Crowdsourced Diagnosis of Professor’s Mystery Ailment

Fans of the open-source software movement are acquainted with Linus’ Law: “given enough eyeballs, all bugs are shallow.” Translated into something more closely approximating conversational English, it means: the more people who examine a problem, the more likely it is that the solution will occur to at least one of them, even if the problem is obscure. Linus’ Law explains why open-source software can be less buggy than proprietary software: when you open up the source code for inspection by a mass audience, chances are someone, somewhere, is going to spot any mistakes.

Linus’ Law explains a lot. It explains why bugs in proprietary software products can languish for years (too few eyeballs!). It provides a reason to believe that, over time, entries on Wikipedia can converge toward accuracy. And, apparently, it’s going to help Harvard Law prof (and cyberlaw giant) Jonathan Zittrain go home from the hospital faster. JZ sets the stage:

I found myself in the hospital last Thursday thanks to unexplained fevers that spiked at night and were gone by day. After a bunch of tests my unfailingly conscientious doctor recommended (well, insisted) I get to the hospital for yet more. By Friday morning I was apparently a very interesting case — offering symptoms that were both general enough (just the fevers) and worrisome enough (a couple numbers very off on some blood tests) that no one could figure out what was going on (put in medicalese that I’m rapidly learning enough of to be dangerous, there was a large “differential diagnosis”) — and yet there was some sense of urgency, especially if what I had was an infection that could go systemic.

With House being, sadly, fictitous, JZ (a solid techie) threw the diagnosis of his own problem, initially suitably anonymized, open for crowdsourcing:

A friend started a blog to keep friends and family updated, under a light password, and then a colleague had the inspired idea of asking a medical blog to put out a gentle call to its audience — primarily doctors — to help in the diagnosis given what a tough nut it was to crack. I mean — I do believe that many eyes make all bugs shallow, and the truly fantastic team of doctors here was OK with a blog being kept. … [Then] The password went away, and initials were used for me[.]

But, as we are all learning, information that starts out anonymous doesn’t stay that way when it hits the net, and it did not take long for JZ’s (very lightly concealed) identity to become known. In the meantime, however, crowdsourcing had done its work:

The blog produced some amazingly helpful comments from people and doctors at large, including references to two discrete academic journal articles — one from a Korean medical journal from 1994! Thanks to the Net I had a copy on my PC and then e-faxed to the nurse’s station on my floor in a matter of minutes. In the meantime, over the course of today (Monday the 15th), additional results have come back to help narrow the diagnosis in a properly documentable and formal way — one that’s converging, it seems, to the obscure Korean article. To be clear, the terrific doctors here have been methodically arriving at this diagnosis already.

All three of us here at Info/Law worked and studied with JZ during our time in Cambridge, and our best wishes go out for his rapid and full recovery — which, it seems, thankfully is now at hand.
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