Flashback Friday.
Two of my favorite podcasts, Radio Lab and Quirks and Quarks, have stories bout how inertia and reliance on technology can inhibit our ability to find easy, cheap solutions to problems.
Story One
The first story, at Radio Lab, was about a nursing home in Düsseldorf, Germany. As patients age, nursing homes risk that they will become disoriented and “escape” the nursing home. Often, they are trying to return to homes in which they lived previously, desperate that their children, partners, or even parents are worried and waiting for them.
When they catch the escapee in time, the patient is often extremely upset and an altercation ensues. If they don’t catch them in time, the patient often hops onto public transportation and is eventually discovered by police. The first outcome is unpleasant for everyone involved and the second outcome is very dangerous for the patient. Most nursing homes fix this problem by confining patients who’ve began to wander off to a locked ward.
An employee at the Benrath Senior Center came up with an alternative solution: a fake bus stop placed right outside of the front doors of the nursing home. The fake bus stop does two wonderful things:
(1) The first thing a potential escapee does when they decide to “go home” is find a bus stop. So, patients who take off usually get no further than the first bus stop that they see. “Where did Mrs. Schmidt go?” “Oh, she’s at the bus stop.” In practice, it worked tremendously. This meant that many disoriented patients no longer needed to be kept in locked wards.
(2) The bus stop diffuses the sense of panic. If a delusional patient decided that she needed to go home immediately because her children were all alone and waiting for her, the attendant didn’t need to restrain her or talk her out of it, she simply said, “Oh, well… there’s the bus stop.” The patient would go sit and wait. Knowing that she was on her way home, she would relax and, given her diminished cognition, she would eventually forget why she was there. A little while later the attendant could go out and ask her if she wanted to come in for tea. And she would say, “Ok.”
Listening to this, I thought it was just about the most brilliant thing I’d ever heard.
Story Two
The second story, from Quirks and Quarks, was regarding whether it is true that dogs can smell cancer. It turns out that they can. It appears that dogs can smell lots of types of cancer, but people have been working specifically with training them to detect melanomas, or skin cancers. It turns out that a dog can be trained, in about three to six weeks, to detect melanomas (even some invisible to the naked eye) with an 80-90% accuracy rate. If we could build a machine that was able to detect the same chemical that dogs are reacting to (and we don’t know, at this time, what that is) it would have to be the size of a refrigerator to match the sensitivity of a dog’s nose. When it comes to detecting melanomas, dogs are better diagnosticians than our best humans and our most advanced machines.
Doggy doctors offer some really wonderful possibilities, such as delivering low cost cancer detection to communities who may not have access to clinical care. A mobile cancer detection puppy bus, anyone?
Both these stories — about these talented animals and the pretend bus stop — are fantastic examples of what we can do without advanced technology. I fear that we fetishize the latter, turning first to technology and forgetting to be creative about how to solve problems without them.
This post originally appeared in 2010.
Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.
Comments 41
Mym — April 19, 2010
I'd still like to know what is the difference in cost between running airport backscatter scanners and using bomb-sniffing dogs. Dogs are not just less invasive, they're also way cuter.
Terrie — April 19, 2010
I would love to see more use of dogs for detection purposes. The number of things they can be taught to detect is amazing. In addition to the usual drugs, people and bombs, I've seen them used to detect produce, mercury and cancer.
ben — April 19, 2010
Since there are already service dogs that can smell the onset of seizures (due to changes in the smell of sweat) and alert the patient by barking, I think that people would be willing to see dogs as a useful tool in cancer detecting. It might be a shock the first time someone sees them, but people would get used to it.
The problem would be people who aren't comfortable around dogs, such as many Somalis who have a cultural aversion to them, or people like me who had a course of 8 rabies shots to the belly. But, traditional means of detection would still exist.
Mike — April 19, 2010
Another point to consider is the wastage in the various guide dog programs already extant: It's considered a good litter that can have a single puppy out of as many as 8 or 12, complete the whole training program to be a suitable guide or detection animal. While those numbers are for seeing eye dogs, I'm not sure that cancer detection training will be any easier. Similarly, from what I recall of cancer detection dogs, each type of cancer needs to be separately trained: So you don't get a generic cancer dog, but you have a bladder cancer dog, or a melanoma cancer dog, etc...
They have the potential to be hugely useful and lifesaving techniques. But I suspect that the best way to use them is going to be to have the appropriate samples sent to a facility where the dogs can screen them, not to try to have a dog in ever large clinic in the country.
Fernando — April 19, 2010
I don't see the point in putting as "fetishizing" technology and authority. It is just the daily experience of uninformed people (you, me, everyone) that could lead us to be skeptical of a dog. So far certain methods (which we see as homogenous because we are not informed) have worked just nicely (for as far as we know). It is not some ignorant impulse to distrust dogs for these tasks.
H — April 19, 2010
One quick comment - would it be possible for you to use gender neutral language in the second-last paragraph? Besides that, I love these two stories and thanks for sharing. They both make explicit such interesting aspects of how we operate.
Intense Minimalism • Sometimes just a sign is enough. — April 19, 2010
[...] — The Bus Stop by RadioLab (via Lisa Wade) [...]
sue — April 19, 2010
What I want to know is where can I sign up my Rosie dog to learn to sniff out melanoma -- hope mine never comes back, but it would be nice to have an early warning system just in case.
Vicki — April 19, 2010
The "bus stop" doesn't even need to be anywhere an actual bus could ever get to it - I once had a placement at a locked geriatric psychiatry ward in a hospital, and in their little, walled courtyard was a "bus stop" which worked wonders.
As a kid, the thing I hated most about visiting my Nana's nursing home was the distressed patients in the lobby trying to get out. (They had a security code on the door - fully signposted with instructions, but modern enough that the patients didn't know what to make of it.) Anything that makes the nursing home a less stressful environment for patients will do wonders for family and staff as well.
Nique — April 19, 2010
the hospital at my school has a pet visitation program, so you can find the occasional dog in the hospital seeing patients. however, they're there to keep patients relaxed and provide some familiarity amongst the new and probably scary environment. so i could very easily imagine them being used as a diagnostic tool, eventually. they're already helping people who have difficulty seeing, and people who have seizures, and finding drugs in luggage and people trapped under snow/debris after disasters. the best thing we ever did as humans was domesticate them because dogs are just so helpful!
Quib — April 19, 2010
In addition to having greater trust in machines and doctors, there also seems to be a preference for dogs over other animals in "sniffing".
Rats have been trained to detect land mines, and tuberculosis (herorat.org) and are smaller, easier to breed, and train faster than dogs. However, there seems to be a bit of a stigma (even tho' I think rats are adorable), because I can't seem to find much of anything about research or implementation outside of Africa. (There was something about gerbils in airport security, but can't find my way back to anything that looks like it's being taken seriously)
P — April 20, 2010
How is building a machine "technology" and training a dog "not technology?" Both apply a technical skill (engineering, dog training) to systematically manipulate the environment (build a machine, breed and train a dog).
Shinobi — April 20, 2010
I agree with P, teaching a relatively unintelligent animal to detect a deadly disease and signal to its handlers when it has been detected is not exactly the stone age. (And I say relatively unintelligent as a dog lover. Last night my dog got his head stuck in the wheel well of my (parked) car. Presumably he was chasing a squirrel? )
Also, as someone who fears and hates all doctors and medical technology, I'd find the dog very comforting.
Bagelsan — April 20, 2010
If we could build a machine that was able to detect the same chemical that dogs are reacting to (and we don’t know, at this time, what that is) it would have to be the size of a refrigerator to match the sensitivity of a dog’s nose.
This is my other qualm about the dog thing, cute and useful as it would be if it worked. Scientists really have a tough time trying to pin down any sort of shared characteristic between cancers -- there are just endless variations, which results in very different cell populations for the same "cancer" -- and it's not like all cancer cells secrete one particular chemical. But perhaps dogs could "specialize" in particular types of cancers; for example, prostate cancer has a pretty good consistent marker (and have fun with *that* exam! The dog sure will! :D)
(Also, the size comparison is a little disingenuous; that would presumably be the size of a machine that *smelled* the "chemical" and not one that was just responsible for detecting it in any way.)
Molly — April 21, 2010
I suspect the barriers to this technology probably have more to do with capitalism than with people's attitudes toward dogs vs. machines.
I don't think it's possible to industrialize the training/distribution/management of cancer-sniffing dogs the way it is the manufacture/distribution/maintenance of high-tech equipment -- so there isn't the same economic incentive to push for the use of dogs.
Jessica W. — April 21, 2010
Dogs are already in medical facilities, including hospitals. When I was hospitalized for two weeks, I was visited by three different therapy dogs, saw a service dog, and had a dog (a Maltese) smuggled in to cheer me up! If you were allergic to dogs, or didn't like them, you didn't have to visit the dog. Nursing homes regularly have animals of all sorts, which actually reduce drug consumption rates, lower the infection rates, and increase longevity. Having a dog around can help alleviate many psychiatric disorders that go with hospitalization. Dogs are also frequently used in psychiatric centers, and are awesome for people with PTSD.
I think that it is a possibility to use cancer-sniffing dogs, and I'd totally go for it.
Reality disorientation « Mental Nurse — May 9, 2010
[...] go home, often to return to husbands and wives who died years ago. I’ve just been e-mailed a novel solution to this problem, from a nursing home in Germany. A fake bus stop. The fake bus stop does two wonderful [...]
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Bill R — October 18, 2015
Tech or no, ingenuity will always be in demand! Great stories...
Albert — October 20, 2015
The bus stop reminds me of a recent news story which I loved. In the Netherlands, a nursing home wanted to cheer up the interior of the home by ordering door stickers. The idea was to personalize each apartment by printing a sticker of a door of a previous home of each resident.
The plan worked and even had some extra benefits: residents were better able to locate their own apartments, were more eager to socialize (telling stories about their own homes), and in general were more happy because they felt more at home. The stickers themselves were really cheap, so it was also seen as a cost-effective way of improving the quality of life.
I could only find an article in Dutch, but hey, Google translate ;)
http://www.ad.nl/ad/nl/1014/Bizar/article/detail/3869675/2015/02/20/Sticker-vroegere-voordeur-wijst-ouderen-de-weg.dhtml
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