Great discussion, wish I had more time...
But this not the "new" in this paper - its essentially the EBO argument.In my opinion, Warden is talking about how to plan... we have to have a plan, and try to reduce even complex systems to something we humans can understand. We then need to try and affect those systems... but the fact that Warden advocates a certain plan doesn't mean that's the end of it... once the plan is executed, there will inevitably be changes made and adjustments based on the enemy.
The problem is it states a premise that is *WRONG*!
we may WANT to reduce complex sytems to something we humans can understand but this is a fool's errand! By their nature, complex systems are irreduble at a certain point and models that reduce them in complexity below that point by introducing cause and effect assumptions cease to be useful.
We seem to all be in agreement about the piece parts - its the way warden assembles them that appears to be the crux of the issue.
The purpose of a model is prediction. You set the dials and levers on the model, you turn the crank, and see what. IF you simplify a complex system to the point where it is "understandable" - ie you get predictable outputs from the inputs - then you have BROKEN IT. By definition you get different outputs from a complex system each time you turn the crank. That is called emergent behavior and is the key caracteristic the differentiates a complicated (but causally simple) system from a complex one.
Complex systems have the inherent property of surpring you.
There are apsects of complext systems that are simple. Like power grids and supply chains. BUt the entirety of system of the kind Warden represent with the 5 rings is not.
The anaolgy I see here is one to medicine. Warden appers to me as an oncolologist who is a practioner of chemotherapy.
He argues that the human body is a system and should modeled as a simple system, with obvious "centers of gravity" that a variety of chemo therapy drugs can effect.
He then makes the leap that the rest of medicine is being held back because it uses a vocabulary dating back to well before oncology even existed and chemotherapy was known.
Medicine has always been stuck in a paradigm of treating symptons in series, over time leading to long and costly hospital stays that are bankrupting health care.
Chemotherpy drugs can be simultaneously injected directly to the site of tumors and can effect individual genes and do all manner of miraculous things.
So to reduce the bankrupting cost of hospital stays, we need to redfine the nature of medicine to the realm of oncology, and adopt a strategy of simultaneously injecting chemotherapy drugs (well, if we think it helpful we can use radiation or other means - its not to say every treatment besides chemotherapy should be eliminated - but in order for chemotherapy to acheive its true capability...), and then follow up in out-patient clinics that are much cheaper.
After all its all about trying to jump directly from treatments to cures as quickly as possible with the lowest cost...
The rest of doctors look at this approach and go "is he fricken crazy...?!?!"
Yes, we need to understand the patient as a system - but a human is more than the sum of its parts it can only be simplified so far before the model of human is useless to guide diagnistics and treatment.
Yes oncology might be the most "intense" form of medicine, but there are a host of medicial problems out side oncology.
Yes chemotherapy is an indespensible form of treatment, but it is not applicable to every disease and it does not makes sense to redefine medicine to oncology becasue of a desire for chemotherapy to "reach its full capability".
Assuming that because hospitalization is expensive, that means that simultaneously injecting chemotherapy drugs, based on simplified models of how a human bodyworks, will be effective, is not a logical argument.
Particularly given the fact carrying the analogy perhaps too far, that you only actually treat a real patient every 10 or 15 years, the rest of the time you just deal with your simplified model and ASSUME that the results will apply to the real patient.
The individual parts of Wardens argument are sound. No one is arguing the 'necessary" part. Its the way he puts them together and says "and therefore... we need to redfine medicine, and completely change the way we treat disease, and if your patient's illness doesn't fit this mode, then we should not be treating them" that has us scratching our heads, like the doctors in the analogy.
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