Responses to Our Summer 2019 Issue

Mission to Mars

George Musser’s advocacy of an Apollo-like program for a mission to Mars (“Our Fate Is in the Stars,” Summer) makes a forceful, albeit rose-colored, argument for the future direction of NASA. In touting a major Mars initiative, Musser overhypes or sidesteps a number of issues. First, he implies that the Apollo program was the driving force behind the dynamic advances in computer and electronics technology that we enjoy today. Though without question the Apollo program was an important component of that development, it must be remembered that NASA did not exist until 1958 and President Kennedy’s call for putting a man on the moon did not come until 1961. By that time, semiconductor technology was already being pursued in universities, the national laboratories, and industry, as the potential of these materials for speed, miniaturization, and reliability became apparent.

Second, although a “think big” perspective is always important in addressing challenging projects, ideas such as the mass colonization of Mars and human interplanetary travel come up against certain physical realities that cannot be overcome—specifically, highly energetic nuclear particles in the form of galactic cosmic rays and solar flares that permeate the solar system. Earth is protected by its magnetosphere and atmosphere, which greatly attenuate the intensity of these particles. Mars has little such protection. In addition to the radiation hazard that will exist for astronauts and their equipment, the most energetic nuclei can penetrate up to a meter of soil. Mars has been bombarded for millennia, inducing nuclear reactions that have created a lasting radioactive background over its surface. Shielding astronauts (or colonists) in this environment will constitute a major challenge.

Finally, given the time scale required to launch a mission to Mars, one must seriously consider the logic of employing humans in this endeavor. In light of the rapid pace of AI and robotics research, by the time the mission is ready for launch, robotics development will have advanced to the point that robots will be able to match or exceed what humans can do. And electronics can be designed with redundant circuits as a countermeasure to radiation damage. Humans lack that capacity.

Vic Viola
Golden, Colorado

George Musser responds: Viola is right to avoid overhyping space-program spinoffs. Economists have found it difficult to quantify the economic returns of NASA research and development. But case studies do find a substantial benefit in specific fields, including electronics. In the book I discuss in my essay, One Giant Leap, Charles Fishman cites the analysis of Yale economist Richard Levin, who showed that although NASA did not invent integrated circuits (or Tang or Velcro), its intense timeline and demands for absolute reliability greatly accelerated their development.

No doubt, a Mars mission would be a serious challenge, and Viola is right to worry about radiation. To study it, NASA equipped the Curiosity rover with a dosimeter. En route to Mars in 2011, it measured a dose of about 2 milli-sieverts per day from galactic cosmic rays. On the surface, the dose fell to about a third of that—the planet does provide some shielding. The lifetime exposure limit is about 1,000 millisieverts, which corresponds to raising the chance of dying from cancer from 21 percent to 24 percent. A mouse study found that cosmic radiation degrades cognitive function. Many proposed shielding technologies would actually make things worse.

Some people might accept the risk. New rocket technologies could speed the trip, reducing astronauts’ exposure, and advances in medicine might enhance the body’s repair mechanisms. As for whether robots could do the job, many leading Mars scientists—the people with firsthand experience of what robots can do—say that humans outperform machines at complex exploration.

The main point of my article is less that we need to think big than that we need to think long. Slow but steady investment in space, compounding over decades, could take on the challenges that Viola identifies. That is the strategy our political system and business culture have the most trouble adopting.

On the Road Again (or Not)

As someone who had to give up motorcycling after 50 years, because texting drivers have become so dangerous, I welcome autonomous vehicles (“The End of Driving”). I now drive a KIA Soul EV. It’s perky, efficient, and spacious. I understand the joys of driving but am less than impressed by watching the scenery and highway adverts. Humans don’t have the ability to attend to two things at once, especially when one of these things is driving and the other conversation. We do it, but poorly. I’ve driven accident-free since 1956 by paying attention for both myself and the others on the road.

Ormond Otvos
from our website

The New Macau?

During the Asian financial crisis of 1997–1999, markets and currencies among Tiger economies collapsed, losing nearly 70 percent of their value. Many explanations were offered—bubbles, speculation in real property, high foreign debt-to-GDP ratios, corruption, and crony capitalism—but the simplest explanation is that these economies could not productively utilize the enormous amount of capital that investors proffered. Overcapacity resulting from overinvestment resulted in negative returns. Eventually, asset values collapsed accordingly.

In “Gambling on the Future” (Letter from Cambodia), Karen J. Coates hints at this risk when she mentions 150 casinos in Sihanoukville Province and a “storm of Chinese money” and suggests it is the “new Macau.” But Macau is far longer established as a gambling destination, and its casinos total fewer than 50. She also fails to mention that increasing gambling capacity (more casinos) rarely increases demand for gambling—it typically divides and redirects it. I wish she had pursued this line of analysis in greater detail. While the stories of individual suffering by families and businesses are heartbreaking and compelling, the overthrust of unbridled investment can destroy entire economies. Small nations such as Cambodia (like Thailand in 1997) are particularly vulnerable. Often, too much investment impoverishes rather than enriches. Herein lies the fundamental idiocy of China’s Belt and Road Initiative.

Tom Gallagher
West Palm Beach, Florida

The Physician as Empath

Sissela Bok’s review of two books dealing with the puzzling phenomena of morality and empathy (“What Makes Us Better”) leads me to share some observations I have made as a professor of medicine.

In the late third of the 20th century, many medical schools and teachers began to look carefully at doctor-patient communication. The most common complaint of patients was some variant of, “The doctor doesn’t listen, and doesn’t understand.” Of all the conversational tactics employed by physicians, meanwhile, the most common was to ask questions, hoping to find a quick answer. A famous study published in 1984 by R. M. Frankel and H. B. Beckman showed that, on average, their doctors in training (medical residents) interrupted a patient’s flow of story after only 18 seconds. Interrupting the patient with a series of questions intended to discover important details meant that many patients never got to finish their story or sometimes even voice their most important symptom—the “chief complaint.”

Correct diagnoses require an accurate assessment of a patient’s symptoms. Pain, nausea, shortness of breath, and so on lead the doctor to a good diagnosis, which leads to good therapy. So it is easy to see why aggressive, direct questioning had been common practice. But medical teachers in the 1970s decided to try to start by listening and then, after trying to understand the patient’s story, providing some sort of summary to show that patients had been heard and understood. Believing that a list of symptoms was preeminent but not all we needed to hear and understand, we sought a means to include the patient’s feelings, ideas, and values. “Tell me what is most important to you in this condition,” doctors would say; they would later offer a summary of what they’d heard.As a result, patients immediately reported that they felt that they had been better understood. Interviews went more rapidly and smoothly. Patients less often had to repeat their stories after being interrupted. The interviewer could relax during the process and let the patient control its flow. Our approach was both doctor- and patient-centered.

We still find, in the medical literature, occasional suggestions that “empathy cannot be taught” or “empathy is a personality trait.” Perhaps so, but we think that the approach described here looks like empathy, sounds like empathy, and feels like empathy.

Frederic Platt
Longmont, Colorado

An Agile, Graceful Roast

The trouble with critical clichés (“How to Be a Big-League Critic,” Tuning Up) is that they are irresistible. You fall on what seems to be the mot juste (aha!) and realize that multitudes have discovered it before you. To avoid this, I would sometimes collect adjectives from The New York Times dance critic Alastair Macaulay and use them in restaurant reviews that I would write. You’d be surprised how appropriate words like lithe or strenuous or supple could be in describing a dish. A musical borscht? A furious hot sauce? Of course, Macaulay was probably having his own problems avoiding clichés.

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