It Might Get Messy

A long time ago, in a galaxy far, far away, I worked for a company called “Failure Analysis Associates”. Over time, somebody in the senior management team had the genius light bulb moment, waking up in a cold sweat on a late night realizing that perhaps the corporate name, and such marketing materials as the annual “Disaster of the Month” calendar, might just possibly maybe potentially could suppress sales to the theoretically large pool of potential customers who considered their problems to be below the “disaster” threshold. 

Said management genius (those of you who have worked with me will know that “genius” is not a term I apply lightly or often to management) kicked things into motion. The corporate management team sprang (“sprang”?! Is that a word? It doesn’t look right. But the only alternative I can think of, “sprung”, doesn’t look good either. Perhaps I should use “leaped” as a substitute…ahhh, no, fuck it, I’m going with “sprang”. Which admittedly sounds like the name given to a popular wallaby in an Australian petting zoo…) into action. Soon a consultant was hired to invent and vet a new corporate brand. I cannot at the moment recall the entire short list of possibilities they came up with. One potential name was “Scieneers”. Another was “Exponent”. The latter won out. My opinion was (and is) that Exponent was an excellent choice. 

California-based Exponent was at that time sitting on a mountain of cash earned by hard work on a number of high-profile and technically challenging projects. The destruction wrought on 9/11, other airplane crashes, train derailments, and a large number of consumer product safety cases were bloating up the portfolio. When things finally started to settle down, the case load shrank (“shrank”?! Is that a word? Doesn’t look…etc.) to something more realistic and less inclined to drive the practitioners to heavy drinking and off-the-grid living in remote corners of Joshua Tree National Park. 

Anyway. The newly named corporation set about using its buckets of Benjamins wisely (those of you who have worked with me will know…etc.). Diversification was needed. The entity that is now Exponent was built and operated almost exclusively on projects involving performance of products of hard engineering. Exponent had a very large market share in this arcane field. As the portfolio of engineering issues grew, it was necessary to invest in senior technologists, support technical staff, and corporate overhead staff to take care of business (literally). Every new staffer made the company better at performing in its market niche. But. Every new staffer also put pressure on market share—the company needed large sums of money (much of it spent on those new staffers) to maintain its power in the marketplace. But revenue growth via more of the same-old same-old began isolating the company, making it a technical boutique. It wasn’t difficult to look ahead and realize the financial risks inherent in a business model focused-like-a-razor…uh, I mean laser… on a finite and intensely competitive core-business. 

So they went shopping. 

Among the fields-of-endeavor they explored were life sciences. There was much overlap of natural resource failure analysis, impact assessment and prediction,  toxicology, energy development, chemistry and biology of pharmaceuticals, ecosystem functioning, and other aspects of environmental stewardship. Once management had this focus in mind, they acted quickly. Triaged environmental consultancies worldwide. Via hard work and focus, the company I (and several other people who regularly read this blog) worked for (some regular readers…you know who you are!...remain, having survived the capitalist analogy of being dragged off the bank of the watering hole and into the depths by an enormous Nile crocodile) bought out several environmental consultancies to add diversified muscle to the heavy-lifting work on engineering failures.

Environmental consulting was an obvious endeavor to add to the company’s portfolio. It was a natural fit in the technical package offerings. Management went diligently at the task of adding environmental power. 

The drastic (and risky) expansion of technical expertise into the environmental field rapidly became a success story. Now the company also had options during lean times. The company could lean on one class of work when the other became difficult. Successful identification, exploration, extrapolation, and maintenance of a high-quality environmental consultancy superimposed on the existing corporate technical structure was a real challenge. But fast thinking and commitment made it work. Exponent had successfully bridged human and environmental performance, along with costs of failure and benefits of success in specific projects.

Such as conducting a detailed analysis of the New England Patriots’ game ball deflation issues for the attorney hired by the league to address same. Exponent did a good job. Their work is an appendix to the report itself, and is available at https://nfllabor.files.wordpress.com/2015/05/investigative-and-expert-reports-re-footballs-used-during-afc-championsh.pdf .

And what is the connection between the balls controversy and cancer? Well, I have read the report, which claims to prove that a couple of dressing room attendants deflated the Pats’ balls after they were inspected by the designated official but before they were used on the field. It turns out that the seemingly simple question—did the Pats doctor the balls—is much more technically challenging than you would think. And the answer is less clear-cut than it seems it should be. It ends up being very much a weight-of-evidence phenomenon, yielding findings of “could have” and “might have” rather than “did”. And based on this weight of evidence assessment, drastic and controversial actions will be taken by the league (or not, which would be equally controversial). 

We’ve talked about the inability of modern medicine to unambiguously diagnose many cancers, and the massive uncertainty surrounding treatment when it IS diagnosed. There is an action analogy here. My doctors have to treat me going forward based on a highly uncertain weight-of-evidence. My lungs are full of spots that could be the yield of the drastic and dangerous treatment technologies, or they could be incipient cancers. Any actions we take in response to their presence at the moment would have enormous uncertainty. Given the powerful and destructive nature of available treatments, we have to get the guesstimates yielded by the weight-of-diagnostic evidence right. 

I’m guessing right now that there are even-up odds that my lungs and chest cavity are nurturing terminal cancers vs. more benign alternatives. The outcome of the diagnostic uncertainty is completely dependent on making the right choices. If they are benign and we treat, the treatments have a pretty high likelihood of killing me outright. If we assume they are benign and we don’t treat, I’m highly likely to die painfully  and quickly if they are in fact malignant. 

The lawyer author of the deflated footballs report draws his primary conclusion—regarding Tom Brady’s knowledge—with a level of uncertainty described as “more likely than not”. It’s a 51% chance. 

Punishing Brady will be difficult and controversial, given the wobbly certainty of his likely involvement. But at the end of his suspension, however long it is, he’ll still be alive. Even if the findings are erroneous. My diagnostic uncertainties are precisely parallel—about a 51% chance. But the outcome of getting the analysis wrong in THIS case is that I’m dead if we get it wrong. Quite the tightrope walk. 

Oh well. That’s the status of the science of cancer management at this moment. When my kids reach my age, I’m betting the diagnoses in cases like mine are close to full certainty. Meaning the odds of their dying of treatment OR cancer will be very low. Sigh. It’s quite the slog up the slope of this bell curve. I sincerely hope that before long, cancer victims won’t have to make the hike. 

Anyway. Use ‘em while you got ‘em, my friends. They are NOT forever!