THE WISDOM OF CANCER by Kai-Fu Lee
All the passages below are taken from the book, “AI Superpowers—China, Silicon Valley, and the New World Order” by Kai-Fu Lee. It was published in 2018.
The profound questions raised by our AI future-questions about the relationship among work, value, and what it means to be human - hit close to home for me.
For most of my adult life, I have been driven by an almost fanatical work ethic. I gave nearly all my time and energy to my job, leaving very little for family or friends. My sense of self-worth was derived from my achievements at work, from my ability to create economic value and to expand my own influence in the world.
I had spent my research career working to build ever more powerful artificial intelligence algorithms. In doing this, I came to view my own life as a kind of optimization algorithm with a clear goals: maximize personal influence and minimize anything that doesn't contribute to that goal. I sought to quantify everything in my life, balancing these "inputs" and fine-tuning the algorithm.
I didn't entirely neglect my wife or daughters, but I always sought to spend just enough time with them so they didn't complain. As soon as I felt I had met that bar, I would race back to work, answering emails, launching products, funding companies, and making speeches. Even in the depths of sleep, my body would naturally wake itself up twice each night- at 2 a.m. and 5 a.m. - to reply to emails from the United States.
That obsessive dedication to work did not go unrewarded. I became one of the top AI researchers in the world, founded the best computer science research institute in Asia, started Google China, created my own successful venture-capital fund, wrote multiple best-selling books in Chinese, and amassed one of the largest social media followings in China. By any objective metric, my so-called personal algorithm was a smashing success.
And then things came to a grinding halt.
In September 2013, I was diagnosed with stage IV lymphoma. In an instant, my world of mental algorithms and personal achievements came crashing down. None of those things could save me now, or give me comfort and a sense of meaning. Like so many people forced to suddenly face their own mortality, I was filled with fear for my future and with a deep, soul-aching regret over the way I had lived my life.
Year after year, I had ignored the opportunity to spend time and share love with the people closest to me. My family had given me nothing but warmth and love, and I had responded to that on the basis of cold calculations. In effect, mesmerized by my quest to create machines that thought like people, I had turned into a person that thought like a machine.
My cancer would go into remission, sparing my life, but the epiphanies sparked by this personal confrontation with death have stuck with me. They've led me to reshuffle my priorities and to totally change my life. I spend far more time with my wife and daughters, and moved to be closer to my aging mother. I have dramatically cut down my presence on social media, pouring that time into meeting with and trying to help young people who reach out to me. I've asked for forgiveness from those I have wronged and sought to be a kinder and more empathetic coworker. Most of all, I've stopped viewing my life as an algorithm that optimizes for influence. Instead, I try to spend my energy doing the one thing I've found that truly brings meaning to a person's life: sharing love with those around us.
This near-death experience also gave me a new vision for how humans can coexist with artificial intelligence. Yes, this technology will both create enormous economic value and destroy an astounding number of jobs. If we remain trapped in a mindset that equates our economic value with our worth as human beings, this transition to the age of AI will devastate our societies and wreak havoc on our individual psychologies.
But there is another path, an opportunity to use artificial intelligence (AI) to double down on what makes us truly human. This path won't be easy, but I believe it represents our best hope of not just surviving in the age of AI but actually thriving. It's a journey that I've taken in my own life, one that turned my focus from machines back to people, and from intelligence back to love.
DECEMBER 16, 1991
The routinized chaos of childbirth swirled all around me. Nurses and doctors in sanitary scrubs streamed in and out of the room, checking measurements and swapping out IV drips. My wife, Shen-Ling, lay on the hospital bed, fighting through the most physically and mentally draining act that a human being can perform: bringing another human into the world. It was December 16, 1991, and I was about to become a father for the first time.
Our attending doctor told me it was going to be a complex labor because the baby was in the sunny-side up position, with her head facing toward the belly instead of toward the back. That meant Shen-Ling might require a cesarean section. I paced the room anxiously, even more on edge than most expectant fathers on the big day. I was worried about Shen-Ling and the baby's health, but my mind wasn't entirely in that delivery room.
That's because this was the day I was scheduled to deliver a presentation to John Sculley, my CEO at Apple and one of the most powerful men in the technology world. A year earlier, I had joined Apple as the chief scientist for speech recognition, and this presentation was my chance to win Sculley's endorsement for our proposal to include speech synthesis in every Macintosh computer and speech recognition in all new types of Macs.
My wife's labor continued, and I kept checking the clock. I desperately hoped that she would have the baby in time for me to be there for the birth and also make it back to headquarters in time for the meeting. As I paced the room, my coworkers called and asked if we should cancel the meeting or perhaps have my lieutenant give the presentation to Sculley.
"No:' l told them. "I think I can make it:"
But as the labor dragged on, it was looking increasingly unlikely that this would happen, and I was genuinely torn about what I should do: stay by my wife's side or rush off to an important meeting. Presented with a "problem" like this, my well-trained engineering mind kicked into high gear. I weighed all options in terms of inputs and outputs, maximizing my impact on measurable results.
Witnessing the birth of my first child would be great, but my daughter would be born whether I was there or not. On the other hand, if I missed this presentation to Sculley, it could have a very substantial and quantifiable impact. Maybe the software wouldn't respond well to my replacement's voice - I had a knack for coaxing the best performance out of it - and Sculley might shelve speech recognition research indefinitely. Or maybe he would green-light the project but then place someone else in charge of it. I imagined that the fate of artificial intelligence research hung in the balance, and maximizing the chances of success simply meant I had to be in that room for the presentation.
I was in the midst of these mental calculations when the doctor informed me that they would be performing an immediate cesarean section. My wife was rushed off to an operating room with me in tow, and within an hour Shen-Ling and I were holding our baby daughter. We all had some time together, and with little time left to spare, I took off for the presentation.
It went extremely well. Sculley both green-lighted the project and demanded a full-on publicity campaign around what I had created. That campaign led to a high-profile TED talk, write-ups in the Wall Street Journal, and an appearance on Good Morning America in 1992, with John Sculley and I demonstrating the technology for millions of viewers. On the program, we used voice commands to schedule an appointment, write a check, and program a VCR, showcasing the earliest examples of futuristic functions that wouldn't go mainstream for another twenty years, with Apple's Siri and Amazon's Alexa. These triumphs filled me with great personal pride and also turbocharged my career.
But looking back, it's not those career successes that stick in my mind. It's the scene in that hospital room. If I had been forced to choose between the birth of my first child and that Apple meeting, I likely would have chosen the meeting. Today, I must confess that I find this deeply embarrassing but not entirely baffling. That's because this wasn't just about one meeting. It was a manifestation of the machine-like mentality that had dominated my life for decades.
As a young man, computer science and artificial intelligence resonated with me because the crystal logic of the algorithms mirrored my own way of thinking. At the time, I processed everything in my life - friendships, work, and family time - as variables or inputs in my own mental algorithm. They were things to be quantified and metered out in the precise amounts required to achieve a specific outcome.
Like any good algorithm, I of course had to balance multiple goals. Self-driving cars don't just optimize for getting you home as fast as possible; they must do so without breaking any laws and while minimizing the risk of accidents. Likewise, I had to make certain tradeoffs between my personal and professional lives. I hadn't been a completely absent father, neglectful husband (the episode of my daughter's birth notwithstanding), or ungrateful son. My social algorithms were good enough that I made a point of remembering anniversaries, giving thoughtful gifts, and spending some time with the people in my family.
But I approached these as minimization functions, looking for ways to achieve the desired result while putting in the least amount of time possible. I always weighted the master algorithm heavily in favor of my own career goals to maximize time at work, personal influence, and status within my profession.
When I was given vacations of four weeks, I would spend one or two weeks with my mother in Taiwan or with my family in Beijing and then head right back to work. Even when a surgical procedure forced me to remain lying flat in bed for two weeks, I couldn't let my work go. I had a metal crane built that suspended a computer monitor above my pillow and connected it with a keyboard and mouse that I could lay across my lap. I was back to answering emails within hours of the surgery.
I wanted my employees, bosses, and fans to see me as a supercharged productivity machine, someone who did twice the work and needed half the rest of a normal human being. It also gave my team the not-so-subtle suggestion that I expected similar effort from them. My coworkers started calling me by the nickname "Ironman.” and I loved it.
That work ethic powered an exhilarating lifestyle. I had a chance to stand at the frontier of science, the peak of global business, and in the limelight of national celebrity. In 2013, I was honored as one of the Time 100, the magazine's list of the most influential people in the world.
WHAT DO YOU WANT ON YOUR TOMBSTONE?
Each of those achievements just added more fuel to my internal fire. They pushed me to work harder and to preach this lifestyle to millions of young Chinese people. I wrote best-selling books with titles like Be Your Personal Best and Making a World of Difference. I traveled to college campuses around the country to deliver inspirational speeches. China was reemerging as a global power after centuries of poverty, and I exhorted Chinese students to seize the moment and make their own mark on history.
Ironically, I concluded these lectures with a striking image: a picture of my own tombstone. I told them that the best way to find one's calling was to picture your own grave and imagine what you want written on it. I said that my mission was clear, and my tombstone was ready:
Here lies Kai-Fu Lee,
scientist and business executive.
Through his work at top technology companies
he turned complex technical advances into products
that everyone could use
and everyone could benefit from.
It made for a fantastic conclusion to the speeches, a call to action that resonated with the ambition pulsing through the country at the time. China was evolving and growing as fast as any country in history, and the excitement was palpable. I felt perfectly in my element and at the height of my powers.
After leaving Google and founding Sinovation Ventures, I began to spend more time mentoring young people. I used my massive following on the Twitter-like platform Weibo to engage directly with Chinese students, offering them guidance and writing open letters that were collected into books. Although I remained the head of one of the country's most prestigious venture-capital funds, students began referring to me as "Teacher Kai-Fu.” an honorific that in China combined great respect and also a certain closeness.
I basked in this role as a mentor to millions of students. I believed that this turn toward "teaching" proved my own selflessness and genuine desire to help others. In my speeches at Chinese universities, I kept the tombstone portion but changed the epitaph:
Here lies Kai-Fu Lee,
who had a love for education
during the time of China's rise.
Through writing, the internet, and lecture,
he helped many young students,
who lovingly called him "Teacher Kai-Fu.”
Delivering that speech to enraptured audiences gave me a rush. The new epitaph made for an even better ending, I thought, speaking to my substantial influence and also a certain wisdom that came with age. I had gone from scientist to engineer, and from executive to teacher. Along the way, I had managed to maximize my impact on the world while giving my fans a sense of warmth and empathy. The algorithm of my mind, I told myself, had been tuned to perfection.
It would take an encounter with the reality that lay behind that tombstone - my own mortality - to understand just how foolish and misguided my calculation had been.
The technician in charge of the PET scan was all business. After he showed me into the room, he immediately set about inputting my information and then programming the imaging device. Each yea rmy wife and I traveled back to Taiwan for our medical checkups. Earlier in 2013, one of our close relatives had been diagnosed with cancer, and so my wife decided that this year we would both get MRI and CT scans. After our checkup, my doctor said that he'd found something during the preliminary scans, and that I should come back in for a PET scan.
While MRI and CT scans require an expert eye to decipher, the results of a PET scan are relatively easy for anyone to understand. Patients are injected with a radioactive tracer, a dose of glucose that contains a tiny amount of a radioisotope. Cancerous cells tend to absorb sugar more intensely than other parts of the body, so these radioisotopes will tend to cluster around potentially cancerous growths. Computer images generated by the scans represent those clusters in bright red. Before we began, I asked the technician if I could see the scan once I was finished.
"I'm not a radiologist:' he said. "But yes, I can show you the pictures:"
With that, I lay down on the machine and disappeared into the circular tube within. When I emerged forty-five minutes later, the technician was still hunched over his computer, staring intently at the screen and clicking his mouse in rapid succession.
"Can I see the pictures now?" I asked.
"You really should go see your radiologist first,' he replied without looking up.
"But you told me that I could see it,” I protested. "It's right on the screen there, isn't it?"
Giving in to my insistence, he pivoted the computer monitor around to face me. A cold chill seized my chest, turning into an icy shiver as it spread across my skin. The black scan of my body was dotted with numerous red blotches across my stomach and abdomen.
"What are all these red things?" I said, my jaw beginning to quiver.
The technician wouldn't look me in the eye. I felt that initial chill turning into a hot panic.
"Are these tumors?" I demanded.
"There's a probability that these are tumors.” he replied, still not making eye contact. "But you should really stay calm and go see your radiologist.”
My mind was swimming, but my body continued on autopilot. I asked the technician to please print the scan for me, and I headed down the hall to the radiologist's office. I didn't have an appointment with the radiologist yet, and it was against the rules for them to examine my printouts casually, but I begged and pleaded until someone there agreed to make an exception. After looking over the scans, the radiologist told me that the pattern of these clusters meant that I had lymphoma. When I asked what stage it was in, he tried to deflect the question.
"Well, it's complex. We have to find out what kind. . .”
I cut him off: "But what stage is it?"
"Probably stage four."
I walked out of the room and then the hospital clutching the paper with both hands, holding it close to my chest so no one passing by could glimpse what was growing inside me. I decided I had to go home and write my will.
That teardrop on the page was going to cost me an hour of hard work. I had tried to dab it away with tissue as it grew heavy on my eyelash, but I was a second too late and it dropped to the paper below, landing squarely atop the Chinese character for "Lee:" As the salty tear mixed with the ink on the page, it formed a tiny black puddle that slowly seeped into the paper. I had to start over.
For a will to be in effect immediately in Taiwan, it must be handwritten, with no blemishes or corrections. It's a straightforward requirement, if a bit dated. To accomplish this, I took out my best ink pen, the same one I'd used to sign hundreds of copies of the books I had written: a best-selling autobiography and several volumes encouraging young Chinese people to take control of their careers through hard work. That pen was failing me now. My hand quivered with anxiety, and my mind couldn't shake the image of that PET scan. I tried to remain focused on the lawyer's instructions for the will, but as my mind wandered, my pen would slip, marring one Chinese character and forcing me to start from scratch.
It wasn't just the memory of those fiery red blotches that made writing so difficult. My will had to be written in the traditional Chinese characters used in Taiwan - complex combinations of strokes, hooks, and flourishes far more intricate and elegant than the simplified characters used in mainland China. These characters constitute one of the oldest written languages still in use today, and I'd grown up immersed in it. I devoured epic kung-fu novels as a kid and even wrote one of my own when I was in elementary school.
At the age of eleven I moved from Taiwan to Tennessee, a move inspired by my older brother, who was working in the United States and told my mother that Taiwan's education system was too rigid and exam-oriented for a kid like me. It was tough for my mother to watch as her baby boy moved halfway around the world, and when we said goodbye, she made me promise one thing: that I would write her a letter in Chinese each week. In her letters back to me, she included a copy of the last letter I had sent to her, with corrections to those characters I had written wrong. That correspondence kept the written Chinese language alive for me as I went through high school, college, and graduate school in the United States.
As I threw myself into a prestigious job at Apple in the early 1990s, our handwritten correspondence grew less frequent. When I moved to Beijing and began work with Microsoft, computers ate away more and more of the time I d spent crafting traditional characters by hand. Writing Chinese on a computer was easier; it required typing out the romanized spelling of a Chinese word (for example, nihao) and then selecting the corresponding characters from a list. Artificial intelligence has further streamlined the process by predicting and automatically selecting the characters based on context. That technology has made typing Chinese almost as efficient as hammering out alphabetic languages like English.
But gains in efficiency had turned into losses of memory. As I now sat hunched over the paper, I struggled to summon the shape of the characters after decades of neglect. I kept forgetting a dot or adding a horizontal stroke where it wasn't meant to be. Each time I fudged a character, I would crumple up the paper and begin again.
My will was just a page long, and in it I left everything to my wife, Shen-Ling. But my lawyer insisted that I write out four copies of that one page, each one to account for a different possible contingency. What if Shen-Ling died before me? Then I would give it all to my two daughters. What if one of them died? What if Shen-Ling and both of them died? It is an absurd set of hypotheticals to foist on someone grappling with his own mortality, but the law doesn't carve out exceptions for a person's internal distress.
Those hypotheticals did, however, refocus my mind on what mattered. Not the management of my financial assets but the people in my life. Ever since I saw that PET scan, the world had seemed to dissolve into a whirlpool of despair, one with me at the center. Why did this happen to me? I d never intentionally hurt anyone. I had always tried to make the world a better place, to create technologies that made life easier for people. I had used my fame in China to educate and inspire young people. I had done nothing to deserve dying at the age of fifty-three.
Every one of those thoughts began with "I" and centered on self-righteous assertions of my own "objective" value. It wasn't until I wrote down the names of my wife and daughters, character by character in black ink, that I snapped out of this egocentric wallowing and self-pity. The real tragedy wasn't that I might not live much longer. It was that I had lived so long without generously sharing love with those so close to me.
Seeing my ultimate end point threw my life into sharp focus and turned my egocentric wallowing inside out. I stopped asking why the world had done this to me or lamenting that all my achievements couldn't save me now. I began asking new questions: Why had I wanted so desperately to turn myself into a productivity machine? Why hadn't I taken the time to share love with others? Why did I ignore the very essence that made me human?
LIVING TOWARD DEATH
As the sun set on Taipei, I sat alone at the table, looking at the four copies of my will, which had taken me four hours to write. My wife was in Beijing with our younger daughter, and I sat alone in the living room of my mother's home. In the next room, my mother was lying down. She had for years suffered from dementia, and while she could still recognize her son, she had little ability to understand the world around her.
For a moment, I felt grateful for the illness that clouded her mind - if she could understand the diagnosis that had just been delivered, I feared it would have broken her. She had given birth to me when she was forty-four, an age at which doctors urged her not to go through with the pregnancy. She refused to entertain that idea, seeing the pregnancy through and then showering me with endless affection. I was her baby, and she loved nothing more than feeding me her handmade spicy Sichuan dumplings, delicately wrapped bundles of pork that practically melted on your tongue.
When I made the move to Tennessee, despite not speaking a word of English, my mother came and stayed with me for my first six months in America, just to make sure I was all right. Preparing to return home to Taiwan, she asked only that I continue to write her those letters in Chinese each week, a way to keep me close to her heart and rooted in the culture of my ancestors.
She was someone who had spent her whole life sharing love with her children. Sitting at her dining table while she lay in the next room, I was racked by wave after wave of remorse. How had I been raised by such an emotionally generous woman and yet lived my life so focused on myself? Why had I never told my father that I loved him? Or truly shown the depth of caring for my mother before the dementia took hold?
The hardest thing about facing death isn't the experiences you won't get to have. It's the ones you can't have back. Palliative care nurse and author Bronnie Ware has written extensively on the most common regrets that her terminally ill patients expressed in their final weeks of life. Facing the ultimate, these patients were able to look back on their lives with a clarity that escapes those of us absorbed in our daily grind. They spoke of the pain of not having lived a life true to themselves, the regret at having focused so obsessively on their work, and the realization that it's the people in your life who give it true meaning. None of these people looked back on their lives wishing they had worked harder, but many of them found themselves wishing they had spent more time with the ones they loved.
"It all comes down to love and relationships in the end.” Ware wrote in the blog post that launched her book. "That is all that remains in the final weeks: love and relationships."
Sitting at my mother's table, this simple truth now burned within me. My mind swam backward through time, dipping in and out of memories of my daughters, my wife, and my parents. I hadn't ignored the relationships in my life; on the contrary, I had very precisely accounted for each one. I had quantified them all and calculated the optimal allocation of time needed to achieve my objectives. Now I felt a gaping sense of emptiness, of irretrievable loss, about how little time for loved ones my mental algorithm had deemed "optimal:' This algorithmic way of thinking wasn't just "suboptimal" at allocating time. It was robbing me of my own humanity.
THE MASTER ON THE MOUNTAIN
Like any epiphany worth having, these thoughts took time to truly sink in. I had felt something shift within me, but it would require patience and brutally honest self-examination to turn these pangs of regret into a new way of engaging with the world around me.
Soon after my diagnosis, a friend recommended I visit the Fo Guang Shan Buddhist monastery in the south of Taiwan. Venerable Master Hsing Yun, a rotund monk with a soft smile, founded Fo Guang Shan in 1967 and remains at the monastery today. His monastic order practices what is called "humanistic Buddhism:' a modern approach to the faith that seeks to integrate core practices and precepts into our daily lives. Its monks eschew the stern mysteriousness of traditional Buddhism, instead embracing life with unconcealed joy. The monastery welcomes visitors from all backgrounds, sharing with them simple practices and gentle wisdom. Around the monastery, you see couples getting married, monks enjoying a good laugh, and tourists taking a moment out of their busy lives to bask in the calm exuding from the people there.
I had practiced Christianity while growing up in the United States, and although I no longer ascribe to a religious faith, I maintain a belief in a creator of this world and a power greater than our own. In visiting the monastery, I didn't have any particular ambition - just a desire to spend a few days meditating on what I was experiencing, and reflecting on the life I had lived.
One day after early morning classes, I was asked to join Master Hsing Yun for a vegetarian breakfast. The sun had not yet risen as we ate multigrain bread, tofu, and porridge. Master Hsing Yun now uses a wheelchair to get around, but his mind remains clear and sharp. Partway through our meal, he turned to me with a blunt question.
"Kai-Fu, have you ever thought about what your goal is in life?"
Without thinking, I reflexively gave him the answer I had given to myself and others for decades: "To maximize my impact and change the world:'
Speaking those words, I felt the burning embarrassment that comes when we expose our naked ambitions to others. The feeling was magnified by the silence emanating from the monk across the table. But my answer was an honest one. This quest to maximize my impact was like a tumor that had always lived inside of me, ever tenacious and always growing. I had read widely in philosophy and religious texts, but for decades had never critically examined or doubted this core motivating belief within me.
For a moment, Master Hsing Yun said nothing, using a piece of bread to wipe the last scraps of breakfast from his wooden bowl. I shifted uncomfortably in my seat.
"What does it really mean to ‘maximize impact'?" he began. "When people speak in this way, it's often nothing but a thin disguise for ego, for vanity. If you truly look within yourself, can you say for sure that what motivates you is not ego? It's a question you must ask your own heart, and whatever you do, don't try to lie to yourself:"
My mind raced with rebuttals. I searched for the airtight logic that would redeem my actions. The days since my diagnosis had been an agonizing exercise in regret about the way I had engaged with my family and friends. I was slowly coming to terms with the emptiness of my emotional life. But as described in Elisabeth Kubler-Ross's theory of the five stages of grief, before acceptance comes bargaining.
Internally, I'd been trying to use my impact on millions of young Chinese people as a bargaining chip, as a way to balance out the lack of love shared with family and friends. I had over 50 million followers on Weibo, and I had relentlessly maximized my impact on this group. I even went so far as to build an AI algorithm for discovering and determining what other Weibo messages I should repost, always looking to maximize impact. Yes, I may have skipped out on family time to make public speeches, but think of all the people I had reached. I'd influenced millions of young students and tried to help a once-great country pull itself out of poverty. If you added it all up, wouldn't you say that the good outweighed the bad? Couldn't the gifts I'd given to so many strangers through my work make up for the dearth of love I had shared with those closest to me? Didn't the equation balance out in the end?
Now Master Hsing Yun was kicking the proverbial last leg of the stool out from under me. I tried to explain myself and cast my actions in the best light, based on what they had achieved. But he wasn't interested in the results that my personal well-designed algorithm spat out. He patiently peeled away my layers of excuses and obfuscation. He continually directed the conversation inward, asking me to confront myself with unflinching honesty.
"Kai-Fu, humans aren't meant to think this way. This constant calculating, this quantification of everything, it eats away at what's really inside of us and what exists between us. It suffocates the one thing that gives us true life: love:"
"I'm just starting to understand that, Master Hsing Yun.” I said, lowering my head, staring at the floor between my two feet.
"Many people understand it.” he continued, "but it's much harder to live it. For that we must humble ourselves. We have to feel in our bones just how small we are, and we must recognize that there's nothing greater or more valuable in this world than a simple act of sharing love with others. If we start from there, the rest will begin to fall into place. It's the only way that we can truly become ourselves.”
With that, he said goodbye and turned his wheelchair around. I was left with his words echoing in my mind and sinking into my skin. The time since my diagnosis had been a whirlwind of pain, regret, revelation, and doubt. I had come to understand how personally destructive my old ways of thinking had been, and I struggled to replace them with a new way of being human in the world that didn't mimic some aspect of that algorithmic thinking.
In the presence of Master Hsing Yun, I had felt something new. It wasn't so much the answer to a riddle or the solution to a problem. Instead, it was a disposition, a way of understanding oneself and encountering the world that didn't boil down to inputs, outputs, and optimizations.
During my time as a researcher, I had stood on the absolute frontier of human knowledge about artificial intelligence, but I had never been further from a genuine understanding of other human beings or myself. That kind of understanding couldn't be coaxed out of a cleverly constructed algorithm. Rather, it required an unflinching look into the mirror of death and an embrace of that which separated me from the machines that I built: the possibility of love.
SECOND OPINIONS AND SECOND CHANCES
While I wrestled with these stark realizations, the treatment for my cancer proceeded. My first doctor classified the disease as stage IV, the cancer's most advanced stage. On average, patients with fourth stage lymphoma of my type have around a 50 percent shot of surviving the next five years. I wanted to get a second opinion before beginning treatment, and a friend of mine arranged for me to consult his family doctor, the top hematology practitioner in Taiwan.
It would be a week before I could see that doctor, and in the meantime I continued to conduct my own research on the disease. In my emotional life, I was turning away from the relentless pursuit of quantification and optimization. But as a trained scientist whose life hung in the balance, I couldn't help trying to better understand the disease and quantify my chances of survival. Scouring the internet, I devoured all the information I could find about lymphoma: possible causes, cutting-edge treatments, and long-term survival rates. Through my reading, I came to understand how doctors classify the various stages of lymphoma.
Medical textbooks use the concept of "stages" to describe how advanced cancerous tumors are, with later stages generally corresponding to lower survival rates. In lymphoma, the stage has traditionally been assigned on the basis of a few straightforward characteristics: Has the cancer affected more than one lymph node? Are the cancerous lymph nodes both above and below the diaphragm (the bottom of the rib cage)? Is the cancer found in organs outside the lymphatic system or in the patient's bone marrow? Traditionally, each answer of "yes" to one of the above questions bumps the diagnosis up a stage. The fact that my lymphoma had affected over twenty sites, had spread above and below my diaphragm, and had entered an organ outside the lymphatic system meant that I was automatically categorized as a stage IV patient.
But what I didn't know at the time of diagnosis was that this crude method of staging has more to do with what medical students can memorize than what modern medicine can cure.
Ranking stages based on such simple characteristics of a complex disease is a classic example of the human need to base decisions on "strong features.” Humans are extremely limited in their ability to discern correlations between variables, so we look for guidance in a handful of the most obvious signifiers. In making bank loans, for example, these "strong features" include the borrower's income, the value of the home, and the credit score. In lymphoma staging, they simply include the number and location of the tumors.
These so-called strong features really don't represent the most accurate tools for making a nuanced prognosis, but they're simple enough for a medical system in which knowledge must be passed down, stored, and retrieved in the brains of human doctors. Medical research has since identified dozens of other characteristics of lymphoma cases that make for better predictors of five-year survival in patients. But memorizing the complex correlations and precise probabilities of all these predictors is more than even the best medical students can handle. As a result, most doctors don't usually incorporate these other predictors into their own staging decisions.
In the depths of my own research, I found a research paper that did quantify the predictive power of these alternate metrics. The paper is from a team of researchers at the University of Modena and Reggio Emilia in Italy, and it analyzed fifteen different variables, identifying the five features that, considered together, most strongly correlated to five-year survival. These features included some traditional measures (such as bone marrow involvement) but also less intuitive measures (are any tumors over 6 cm in diameter? Are hemoglobin levels below 12 grams per deciliter? Is the patient over 60?). The paper then provides average survival rates based on how many of those features a patient exhibited.
To someone trained in artificial intelligence - where even simple algorithms base decisions on hundreds if not thousands of distinct features - this new decision rubric still seemed far from rigorous. It sought to boil down a complex system to just a few features that humans could process. But it also showed that the standard staging metrics were very poor predictors of outcomes and had been created largely to give medical students something they could easily memorize and regurgitate on their tests. The new rubric was far more data-driven, and I leaped at the chance to quantify my own illness by it.
Rifling through stacks of medical reports and test results from the hospital, I dug out the information for each metric: my age, diameter of largest involved node, bone-marrow involvement, B2-microglobulin status, and hemoglobin levels. Of the five features most strongly correlated to early death, it seemed to appear that I exhibited only one. My eyes frantically scanned the page, sifting through charts and tracing lines between my risk factors and survival rate.
And there it was: while the stage IV diagnosis from the hospital meant a five-year survival rate of just 50 percent, the more detailed and scientific rubric of the research paper bumped that number up to 89 percent.
I kept going back to check and double-check the numbers, and with each confirmation I grew more ecstatic. Nothing inside my body had changed, but I felt that I had been pulled back from the abyss. Later that week, I would visit the top lymphoma expert in Taiwan. He would confirm what the study had indicated: that the designation of my lymphoma as stage IV was misleading, and my illness remained highly treatable. Nothing was certain ---I knew that now more than ever---but there was a good chance I would get through this alive. I felt reborn.
RELIEF AND REBIRTH
There's a certain sensation most people experience right after narrowly avoiding disaster. It's that tingling feeling that crawls over your skin and across your scalp a few seconds after your car skids to a halt on the highway, just a few feet away from an accident. As the adrenaline dissipates and muscles relax, most of us make a silent pledge to never again do whatever it was that we were just doing. It's a pledge we might keep for a couple of days or even weeks before slipping back into old habits.
As I underwent chemotherapy and my cancer went into remission, I too vowed to hold onto the revelations that cancer had given to me. Lying awake at night in the weeks after my diagnosis, I ran over my life again and again, wondering how I had been so blind. I told myself that however much time I had left, I wouldn't let myself be an automaton. I wouldn't live by internal algorithms or seek to optimize variables. I would try to share love with those who had given so much of it to me, not because it achieved a certain goal but just because it felt good and true. I wouldn't seek to be a productivity machine. A loving human being would be enough.
The love of my family during this time served as a constant reminder of this promise and an abiding source of strength during my cancer treatment. Despite years of giving them too little of my own time, when I fell ill my wife, sisters, and daughters all sprang into action to care for me. Shen-Ling was always by my side throughout the exhausting and seemingly endless chemotherapy sessions, tending to my every need and stealing a few hours of sleep leaning against my bedside. Chemotherapy can disrupt digestion, with normal smells and flavors causing nausea or vomiting. When my sisters brought me food, they took careful note of my reaction to each smell or taste, constantly adjusting recipes and tweaking ingredients so that I could enjoy their home-cooked food during treatment. Their selfless love and constant care during this time simply overwhelmed me. It took all the ideas that I had come to understand and turned them into emotions that washed over me and came to live within me.
Since my recovery, I've come to cherish time with those closest to me. Before, when my two daughters came home from college, I would take just a couple of days off work to be with them. Now when they visit from their busy jobs, I take a couple of weeks. Whether on business trips or vacations, I travel with my wife. I spend more time at home taking care of my mother and try to keep my weekends free to see old friends.
I've apologized and tried to mend friendships with those that I have hurt or neglected in the past. I meet with many young people who reach out to me, no longer communicating only through impersonal blasts across my social media accounts. I try to avoid prioritizing these meetings by who "shows potential.” doing my best to engage with all people equally, regardless of their status or talents.
I no longer think about what will be written on my tombstone. That's not because I avoid thinking about death. I'm now more aware than ever that we all live in direct and constant relationship to our own mortality. It's because I know that my tombstone is just a piece of stone, a lifeless rock that can't compare with the people and memories that make up the rich tapestry of a human life. I recognize that I'm just beginning to learn what so many people around me understood intuitively all their lives. But simple as these realizations are, they have transformed my life.
They've also transformed how I view the relationship between people and machines, between human hearts and artificial minds. This transformation crept up on me as I reflected on the process of my illness: the PET scan, the diagnosis, my own anguish, and the physical and emotional healing that followed. I've come to realize that my cure came in two parts, one technological and one emotional, each of which will form a pillar of our AI future as I explain in the next chapter.
I have great respect and deep appreciation for the medical professionals who led my treatment. They put years of experience and cutting-edge medical technology to the task of beating back the lymphoma that grew within me. Their knowledge of this illness and their ability to craft a personalized treatment regimen likely saved my life.
And yet, that was only half of the cure for what ailed me. I wouldn't be here today if it weren't for medical technology and the data-driven practitioners who use it to save lives. But I wouldn't be sharing this story with you if it weren't for Shen-Ling, my sisters, and my own mother, who through quiet example showed me what it means to lead a life of selflessly sharing love.
Or people like Bronnie Ware, whose heartfelt book on the regrets of the dying gave me life at my weakest moment. Or Master Hsing Yun, whose wisdom shook me from my career delusions and forced me to truly confront my own ego. Without these unquantifiable, non-optimizable connections to other people, I would never have learned what it truly means to be human. Without them, I would never have reordered my priorities and reoriented my own life. I soon began working less and spending more time with the people in my life. I stopped trying to quantify the impact of each action - who I took meetings with, who I wrote back to, who I spent time with and instead aimed to treat all those around me equally. This shift in the way I treated others wasn't just beneficial to them; it filled me with a sense of wholeness, satisfaction, and calm that the hollow accomplishments of my career never could.
The reality is that it will not be long until AI algorithms can perform many of the diagnostic functions of medical professionals. Those algorithms will pinpoint illness and prescribe treatments more effectively than any single human can. In some cases, doctors will use these equations as a tool. In some cases, the algorithms may replace the doctor entirely.
But the truth is, there exists no algorithm that could replace the role of my family in my healing process. What they shared with me is far simpler - and yet so much more profound - than anything AI will ever produce.
For all of Al's astounding capabilities, the one thing that only humans can provide turns out to also be exactly what is most needed in our lives: love. It's that moment when we see our newborn babies, the feeling of love at first sight, the warm feeling from friends who listen to us empathetically, or the feeling of self-actualization when we help someone in need. We are far from understanding the human heart, let alone replicating it. But we do know that humans are uniquely able to love and be loved, that humans want to love and be loved, and that loving and being loved are what makes our lives worthwhile.
This is the synthesis on which I believe we must build our shared future: on Al's ability to think but coupled with human beings' ability to love. If we can create this synergy, it will let us harness the undeniable power of artificial intelligence to generate prosperity while also embracing our essential humanity.
This isn't something that will come naturally. Building this future for ourselves - as people, countries, and a global community - will require that we reimagine and reorganize our societies from the ground up. It will take social unity, creative policies, and human empathy, but if achieved, it could turn a moment of outright crisis into an unparalleled opportunity.
Never has the potential for human flourishing been higher - or the stakes of failure greater. [175- 196]