A Conversation with Abhinav Gautam

This is the transcript of a conversation with Abhinav Gautam, pioneering doctor, entrepreneur, musician and an astute observer of our times. Some easy links to his work:

Medicine https://vitruvia.co
Music: https://abhinavmusic.com; https://open.spotify.com/artist/1AFezncT8Nv1bZ8mZqFCtq;

Radio: https://soundcloud.com/michaelcawthorn/seeing-sounds-interview-for-humana-radio

AI and medicine

Me: There are many who believe that this moment is an inflection point of history with what AI has done or what it will do in the near future, and economic and political power shifting from the West to Asia. Many people have lost trust in institutions and there is a huge reproducibility crisis in medicine. From your vantage point as a doctor and entrepreneur, what do you think is going to happen related to the Covid pandemic, and how it might impact society.

Abhinav Gautam:

I think the question about artificial intelligence (AI) and its relationship to medicine provides insights into many other changes taking place in the world.

First, AI is created by human beings, and so there’re implicit limitations to what the AI system is able to do and comprehend.

Nevertheless, in conceivable future, I see a world where AI takes over more and more of the easy tasks of society that are basically pattern recognition. So, the more routine one’s task is, the more likely it will be done by AI.

Radiologists, for example, are diagnosticians who rely on their knowledge library that they’ve built up over the course of their career. It’s not surprising then that machines are highly adept at diagnosing and recognizing pathologies, because fundamentally that’s all basically pattern based.

We can take the flip side of that and look at, let’s say, a surgeon. We’re not anywhere close to having AI actually do a surgery, for machine are not autonomous. AI can be used in healthcare to streamlines the workflow of the physician, but I think the danger lies in people assuming that the doctor-physician relationship can be supplanted by a patient-machine relationship.

In many ways, AI is inevitable due to the efficiencies that are needed in healthcare to offset its ballooning costs. America, for example, spends somewhere near 18% of the GDP on healthcare, and even with that it’s pretty clear that the vast majority of our population need to get a lot healthier.

When we consider chronic disease, something that I thought about a lot when I was going through my own journey learning medicine, it’s easy to see that there’s is a huge gap in the efficacy of the treatment.

Meanwhile, a sociological change is occurring in the expectations people have from medicine. Living as we do in the Internet age, it’s only natural that people’s curiosity about their own well-being will lead them to start asking more questions. Unlike a generation ago when the doctor’s word was considered gospel, people are realizing the most medicine as practiced is sub-optimal and that leaves a kind of bitter taste in peoples’ mouths.

In my own journey, my father telling me as a young kid to see the world for what it is, that is see things as a child would, has had much impact. And as silly as it sounds I’ve been persistent to get to the root cause of pain.

As an anesthesiologist, my mission has been to try to create what amounts to a unified theory of our sense of the body that can explain why people suffer from chronic issues ranging from tinnitus to gout. It could be pain in the toe, or Reflex Sympathetic Dystrophy (RSD), or chronic lower back pain, or neck pain, and I insist that all this isn’t because of peoples’ genes.

We have to stop using the intellectual copout of assigning something you don’t understand to the DNA. That’s dangerous for it suggests that some bodies are defective machines. Personally, I don’t believe most human beings are lemons, particularly if they’ve been healthy for the vast majority of life and then succumb to some kind of malady.

I think one should think of the human body like the most marvelous machine with a schema that is universal in nature. What we’ve uncovered in the last four years is that the connective tissue or fascia layer of the body, specifically the loose connective tissue, basically invests all other parts of the body (hence the label “connected”). This layer is truly alive in the sense that our awareness resides throughout this layer.

The Covid pandemic

Me: To draw some broad conclusions from what you’ve said, AI is, in some sense, mechanical, for it works according to rules. These rules give it power but also make it deficient in other ways. If one were to generalize and see science and bureaucratic decision-making itself as AI in action, one will understand the ham-handed way governments and public health departments have dealt with the COVID pandemic. They’ve not necessarily used common sense, or they’ve left out questions related to how different demographic groups should be dealt with differently. They ought to be driven by numbers associated with the disease, and not by blanket precepts just because they sound good to one political group or the other.

One important takeaway from here that ties up with what you were saying is that we are more than the genes because what we do and how we think also make the genes express differently. We are more than machines, and we have agency, but the world tells us we don’t. It is the view that we are nothing but bodies that has led to this great sense of despair that last year, 100,000 Americans died because of drug overdose. It’s astonishing that people are throwing away life in their 20s and 30s.

This view of contemporary society that we are primarily bodies with limited agency flies against cutting edge science according to which consciousness is the deepest mystery, which overarches everything else. This has parallels with your research and practice. And your pioneering insights have shown that within the body itself, things happens recursively. If you talk first of consciousness and then the body, then within the body is the connective tissue layer, and everything else is within the connective tissue.

Nevertheless, the ruling classes want the world to go the way it’s going. Right now, with the huge panic about the pandemic people have been made so afraid that many will do whatever the state wants them to do.

I mentioned in the opening remarks, we have this huge reproducibility crisis in medicine. What is it as a doctor that ought to be done? Also fashionable new theories say that the color of skin privileges some people, which is quite wrong. It’s the humanity in each one of us which makes us who we are no matter what the color of the skin and past history. Each human being is as wonderful as any other.

Abhinav:

Many of our problems arise from the bureaucracy in education, and the compromised elites in journalism and politics.

I think, for starters, old-fashioned journalism is dead. It has largely become the propaganda arm of the techno and power elites.

And whether it’s physicians or everyday people, the education system does not facilitate the inner work required to learn to trust one’s own intuitions.

Common sense has basically gone out the window. And regarding the virus, it’s pretty clear that there’s something else is going on. What that is, no one knows. But, you know, basically, this is the first time in the history of humanity where healthy people are being quarantined.

Additionally, many governments have chosen to treat this virus like a computer virus, and not like a real virus. Unlike computer viruses, biological viruses mutate, and in the process they become more viral, but less deadly.

The flu virus, for example, is a circular genome. I’ve been saying this from the very beginning — two years — that it’s impossible to vaccinate against the flu, because the flu will always stay one step ahead of human beings.

New research is confirming that, indeed, natural immunity is superior to vaccinations.

This concept that we’re living in a world where people aren’t ever supposed to get sick is a bit absurd.

There are other very, very troubling quandaries that humanity is dealing with right now. Most importantly, we face an explosion in the population. More and more human beings are being born into a world that has less and less opportunity. Furthermore, efficient technology is reducing the need for people. So we’re at a real crossroads.

The sad thing is that the leaders of most of the world are trying to lead through fear rather than love and commonsense. Most are completely inept, a consequence if the vast corruption and skullduggery that has occurred over the last 30 years.

At this moment, I see Florida as a beacon of hope for the world. In Covid, we have the best numbers in the entire United States for we have taken a commonsensical approach to dealing with it.

Me: We seem to have arrived at a perfect storm. I think the leaders of many countries arer not necessarily free agents themselves, and they are also fearful because W.H.O. directors are screaming that the skies are falling.

Abhinav:

The new religion is science. It sounds wonderful but, sadly, it’s completely corruptible, quite like old-time religions. It can degenerate into exercise of power.

Me: Also, the paradigm within which mainstream science operates is that of the machine.

Abhinav:

This leaves out consciousness, and it leaves out the quantum nature of things, both in pharma and in biotechnology. It’s a reductionist approach, which is the exact wrong way to think about life. The correct analogy for the workings of the body is that of a symphony.

It’s not just one instrument or four that are playing: it’s a complex orchestration of thousands of different instruments. So, when scientists start trying to reduce things down to one molecule, which they do so that they can get a patent that invariably almost always leads to a bad outcome because you are disrupting the homeostasis of the body by overloading it with one instrument. Imagine that you have a beautiful orchestra, and the trumpet player goes out of control playing louder than everybody else, the song is gonna sound horrible.

Most people are smart and their intuition tells them that the way things are going has problems, which is one reason for the loss of faith in institutions and why people are doing things in ways different from how they were done a generation ago.

Crypto

Me: Is this the reason people are moving away from stocks and banks and going into crypto? In the decade since 2009, trillions of dollars have been printed. Although the US has managed to pressure oil producing countries to keep on pumping oil and keep energy prices low, eventually, prices will explode. And when that happens, middle class people will be impacted most.

There is a general sense of unease. Is that one of the reasons why people are getting into crypto and I mention it because your moniker on Twitter is Crypt◎D◎C @abh1navgautam.

Abhinav:

I call myself a “whale healer” and what that means is, you know, most people in crypto are people who question the status quo and they’re looking for a better alternative, which is bigger than what the mainstream offers.

“Whale” is also a term for very high net worth individuals. Fortunately, due to the novel nature of what I’ve invented and its incredible efficacy, we’re attracting a very interesting set of patients, many of whom are the heavy hitters of the crypto world. The problem with the old power centers of the world is as spoken by William Pitt the Elder, “absolute power corrupts absolutely,” or in the words of Honore de Balzac, “behind every great fortune is a great crime. ”

The blockchain of crypto is the revolutionary idea of “immutable trust”. This is due to the decentralization of the ledger, so you can keep track of everything. Since it’s decentralized and anonymized, it’s basically immutable and impossible to corrupt.

To me, that is extremely exciting because, fundamentally at the end of the day, I don’t think it’s an issue of supply and demand of resources that’s causing current problems. It’s woeful inefficiency, waste and corruption.

Moreover, many of the things that exist because of the centralized nature of the current way of society have become problematic. Big tech is a problem for it is essentially completely centralized.

I think in the ideal world, the entire government, and all of its spending would be on the blockchain. I think people who have embraced this new technology, are going to find themselves in very fortunate situations. The people who think that cryptocurrency is going away, or that it’s worthless, and are kind of staying in the fiat currency camp are going to find themselves in a less pleasant situation.

Given that 20% of all of the US dollars were put into circulation just last year, extreme inflation is impossible to avoid. We’re already seeing these things. The current cap centralized capitalistic model is failing for everybody but those who run it. Cryptocurrency through the new concept of decentralized finance will bring the benefits of money to many more people than before.

Me: One immediate question related to crypto is that whereas US has some institutions that are compromised, there are many others that are still robust and have integrity, which is the reason why America is still a very powerful country. Now, in poorer nations you have only one or two strong institutions which are normally the military and the government. Does crypto create the danger that to bribe the leaders of its kleptocracy will become easier than ever before? Will Western powers and China, with their history of imperialism, use crypto as another instrument in their arsenal to keep the poor countries down or to destabilize them?

Abhinav:

No, I’m not sure about that, because I don’t think the Western nations are in control of the crypto world, and they have no idea what to do with it. Western politicians are also scared of crypto because this is a moment in history where the power is going back to the people.

Access to asymmetric information that can be turned into profit is the reason why many people get into politics. There’s a joke going around that by copying the trades made by powerful politicians one can come out ahead in stock trading.

I find the Baby Boomers are a most corrupt and selfish generation. They’re just clinging on to power and it is possible that not only the underdeveloped countries or dictatorships outside of the Western world will be destabilized by the unknown force of crypto. Even rich countries could see changes that the ruling class in these countries have never anticipated.

Banking and debt has been the basis of modern prosperity. You can’t get wealthy if you have to save all your money and put it in your mattress. So I think that we’re gonna unlock trillions of dollars of global economy with new models of playing to earn and learning to earn in ways that can be life-changing.

Thus in the Philippines you have thousands of people that are no longer driving for Uber or struggling with jobs when the tourism industry took a huge hit. They’re now making more money playing video games that can be monetized. Play to earn is the major disruptive model right now, and I think the next one will be learn to earn where students are able to get money by spending time in constructive uses of technology, providing them the ability to learn and make money.

Me: One thing that comes to mind is that the crypto world is based on secrecy, decentralization and gaming. In Sanskrit there is a term for sacred gaming, Leela. Life lived well is part of Leela, with the difference that it includes the ideas of freedom and consciousness.

The crypto world as it is emerging is based on a reductionist and materialist paradigm. Is it possible that it may not be giving enough space to agency and freedom and the spirit, as it should? And if it doesn’t, could it lead to a dystopian future?

Abhinav:

I think it’s the opposite. I mean if crypto becomes centralized, then yeah, you could have a dystopian outcome like you have in China with its social credit score and the digital Yuan. But I think for the most part, it’s going to do the exact opposite and set people free. Right now, ninety-nine percent of people are unhappy because they’re stuck in the matrix they’re in. They’re on a hamster wheel.

I think the fundamental changes being unleashed will encourage people to break free from not only scientism but also old-time religion that does not allow people to think for themselves, or turns people into fanatics who wish to kill unbelievers and to destroy art and books.

Life lived well is both action and knowledge. We may have explored the physical world, but there exist countless regions of the inner world that await similar exploration. I expect people to turn to meditation, the arts, and harmonious life that leads to the inner science of the Veda and to wisdom.

Note: This is the first of a series. The next parts will be on music, art, spirituality, and consciousness

सुभाष काक. Author, scientist.