Published! ‘Incorporating Care in Silicon Valley’…

My esteemed colleague (and mother) Jan English-Lueck and I have officially been published in the most recent issue of the Anthropology of Work Review. There you can find our article, sadly behind a pay wall.

We ask: is the vaguely California-Buddhist (but mostly utilitarian) “caring” of Silicon Valley corporations a good thing? We answer, very academically: maybe, sometimes, someday. But today, it mostly stands in agonizing juxtaposition with horrendous inequality.  If some by long-shot thoughtful stars align…yes someday it could be some definition of good. We are trying to force some alignment from our humble positions. Join us?

If you think that seems interesting, this article is worth a read.

Here’s the abstract:

The struggle for labor rights is often one of asserting embodied care. Workers negotiate for rest and safe physical conditions. In the United States, further embodied care is translated into health care and family leave benefits. In Silicon Valley, while labor still struggles in the service and manufacturing sectors, professional high-tech work constitutes another set of challenges and expectations. Startup culture draws on the university-student lifestyle—where institutionalized care includes a broad palette of wellness care, cafeterias, and structured recreation. So it is not surprising that yoga, massage, food, and managed fun made their way into high-tech workplaces of the late twentieth century. Increasingly, however, that corporate care is a requirement, not a perquisite, of progressive companies recruiting elite workers.

Effective care requires personal awareness and corporate surveillance in order to be effective. Corporate responsibility in Silicon Valley workplaces embraces discourses in which worker productivity and care intertwine. This care is not evenly distributed or available to all workers, but still points to an emerging set of corporate care practices. Knowledge workers are expected to work more intensively, and employers sustain them by providing care. That logic of care shaped the social experience of both care providers, such as chefs and concierges, and workers, who learn to be the subjects of such care. Based on two decades of fieldwork in companies from Apple to Yahoo, this article outlines the uneven evolution of Silicon Valley’s corporate care.

And here’s an excerpt, which I think is within the limits of what I’m allowed to post here. Specifically, the prologue, which I wrote based on field notes from one of the more surreal experiences of my entire life.

A deep bell sounds at the hands of a brown-robed monk as hundreds of people bow their heads over trays carefully balanced on their laps. It is the fall of 2013 and the corporate dining room of an iconic Silicon Valley company is transformed as rows of workers, vendors, and guests sit in silent contemplation. Thich Nhat Hanh, renowned mindfulness teacher, leads the room in a guided meditation over the vegan lunch of subtly spiced Southeast Asian vegetables and rice. We are participants attending a workshop designed to cultivate a wonder of food in the larger ecosystem and an awareness of the act of eating.

The teacher asks us to savor each bite. He asks us to contemplate how dietary choices like these can heal a climate-disturbed planet. He asks us to consider the life of these plants, and all the human hands—farmers, cooks, and workers—who made it possible for us to eat the plants in that moment. Thousands more watch this performance through cameras placed around the room, possibly eating on their own, in homes and offices around the world. The organizers, chefs, and workers convinced that technology and compassion could do more together than apart, invited the monks to give their peers a transformative experience and to enlist allies.

Four months later, presenters from that same corporation, while reporting on that experience and the larger effort around mindfulness at the Wisdom 2.0 conference, were interrupted by an onstage protest. Local San Francisco activists waved signs reading, “Wisdom Means Stop Displacement” and “Wisdom Means Stop Surveillance.” The company’s efforts to care for its own workers and the planet, though literally fashioned on “noble intentions” drawn from Buddhist and secular compassionate practice, are mired in an inescapable context of a system that produces economic inequality and unequal access to physical resources. Diverse stakeholders contest the values around information flows and privacy. The ubiquitous computing that fuels the Silicon Valley economy also produces a panopticon of available information, which changes the lives of its workers and the communities in which they live. Those care practices also require a degree of self-disclosure and behavioral observation to be effective. If an employer wants its workers to be at “peak performance,” it needs to know how to promote that productivity year after year, and how to help its workers attain it for themselves.

Wanted: Adaptive Encouragement

Or, Health Horizons S&T Map Blog Posts, New Year’s Edition.

I am sick, writing in bed, but that seems to be good, since I don’t really want to do anything, so I might as well write.

Bang! Posted.

 

It’s that time of year again. The global holiday of January 1, and with it, the annual ritual of self-improvement: setting New Year’s resolutions.  It’s a time when we’re called on to reflect on our lives and the behaviors we might want to change—and bombarded with ideas on how to do so.  It’s the time of year that makes me crave the realization of one of our Science and Technology forecasts: Adaptive Encouragement.

Adaptive encouragement: From self-quantifiers to life doulas

 Imagine a digital advisor that interprets your raw health data and offers continuous support along with interactive data visualization and recommendations for changing—and maintaining—daily routines or medications. 

 Embodied in intelligent programs, mobile devices, and the cloud, a life doula (like a birth doula) will remind us of our goals in moments of weakness. It will offer suggestions and encouragement in context to help us make healthy choices. 

 This kind of adaptive, personalized support will improve chronic illness management with automated diet tracking, in-home blood marker monitoring, and realtime analysis of genetic, metabolic, and protein data.

A quasi-intelligent automated system that takes the heavy lifting out of learning about your habits and changing them? Sold!

This vision is part of a future when roles like life coaching are automated and extended through ever-present technology.  It also points to the possibilities of adapting care systems to optimize the well-being of people with chronic ailments: rather than a slap on the wrist at the doctor’s office, you get a gentle vibration to get you out of your chair and moving.  Haptic feedback and sensitivity, emotional support and peer interactions are the future of this softer side of mobile health, beyond the expert-fed prescriptive reminders. This is a future of gentle nudges to show us the actions that will help us increase our capacity for well-being, but also remind us to do nothing when that’s what’s really best for us.

Our colleague Alex Charmichael over at the Quantified Self wrote this forecast, and I’ve heard it echoed in the desires of my of the quantified selves I’ve been interviewing for our project for the RWJF building and refining the QS Guide to Self-tracking Tools. For those of us who generally only embark on self-improvement binges once a year, there are a lot of lessons and tools we can learn from both the continuous and episodic efforts of the QSers.  One tool I learned about in interviews that might be of particular interest to New-Years Resolvers is Health Month—a game that helps you focus on making progress towards your goals on a daily basis.  (The game starts promptly on the first of each month, so start on Jan 1st to get credit for your progress!)

Most importantly though, one of the key lessons I’ve heard that’s especially crucial for  new years resolutions is self-compassion in all your self-tracking and self-improvement efforts.  Shame and frustration at little slip ups can do a lot of harm—so this year, try staying future-focused and forgiving.

Writing, death, and vat-grown kidneys

Hey, wasn’t I going to blog more and stuff?  Did somebody die or something?

Oh wait.  Actually, yes.

So my SB challenge and so many other things have been on hold for the past week.  I’m not done grieving, and won’t be for a good long while, but I do need to start writing again.  My kick in the pants came from the realization that it was Viv’s turn to do the regular blog post in our blogifying map forecasts series.

I started writing it and then I stopped.  I decided to share her words instead.  It still took me most of the day to track down links and proof and whatnot. It was both cathartic and helpful to tiptoe around the cognitive dissonance of writing about forecasts bathed in optimism bordering on hubris with ruminations on mortality rattling about my brain.

Here’s the post:

Replacement parts: “We can rebuild him, we have the technology”

Regenerative medicine will replace, restore, maintain, or enhance tissue and organ functions, dramatically improving patients’ health and quality of life, and potentially reducing the cost of their care. Tissue engineering will heal diabetic foot ulcers, reducing the need for amputations; organs grown in a lab will ease our dependence on donor transplants; and tendons, cartilage, and bone regrown with autologous cells will be used to repair injuries and joints. Advanced prosthetic devices and biomechatronic-based limb replacements will interface with the body’s nervous systems to give users a range of natural function and movement.

 When we first presented this forecast at a conference, our colleague Vivian told a story that illustrates the potential, and some possible pitfalls, of the growing capacities of regenerative medicine. It was part of a complicated dance of vignettes and exposition with Vivian, Bradley and myself that will remain one of my fondest memories of working here.

Viv presenting, by Rachel Hatch

Image by Rachel Hatch

Of course, when you get sick enough, you end up having to go to the doctor for help.

That’s what finally happened with Eric, who has Type 2 Diabetes.  He is a very successful 56 year old lawyer.  He has a history of working too much and not taking very good care of himself.  He was overweight, ate poorly, and didn’t track his blood sugar levels consistently.  As a result, he has had some serious complications from his illness.  Last year, he developed a foot ulcer that just wouldn’t heal.  The doctors had to amputate his foot.  His eyesight also deteriorated because of damage to his retina.  And his doctors have been warning him that he may need to go on dialysis.  Eric’s body is failing him.

Remember that TV show in the ’70’s?  The Six Million Dollar Man?  Do you remember the show’s tagline?  “We can rebuild him. We have the technology.”

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Optimizing Healthspans: branching paths of longevity and death post up

This took me a uper long time to write, resolving my conflicting feelings about extreme longevity as a topic.  This is another one of the Science, Technology and Well-being 20202 Forecasts.

Again, full post available here.

To clear up your first question, (what’s a healthspan?), by healthspan we mean the length of healthy, quality living. In the last hundred years we’ve seen a dramatic lengthening of our life expectancy, and radical life extension hopes to lengthen our lifespans, but what we’re grappling with now and in the next decade is optimizing our chances of those added years being happy and healthy.

So, how will we do that?

 Flickr user kevindooleySource: Flickr user kevindooley

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Programming Immunity post up

This was a post about one of the handful of forecasts boldly written last year by my colleague Alex Carmichael, which it fell upon me to perform, promote, and continue investigating from our recently released forecast map on Science, Technology and Well-being.  I must admit that I am personally less technologically optimistic than many of the forecasts on that map.  With this forecast, my own personal experience with immunomodulators is that we are still at the blunt instrument, barely-know-what-we-don’t-know stage of understanding, more than a decade away from precision interventions for anybody, let alone brad accessibility.  Luckily the week before there was a major breakthrough in this area: the first success of gene therapy, which promised to be just around the corner back when I was in high school biotech classes. And what this therapy did was effectively re-train patient’s immune systems in a specific, fine-tuned and persistent way.  So, maybe this forecast is on a much shorter horizon than I originally gave it credit.

Excerpt from the full post:

Our immune systems are the key to humans’ profound resilience in the face of all the other organisms around and inside of us.

Over the last few decades we’ve made great strides in understanding the workings of various parts of our immune systems, as they function normally and as they get jammed up in strange ways. This forecast posits that over the next decade we’ll be able to put this knowledge to striking use: honing our immunomodulation therapies, mainstreaming the maturing promise of gene therapy, and hacking our immune systems to accelerate our resistance to all kinds of infections.

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Dancing in the Park

A teenager in yellow jeans shifted a little into a shadow of a dance step, furtively mimicking the handful of more exuberant men and women twirling and gesturing gracefully in the center of the clearing. A man in a suit sits on a bench, flipping through the music on his karaoke machine, filling the area between three large trees with a few bars at a time of music both grand and pop. The dancers are unconcerned, continuing their movements and tailoring them every minute or two to the new music.


This was just the beginning. This is what I came here, to Purple Bamboo Park, to see. This was my first day “off” in a week of interviews and facility tours across Beijing, two to three each day. Today I spent walking—over 8 miles all told—visiting places that people we interviewed mentioned as significant to their well-being. Time and again we heard that the “health dances in the park” were where someone got out to, socialized and exercised. So here I was, in this enormous park that is only the seventh largest in Beijing, looking for dance.

I had been wandering around for hours, watching joggers wind through the bamboo groves, parents and children and elders using the public cardio and self-massage equipment. I was actually on my way out, ready to give up, when I stumbled on this scene in a clearing, surrounded by benches and coat racks, with a few dancers and their audience.

A discordant blare broke the mad rhythm of the indecisive karaoke box.

There was another speaker on wheels in the clearing, louder, indicating they were ready to provide the music now. The style was older—chanting choirs and a vaguely military rhythm. The handful of pioneers dancing to the light of the setting sun became more synchronized in their movements. As they danced, a cluster of a dozen people approached the new music master with friendly greetings, then fanned out to join the dancing. (Adding more videos when I get around to editing them. I took a lot of video. Video is slow.)

As twilight set in I was now swaying on the edges of a sizable group of thirty or so people, arrayed roughly in a grid, stepping and swaying and gesturing in unison. Sometimes they would rearrange, and the men and women would trade-off in some pre-determined pattern. Another few dozen people were on the outskirts like me, swaying and stretching and bouncing in a more partial mode of participation. The ages now ranged from 16 to 60.

I noticed I could hear other music now. I skirted the group and wound my way to the next clear spot—a wide plaza by one of the park gates. There fifty or so women with bright red pom-poms and fans did their own choreographed thing. As I watched them someone set up another karaoke machine on the bench on the other side of the widening path from me, and before I knew it there were 3-4 couples doing competition-level ballroom dancing in suits and dresses, with a fast-gathering circle of fans. Just beyond them in the gathering gloom, over the heads of men clustered around dimly lit games of mahjong, was yet another dance area in a wooded courtyard, filled with several dozen couples swaying.

A gregarious autodidact approached me, eager to practice his English. He was in his mid fifties, all smiles over a gray Mao jacket. I asked him if this was a typical turnout for a Tuesday night in the park. He asserted that this was typical every night it didn’t rain—even in the winter people dance in coats. “The everyday people, you see, the workers, not the cadres, they can’t afford to go to fancy cinemas, things like that. This is real entertainment. And it’s free! Free for everyone. Every night.” (It’s amazing how just a few years variation in age between the cohorts in their 40s, 50s, and 60s makes all the difference in whether someone speaks the language of the cultural revolution with caution, irony, sincerity, or nostalgia. After a while the conversation turned to wages, housing, family, and the comparative necessities of a good life in the US and China.)

When I lived in China as a child, I dimly remember the early mornings in the park filled with people practicing tai chi in large groups; marching and dancing with my pre-school classmates in our yellow Transformers jumpsuits. And I’ve read Judith Farquar’s extensive and nuanced analyses of the park as a site of civic life, biopolitics, and embodied nationalism. But dim memories and scholarly imagining didn’t quite prepare me for the scale, the rigor, the total experience of hundreds of people gathering nightly to dance in public.

And in the back of my head, some distance away from my observe-describe [and participate just a little] ethnographer’s brain, I kept wondering,

“WHY CAN’T WE DO THIS BACK HOME?”

People dance a little at street fairs, at concerts, they pay to dance in clubs, in gyms. There are flash mobs and performance artists and the self-consciously alternative Burning Man frequenters. But why can’t teenagers and elders dance in any park, any time?

What would it take to get anybody to dance together as if nobody was looking, for free, in public, any night of the week?

Seriously. Any ideas?