From The New York Times last week:
Brainy, Yes, But Far From Handy
“STANFORD, Calif. — In factories and warehouses, robots routinely outdo humans in strength and precision. Artificial intelligence software can drive cars, beat grandmasters at chess and leave “Jeopardy!” champions in the dust.
But machines still lack a critical element that will keep them from eclipsing most human capabilities anytime soon: a well-developed sense of touch.
Consider Dr. Nikolas Blevins, a head and neck surgeon at Stanford Health Care who routinely performs ear operations requiring that he shave away bone deftly enough to leave an inner surface as thin as the membrane in an eggshell.” (Emphasis added)
It’s an interesting piece and well worth a read, but I think that what the article talks about could be better defined as “feel” rather than touch.
It’s a subtle distinction, granted, but one that can be seen in the definitions of the words:
Touch – to put your hand or another part of your body lightly onto and off something or someone.
Feel -to touch something in order to discover something about it.
Of course feel also has other uses and meanings relating to emotions, opinions, desires and experience in general. But feel, in a physical sense, is a very special ability.
Kevin O’Regan, author of “Why red does’t sound like a bell: Understanding the feel of consciousness” suggests that feel does’t come from the finger tips, nor does it come from the brain, but rather, feel emerges as a dynamic relationship between the animal, it’s embodied nervous system and the environment.
O’Regan collaborated with Alva Noë in developing the sensorimotor approach to explaining the ‘feel of consciousness’ (although they have each taken the initial ideas in different directions now) and starting from about 16 minutes into the following video he uses the example of the ‘feeling of softness of a sponge’ to explain his theory. O’Regan’s explanation* sits very nicely with the definition of feel that links to the notion of discovery- of interaction, with the physical world.
As an emergent, dynamic interaction between a human and it’s environment – a mode of being in, exploring, and understanding the world through contact, the extension of touch and feel to therapeutic uses seems natural, perhaps inevitable. But a deeper understanding of feel, as offered by O’Regan’s sensorimotor approach, offers some useful notions and perhaps a caveat or two in relation to manual therapy.
The sensorimotor approach suggests that the softness of a sponge is not an inherent characteristic of the sponge, but instead an emergent, dynamic interaction between a human and the object, which will be modified by the nature of the human’s body. As a simple example, the feel of the softness of a sponge will be different to a child than to an adult, different to a person with a healthy hand than to a person with severe rheumatoid arthritis or CRPS. The feel of the sponge to one person is “private” and unknowable to others – just like pain.
There is also relevance to the idea of feeling ‘things’ in another human – trigger points, tight bands, ‘stiff’ joints, tight muscles, ‘tension’ etc. Taking the sensorimotor approach, and considering that the feel of a muscle, of a joint or any part of another’s body will emerge as a reciprocal interaction between two constantly changing human beings, is there any wonder about the lack of inter- and intra- tester reliability of therapeutic related touching and manual probing?
Rather than being disheartening from a therapeutic point of view, O’Regan’s theory may be able to free the therapist from a potentially pareidolic trap – rather than focusing on labelling and judging what is (thought to be) felt and what it ‘means’, the focus might shift to the dynamic interaction between two people with both discovering something new.
*O’Regan extends his theory to argue that robots will be able to be developed some time in the future that will truly “feel” – not just the feeling of ‘softness of a sponge’, but emotional ‘feelings’ as well. In the mean time, robots are definitely getting quite handy. A video embedded in the New York Times piece shows a remarkable bomb disposal robot being remotely controlled and demonstrating a high level of dexterity*. But there is clearly a way to go. The robot hands fumble at times and only succeeds in grasping the detonator with an ‘inferior pincer grasp’, which if memory serves me, develops in children at the age of about 7-10 months and is surpassed with a fine pincer grip at the age of about 12 months. There is also something a bit creepy about seeing those robot hands work, they are so close to natural human movements at times. Seems there is an uncanny valley for hand movements too?
A most beautiful piece Tim, eloquently expressed. I felt every word 🙂
This piece is something I’d like to point my students toward. To many, “feel” is first and foremost about their emotional reaction but there’s much more to be said about it. This helps me.
Thanks for taking the time to comment, glad you enjoyed the piece.
Understanding the meaning of words is vital ……. It was once explained to me the difference between Completed and Finished……..If you are with the right partner you are complete……if you are with the wrong partner you are finished……if the wrong partner finds you with the right partner you are completely finished 😉
Thanks David – great stuff. I can’t help but wonder if you are speaking from experience…
On the topic of robotics, I imagine it won’t be long before it’s possible to program a droid to perform a very accurate diagnosis and appropriate physical treatment.
The sum total of all knowledge in physiotherapy could be uploaded very easily. Then it would be a matter of developing a decision tree or flow chart in order to process incoming client data. My first boss attempted to do this over 15 years ago! He got quite a way with it as I remember. Looking at his charts I could see that it was quite simple, but required a lot of different IF/AND/OR statements and a huge sheet of paper! Nowadays there would be software which would create a decision tree at the click of a mouse.
So anyway… say we have this droid with incredibly gentle and sensitive touch and more ‘at hand’ knowledge than any human practitioner, with all the flow charts ready to go. Would you attend such a clinic?
Consider: No congruence, no empathy, no eye contact. Just perfect knowledge and extremely sensitive touch. Certain patients might have very high built in expectations of such a machine. Would it work?
We’d be pitting expectation versus love. Both powerful.