was a series about the power of light and friendship. I can also report that, at one point, Elsa from Frozen sings "Let It Go" for its full runtime while Sora, Donald, and Goofy look on in awe, and I can tell you I laughed uncontrollably.

I can't tell you whether any of that will resonate with you. It might come off as unbearably twee, or naive, or confusing and poorly plotted. But for me, every moment, even the absolute dumbest, worked. It worked because of nostalgia, sure, and because of the sentimental connection I have with the series as a whole. I'm invested in these characters and the world they live in. But also because its thematic content, its ideas about friendship and hope and heroism, resonate. Kingdom Hearts III is a game about growing up, about facing tragedy and death and deciding, y’know what, screw that stuff, we have our friends and we're going to fight. It's willfully, thoughtlessly cheerful and straightforward, even in the bleakest circumstances. When I was a kid that seemed charming. Now, it seems vital, and playing Kingdom Hearts is an exercise in holding on to those optimistic parts of myself.

Sora is a hero who goes around talking about how his friends are his power, how together they can get through anything. I really, really want to believe him. Whether you like Kingdom Hearts III is largely going to be a matter of whether you want to believe him, too.

About 40 years ago, Louise Brown, the first human created using in vitro fertilization, was conceived in a petri dish. Not long after her birth, Leon Kass, a prominent biologist and ethicist at the University of Chicago, wrung his hands about the then-­revolutionary technology of joining sperm and egg outside the body. The mere existence of the baby girl, he wrote in an article, called into question “the idea of the humanness of our human life and the meaning of our embodiment, our sexual being, and our relation to ancestors and descendants.” The editors of Nova magazine suggested in vitro fertilization was “the biggest threat since the atom bomb.” The American Medical Association wanted to halt research altogether.

Yet a funny thing happened, or didn’t, in the decades that followed: Millions of babies were conceived using IVF. They were born healthy and perfectly normal babies, and they grew to become healthy and perfectly normal adults. Brown is one of them. She lives in Bristol, England, and works as a clerk for a sea freight company. She’s married and has two healthy boys. Everyone is doing fine.

Nothing so excites the forces of reaction and revolution like changes in human reproduction. When our ideas of sex are nudged aside by technologies, we become especially agitated. Some loathe the new possibilities and call for restrictions or bans; others claim untrammeled rights to the new thing. Eventually, almost everyone settles down, and the changes, no matter how implausible they once seemed, become part of who we are.

We are now on the brink of another revolution in reproduction, one that could make IVF look quaint. Through an emerging technology called in vitro gametogenesis (or IVG), scientists are learning how to convert adult human cells—taken perhaps from the inside of a cheek or from a piece of skin on the arm—into artificial gametes, lab-made eggs and sperm, that could be combined to create an embryo and then be implanted in a womb. For the infertile or people having trouble conceiving, it would be a huge breakthrough. Even adults with no sperm or eggs could conceivably become biological parents.

In the future, new kinds of families might become possible: a child could have a single biological parent because an individual could theoretically make both their own eggs and sperm; a same-sex couple could have a child who is biologically related to both of them; or a grieving widow might use fresh hair follicles from a dead spouse’s brush to have a child her late husband didn’t live to see.

At the same time, modern gene-editing technologies such as Crispr-Cas9 would make it relatively easy to repair, add,
or remove genes during the IVG process, eliminating diseases or conferring advantages that would ripple through a child’s genome. This all may sound like science fiction, but to those following the research, the combination of IVG and gene editing appears highly likely, if not inevitable. Eli Adashi, who was dean of medicine at Brown University and has written about the policy challenges of IVG, is astounded by what researchers have achieved so far. “It’s mind-boggling,” he says, although he cautions that popular understanding of the technology has not kept pace with the speed of the advances: “The public is almost entirely unaware of these technologies, and before they become broadly feasible, a conversation needs to begin.”

The story of artificial gametes truly begins in 2006, when a Japanese researcher named Shinya Yamanaka reported that he had induced adult mouse cells into becoming pluripotent stem cells. A year later, he demonstrated that he could do the same with human cells. Unlike most other cells, which are coded to perform specific, dedicated tasks, pluripotent stem cells can develop into any type of cell at all, making them invaluable for researchers studying human development and the
origins of diseases. (They are also invaluable to humans: Embryos are composed of stem cells, and babies are the products of their maturation.) Before Yamanaka’s breakthrough, researchers who wanted to work with stem cells had to extract them from embryos discarded during IVF or from eggs that had been harvested from women and later fertilized; in both cases, the embryos were destroyed in the process of isolating the stem cells. The process was expensive, controversial, and subject to intense government oversight in the United States. After Yamanaka’s discovery, scientists possessed a virtually inexhaustible supply of these so-called induced pluripotent stem cells (or iPSCs), and all over the world, they have since been trying to replicate each stage of cellular development, refining the recipes that can coax stem cells to become one cell or another.

In 2014, as a consequence of Yamanaka’s work, a Stanford researcher named Renee Reijo Pera cut skin from infertile men’s forearms, reprogrammed the skin cells to become iPSCs, and transplanted them into the testicles of mice to create human germ cells, the primitive precursors to eggs and sperm. (No embryos were created using these germ cells.) Two years later, in a paper published in Nature, two scientists in Japan, Mitinori Saitou and Katsuhiko Hayashi, described how they had turned cells from a mouse’s tail into iPSCs and from there into eggs. It was the first time that artificial eggs had been made outside of an organism’s body, and there was even more extraordinary news: Using the synthetic eggs, Saitou and Hayashi created eight healthy, fertile pups.

But baby mice do not a human make, and Saitou and another scientist, Azim Surani, are each working directly with human cells, trying to understand the differences between how mice and human iPSCs become primordial germ cells. In December 2017, Surani announced a crucial milestone concerning the eight-week cycle, after which germ cells begin the process of transforming into gametes. His lab had successfully nudged the development of stem cells to around week three of that cycle, inching closer to the development of a human gamete. Once adult human cells can be made into gametes, editing the stem cells will be relatively easy.

How soon before humans have children using IVG? Hayashi, one of the Japanese scientists, guesses it will take five years to produce egg-like cells from other human cells, with another 10 to 20 years of testing before doctors and regulators feel the process is safe enough to use in a clinic. Eli Adashi is less sure of the timing than he is of the outcome. “I don’t think any of us can say how long,” he says. “But the progress in rodents was remarkable: In six years, we went from nothing to everything. To suggest that this won’t be possible in humans is naive.”

Some cautiousness about IVG and gene editing is appropriate. Most medicines that succeed in so-called mouse models never find a clinical use. Yet IVG and gene editing are different from, say, cancer drugs: IVG induces cells to develop along certain pathways, which nature does all the time. As for gene editing, we are already beginning to use that in non-germ-line cells, where such changes are not heritable, in order to treat blood, neurological, and other types of diseases. Once scientists and regulators are confident they have minimized the potential risks of IVG, we could easily make heritable changes to germ cells like eggs, sperm, or early-stage embryos, and with those changes, we’d be altering the germ line, our shared human inheritance.

Used together, we can imagine would-be parents who have genetic diseases, or are infertile, or want to confer various genetic advantages on their children going to a clinic and swabbing their cheeks or losing a little piece of skin. Some 40 weeks later, they’ll have a healthy baby.

DISCUSSION

Join Parenting In a WIRED World, a new Facebook Group for parents to discuss kids' health and their relationship to tech.

The demand for IVG coupled with gene editing would be significant. Around 7 percent of men and 11 percent of women of reproductive age in the US have reported problems with fertility, according to the National Institutes of Health. And IVF, which is typically the last, best hope for those struggling to conceive, is invasive, often doesn’t work, and can’t work for women who have no eggs at all.

Then there is genetic disease. Of the more than 130 million children who will be born next year, around 7 million will have serious genetic disorders. Today, parents who don’t want to pass on genetic abnormalities (and who have the thousands of dollars often required) might resort to IVF with preimplantation genetic diagnosis, where embryos are genetically tested before they are transferred to a woman’s uterus. But that process necessarily involves the same invasive process of IVF, and it entails rejecting and often destroying embryos with the unwanted genes, an act that some parents find morally impermissible. With IVG and gene editing, prospective parents would think it unremarkable to give doctors permission to test or alter stem cells or gametes. A doctor might say, “Your child will have a higher chance of developing X. Would you like us to fix that for you?”

Proving that IVG and gene editing are broadly safe and reliable will be necessary before regulatory agencies around the world relax the laws that currently preclude creating a human being from sythnetic gametes or tinkering with the human germ line. Although IVF was greeted with alarm by many mainstream physicians and scientists, it nonetheless was subject to little regulation; it slipped through the federal regulatory machinery charged with overseeing drugs or medical devices, as it was neither. Because IVG and gene editing are so strange, there may be popular and expert demand for their oversight. But in what form? Richard Hynes, a professor of cancer research at MIT, helped oversee a landmark 2017 report on the science and ethics of human genome editing. “We set out a long list of criteria,” Hynes says, “including only changing a defect to a gene that was common in the population. In other words, no enhancements; just back to normal.”

Critics imagine other ethical quandaries. Parents with undesirable traits might be coerced by laws—or, more likely, preferential insurance rates—to use the technologies. Or parents might choose traits in their children that others might consider disabilities. “Everyone thinks about parents eliminating disease or [about] augmentation, but it’s a big world,” says Hank Greely, a professor of law at Stanford University and the author of The End of Sex and the Future of Human Reproduction. “What if there are parents who wanted to select for Tay-Sachs disease? There are plenty of people in Silicon Valley who are somewhere on the spectrum, and some of them will want children who are neuro-atypical.”

And what of unknown risks? Even if Saitou, Hayashi, and their peers can prove that their techniques don’t create immediate genetic abnormalities, how can we know for sure that children born using IVG and gene editing won’t get sick later in life, or that their descendants won’t lack an important adaptation? Carriers of the gene for sickle cell, for example, enjoy a protective advantage against malaria. How can we know if we are shortsightedly eliminating a disorder whose genes confer some sort of protection?

George Daley, the dean of Harvard Medical School, has a simple answer to that question: We can’t. “There are always unknowns. No innovative therapy, whether it is a drug for a disease or something so bold and disruptive as germ line intervention, can ever remove all possible risk. Fear of the unknown and unquantifiable risks shouldn’t absolutely prohibit us from making interventions that could have great benefits. The risks of a genetic, inherited disease are quantifiable, known, and in many cases devastating. So we go forward, accepting the risks.”

Among the current unknowns are the name and sex of the first child who will be born using IVG. But somewhere there might be two people who will become her parents. They may not know each other yet or the difficulties with fertility or genetic disease that will prompt their physician to suggest IVG and gene editing. But sometime before the end of the century, their child will have her picture taken for a birthday profile in whatever media exists. In the likeness, her smile, like Louise Brown’s today, will be radiant with the joy of being here.

Read More

Tools for Fetal Surgery •
Save the Preemies •
The Year's Best Tech Playthings •
Cashing in on Kiddie YouTube •
The #MiniMilah Effect •
Rethinking Screen Time •
A Brief History of Digital Worries •
Solving Health Issues at All Stages


Jason Pontin (@jason_pontin) is the former editor in chief and publisher of MIT Technology Review.

This article appears in the April issue. Subscribe now.

Related Video

Science

Crispr Gene Editing Explained

Maybe you've heard of Crispr, the gene editing tool that could forever change life. So what is it and how does it work? Let us explain.

Last week, a commercial made by the producers of My So-Called Life and Thelma and Louise, the author of the Orphan X thriller series, and a left-leaning PAC went modestly viral. The commercial, “Built Not Bought,” is a highly polished, beautifully scored, Americana festooned four minute short film. By crafting an optimistic, pro-business-yet-anti-corruption message, the video aims to be a new mission statement for the branding-challenged Democratic Party. It features a diverse cast of factory workers, and a down-home rhetorical style and message best summed up by its opening line: “We stand for the working men and women. Always have, always will.”

It is, in short, exactly what you’d expect to get when you add Hollywood cinematic glamor to the political campaign ad. “After the 2016 election, my colleagues kept saying the same thing over and over,” says Mark Riddle, CEO of Future Majority, a PAC Riddle founded to support centrist Democratic politics. “‘We have a lot of very talented people in our party, the best storytellers in the world, and we don’t make good use of them. Why would you not be using those talents?’”

Fair question. But then again, Hollywood’s relationship with American politics has always been fraught. Though these days Hollywood is most often linked to Democrats, for the last 90 years both parties have made frequent use of LA’s glamor factory—often disparaging the other’s strategies as elitist and out of touch, then copying them immediately. By inserting itself into politics, Hollywood may think that it was doing something at worst benign and at best patriotic. But by giving choice candidates a broader, more attention seeking tool-set, in reality what they did was prime American audiences for a new kind of political voice—one that prioritizing grabbing and holding attention over anything else.

Hollywood may now be a bastion of liberalism, but it wasn’t always that way. In 1928, Louis B. Mayer, the cofounder of Metro-Goldwin-Mayer, “turned MGM into the publicity wing of the Republican party,” says Steven Ross, author of Hollywood Left and Right: How Movie Stars Shaped American Politics. (Mayer also got to spend a night in the Lincoln bedroom as a thank you for helping elect Herbert Hoover.) Hollywood didn’t make as strong a showing for progressive politics until the mid-‘30s and ‘40s—when movie stars like Orson Welles, James Cagney and Humphrey Bogart worked to promote Franklin Roosevelt’s candidacy and social issues like ending segregation.

Both parties have been vying to capture Hollywood’s glitz ever since—but with very different strategies, in part because of the Red Scare. In the late 1940s, many of the actors investigated by the House Un-American Activities Committee were advocating for Democrats. Creating close ties with individual celebrities backfired. Rather than acquiring glamor, political candidates acquired a whiff of communism at the worst possible moment. “That really shaped the way the Democratic party thought about Hollywood,” says Kathryn Cramer Brownell, author of Showbiz Politics: Hollywood in American Political Life. “They got really nervous and moved towards looking to Hollywood primarily for fundraising instead.” In addition to campaign contributions, Hollywood liberals from Harry Bellafonte to Jane Fonda began backing movements more than they did candidates.

Republicans took the opposite tack. Though publicly, party leaders criticized Democrats for glamorizing politics with show business, internal memos reveal that, secretly, some conservatives wanted to resurrect the chummy relationships of FDR’s presidency. In the 1950s, President Eisenhower gave actor Robert Montgomery an office in the White House so he could coach the president on how to be more photogenic and media-friendly. Instead of giving politicians’ celebrity-style poise, the strategy snowballed until politicians began casting themselves as actual entertainers. Figures like Nixon (as advised by Roger Ailes) began to credit their campaign successes celebritizing stunts like Nixon appearing on Laugh In. Eventually, Republicans started recruiting entertainers to run for office themselves—beginning in the 1950s, but accelerating over the next two decades.

Enter Ronald Reagan, and Arnold Schwarzenegger, and President Trump. Despite the perception of liberal Hollywood’s political power, liberal Hollywood has actually produced vanishingly few political candidates—Al Franken and Cynthia Nixon being notable exceptions. Most ultra-successful Democrats like Presidents Obama and Clinton are politicians-first, and managed to celebritize and glamorize themselves with the help of Hollywood money and counsel.

But hang on—aren’t conservatives supposed to identify more with heartland fly-over states more than frivolous Hollywood? “Few voters, Democrat or Republican, are persuaded on who to vote for by an endorsement from a Hollywood star or group,” says Don Critchlow, an American political historian at Arizona State University. “As evidenced by many polls, they don’t see Hollywood as saviors of the Republic or protectors of working Americans.” Riddle noted that this dynamic is one of the reasons he’s sometimes hesitant to publicize Future Majority’s Hollywood collaborators.

So why do political operators, past and present, think buddying up with Hollywood is the way to go?

Because, in some ways, it works. Celebrity endorsements and appearances only go so far: “Voters aren’t idiots,” says Ross. “Oprah endorsing Obama didn’t get him elected. Celebrity endorsements just make people more likely to take a closer look at a candidate.” According to Brownell, the key benefit of working with Hollywood is celebrities’ ability to generate excitement for a person or issue. Think: Chance the Rapper leading Chicago voters to the polls, Beyoncé endorsing feminism to generate more mainstream acceptance, or President Trump tweeting about winning or witchhunts to rile up (and distract) his audience.

But in other ways, all that matters is that the people running campaigns believe their showbiz politics is working. “What politicians believe makes a successful campaign can really impact how the campaigns that come after it are run,” Brownell says. “Trump and Cynthia Nixon are both products of ideas like Richard Nixon’s—that political authority is firmly rooted in being able to get media attention.” Trump’s qualifications, as he often says himself, are that he’s able to get good ratings. The same idea powers some progressive’s longing for President Oprah Winfrey or President Dwayne “The Rock” Johnson.

The polish of projects like “Built not Bought” are good uses of Hollywood’s undeniable storytelling skills. But it’s important that Hollywood and average citizens alike be aware of movie magic’s role in fueling Trump-style politics. LA glitz and glam does capture attention, but ultimately, it’s a marketing technique with serious, country-shaping consequences.

Before it was even released, Homecoming was notable for many reasons. For one, it was the new project from Mr. Robot mastermind Sam Esmail. For another, it marked Julia Roberts’ first turn leading an episodic television show. And finally, the Amazon original series was one of Hollywood's first big bets on adapting podcasts for the screen.

Related Stories

None of those things would matter if Homecoming fell flat. Yet, this Friday the series hit Amazon Prime and—voila—it very much soared. A little bit drama, a little bit noir, and a lot of suspense, Esmail’s new show proved to be a tense thriller that kept us pushing Play on each new installment—right up to the breath-holding ending.

Homecoming also gave viewers a lot to unpack: emotional turns, surprise twists, and a really trippy score. (Also, let’s hear it for Julia Roberts!) To dig into Amazon’s latest, we corralled WIRED’s biggest bingers—writers and editors Jason Parham, Brian Raftery, Peter Rubin, and Angela Watercutter—to break down everything they liked, or didn’t, about Amazon’s latest prestige series.

Angela Watercutter: I’ll be honest: If I start this off it’s just going to be one long Stephan James appreciation post and even though we should definitely talk about how amazing he is as returning Afghanistan veteran Walter Cruz, there’s a lot to discuss with Homecoming. What did you all think? When did the show click for you?

Peter Rubin: Even with the best shows, I’ve become accustomed to experiencing Pilot Syndrome—that wait-and-see generosity we deploy to forgive the exposition and worldbuilding contrivances that can overwhelm a first episode. Not Homecoming. From the opening sequence that zoomed out of an aquarium and into social worker Heidi Bergman’s office, to the typography and aerial shots that so define the show’s art direction, Homecoming felt like a cohesive thing, an assured and compelling fully formed entity.

The question, of course, is whether that’s due to Sam Esmail’s work adapting the original Gimlet podcast—something you talked to him about, Angela—or if it’s simply the podcast’s merits shining through. I came in having never listened to an episode of the podcast, which honestly felt like a bit of an advantage; I never thought about how Julia Robert’s Bergman stacked up to Catherine Keener’s, or how James as Walter Cruz matched Oscar Isaac’s portrayal of the soldier who entered the secretive “Homecoming” program for help integrating into civilian life. However, they both gave measured, naturalistic performances (as did Bobby Cannavale as Bergman's super-shady boss, Colin, and Shea Whigham as the magnetically bespectacled DoD official looking into what exactly happened at Homecoming), so it seems like a win-win.

Jason Parham: I think because TV, as a medium, has undergone a kind of bloat in the last half-decade—as it stands, there are simply too many TV shows to keep up with—I often look for small aesthetic flourishes in a series. More than plot or award-worthy acting, what can pull me in? The Good Place, Atlanta, Random Acts of Flyness, Pose—each show has its own particular set of aesthetic quirks. Where Homecoming excels in this regard, and to Peter’s point about it feeling like a fully formed entity, was Esmail’s visual vocabulary. All of it had the sheen of a Hitchcock noir-mystery—but it didn’t feel at all dated, or out of touch.

There's a particular sense of paranoia that runs through each episode and Esmail does a fantastic job—maybe even more so than on Mr. Robot; though I only made it through Season 1 of that show, so take this with a grain of salt—of translating that paranoia to the screen, and often without dialogue (an even more impressive feat given Homecoming is based on a podcast). The overhead shot of Carrasco (Whigham) descending into a maze-like stairwell. The hazy, hushed lighting that haunts just about every shot. The use of split screens, or of aspect ratios to delineate between the past and present, heightening the sense of claustrophobia. It felt like gazing into a petri dish and watching people’s lives play out in disastrous concert. I couldn’t take my eyes off any of it.

Watercutter: Jason, that’s absolutely it. I’ll admit, and I’m in the minority here, it took me a while to get into the Homecoming groove. I enjoyed Roberts and James’ chemistry, but I wasn’t gripped until the fourth or fifth episode. It was those flourishes, though, that kept me coming back. The show doesn’t give us a lot in the beginning—sure, Shrier (Jeremy Allen White) says he doesn’t trust Homecoming but the mystery doesn’t unravel until much later—but those notes of more to come made me want to keep digging. It is, as Jen Chaney noted on Vulture, the best of WTFTV.

Raftery: Like all of you, I admired Homecoming for its medium-bending stylistic flourishes; its intoxicating corporate-noir-meets-Hitchcock set-up; and its performances (I especially enjoyed watching Shea Whigham–who’s played so many memorably ball-busting alpha-males–sweat it out as a neutered middle-management lifer). But one of the reasons why the show had me hooked from the get-go came down to pure math: With each episode clocking in at around 30 minutes, I didn’t have to worry that I was throwing away time that could be better spent elsewhere.

My Wired coworkers know all too well my frustration with Netflix’s dramas, which are invariably in need of editing–with the exception of the excellent Mindhunter, I can’t think of a single Netflix series that didn’t overstay its welcome at one point, either with sloggy episodes, or with drawn-out episode orders. But a five-hour, fast-burning thriller like Homecoming? That seems doable, especially our way-too-packed prestige-streaming era, in which it feels like a half-dozen new offerings are being shoved down the internet’s tubes every week.

And even though Homecoming could have ultimately shed an episode or so and still not lost the plot–I’m not sure how much we needed Sissy Spacek’s character, as much as I love her performance–I think Esmail and his writing team did a fine job of stripping the story down to its high-end-pulp essentials. The streamers like long-playing, long-running series–it keeps viewers stuck within their eco-system. All too often, creators have abused that privilege. But Homecoming proves you can accomplish a lot in just a few hours.

Watercutter: Also, what did you all think of the music? It was intense. Also, I felt like I had Shazam open for quite a bit of my binge—just like, wait, what is this?? (Fun fact: During that scene where Heidi freaks out a little bit and pulls all of her desk tools under her head and lays down on top of them, the song playing is from The Conversation, which Esmail had mentioned was an influence on Homecoming.) And any show that ends its season with—spoiler alert!—Iron & Wine is OK by me. Any other musical queues strike you all?

Raftery: It took me a while to realize just how deftly Esmail and his music-supervision team were incorporating classic film scores into Homecoming, but once I did, it became a welcome spot-the-tune semi-distraction: I loved hearing John Carpenter’s haunted synth-score for The Thing being repurposed for a white-collar thriller, or catching David Shire’s classic All the President’s Men cue play out in one of its final episodes. Esmail is clearly a movie obsessive: Mr. Robot was loaded with references to everything from Kubrick to The Third Man to even Risky Business. But Homecoming takes it even further, with its soundtrack-swipes and numerous Hitchcock nods–all of which are so carefully grafted into the show, they never once feel like fawning homages. It’s a uniquely mixed-medium show: A drama that’s based on a scripted podcast; structured as a TV show; and shot and stylized like a patient, claustrophobic ’70s thriller.

Watercutter: And what did folks think of the show beyond its flourishes? Personally, once I felt invested in everyone I found it to be quite wrenching, really. I enjoyed the suspense questions—What are the goals of the Homecoming facility?, What’s that drug doing to the returning soldiers?, Why can’t Heidi remember what she did while she worked there?—but there was something about Walter and Heidi’s struggle to connect in such a sterile environment that just killed me. I know that’s a really obvious point to make, but at the same time I think those kind of core relationships are lacking, or very thin, in a lot of suspense thrillers, so I was glad to find them here. Also, the back-and-forth scenes as Heidi, Carrasco, and Walter’s mother Gloria (Marianne Jean-Baptiste) start putting the pieces together had me holding my breath at times. Carrasco

Parham: Beyond the visual and auditory highpoints, I found the series mostly compelling. It’s the breed of narrative that sits in that fragile corridor between truth and fiction—one that seems almost too ideal, too devastatingly ripe, for our fractured moment. It’s a story bizarre enough to be believable: Geist, a Fortune 500 corporation known for developing food and skincare products, wants to manufacture a drug that cures soldiers of PTSD. So they build a facility with the goal of transitioning veterans back into the real world—only the truer, darker aim isn’t actually to get these men ready for family and work life, but to rid them of their psychological war wounds so they can re-enlist. Of course, the other catch is just as gutting: the drug doesn’t just wipe clean symptoms of anxiety, social isolation, depression, or explosive bouts of anger, it erases whole memories.

What Homecoming becomes, then, is a sharp critique on systemic abuse, and how the corruption of such power infects everything, and everyone, it touches. For me, the saddest realization was how easy it remains for veterans—already discarded by the same government they so proudly served—to be exploited, and held captive. Stephan James brings humanity, if a bit of naivety, to Walter Cruz, but in doing so sheds light on how the system can, at every turn, fail people, even as they continue to believe in its good.

Watercutter: Yes, that’s it! Which is why when it all comes together in the end…

Parham: What made the closing scene so satisfying, for me, was all the brilliant stylistic work Esmail did in the lead-up to those last few minutes. The scene rejects the isolation, darkness, and near-violent panic that shadowed characters all season. We’re in a northern town, far from the swamps of Tampa, the skies are as radiantly blue as we’ve seen them, and the score that augments the shot—Iron & Wine’s “The Trapeze Swinger”—carries with it none of the soundtracked terror from earlier episodes. It’s as if this scene exists in an alternate universe. I won’t spoil the final shot, but how it culminates—for Walter and Heidi, at least—is just as surprising: with a flash of tangible, no-strings-attached hope that everything, for the first time in a very long time, might actually be OK.

The past seven days have brought another Democrat looking to be president, another Trump associate being called to testify before Congress, another potential escalation—and then de-escalation—in the tension between India and Pakistan, another sign that California is struggling more than many states with climate change, and another album from Solange. (It also brought another Oscars, but whether it's upset over Green Book's wins or gossip about Gaga, that already feels like a lifetime ago.) It's not all been re-runs, though; there have also been big developments in ongoing stories that people have been discussing for some time. What have people been talking about online this last week? We're glad you asked.

What Not to Say in Your Outside Voice

What Happened: You'd think that an attorney would know better than to attempt to intimidate a witness via social media, considering how much trouble it could get everyone in. You'd think.

What Really Happened: It was the (now deleted) tweet that got everyone's attention. Ahead of former Trump lawyer Michael Cohen's testimony to Congress last week, Florida Republican representative Matt Gaetz tweeted the following message: "Hey @MichaelCohen212 — Do your wife & father-in-law know about your girlfriends? Maybe tonight would be a good time for that chat. I wonder if she'll remain faithful when you're in prison. She's about to learn a lot."

Well, that's certainly a thing. And one that got a lot of people's attention, not least of all the media, because of course.

Some had some theories about where this tweet actually came from.

We'll come back to that later. For now, let's be thankful that Gaetz seemed to appreciate see the gaffe here. Just kidding.

The tweet remained up until the Speaker of the House sent out a particularly pointed subtweet of her own.

That, in turn, prompted Gaetz to finally apologize.

Turns out, an apology wasn't enough to handle the fallout of the tweet. Not from Michael Cohen, who had more important things on his mind—we'll come back to that soon enough, too—but from the Florida Bar, which launched an investigation into Gaetz over whether or not he violated professional conduct rules with the tweet. It may not be the only investigation he faces; a Democratic lawmaker has asked for an House Ethics Committee investigation, too.

Oh, and remember the question about whether or not the president was involved with the tweet in the first place?

For his part, Gaetz denies this. But, really, what is true anymore?

The Takeaway: For those who thought that this entire story seemed too cliché to be true, you're not alone, apparently.

The Michael Cohen Hearing

What Happened: For those hoping for epic political theater, last week's public testimony from former personal attorney (and infamous “fixer,” although, says who?) Michael Cohen proved to be not only worth the price of admission, but everything anyone could have hoped for.

What Really Happened: So, how did that whole Michael Cohen testimony on Wednesday go, anyway? The answer, as might have been expected, was "particularly explosively." So much so that things started exploding as soon as his opening statement leaked to the press hours before the hearing itself.

The statement, which really should be read in full for the appropriate effect, is available in many places but this Washington Post annotated piece is perhaps the best primer. It was, to be blunt, pretty damning stuff, although of course there were those who simply brushed it off as the ravings of an admitted liar. The hearing itself, however, proved to be just as amazing. Some brief highlights:

Heady stuff, and enough to give the media a lot to pick over and analyze for days to come. (And not just how poorly the Republicans fared.) The president, who was out of the country at the time of the hearing—stay tuned, we're about to get to why—let his spokesperson do the talking for him, for once.

Well, OK; he waited a day before commenting directly, at least.

All other kinds of interested parties had a lot to say about Cohen's testimony, as well.

Still, at least the Republican Party had a plan to make sure that people didn't pay too much attention to everything that Cohen was saying.

Yes, that's right. We should all stay focused on the president's historic meeting with North Korea. There's no way that could go wrong, right?

The Takeaway: For those wondering just how bad this was for the president, you might want to read this Twitter thread. But, suffice to say: This was a historic event when it came to demonstrating just how bad things have become.

The North Korea Summit Goes South

What Happened: If the Trump administration had hoped to drown out any and all bad news last week with a successful summit with North Korea, reality took a very different turn. Really, it wasn't a good week for the president.

What Really Happened: Getting back to why President Trump was out of the country during the Cohen testimony: He was in Vietnam for the second US/North Korea summit, a prospect that worried some, not least because of concerns over how far the president would go to get a deal he could boast about. Despite attempts to silence the press, initially, hopes were high.

Late Wednesday, however, it suddenly became obvious that things weren't going according to plan.

The hastily-rescheduled press conference confirmed what people were suspecting: The talks had fallen apart.

There's something odd about this sticking point, however; while Trump said that he was willing to ease some sanctions but North Korea was asking for all sanctions to be lifted, that's not what North Korea is saying they asked for.

Some after-the-fact positioning so North Korea could save face, or a case of the president lying? It's genuinely difficult to tell. On social media, some were arguing against those calling the summit a failure for Trump, as the hashtag #TrumpFail started to trend.

Funny story about giving legitimacy to a dictator; even though the summit fell apart, that didn't mean that the president wasn't willing to find some way to bow to North Korean interests in a truly dangerous, damaging way.

It didn't escape anyone's notice, either.

All told, this trip really didn't go so well for the president. But there's always next time, right?

The Takeaway: You know the traditional thing where Donald Trump says something today, and there's usually a tweet from the past where he completely contradicts himself? This time, it's not a tweet; it's far longer.

Takers and Fakers and Talkers Won't Tell You

What Happened: Oh, don’t worry; as bad a week as it had been for Trump before Thursday, things actually got worse when news emerged that he'd overruled experts to help his son-in-law.

What Really Happened: As last Thursday afternoon rolled around, Trump was surely glad to get back to the United States, where everything was calm and … You know where this is going, don’t you?

As reported by The New York Times, President Trump ordered then-Chief of Staff John Kelly to grant top-secret security clearance to son-in-law Jared Kushner last year, despite concerns by intelligence officials and the White House's top lawyer. Kelly was so disturbed by the order that he quit in protest—no, sorry, he "wrote a memo about how it wasn't his fault." Potato, tomato. You know how it is.

The report was quickly picked up by other outlets. It's almost as if people care about who gets security clearances that they probably shouldn't have.

The fact that the president had overruled his own intelligence people was, unsurprisingly, very much at odds with the way in which the issue had been addressed by administration officials in the past.

But that's not to say they didn't know what was going on wasn't a problem, apparently.

The timing of this would appear to be an issue for the administration.

Meanwhile, it's the substance that's an issue for … well, everyone else in the United States, really?

For those wondering why this is such an issue, here's one explanation:

Here's another, arguably more speculative, definitely more serious, one:

Maybe we're all overreacting, though! Perhaps there was a really good reason for it.

The Takeaway: If only there was some sign that the man who advised Saudi Prince Mohammed bin Salman shouldn't be given top secret security clearances. If only.

Meanwhile, in Another Hipster Coffee Shop

What Happened: Let's wrap up this week with something lighter, of sorts. If you have ever thought to yourself, "Hey! Twitter doesn't seem to do anything about all the ideologues on the platform, what would it take to get one thrown off?" Congratulations; You got an answer this week, and it was perfect.

What Really Happened: Maybe you remember Jacob Wohl. He's a far-right activist, who you may recall tried unsuccessfully to create a sexual assault conspiracy against Robert Mueller. He is, shall we say, someone that is going places, as long as it’s understood that those places may include being a punchline.

His journey towards that destination went farther last week when he gave an interview to USA Today in what seemed to be an attempt to tout his genius and strength in the surreal electoral playing field that is 2019.

In said story, Wohl boasted that he planned to create fake Facebook and Twitter accounts to, quote, "steer the left-wing votes in the primaries to what we feel are weaker candidates compared with Trump." Funny thing about announcing your intent to essentially duplicate the Russian troll operation during the 2016 election in a national newspaper: People notice.

Yes, a man famous for using Twitter to report on how hipsters in hipster coffee shops were repeating right-wing talking points ended up being banned from the platform after declaring his intent to weaponize it. There's no small irony here, and as should only be expected, a lot of people couldn't pass up the chance to use a favorite Wohlian construct to talk about his banishment.

It wasn't all jokes about Wohl's former meme-worthy status, however. There were some other things to consider about his removal. Well, kind of.

Wohl responded to the news with an amazing YouTube video in which he declared that the ban was actually good news, really, because look how viral he'd become before heading to the conservative conference CPAC to push a new conspiracy theory about Democratic lawmaker Ilhan Omar. Guess how that went?

Once again: This man got a profile in USA Today where he claimed to be an important figure in national politics. Just in case you're wondering how 2019 is going.

The Takeaway: It’s worth considering this when it comes to Wohl getting banned from Twitter.

If you think your on-the-job training was tough, imagine what life is like for newbie surgeons. Under the supervision of a veteran doctor, known as an attending, trainees help operate on a real live human, who might have a spouse and kids—and, if something goes awry, a very angry lawyer.

Now add to the mix the da Vinci robotic surgery system, which operators control from across the room, precisely guiding instruments from a specially-designed console. In traditional surgery, the resident gets hands-on action, holding back tissue, for instance. Robotic systems might have two control consoles, but attendings rarely grant residents simultaneous control. According to UC Santa Barbara’s Matt Beane—who recently published a less-than-rosy report on robot training for residents—he never once saw this happen.

Beane judged the state of the field by collecting interviews with surgeons and observations of hundreds of traditional and robotic procedures. (Robots, by the way, are good for things like hysterectomies or removing cancerous tissue from a prostate.) What he found was troubling: During minimally invasive robotic procedures, residents sometimes get just five or 10 minutes at the controls on their own.

“Even during that five or 10 minutes during practice, I'm helicopter-teaching you,” Beane says. “Like, ‘No no no no!’ Literally that kind of stuff. ‘Why would you ever do that?’ So after five minutes you're out of the pool and you feel like a kid in the corner with your dunce cap on.”

Some medical schools put more emphasis on robotic training than others. But Beane has found that a worrying number of residents struggle mightily in this environment. “I realized, good god, almost none of these residents are actually learning how to do surgery,” he says. “It's just failing.” Beane reckons that at most, one out of five residents at top-tier institutions are succeeding at robotic surgery.

That’s especially troubling considering that the da Vinci robot, the pioneer in a growing class of medical robo-assistants, has been in service for almost two decades. The benefits of the system are obvious: precision, cleanliness, reduced fatigue. But those benefits only materialize if medical schools are properly training their residents on the system. (Intuitive Surgical, maker of the da Vinci system, declined to comment for this story.)

The da Vinci system is indeed designed to accommodate residents in training, thanks to that secondary console. “The resident will be watching either on a monitor or on the second console,” says Jake McCoy, a urology resident at Louisiana State University. “At some point either the attending decides it's an appropriate time for the resident to take over, or if the resident wants to speak up and say something, then the resident might get control of the robot.” But McCoy is nearly done with his training, and he says he's never worked a case from start to finish. “There are certain parts that they just absolutely won't let me do.”

“I think at this point I'm going to be a little bit hesitant, or at least a little bit wary, to go out and unsupervised do any case that has any bit of complexity,” he adds.

Which is not to say 100 percent of residents aren’t getting fully trained on robotic surgery. “I think we get excellent robotic experience, and I’m very comfortable doing certainly standard procedures and maybe even more complex ones on my own,” says Ross McCaslin, a urologic surgery resident at Tulane. For McCaslin, that competence came in part from doing base-level training in simulators, just like a pilot would, supplemented by real patient experience. (All programs that Beane studied required simulator training.)

Same as it ever was, though. “It's a dirty little secret, but even when we did open surgery there are residents that are trained better than others depending on what program they're at and who their mentors are,” says Jonathan Silberstein, chief section of urologic oncology at Tulane.

Good training, whether in open or robotic surgery, requires extreme patience. “Training can slow us down,” Silberstein adds. “It can add significant time to an operation. It certainly increases my stress level, my blood pressure, the number of gray hairs I have. But that's our duty as physicians who have accepted this responsibility to train the next generation.”

While teaching by way of robotics may have its challenges, it also has its perks. For one, in open surgery, a resident and an attending have literally a different view of the procedure, which gets particularly complicated in a labyrinthine system of overlapping organs. But with the robot, they see the exact same picture through a camera. And after the surgery, the attending can walk the resident through a recording of the procedure, a sort of play-by-play for the operating room.

But residents who aren’t so well-nurtured tend to slip into what Beane calls shadow learning. They go out of their way to load up on simulations, or binge on YouTube videos of procedures. Which seems useful until you consider that attendings notice they're improving and give them more time at the console at the expense of other residents.

The good news hidden in all of this? Maybe surgery training gaps won’t be a problem for long. “Many of the very advanced surgeons at top institutions that I talked to say surgery definitely has a half-life,” says Beane. “In 50 years we're going to look back and be like, What? You wounded someone to try to heal them? What?” He’s thinking about noninvasive solutions like nanobots.

The field of surgery was early to the robotics game, and although the da Vinci system comes with serious costs, robotic surgery also means less recovery time and therefore less hospitalization. (Malfunctioning surgery robots, though, have also been implicated in patient injuries.) But the future will see doctors ceding ever more control to the machines, and then the difficulties of training residents will be history. “Maybe this problem is just going to suck for a little while,” says Beane. “And then people won't do that anymore.”

More Medical Robotics

  • Robot surgeons need to train, just like humans do. So researchers at UC Berkeley have developed a shifting platform that simulates the heaving body of a living patient.

  • Implantable robots also hold great promise in medicine. Take, for instance, a robotic sleeve that fits over the heart to keep it pumping.

  • In less … invasive medical robotics, we'd like you to meet Tug, the charming robot that roams hospitals delivering drugs and food.

Related Video

Science

Fear Not the Robot Singularity

The robot revolution we’re in the midst of is way more interesting and way less murder-y than science fiction. Call it the multiplicity.