Back to Basics
I’m going back to basics this weekend and to return to a sense of learning and purpose with colouring pens and a pad. Inspired in no small part by Matt O’Neill’s excellent post on LinkedIn around brain fry, which had me thinking about ownership. Matt describes the sense of producing more but feeling less in control, about an erosion in the sense of ownership. And I get that. It made a lot of sense about where I can find myself sometimes. I’m using this wiki I’ve written about to create a lot of the competence that I don’t have around learning and knowledge. And that in itself sometimes looks very daunting, gazing up at this virtual range of educational Himalayas. And this is all in the knowledge that a lot of what I’m going to do is be built using large language models ranging from the technological authority to the research and development to the actual coding. So , whilst I’ve got this framework of different systems that all contribute, I to take a step away from it from time to time and delve back into the to the actual thinking process because you can’t outsource that process to a machine to do that. I quite like bouncing ideas around with a Claude, no shame in that, but it has a couple of effects that a detrimental to this specific process. Firstly its a world full of rabbit holes, cul de sacs and Easter eggs. All of which are inimical to a clear head. Secondly, the purpose of what I am trying to build is human orientated so in a sense its a nonsensical approach to take for the ideation work,in a sense there’s no point in dealing with it at all if you’re failing to identify the human parts of it.
Tl;dr; I’ll be sketching the ideas out with men and paper this weekend.
I blame Stephen Hall. We spoke at length this week, reviewing the moving parts of the journey though the system, the migratory habits of data points in the AI affected ecosystem — and that had me reaching for an imaginary pen to draw out behind me on an imaginary whiteboard the concepts and the flow. And I’m finding it increasingly hard sometimes when you’re getting deep into the think of the problem and involved in some of these things at a more abstract level not to have that pen in your hand.
The conversation itself was fascinating and I find myself increasingly drawn as I posted over this week to the considerations of the human in the loop. The humans here, as some are focusing on, are not the operators or the owners of the prompt or the machine; not the overseers, managers, or auditors. I mean, in this sense, the person who is in focus — the vulnerable adult, the child in care, the patient. And this is think is such a powerful way of trying to understand the relative positions of the problem; it is in software architecture terms “a user journey”, but its one that really does need to focus on those who have need of agency in that box. And I’ve heard of it spoken of this week, in an elegant concept, which I really like, of a glass box rather than a black box where you can actually see, feel and interact with that person as they go through the system. And so can they, importantly, they can see where they are in their decision-making cycle. Because increasingly e are becoming othered from that process. We’ve always existed in a paternalistic system, of having decisions made for us, to us, with varying degrees of agency, but as we move into this brave new AI world it is already starting to feel, (and doubtless is being cheered on from the sidelines by the Thiels of this world) like the decision-making is increasingly out of our hands. And its there, in that idea of a vanishing degree of consent, of increasing difficulty in controlling our own data, that of course Vitanium was born.
And the reasons for greater vigilance and control aren’t in short supply. https://www.digitalhealth.net/2026/05/palantir-to-be-granted-unlimited-access-to-nhs-patient-data/
This looks and feels like doing something properly is inconvenient, it looks like ethics and patient trust are heading out the window, and doing so before a Single Patient Record is established and access to GP data , the primary source of medical information gets woven in, as it will, we’re promised in the forthcoming King’s Speech. Nothing to see here. Move along.
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Its here that a piece of real insight cuts through the gloom. Tony Fish’s excellent piece for me did a beautiful, elegant job of cutting through the layers of anger, confusion and ignorance. Its a long piece, but well worth investing some time to read and cogitate. To do the thing that the article asks us to do. The bit in it of particular relevance to the story above is here — “Faster procurement cycles eliminate the time where judgment develops, automated evaluation removes the friction where expertise accumulates, and career structures that reward speed and consensus punish the very behaviours that build the capacity for scrutiny. We have systematically removed the conditions from which institutional judgment consurges, and then we wonder why nobody catches the problems until it is too late. “ I’d urge you to read it — find it here . It also, crucially loops back here and speaks precisely to that glass box problem, and argues for the self same probity, I think its the word, the decorum of it all.
I have recut my learning plan — the wiki is starting to give me some insight into the technology gaps, but also has underlined the areas that need developing and reinforcing at a theoretical level, hence the pens. That’s also come in useful as I’ve spent most of this week working on the Cattlegrid proposition as we approach launch, and giving thought to how observability is at the heart of what we ‘re trying to do there as well. In Cattlegrid’s case, its about the instrumentation that guides the prompt, the data that is ingested, and maintains its integrity as its being processed; ensuring its kept in thh regulatory condition it is supposed ot be in that privacy is upheld, the compliance is assured on the Personal data as its being typed in. That has a bearing on consent too and its interesting to watch these ideas complement and contribute ot each other as they both mature.
The one thing I’ve done this week, is to take the time to stop and smell the roses. Well, not quite, the roses arent out yet, but the Wild garlic is and out in great snowy drifts, that compete with blankets of bluebells. So my morning walks have becomes gentle saunters, no headphones, jus birdsong and blossom. Restorative to say the least
The thing I’ve learned this week, is that the critical sales stage of qualification, of understanding the users needs, of making sure that they have the money, the authority and the ability to make a buying decision is not something that lives only in selling. Its a discipline worth applying in a great many interactions
The thing I’ve read, or rather am reading this week is Metamagical Themas by Douglas Hofstadter. A fascinating collection of his columns for Scientific American from the early 80’s and I get an immediate sense of the nostalgic, and of reminiscence just looking at the dates, taking me back to my first computer, to the Falkands War and to the shadow of a very active seemingly very hot cold war in the shadow of the air bases at Greenham Common. This is frequently the locus of a very subjective nostalgia, not of looking back necessarily on me subjectively, but it was a time when the world first was really exposed to my eyes, and I feel very keenly a sense of place with a time, rather than any desire to be back in it.
But the amazing thing is how prescient it is. I’ll draw your attention just in one paragraph, from section two, Sense and Society. “The harm that occurs from vast numbers of people, except for in their reflection, the words, sayings, ideas, fads, styles, and tastes paraded in front of them by indiscriminate media and popular myth. Our society does rather a poor job of making us aware of, let alone interested in, the nature of common sense, the hidden assumptions that permeate thought, complex mechanisms of sensory perception and the will to believe, the human tendency towards gullibility, typical flaws and arguments, the statistical inferences we make unconsciously, the vastly different temporal and spatial scales on which one can look at the universe, and the many filters which can perceive and conceptualize people and events and so on. The resulting deceptions, delusions, confusions, ignorances and fears can lead to many disquieting social consequences. Such as mildly or absurdly wasteful spending of funding, blatant or subtle discrimination against groups, and local or global apathy about the current state of affairs..”
Something I’ve listened to is Schubert. his last quintet, written almost towards the end of his life. I was going down a rabbit hole from Douglas Hofstadter, in fact, around Tęsknota , which is the Polish sentiment of melancholy arising from a loss, an indescribable loss of something abstract, a sense of place in the world perhaps, brings a faint air of melancholy at what has gone.. It’s almost like nostalgia, but not. And I started building a playlist. One of the things I like to do is build a playlist with some to and fro interplay with Claude. And it usually comes up with some good ideas, so I was feeding into it to complement this idea of Tęsknota. I started with Hofstadter. For him it is Chopin, his Etudes. For me, that kind of sentiment lies in George Butterworth’s Banks of Green Willow, in The Lark Ascending. I added Smetana with Ma Vlast, of course. And Claude came back with Arvo Part with Janacek’s Overgrown Path. And also, interestingly, came back with Schubert and this late piano quintet, this late quintet. And it’s a beautiful evocation of a man whose horizons are narrowing, whose ability to escape the ever-narrowing funnel, tunnel, whatever it is that he’s in. It’s beautiful and sad and melancholy and has this sort of insistent mournful funereal beat underneath.
Something I’ve watched is Widow’s Bay; a show that seems thus far to be pulling off that rare trick that I really enjoy if it can be done well of blending that sense of supernatural unease with humour. Only a couple of episodes in , but I’m really curious to see where it goes next.
Next week, the wiki will be finally built and automated, and we’ll be further along the governance highway, and have some interesting converasations lined up with former colleagues, new contacts and some local primary care and ICB people that shoould help inform the debate greatly.
