Path dependency, a threat to our bright future

Now that I have completed some experiments in integrating graphics with entries and looked at the results, I feel it is time to go back into a more serious mode in terms of subject matter. For this entry, I will talk about the problem called path dependency. Path dependency is, bluntly put, a threat to one of the things that we as a species desire most. We desire to progress in a forward direction, to leave the worst remnants of our past behind, and to have better than previous generations did.

The first question I am sure you will ask is, “what is path dependency?”. The best way to answer is through analogy. Imagine for a moment that you are a lion, wolf, or similar large animal of prey that depends upon a fast run and a powerful bite in order to win meals. You are chasing game that is a tiny bit slower in the long haul, and of a size that will keep you eating enough to make the expenditure of energy worth it in the end. But out of the corner of your eye, you see game that is far easier over the long term to bring down, and will yield a much bigger feast for yourself once the hunt concludes. So what do you do?

In a world where there are no “transaction costs”, or costs associated with the change in direction and target, the answer is obvious. You change direction, and go after the big game because the effort/risk versus reward sum favours it. But in the real world, the world ruled by the laws of physics, it is not that simple.

For one thing, when any animal or machine designed for travel tries to change direction, it must make great effort to do so. Far greater effort than is the case when deciding to keep moving in the same direction. For one thing, in order to turn in a curve or make an abrupt change in direction, and do so without hurting oneself, one has to reduce their speed. You can see this in car races, where the cars reduce their speed by an amount commensurate with the tightness of the turn that they are going into. Although prey that is sufficiently slower to be considered an easier kill might make the change in direction worth it, another factor in the transaction is simple habit. Although people often describe each other with words like “creature of habit”, every Human meets this description to one degree or another. This makes the expression a comparative term, rather than an absolute one.

For another, although we can make an educated guess based on first impressions, there is a chance our guesses will turn out to be wrong. That larger, slower beast that we think might be an easier meal might turn out to be so strong that it does not need to outrun us, or otherwise endowed in a manner that might unpleasantly turn the tables on us. So a suitable analogy for path dependency is preference for the familiar path.

This is all well and good when we are talking about such basic things as hunting. But when we are talking about the development of machines, of medicine, or of technology, it poses a big problem. If you had the choice between sticking with an interlaced, .414-megapixel video solution with lossy audio, or spending some cash to upgrade to a progressive, 2.073-megapixel video solution with lossless audio, and found the expenditure within your means, would you stick with the former? If you are anything like me, you would be offended that anyone even needs to ask. Yet we have people piling up at our proverbial door, trying to make a unilateral decision for us that we not only should stick with the first option, but must do. And it is not just luxuries in home entertainment where we suffer this effect.

The philosophy behind generic medicines is a sound one. That is, proponents claim that since the active ingredient and amount thereof is the same, the rest of the formula and the brand name is unimportant. With such medicines as basic antibiotics, painkillers, and anti-allergens, this tends to be pretty true as long as certain standards are adhered to. But when the medicine in question is a complex genetic recombinant, a synthetic hormone like insulin for example, it is not that simple. Not only is the total solution for injection a complex list of ingredients (including water), but the active ingredient is a complex formula made up of molecules that literally have to be bred in laboratory conditions. Hence, insulin aspart and insulin glulisine are most emphatically not the same thing as insulin lispro (the one I use for rapid effect). I will not reveal which, but one of these formulae even has half the action time of its nearest competitor.

It boggles my mind, but there are so-called medical professionals who seriously believe that the insulin formula with the brandname Actrapid is the same as insulin lispro. I wish I could say that such incompetence only prevails in Queensland, but unfortunately it seems to have elements and roots in the other two Eastern capital cities, too. In fact, at the time I was diagnosed with diabetes, Actrapid was a porcine-source insulin (that is, they make it by getting it out of pigs). Porcine source insulin was discontinued a scant few years after I was diagnosed, but the problem remains the same. Its name is a complete misnomer. Whereas Humalog begins acting more or less as soon as it is injected (albeit at a rate that progresses with time), one could have a blood glucose level of 10.0 mmol/l, inject half a millilitre (or 50 units) of Actrapid, and have enough time to eat an entire buttercake before it begins to work.

Path dependency is the reason that so many medics who come in contact with diabetes patients seem utterly ignorant of even the most basic things about diabetes treatment. One insulin is as good as another to them. Even when the patient, who has twenty or more years of experience in being diabetic to back up their statements, tells them that they are wrong, the one size fits all approach seems to rule their decision-making. Whilst the need for some degree of competition in the pharmaceutical industry is well-recognised, competitors who keep marketing old formulae that are no longer of use to anyone who wants to stay healthy have no place in the market for medicines.

Or let me put it another way. You are sick with an illness that will never go away unless researchers make a leap akin to breaking the sound barrier. You are told that the best you can do for the time being is to keep the biological meter this illness most directly affects within an acceptable range through use of medicines that are both complicated and expensive to make. And you find that the medicine that works best for you in this respect so far, whilst being a very new and premium formula, works so much better that you do not want to use anything else. Failure to maintain this biological range on one side can result in extreme glue-mouth thirst, arthritic-like pain in your bones, and a propensity to piss like only people twice your age ever exceed. So when a person who should know far better simply by virtue of their profession expects you to inject a different medicine that for all intents and purposes acts no differently in your body to water.

This insulin, falsely called Actrapid, should have disappeared the moment that synthetic Human insulin became the expected norm. Yet it hangs around because people think one thing is as good as another. That, in a nutshell, is why path dependency is not a good thing not only in consumer electronics, but in any branch of life where it can and does occur. If sufficient resources were allocated to combating it, what we jokingly call High Definition now would already have been surpassed, amputations and blindness relating to diabetes would be dramatically reduced, and for all we know, the weird fantasy life depicted in such animations as The Jetsons might be more than a fraction of a percent on the way to becoming true.

If you have read this far and understand what I am getting at with this collection of meanderings, then please accept my thanks. If you have a person with a chronic illness in your family and now understand why they insist on a specific treatment for it, then I can sleep easier.

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