This writing is inspired by my conversation with Barry Davis on An Analog Brain In A Digital Age — watch the episode. His book: The Preventioneers: Diseases, Disasters, and the Discoveries That Changed Our World. Inspiring stories of individuals who shaped prevention as a public good.
You Don't Have to Touch the Candle
On prevention, invisible harm, and the beep we stopped hearing
Confession first: I recorded this conversation a while ago, and it waited in line far longer than it deserved. Too many conversations, one analog brain. It's a big part of why I mostly record on my own these days. Apologies to my guest, and thanks for the patience.
This writing is inspired by my conversation with Barry Davis on An Analog Brain In A Digital Age — watch the episode. His book: The Preventioneers: Diseases, Disasters, and the Discoveries That Changed Our World. Inspiring stories of individuals who shaped prevention as a public good.
I put my seat belt on without thinking about it. Door closes, hand reaches, click. Somewhere along the way it stopped being a decision and became part of the car, like the steering wheel.
It wasn't always like that. For years the belt was there and almost nobody wore it. Then the car started beeping. Then came the fines. Then, slowly, the click moved from the law into the hand, and from the hand into a habit nobody notices anymore.
That's the strange thing about prevention when it works. It disappears.
Barry calls it a victim of its own success. Measles leaves the country, and the reason to vaccinate leaves with it. The thing that kept the danger away becomes the argument for letting our guard down.
Nobody throws a party for the fire that didn't happen.
But fire, at least, is visible. When Ben Franklin wrote that an ounce of prevention is worth a pound of cure, he wasn't talking about medicine. He was talking about fire. Smoke, flames, a street where houses used to stand. Nobody needs a statistic to believe in it.
Car crashes are visible too. Doctors see them every day in the emergency room, and we see them in the news and in the streets.
Floods are visible too. We watch the water rise, live, on every screen.
Other harms are not as visible as these.
A disease you've never seen becomes an abstraction, then a rumor, then something your neighbor isn't sure is real. A cyberattack makes no smoke. I've spent more than a decade around cybersecurity, and most of the damage there is invisible. Data walking out the door. Identities stolen and used somewhere far away. Companies compromised for months before anyone notices. We sweep it under the rug and wait for the big one, the event so dramatic it will finally change us. Barry isn't sure even that would work. People move on.
And now AI, where the harm won't even look like harm. It will look like a decision. A mortgage denied for reasons nobody can explain. A diagnosis checked by a machine, or not. A video of someone saying something they never said. No smoke, no flood, nothing on the news. Just an outcome that seems perfectly normal, until you ask who decided, and nobody quite knows.
The technology world has a name for getting ahead of this: security by design. It's a good idea with an old soul. It's prevention. Franklin would have recognized it in a second.
It also carries the same curse. If it works, nothing happens. And nothing is very hard to defend in a room full of people who want to ship.
That makes the job harder. Prevention has always started from what we can see. For these harms, it has to start from what we can imagine.
That's a different muscle. It's the one we use for stories, not statistics. Science fiction has always done this kind of work, rehearsing disasters so we don't have to live them. Kim Stanley Robinson opens The Ministry for the Future with a heat wave that takes twenty million lives, because that's what it takes to get the world in his novel to move. Fiction can afford that kind of catastrophe to make its point.
We can't.
Maybe that's what the beep has been all along. Not a sensor. A story, repeated until we believe it without needing the crash.
When we're kids, someone tells us not to touch the candle. We touch it anyway, just to be sure.
We have always learned faster from the burn than from the warning. More and more of the burns are invisible.
You don't have to touch the candle.
— Marco Ciappelli
The Preventioneers Diseases, Disasters, and the Discoveries That Changed Our World - With Author Barry Davis
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[00:00:00] Barry Davis: extremely important. It's a fantastic thing. You know, you get to the extremes of ai. You get these so-called experts that say, this is sort of gonna be our golden age. you get the other people that say, this is gonna be the end of mankind. So, you know, like everything else in life, it's gotta be somewhere in between. Um. But we need to maybe now, I wouldn't necessarily say slow down, although that may be best, but we need to at least try and keep pace with this,
[00:00:30] Marco Ciappelli: Hello everybody. Welcome to another episode of, uh, an analog Brain in a digital Age. Sometimes I, I inverted in my, in my head when I say this because I'm not really sure where we are standing. And I think today is gonna be in a fantastic conversation with Barry Davis, which actually wrote a book about, uh, uh, how some things could be.
Prevented. Um, as a matter of fact, the, the book is called The Prevention Years [00:01:00] is a good title, disease disaster, and the discoveries that change our world.
And uh, I am already talking way too much. So, Barry, welcome to the show and let us know a little bit about yourself, who you are, and why you decided to write this book.
[00:01:15] Barry Davis: Thank you, Marco. Well, I am a, Meritus professor at the University of Texas School of Public Health. Um, I have a background in uh, preventive medicine, biostatistics, clinical trials. Um, so I've had a, a long history with prevention. Um, I, for years worked on hypertension and clinical trials and saw of, uh, treating hypertension, how it could prevent serious events. But I've always been steeped in looking at prevention. Why do we let things happen? Um, and, uh, during COVID, it just hit me right away that at the very [00:02:00] beginning there were so many more things that could have been done try and prevent the spread before we actually had a vaccine. Um, and even when the vaccine came along, more things could have been done.
I, I know hindsight is great, but, um, we can learn from history. So I decided to investigate and I started off by thinking about the famous phrase, an ounce of prevention is worth a pound of cure. And, um, it came from Ben Franklin, who a lot of things come from Ben Franklin. Uh, and, uh, he wasn't talking about disease He was talking about fire, uh, and he was very much into fire prevention because he had experienced. Quite a few fires in his life. Uh, and he, um, came up with these ideas, many of them he borrowed, uh, they weren't all original, how to prevent fires. And he wrote a, a [00:03:00] sort of a, a paper about a letter. Um, and I decided to move on from there and look at other people who are really steeped in prevention. And it turns out, as I looked at many, many different areas, there seemed to be a pattern. People, no matter where they lived or worked, uh, they saw harm they thought, how could this harm be preventive? And then they decided to do something about it. The evidence had to accumulate. Um, and then that evidence had to turn into, um, something that could be formed into a solution.
Something translated. Then once translated, it had to be implemented in some fashion and hopefully implemented in a way that would be standardized. And part of the, the, the laws or the culture or some other, um, guideline that would make it permanent
[00:03:54] Marco Ciappelli: Yep.
[00:03:55] Barry Davis: technology is, you know, a great example of this, uh, um, auto, [00:04:00] auto safety.
I have a whole chapter about auto safety.
[00:04:02] Marco Ciappelli: Yeah,
[00:04:03] Barry Davis: You know, when cars first came out. There was no safety thoughts. This is back in the twenties. It was just amazing when people got in accidents. I would just tear things apart, let alone if they went through the windshield.
[00:04:16] Marco Ciappelli: well, if I remember, if I remember well, there was something related to actually the first cars that didn't have brakes. I don't know if he's a legend or not, but, but I heard of it, so really like, let's, let's go and we'll figure it out.
[00:04:33] Barry Davis: So anyway, um, there were a number of doctors who treated injuries, whether the person was a neurosurgeon or a plastic surgeon or uh, ENT doc. Uh, and there was a police surgeon. all saw these injuries. Um, and they said, why, why are they so injuries so devastating? thought about it and they realized that, well, yes, people got in [00:05:00] accidents, but. Maybe there's something wrong with the design of the car. And then over the years, these docs and other people accumulated evidence. showed that you could redesign the car to make it safer, like the dashboard, making the steering wheel retractable, um, using seat belts. And then, you know, from there it went on and on and on.
And now we have airbags and this fancy stuff that's come out in the last 10 years. But it did reduce the. Injuries, deaths the, um, devastation of the injuries. So it was, you know, the technology was there way ahead of, uh, people did to try and do something about it. But one other interesting is that even when the seat belts were sort of mandated in cars, didn't use them.
[00:05:53] Marco Ciappelli: Yeah, I remember that.
[00:05:56] Barry Davis: you know, get the beep in the car and tell you to put your seatbelt on before they put. [00:06:00] Laws in place that if you weren't wearing a seatbelt, you, you have to face a fine. Uh, it just became part of the culture eventually. Unfortunately, people still don't use seat belts and there are a lot of injuries that show up in emergency rooms where if they had just worn a seatbelt that could have been prevented.
[00:06:19] Marco Ciappelli: Right. Let me, let me ask you something because of course we have a lot of example of. How we didn't apply prevention. Do we have, not just to be the optimistic in the the optimist in the room, but do we have cases where actually something happened in the opposite direction where we did prevent, or the big question is it's just who we are.
[00:06:46] Barry Davis: All of these cases in the book except for. Climate change, uh, ended up with some form of prevention. Uh, even if we go back to like Ben Franklin, I mean, he talked about fire [00:07:00] prevention and as a result of all of his work, I mean, we do have all these ways to prevent fire even though they still occur. Um, and he, uh, well there, there were all these fire museums across the country, if you go to any of them, one of the things you'll always see there is Ben Franklin. He was like the father of fire prevention. Um, but things work. I mean, they, they work slowly. People resist. That's another pattern that's in prevention, this incredible resistance from many quarters, industry, uh, culture. But it happens. And, uh, eventually things can change. I mean, things did change for fire.
They changed for. Uh, auto safety, they changed for cigarettes. Smoking as much as we'd like to. I mean, this recently, the United Kingdom just passed a law to prevent access to the next [00:08:00] generation from getting tobacco. They figured they couldn't deal with the present one, they, maybe they can do something about the next generation. So there, there were, there were, um, optimistic, good stories in there. It's that there's this pattern and it takes persistence and, and maybe certain heroes push forward to make things happen.
[00:08:25] Marco Ciappelli: Right. So I deal a lot with cybersecurity, and that's of course part of technology, but it's become part of everyday life, and that's definitely a very big conversation, what you just said, like people just don't see it, right? It's not tangible. And even when you say things are tangible, like lock your door.
Uh, you know, be sure that you put your, your helmet when you ride a bike or when you, you put the, the seatbelt when you, you know, people don't even see what happen in the computer. They don't understand it in their phone and so on. So it, it is really like, whatever, you know, [00:09:00] convenience versus security slash safety.
So to me, sometimes these changes that you just mentioned needs to be kind of forced, almost like. Gotta force you to be free, gotta force you to be safe by applying laws. And still it takes time. And with technology, the problem is that we don't have time because it's just rolls so fast. So that, that's a big topic right there.
How do you see this?
[00:09:33] Barry Davis: Well, I, I would say a few things about what you just said. One is that. Yeah. Yes. I, I hate to use the word force, but it would be nice to have some laws, but the best thing is to have some, ~uh,~ reminders constantly and to have some part of the culture, uh, enforce this. I mean, the thing about prevention is that it's a sort of a victim of its own success. If you [00:10:00] prevent things like in the case of measles. You know, prevented. Nobody had measles anymore. It was eliminated from the United States. Well, why should I get a vaccine? Nobody has measles. Well, because it's still around and if you don't give the vaccine you could get it.
[00:10:15] Marco Ciappelli: Right.
[00:10:16] Barry Davis: The same thing with you, I guess what you are talking about, cybersecurity. I'm I playing around with my computer? There's all these safeguards. I got all these software built in. do I have to be so careful all the time? You know it, it'll take care of itself. Well, you have to be reminded all the time that no, you need to be s wary. You need to know how to do things. So the case, you know, which I thought we were, we're gonna, I guess we're, we're here now.
Maybe we get to eventually is about, um, artificial intelligence. AI is that it's new technology, well new in the sense of how rapidly it's evolving and becoming part of everyday use, uh, [00:11:00] and. There isn't really that much governance around it. It's taking off so rapidly and people are thinking about it. There are some maybe some countries around the world that are trying to institute standards and some guidelines and even some laws to deal with it. But it could get ahead of, we need to be very careful. I mean, the things that I worry about are, um, and accountability. You when people talk about things like deep fakes, let alone somebody's robbing their personality, we'd have a, all this politics going on, you don't know what's real and what's not.
Where's the trust anymore? So it would be nice if there was some more action being taken governments and by societies. Uh, providing guidelines and maybe actually [00:12:00] laws governing this stuff so that we wouldn't up with, uh, people not trusting anything in.
[00:12:06] Marco Ciappelli: That's true. So one, one of the issue there is, as you said, many countries and many states, even in the United States, are applying what they call the guardrail. So it's already happening. The road, it's full of AI agents, all of that. And let's, let's limit what they can do so we can apply some safety ethics and, and on.
So on the big deal will be what if we could apply instead of as a afterthought, as a. Security by design, which is another big, big word in a lot of technology and, and cybersecurity, but also security by design. To me it's, it's, it's prevention. It's just another way to say prevention. So. What can we learn besides the fact that we agree it's really fast and regulation and governance come really [00:13:00] slow and and so on.
Is there, what can we learn from the past, like all these phenomenon that you have seen and analyze from the fire prevention to this smoke smoking to the climate change? And we can touch on that as well. Yeah, anything we can learn. 'cause I feel like humans, I, I'm just being extreme here, but humans are really, you know, they really tend to forget the past instead of learning from it, which is a big problem.
[00:13:31] Barry Davis: You're absolutely right. Um, we tend to forget the past. also like the status quo. like to change things, you know, and you also don't like to be told to do things. Um, but you know, the leaders in this field. They're, and on the one hand, they should be the ones who should be proposing this. On the other hand, they realize that, you know, [00:14:00] it's, if it's unregulated, they can move ahead as fast as they want and try and capitalize on it as much as they want. So, I mean, it's up to the leaders and other people who are experts in the field to try and call the alarm, sound the alarm for this, get people to. things. I mean, it, it would be easy to provide many, many areas where things are happening so fast that, uh, show what's wrong, with deep fakes or, um, in some fashion. I mean, there are many fields, whether it's in health, you know, how do you know the, your doctor did or how do you know when your doctor consulted ai, that they made sure that it was correct? Uh, when people apply for, let's say mortgage or something, what was the method used to see whether their mortgage was denied it? Um, and then there is this other aspect of it, which is also growing [00:15:00] at a rapid pace because of ai, which is this growth of data centers. I mean, you know, and everybody's talking about this and one built in your community, which may create jobs and such, but what's it gonna do to the infrastructure? What about the water usage to cool the, I mean, all these things are important. AI is extremely important. It's a fantastic thing. You know, you get to the extremes of ai. You get these so-called experts that say, this is sort of gonna be our golden age. you get the other people that say, this is gonna be the end of mankind. So, you know, like everything else in life, it's gotta be somewhere in between. Um. But we need to maybe now, I wouldn't necessarily say slow down, although that may be best, but we need to at least try and keep pace with this, that it's a, an ongoing problem and, and the the storm is coming and we better do something about it.
[00:15:55] Marco Ciappelli: Yep. To, to me it comes down [00:16:00] to really be, you know, honestly it's a solid sociology lenss through all of this. Like, I mean, you can put a little bit of psychology, healthcare, technology and all of that, but it comes down to the way, the way we are. And that's very hard to predict. It's not a sure science. Um, and I think there is a lot of things that are.
Affecting it. And you, you mentioned social media before. I don't remember if it's before we started recording or not, but we know, right? I mean, we smoking, I, I'm a former smoker. I've been, you know, not smoking for many, many years, but as a young kid growing up in Italy, yeah, I was a smoker and I, I knew it was bad for me, right.
I, and we do things that we know are bad for us. One thing that I do like of what you said is that. Reminding the constant reminder that could really be something. And I'm thinking like, keep seeing an ad, [00:17:00] a public announcement. It, it kind of start resonating with your head. A reminder of a beep in the cart, put the seatbelt on.
A reminder on your computer there. Did you update your security, uh, your operating system? Did you get the patch? So it is not really forced. I mean, I was going to extreme and being provocative about that, but I, I really think that gotta be a mechanism that it's reminding and at the same times educating, because I feel like it's intrinsic in the way we are and we gotta find a way around it.
[00:17:35] Barry Davis: No, I, I. With that. I mean, you need to remind and educate and think back. We, we used to have ads on tv, many more about smoking or even auto safety. Remember the crash tummies,
[00:17:49] Marco Ciappelli: Yep.
[00:17:50] Barry Davis: uh, and we had many things about that. And it's if you nudge people along to [00:18:00] remember about these things and what they should do and the consequences if they don't. And realize that why we, we, you're, you're safe now because this works so well. But if you don't keep on trying to prevent things, you're not gonna be as safe. I mean, and the thing that, that, you know, my book ends with the climate change. And I mean, we've known about climate change for decades, decades. into the nineties, you started having early international conferences. People were trying to do things, but it's on a planetary scale, let alone getting individuals to do anything. I, you know, I think it's really hard for an individual to like climate change. It's gotta be on a government level, but you know, how do you get all the nations of the world to cooperate?
How do you get governments to do the right thing? It's been an extremely difficult problem that we've had. Forward motion and [00:19:00] backward motion in, in the meantime, the climate is changing. The number of billion dollar climate events in the United States just goes up and up and up every year. Um, and people, it happens and say, well, it's climate change. Well it is. What are you it's gonna do about it?
[00:19:19] Marco Ciappelli: We know, we know what it is. I don't, I don't need you to tell me about it. Right. Uh, you know, but yeah. I, I agree. I, I feel like it's, in a way, if you wanna look at it from a philosophical perspective, it, it's a way of being a selfish. Society like being like, let, let the future generation deal with it. And, and I, I, I know it's really bad, but, uh, you know, the economic consequences of changes, the push from corporations and you know, the evil of growing the company no matter what, who cares what?
What happened? I mean, the, the climate change you mentioned, I mean, I feel like, [00:20:00] I remember there were people ringing the alarm in the fifties, not even in the nineties, but back in the fifties and they were shut up. You know, like, I live in la I seen public transportation is starting again now, but we had apparently one of the best public transportation in the world back in the fifties.
And then. It was tore down to have more car on the road to sell more tires, more gasoline and and so on. So yeah, the power of the individual is set as it is. Uh, it's, it's very limited unless there's a way that we can come together. So what are, what are the lessons that, that you can, you know, any, any tips, any eureka moment that you had analyzing all this phenomena?
[00:20:43] Barry Davis: You need. I mean, the book is about sort of these prevention pioneers, these heroes. We need more heroes like that. who are willing to step out front, persist, fight against the, uh, David [00:21:00] against Goliath. You have to just keep on doing this. it just, it does amaze me. As you just said, like climate change that you know, well, let's just live for today.
But, you know, you have, people have children, they have grandchildren. There's a future generation. They just so selfish that they don't care about that. Um, it would be one thing if the science was the evidence was scanned, the evidence is overwhelming. It just, it just boggles the mind in some way that people. At least leaders aren't paying more attention. Now. There are in climate change, there are a whole bunch of people who are pushing, pushing and very persistent, and they're well known. There's hundreds of them, but somehow it just hasn't caught on. Hopefully it will, they just have to persist.
[00:21:57] Marco Ciappelli: Yep. I, and I think it, [00:22:00] it, it comes down a lot to education, but in order to educate, you need to have a, you know, if you're a teacher, you need a student that wants to learn, right? You, you can't, it cannot be a one way type of thing. So something gotta happen. And oftentimes we talk about that catastrophic event.
Again, I bring cybersecurity. It's gonna be something so bad that is gonna happen in the infrastructure. Um, but stuff are happening really bad every day. I mean, breaches and identity loss and, and you know, money hacking and software getting damaged and company being damaged, but we're still trying to put stuff under the rug and move on.
[00:22:46] Barry Davis: Yeah, no. I mean, you would think that if there was a dramatic event, something so dramatic it would change people's minds, but. On the one hand, I think that that would do it, on [00:23:00] the other hand, back of my mind is something saying that, nah, they'll move on. Uh,
[00:23:06] Marco Ciappelli: Yep.
[00:23:07] Barry Davis: there's a, there is a science fiction book called The Ministry for the Future. And for the moment, I'm the author's escapes, um, very well known science fiction. It's about. The world actually dealing with climate change. But the catastrophic event in that book that starts the book off is that 20 million people died climate related disaster. 20 million people, I mean, I hope we don't have to go to that.
[00:23:44] Marco Ciappelli: I hope not.
[00:23:46] Barry Davis: Oh, Kim Stanley Robinson. Great, great science fiction. Learn.
[00:23:50] Marco Ciappelli: Okay. So if we want to end this conversation in a, in a positive note, what, what, what can we. [00:24:00] What have, what have you learned positive? We learn about people that really start fighting the battle and getting followers. And I, and I, I'm thinking, and tell me if I'm wrong, we, we can spend another couple of minutes.
'cause it's really interesting to me the psychology of change, right? Like Benjamin Franklin, if I'm correct, he witnessed a really bad fire and then it was. Even motivated even more to do something about it. So it is not a catastrophic global scale event, but for someone, it's enough. Like when you see people that start doing, uh, charity and, and research or some kid wants to become a doctor to fight cancer because somebody in the family had it, so that that big event could be a personal event.
And, and I, and I think that. I mean, I really hope we don't need to lose millions of people in [00:25:00] order to learn something. I, I don't think we need the, an AI that is gonna take over in hospital and kill everybody just because the, the goal was, the prompt was set in a very misleading way. You know, like, you know, if, if we look at sci-fi again, but we should learn before things happening.
We should trust that you shouldn't touch the candle because you're gonna burn your finger. And you don't have to touch the candle, so.
[00:25:27] Barry Davis: No, I mean, I, I do have hope the sense that there are many people out there who are basically fighting a good fight. you think about any movement that changed things. There were leaders in that move and they persisted. There were setbacks all the time. You know, sometimes it's a dramatic setback, but they come back or other people come back and they realize that they have to keep fighting and fighting and fighting. Um, and eventually, um, they'll make [00:26:00] progress. I do believe in that phrase from Martin Luther King, that, uh, you know, the moral of the universe is bending towards good.
[00:26:10] Marco Ciappelli: Yep. Well, Barry, I think this is the kind of episode that, that I like, and even if we end up on a, on a pause. Is because we're thinking, we know in, in talking, if anybody does public speaking, housing gives time to people to think about it. We shouldn't rush into words all the time, and my goal is to leave the audience with more questions in their head.
Then answers because I think with your book and other books like yours, it's really rising a concern some points, and letting people reflect with their own brain and not. Forcing as I was using the word in a provocative way before. So I, I, I thank you very much for being part of my show and, and I hope that people get [00:27:00] a good idea of what the book is about.
I hope that they actually do read the book, and I will put, of course, links to your, uh, website and your book so they can get in touch with you and of course, um, buy it, read it, and uh, made up their own mind. Hopefully they'll join, they'll join us.
[00:27:19] Barry Davis: Right. Hopefully. Yes. I appreciate it, Marco. Thank you very much.
[00:27:22] Marco Ciappelli: Yeah, it was great having you and everybody else. Stay tuned. Follow my newsletters where they'll obviously be, uh, and you probably learn about this podcast as well, so subscribe, stay tuned and, uh, there'll be more. Thank you again, everybody.