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Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

What factor necessitates the change in frequency of performed C-sections?

Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

Which factor is the best predictor of necessity for an emergency C-section on a fetus?

Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

Describe how the frequency of C-sections has changed over time

Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

What risk, according to the author, is increased by practitioners who are wary of performing C-sections?

Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

What inspired Tydeman to develop his device?

Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

According to Tydeman, what has caused the Tydeman tube to not get sold/approved?

Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

What is the inspiration for the simulator's name?

Obstetrics for beginners It's my first go at delivering a baby by caesarean section – and the foetal head is impacted, jammed in its mother's pelvis. To be honest I'm struggling. Incisions have been made in the lower part of the mother's abdomen and womb. I've pushed my gloved hand inside and managed to slide my fingers between the baby's head and the surrounding uterine tissue. But it's difficult. The baby is tightly wedged in. I've had to push hard to get my hand to the far side of its head, and even though I'm now cupping and grasping it in the approved manner, I can't seem to pull it out. Dare I grip its head more firmly? Dare I pull harder? The baby's mother – she's called Debra – remains impassive throughout these agonised fumblings. Her face reveals nothing of what she may be feeling. But then Debra has no feelings. Indeed she has no face… So you can stop worrying. Debra – Desperate Debra to use her full trade name – is a simulator designed to help doctors practise their skill at dealing with impacted foetuses: babies that get stuck trying to exit the womb by the normal route. She comprises the lower two thirds (ie from the mid-chest region downwards) of a life-sized but limbless female torso made of flesh-coloured silicone rubber. She comes with a vulva, a pre-cut incision in her abdomen and, most importantly, a uterus containing a foetal head that should, in the normal way of things, be free to emerge between her legs. But this fetus is going nowhere until an obstetrician – or in this case me – can successfully grasp and pull it out. The clever and sophisticated simulator I'm playing with started life as a lash-up in an obstetrician's home workshop: a Heath Robinson-style contraption barely recognisable as a model of the human body. But it wasn't at that stage intended as a simulator for training medical staff. Its sole purpose was to test the effectiveness of a novel device called a Tydeman tube. Paradoxically, although the testing equipment, Debra, is now commercially available, the device it was intended to test has yet to reach the market. The inventor of the tube and of Desperate Debra is Dr Graham Tydeman, a consultant in obstetrics and gynaecology at Victoria Hospital in Kirkcaldy, Fife. Only after he'd built Debra did he realise that she might serve a purpose beyond his original intention. His is a decade-long tale of inspired insights, thwarted aims and shifting purposes; but with a good outcome. Although the Tydeman tube is still in gestation, Desperate Debra herself is now thriving. To understand the desperation of Debra and how the Tydeman tube might help to relieve it requires a brief foray into basic obstetric knowhow. Evolution has endowed us with heads proportionally so large that even when labour runs according to plan, the delivery process involves a bit of a squeeze. For the baby's head to get stuck on the way out may not be usual, but it's by no means a rarity. The standard response is to perform a caesarean section. Every year some 160,000 babies are born in the UK this way, with almost two thirds of them classified as emergencies. One audit has suggested that roughly 8,000 babies get stuck and have to be delivered by caesarean at a stage when their mothers are fully dilated. "Some of the babies will be so close to coming out by the normal route," says Tydeman, "that it's then difficult to get them back up and remove them through the hole in the woman's tummy." Which women are most at risk of this setback seems to be largely unpredictable. "We just observe that it happens… It's been discussed in the medical literature since the 1940s, but until 10 years ago, and throughout my training and most of my life as a consultant, it wasn't really talked about." Considering the universality of childbirth, impaction and the best way of dealing with it are topics that seem to have gone remarkably unstudied. "There are strong opinions about why it happens and what to do, but very little research evidence," says Tydeman, adding that many of these opinions are contradictory. In a protracted birth that's destined to end with a caesarean, the longer the labour is allowed to go on before the obstetrician decides to intervene, the greater the likelihood that the baby's head will become impacted. However, concern over the rising number of babies born by caesarean has made doctors more wary of doing them – one consequence of which is that medical staff may allow a difficult birth to continue for longer before they resort to surgery. This could be boosting the frequency of impaction. But, again, no one is certain. When obstetricians doing planned caesareans slice open a mother's womb, what they usually see is the baby's head. By slipping a hand round and below it they can easily guide the baby out. "When you do a caesarean for an impacted baby," says Tydeman, "you make the incision in the same place, but what you might come across is a shoulder because the baby's so much further down [the birth canal]." As I'd discovered for myself, sliding a hand around the baby's head is then far more difficult. "It makes your fingers hurt," says Tydeman. "It makes your pulse rate go up to about 200, and you break out in a sweat because know you've only got about five or 10 minutes before there are serious consequences. The clock is ticking." If a baby's head is jammed down in the mother's pelvic region, common sense suggests that it might help if a second person gives a gentle backward push on the area of its head visible through the mother's dilated cervix. "In our unit," says Tydeman, "when the woman is fully dilated and you'd expect the baby to come out normally [but it doesn't]… a registrar will be asking for a push-up about one in five times." Although registrars are doctors still in training, they're nonetheless experienced; which suggests requests for push-ups during unplanned caesareans are far from uncommon. The Tydeman tube is a gadget intended to make this manoeuvre safer and more effective. Creativity and innovation have many unlikely sources. What seems to have inspired Tydeman to develop his device was the characteristic sound of a Wellington boot being pulled free of wet, muddy ground: a slurpy, sucking, gurgling noise. When an impacted foetal head is pulled free of the uterus it's often accompanied by a similar sucking noise, the result of air rushing in between the obstetrician's fingers to fill the space vacated. "What occurred to me years ago was that if the air can't get in, why not put a tube up into the vagina so that it can get in from below the baby's head." From time to time, if he felt he felt the baby might stick, Tydeman would slip a length of sterile silicone tubing through the woman's vagina and up into the womb next to the baby's head. Allowing air in by this route would release any suction forces tending to hold it where it was. Tydeman didn't do much with the idea until 10 years ago when one trainee, who was experiencing real difficulty getting heads out, prompted him to think again about the problem. Around the same time, he met professor of obstetrics Andrew Shennan and consultant midwife Annette Briley, both of the Women's Health Academic Centre at St Thomas's hospital. Between them they came up with a device – the Tydeman tube – to make pushing on the foetus more controlled while simultaneously releasing any vacuum that might be holding it in place. The instrument is made up of a rigid plastic tube opening into a softer silicone cup. Pressure to the foetal head is applied using four pads projecting forward from the cup's interior. Holding the device by the tube, the user places the cup against the part of the head exposed through the dilated cervix, and presses. This pushes the baby back up into the uterus while releasing any suction pressure that may have been holding it, so allowing the obstetrician to extract it more easily. Because pressure is distributed equally between the four pads with a greater combined surface area than that of a user's fingertips, the risk of inadvertent damage is minimised. The team found some money to employ a product designer who used computer-aided design technology and 3D printing to make a prototype. "We were at the point of getting one made in silicone," says Tydeman, "when we realised that before we started experimenting on women we really ought to test it on a simulator." No such simulator existed – so he decided to make one himself. That Tydeman was able to do this comes as no great surprise once you've glanced at his website. His career may be rooted in medicine but his interests encompass sculpture, furniture making and much else. He works in wood, glass, metals and plastic. "I've got a big workshop with a lathe and a forge," he says. "I make stuff. I always have, ever since I was a child. My dad was a woodwork teacher, my mum was very creative with fabric." Although tests carried out with the Debra prototype showed that the tube would work as intended, Tydeman and his colleagues then faced what he calls a kind of medical catch-22. "We had the tube finished about three years ago… but we were more interested in trying to save lives than selling a product. We thought that the right thing to do before commercialising it was to be sure we'd got the best design." They tried it on a dozen or so women in labour, and concluded that it did what it supposed to. But they held off trying to market it because they wanted to do more extensive, more rigorous clinical studies. This presented a problem. "If you've applied for research money," says Tydeman, "but you've already got what seems to be a commercially viable design, potential funders are going to say that the company aiming to sell it should pay for the work." On the other hand, commercial interest is easier to drum up if you've already got evidence that a device is safe and effective. That said, the team didn't want to leave the tube sitting on the shelf. So they eventually decided to go ahead and find a commercial partner willing to manufacture and market it. They have now identified one, and are fairly confident it will soon be in production. With sufficient users it should then be possible to compile factual – as opposed to anecdotal – evidence of benefit. Not ideal, Tydeman concedes, but the best they can do at present. In the meantime, back to Desperate Debra: so named, Tydeman says, not after any particular person but because the appellation is memorably alliterative. He put together the original Debra in a weekend. The skin was made out of a neoprene wetsuit fixed to a scaffolding formed from plastic tubing he'd found 20 years ago in skip outside a Glasgow pub; the head was cast in silicone from a model he'd made in plasticine, and the rest comprised old springs and other bits of stuff lying around his workshop. "It wasn't actually that difficult," Tydeman says. When originally conceived, remember, Debra was simply a means of testing the effectiveness of the tube. What she looked like was neither here nor there. It was only once Debra was reborn as a teaching aid that she needed sprucing up. Tydeman can remember the exact moment when the idea of her having a greater role dawned on him. "I was on the sleeper train down from Scotland to London," he says. "Debra was with me because the first Tydeman tube had become available at St Thomas's… It was about midnight, I'd had my free whisky and I suddenly thought, 'Blow me! Even if the tube doesn't work, Debra could be useful as a teaching aid'." The following morning, at St Thomas's, Tydeman asked a visiting professor of obstetrics to have a look at Debra and tell him what she thought. She put her hand into Debra's womb, grasped the foetal head and said it felt just like the real thing. "Terribly flattering," Tydeman laughs. With a grant from the Guy's and St Thomas's Charity fund they made Debra more presentable. Tydeman showed the prototype to Adam Rouilly, an established company specialising in medical models and simulators. They were impressed. A year later, the first of Debra's smartened-up sisters was on the market. In Debra as she is now, the precise extent and nature of her desperation can be fine-tuned according to need. The foetal head inside her uterus can be moved to mimic the various positions that an unborn baby may adopt. By tightening a spring inside Debra's body, it's also possible vary the degree of impaction from mild to so severe that the head is virtually impossible to extract. In this way she simulates the full range of difficulty that obstetricians are likely to encounter. So how valuable in training medical staff is a simulator like this? Very, according to Annette Briley. Imagine it's the middle of the night and an unplanned emergency caesarean is required: "Some poor junior doctor might find himself trying to manage it on his own." To have practised the knack of extracting a firmly impacted baby from a simulator is lot better than first honing your skill on a real woman. At St Thomas's, midwives in training also get an opportunity to practise on Debra. The chances that midwives will find themselves having to do the actual extraction of an infant are slim; but they're quite likely to be asked to help the obstetrician by pushing a stuck baby from below. Debra's anatomy allows them to practise this skill; and to learn where and how hard to push on the infant skull. "Any practice you've done in the cold light of day will help you stay calm and composed in an emergency, and that's what we're aiming for," says Briley. It's still too soon to make a final judgement about Debra’s impact. "When we first brought Debra out," Briley recalls, "some of the really experienced professors said things like, 'We always managed without one. Why would you need this?' But ask them to have a go at using it and then they admit it's really good." Medicine as a whole has an oddly ambivalent relationship to innovation. Some new findings, techniques or equipment take years to penetrate the profession; others are seized upon immediately. A proper study of the clinical effectiveness of the Tydeman tube will necessarily involve women giving birth. Assessing the value of Debra as a simulator didn't require human subjects; and the team has already conducted such a study. Thirty obstetricians, from three NHS maternity units and with varying levels of experience, took part. They all received a brief explanation of how Debra works, and were then asked to try a timed removal of the foetal head at three different levels of difficulty. Overall, 87 per cent reported that the simulator offered a realistic experience of dealing with an impacted head, and 93 per cent thought it would be valuable as a training device. The use of simulators to teach technical skills is now common in medical schools. You can learn to sew up a knife wound, catheterise a bladder or intubate an airway. You can practise cardiopulmonary resuscitation or ear syringing or even go through the motions of a keyhole surgical procedure. The technology required to do these things may cost a few pounds, or tens of thousands. Either way, given that most of these devices were invented during the past three or four decades, it comes as something of a surprise to learn that simulation for medical purposes can be traced back as far as the Chinese Song dynasty of 960-1279 AD. One of the treatments of choice in that era was, naturally, acupuncture. But how to teach tyro-acupuncturists where to place the needles? Simple. A life-size bronze statue dotted with small holes indicated the points of insertion. And how then to test the students' grasp of their subject? If the statute was hollow, filled with liquid and given an outer coating of wax to mask the holes, a correct needle insertion would be followed by a leak. Given the universality of childbirth it's no surprise that, then as now, the womb turns out to be the most simulated of our organs. For the benefit of 18th-century midwives and doctors-in-training, the Bologna surgeon Giovanni Antonio Galli devised a birthing simulator comprising a glass uterus supported by an artificial pelvis and containing a flexible foetus. Trainees had to deliver the baby while wearing a blindfold. Only the tutor could witness the fumbling of their hands. As the material for a convincing simulation, glass clearly has its drawbacks. But another 18th-century contraption used a pink cloth-covered mannequin comprising a female torso complete with genitalia, a set of implantable foetuses of various ages, and even – a real coup de théâtre , this – a facility for exuding suitably coloured liquids at the appropriate moment. Oddly, as medicine became more scientific, most of these devices fell by the wayside. As an academic review of these and other devices has pointed out, much of the 20th century was something of Dark Ages for simulation. Its value in professional training has had to be rediscovered: an endeavour in which inventive people like Graham Tydeman, sometimes with workshops rich in discarded junk, are still fruitfully engaged. This article was originally published on TheLong+Short. Read the original article.

Which terms best describe the medical field's response to new development of medical technology?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

What is the author's grievance against photographers?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

What does the author mean to communicate by comparing the photographer's task to the sculptor's mission?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

According to the author, what makes it difficult for the author to capture a subject's soul?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

How does the author try to disarm their subjects?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

Which statement would the author most likely support?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

What potential drawback does the author acknowledge regarding the popularity of Creative Commons licenses?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

What is the central purpose of the article?

Just another free soul In his foreword to the book, Lessig writes that you understand your subjects “by learning to see them in a certain way.” What is that certain way? I think I’m trying to get a mental image of a person, certain expressions, or what I think that person is about. I’m trying to capture what I think they look like, which is many times a minority of their typical expressions, or their typical stance. So, if I’m taking pictures of Larry [Lessig], I want to have his signature hand gestures, and not just random ones. I think I’m trying to capture pictures of people that help others see what they’re about. Some photographers will make someone look the way the photographer wants them to look, and not the way they appear, so they’ll pick the one picture out of 100 where the guy looks more egotistical than he really is. Some photographers are almost medical, and are going after a perfect portrait. I’m somewhere in between. It’s amazing how many people will upload snapshots of people where the pictures don’t look like them at all. To me, uploading a picture that is not an easily recognizable picture of that person defeats the point, which I’m working toward, to try to express who they are. On the other hand, professional photographers usually have a subject whom they don’t know personally, so they end up having to try to capture an image that they’ve created based on who they think the person is or how they want that person to appear. You know how sculptors often say that they’re just freeing an image from a block? What I’m trying to do is free someone’s soul from his or her image. There are a lot of things that make this hard. A lot of people are uncomfortable in front of a camera, or might make expressions that aren’t very natural for them. And if the person is nervous, it’s very difficult to try to see what it is that you’re trying to capture. A lot of what I’m doing is, I just start shooting photos. After half an hour of having their picture taken, people start to ignore you. Or I’ll take pictures when I’m talking to people about what they’re doing, so after a while they get distracted by the conversation and forget about the camera. That’s something that I’m not perfect at, but I’m getting better. I think good photographers are also able to disarm people through conversation, but still, it’s difficult to have a disarming conversation with somebody you don’t know, or to make them laugh. Many times people make a face for me that they wouldn’t make for a professional photographer. For instance, a board meeting picture, like the one with Eric Saltzman: that was during a very tense discussion. I’ve found that people are at their most animated at these kinds of meetings, and look the most alive when they are under a lot of pressure, and super- focused. But usually if an outsider is in the room, they won’t get into that. I mean, it would be difficult for a cameraman to be in a room where a board is having a heated debate. But those are the things that I’m trying to capture, because most people don’t get to see that. At the Creative Commons board meeting, Larry asked me to put the camera away after awhile [laughs] because it was distracting. We were having a very heated discussion and I was taking all of these pictures. But he credited me later because afterward those pictures turned out the best. In your mind, what is a ‘Freesoul’ ? A freesoul is somewhat of a pun. On the one hand it means you are free, liberated. You, as a human spirit, are open. And then, it also has the meaning that you are unencumbered legally, that you are free, as in ‘free software.’ There’s a paradox: with many people’s Wikipedia articles to which I’ve contributed, when it comes to the picture, many of these people don’t have any free photos of themselves on the web, so while they are “notable” on Wikipedia, their images aren’t free of the copyright of the photographer, or the institution who hired the photographer to take the picture. Often, even the subject of the article can’t make an image available to the Wikimedia/Wikipedia community. This means that a lot of people who have a Net presence have a legally encumbered Net presence. People who are invited to conferences get asked all the time, “By the way, do you have a photo that we can use?” But they don’t. By making these pictures available under a Creative Commons license, now they do. This is solving the issue of legal freedom. The third part of the pun is that, since I’m asking for a model release from the subjects, I’m asking everyone to be much more open and giving about their image than most people typically are. I’m giving, you’re giving, we’re all giving to participate and to try to create this wonderful work, and allow others to create derivative works. Of course people can abuse that, just like they can abuse anything. But I want people to see the value in sharing over the fear in sharing. The fact is, it’s much more likely that somebody is going to use these pictures for something positive, rather than for something negative. The benefits greatly outweigh the risks. I think we spend way too much of our lives worrying about the risks, at the cost of a lot of the benefits. This is a celebration of all of the people who are willing to give. In a way, giving up your image and allowing anyone to use it: it’s the ultimate gift. In one way it’s kind of vain. [laughs] But in another way it’s wonderful. A Wikipedia article on some person but with no picture is sad. Besides Wikipedia, how do you imagine these photos being used? They can be used in textbooks and in mainstream media articles about the person. Now they can get a picture that represents the person, at least from my perspective. That said, I shouldn’t be the only person doing this. More people should do the same, and make the photographs available freely. For one, I feel that “free” CC licensed photos have a much higher chance of not disappearing. But I don’t know exactly how these photos are going to be used, so in a sense I’m curious. For example, recently I received the Harvard Berkman Center pamphlet. It was a report of what they’re doing, and they also had a bunch of my pictures in there. They all had attribution, and it made me feel really good. There were pictures of different Berkman Center members that I had taken in various places all over the world. I think that the subject is probably happy with this, and I’m happy, and the Berkman Center’s happy because they’re not all pictures of people sitting at desks in the Berkman Center. There’s one more important thing: Creative Commons is great for original creative works or derivative creative works, but when it involves human images, it gets very complicated. We all know the Virgin Mobile case, where Virgin used CC licensed images in an advertisement without getting permission from the models, and got in trouble. What we’re trying to do here is to expand beyond just copyright, to make it more thorough from a legal perspective. It’s also an important educational point, so people understand that, in addition to the Creative Commons licenses, we need people to provide other rights in cases where the law requires such rights to be cleared before reuse. What have you learned about the people in these networks, just in the past year? That’s a good question. I think that at least Creative Commons has become much more mainstream. Creative Commons has moved from a fringy academic discussion to a boardroom discussion. Yahoo announced that it will be using Creative Commons for all of their basic infrastructure, and integrating it all. Google has CC search in their advanced search. Microsoft is working with CC as well and have a plug-in. Nine Inch Nails released their album, Ghost, under a Creative Commons license. The list goes on. Many people are asking: can you make money and share? The answer is, yes. CC is becoming an important part of the business discussion. But one thing that happens when a movement like CC becomes a business thing, is that a lot of the pioneers fade into the background, and it becomes a part of industry. This happened to the Internet. And so while you still have the core people who still remember and hold the torch for the philosophical side, the Internet has become much more of a business. Now, when you go to many Internet conferences, it’s mostly salesmen in attendance. I believe that the success of the Internet has two parts. The first part is the market- driven business side, which has made the Internet affordable and ubiquitous. The second part is the strong movement of participants who fight to keep the Internet open and try to prevent the business side from corrupting the fundamental elements that make the Internet great. The Net Neutrality or Open Network discussion going on right now is a good example of the importance of continuing to balance these principles with business interests. Similarly, I think that business interests can help make Creative Commons ubiquitous and more easily accessible to everyone. However, I think it’s important to remember to keep pushing to make content more “free” and not allow businesses to use Creative Commons in exploitive or destructive ways. In addition to the business side, Creative Commons is being used by educators to create open courseware around the world and in the area of science and technology to promote sharing in research. And as of now, we have the license ported to at least 44 jurisdictions, and the number of countries with projects continues to grow. In many ways, the movement outside of the United States has become much bigger than the movement in the United States. Although the United States is still slightly farther ahead in terms of commercialization, the size of the whole free culture movement outside of the United States is huge now. The CC China Photo exhibit was just amazing. There were some great images, and a lot of the photographers were professionals. This is beyond what anybody has done in the US. A lot of the progress that we’re making is international. What are your personal realizations or experiences? Well, we’re all getting old, if you look at these pictures. But there’s another thing, though, about this book: the number of professional-quality amateurs has increased significantly due to the importance of digital in both professional and high-end amateur photography I hate to say it, a lot of people love the darkroom, but it really feels like the death of the darkroom with this year. With new 22 megapixel cameras coming in under $10,000, and Lightroom and some of this software at a couple hundred dollars, it doesn’t really make sense, except for particularly fussy artists, to do wet-work anymore. If you’re a commercial photographer or a high-end amateur, you can do anything you used to do in the darkroom. I think it has really lowered the bar. I don’t know how that affects the industry directly, but for me, it bridged a huge gap. I used to be darkroom geek. I loved my darkroom, and even when I didn’t have my darkroom anymore, I still was shooting 6x6 Hasselblad 120 film and processing it in a special lab, and then digitizing it. For me, that film was it. You could never get as good as medium-format film or large-format film At the time, the digital Hasselblad backs were too expensive, and were still not as good as 8x10 film. So there was this whole period where the darkroom was not all that exciting, but the digital wasn’t perfect. I went through a limbo period. I had invested so much in my Hasselblad system, and my Leica M6 set. I had bought the Leica R8, but I was kicking myself because it was terrible. But then the Leica M8 came out, and I bought one at the beginning of 2007. The M8 really got me to where I could use my old gear, and it had enough megapixels to be as good as some film. Another way of saying it was that there was a gear breakthrough at the beginning of last year. Okay, that’s pretty materialistic! So there was a technology breakthrough, let’s call it that, that allowed me to switch completely away from film, and I think this happened to a lot of photographers. It caused an explosion of content and an increase in the quality of content on sites like Flickr. It has allowed amateurs to create a business model with professionals. Interestingly, I think these new high-end amateurs are buying more photography books and photographs and are probably providing an increasing revenue stream for professional photographers. I think most amateurs, including myself, are paying homage to the professionals and not trying to “compete” with them. Despite the existence of social software, what is still important about meeting people face-to-face? For me, the right way to use a lot of the new social software is by making it easier to spend more physical time with the people you like best. Dopplr is a great example. When I visit a city, I will see all of the people who are in the city at the same time. When I went to London awhile ago, there were 47 people I knew in London, and a huge percentage of those people don’t live there. I would bet that more than half of the photos in this book are pictures of friends, and they’re not in their hometown. That’s the really interesting thing that is happening right now: it’s really increasing your ability to spend quality time with, actually, a smaller number of people. It allows you to actively filter. Your meetings don’t have to be random. If I look at the list of people in this book, although there are some obvious people missing whom I didn’t see last year, probably met more of my friends last year, my real friends, than I’ve met in any other year. I know my travels were crazy, but I think that the online world has allowed me to do that. What’s great about photography is that it captures the moment that I was sharing with that person. It’s not just a connection on a social network online, which is really pretty binary. I can look at all these photos and remember exactly what we were doing, what we were eating, what we were drinking, what we were talking about, and to me that’s a much more rich experience. It’s the combination of social software and photography. For me, reality is “the present” plus what you remember from the past. I think this project is really sharing memories with people. Blog posts contribute as well, but to me photography is a really good way of doing that. When I look at the expressions, I remember the moment and get a sense of presence. I think the main problem for me is the environmental impact of flying around. Just as I never believed that we would have a paperless office, being able to connect with people through social software mostly increases your travel, it doesn’t decrease it. It is great because you get to meet all these people. But it is bad for the environment, and bad for our jet lag. How would you characterize your contributions to free culture? I think it’s mostly incremental. I think there is very little we actually do all by ourselves, and I hate saying, “I did this” or “I did that.” I think that in most cases, focusing on individual contributions or achievements undervalues the importance of everyone else involved. Having said that, I think my main contribution is probably in supporting Creative Commons as a fan, board member, chairman of the board and now CEO. I think CC has a significant role, and helping to keep it on track and growing is probably the single most important role that I have in Free Culture. Specifically, I think that trying to keep an international focus and a balance between business and the non-business elements of the movement is essential. My job is to keep that focus and maintain that balance. Also, CC needs to run smoothly as an organization and there is a lot of operational work that we all need to do. My photography is a way for me to participate in a small measure on the creative side of the Free Culture movement, and helps me see things from that perspective as well. However, I believe in emergent democracy and the importance of trying to celebrate the community more than the heroes. Of course, I’m a huge fan of Larry’s and I have great respect for the leaders of our movement. But more than anything, I’m thankful for and respectful of all of the participants who aren’t so well known and who are essential to moving everything forward. Personally, I don’t think it’s ultimately meaningful to talk about one individual’s personal contribution to any movement. The real meaning is in the whole movement. I’m just one participant. Just another free soul.

What impact does the author believe they have made on society?

Sharism: A Mind Revolution With the People of the World Wide Web communicating more fully and freely in Social Media while rallying a Web 2.0 content boom, the inner dynamics of such a creative explosion must be studied more closely. What motivates those who join this movement and what future will they create? A key fact is that a superabundance of community respect and social capital are being accumulated by those who share. The key motivator of Social Media and the core spirit of Web 2.0 is a mind switch called Sharism. Sharism suggests a re-orientation of personal values. We see it in User Generated Content. It is the pledge of Creative Commons. It is in the plans of future-oriented cultural initiatives. Sharism is also a mental practice that anyone can try, a social-psychological attitude to transform a wide and isolated world into a super-smart Social Brain. The Neuron Doctrine Sharism is encoded in the Human Genome. Although eclipsed by the many pragmatisms of daily life, the theory of Sharism finds basis in neuroscience and its study of the working model of the human brain. Although we can’t entirely say how the brain works as a whole, we do have a model of the functional mechanism of the nervous system and its neurons. A neuron is not a simple organic cell, but a very powerful, electrically excitable biological processor. Groups of neurons form vastly interconnected networks, which, by changing the strength of the synapses between cells, can process information, and learn. A neuron, by sharing chemical signals with its neighbors, can be integrated into more meaningful patterns that keep the neuron active and alive. Moreover, such a simple logic can be iterated and amplified, since all neurons work on a similar principle of connecting and sharing. Originally, the brain is quite open. A neural network exists to share activity and information, and I believe this model of the brain should inspire ideas and decisions about human networks. Thus, our brain supports sharing in its very system-nature. This has profound implications for the creative process. Whenever you have an intention to create, you will find it easier to generate more creative ideas if you keep the sharing process firmly in mind. The idea-forming-process is not linear, but more like an avalanche of amplifications along the thinking path. It moves with the momentum of a creative snowball. If your internal cognitive system encourages sharing, you can engineer a feedback loop of happiness, which will help you generate even more ideas in return. It’s a kind of butterfly- effect, as the small creative energy you spend will eventually return to make you, and the world, more creative. However, daily decisions for most adults are quite low in creative productivity, if only because they’ve switched off their sharing paths. People generally like to share what they create, but in a culture that tells them to be protective of their ideas, people start to believe in the danger of sharing. Then Sharism will be degraded in their mind and not encouraged in their society. But if we can encourage someone to share, her sharing paths will stay open. Sharism will be kept in her mind as a memory and an instinct. If in the future she faces a creative choice, her choice will be, “Share.” These mind-switches are too subtle to be felt. But since the brain, and society, is a connected system, the accumulation of these micro-attitudes, from neuron to neuron and person to person, can result in observable behavior. It is easy to tell if a person, a group, a company, a nation is oriented toward Sharism or not. For those who are not, what they defend as “cultural goods” and “intellectual property” are just excuses for the status quo of keeping a community closed. Much of their “culture” will be protected, but the net result is the direct loss of many other precious ideas, and the subsequent loss of all the potential gains of sharing. This lost knowledge is a black hole in our life, which may start to swallow other values as well. Non-sharing culture misleads us with its absolute separation of Private and Public space. It makes creative action a binary choice between public and private, open and closed. This creates a gap in the spectrum of knowledge. Although this gap has the potential to become a valuable creative space, concerns about privacy make this gap hard to fill. We shouldn’t be surprised that, to be safe, most people keep their sharing private and stay “closed.” They may fear the Internet creates a potential for abuse that they can’t fight alone. However, the paradox is: The less you share, the less power you have. New Technologies and the Rise of Sharism Let’s track back to 1999, when there were only a few hundred pioneer bloggers around the world, and no more than ten times that many readers following each blog. Human history is always so: something important was happening, but the rest of the world hadn’t yet realized it. The shift toward easy-to-use online publishing triggered a soft revolution in just five years. People made a quick and easy transition from reading blogs, to leaving comments and taking part in online conversations, and then to the sudden realization that they should become bloggers themselves. More bloggers created more readers, and more readers made more blogs. The revolution was viral. Bloggers generate lively and timely information on the Internet, and connect to each other with RSS, hyperlinks, comments, trackbacks and quotes. The small-scale granularity of the content can fill discrete gaps in experience and thus record a new human history. Once you become a blogger, once you have accumulated so much social capital in such a small site, it’s hard to stop. We can’t explain this fact with a theory of addiction. It’s an impulse to share. It’s the energy of the memes that want to be passed from mouth to mouth and mind to mind. It’s more than just E-mail. It’s Sharism. Bloggers are always keen to keep the social context of their posts in mind, by asking themselves, “Who is going to see this?” Bloggers are agile in adjusting their tone−and privacy settings−to advance ideas and stay out of trouble. It’s not self-censorship, but a sense of smart expression. But once blogs reached the tipping point, they expanded into the blogosphere. This required a more delicate social networking system and content- sharing architecture. But people now understand that they can have better control over a wide spectrum of relationships. Like how Flickr allows people to share their photos widely, but safely. The checkbox-based privacy of Flickr may seem unfamiliar to a new user, but you can use it to toy with the mind-switches of Sharism. By checking a box we can choose to share or not to share. From my observations, I have seen photographers on Flickr become more open to sharing, while retaining flexible choices. The rapid emergence of Social Applications that can communicate and cooperate, by allowing people to output content from one service to another, is letting users pump their memes into a pipeline-like ecosystem. This interconnectedness allows memes to travel along multiple online social networks, and potentially reach a huge audience. As a result, such a Micro-pipeline system is making Social Media a true alternative to broadcast media. These new technologies are reviving Sharism in our closed culture. Local Practice, Global Gain If you happened to lose your Sharism in a bad educational or cultural setting, it’s hard to get it back. But it’s not impossible. A persistence of practice can lead to a full recovery. You can think of Sharism as a spiritual practice. But you must practice everyday. Otherwise, you might lose the power of sharing. Permanently. You might need something to spur you on, to keep you from quitting and returning to a closed mindset. Here’s an idea: put a sticky note on your desk that says, “What do you want to share today?” I’m not kidding. Then, if anything interesting comes your way: Share It! The easiest way to both start and keep sharing is by using different kinds of social software applications. Your first meme you want to share may be small, but you can amplify it with new technologies. Enlist some people from your network and invite them into a new social application. At first it might be hard to feel the gains of Sharism. The true test then is to see if you can keep track of the feedback that you get from sharing. You will realize that almost all sharing activities will generate positive results. The happiness that this will obtain is only the most immediate reward. But there are others. The first type of reward that you will get comes in the form of comments. Then you know you’ve provoked interest, appreciation, excitement. The second reward is access to all the other stuff being shared by friends in your network. Since you know and trust them, you will be that much more interested in what they have to share. Already, the return is a multiple of the small meme you first shared. But the third type of return is more dramatic still. Anything you share can be forwarded, circulated and republished via other people’s networks. This cascade effect can spread your work to the networked masses. Improvements in social software are making the speed of dissemination as fast as a mouse-click. You should get to know the Sharism-You. You’re about to become popular, and fast This brings us to the fourth and final type of return. It has a meaning not only for you, but for the whole of society. If you so choose, you may allow others to create derivative works from what you share. This one choice could easily snowball into more creations along the sharing path, from people at key nodes in the network who are all as passionate about creating and sharing as you are. After many iterative rounds of development, a large creative work may spring from your choice to share. Of course, you will get the credit that you asked for, and deserve. And it’s okay to seek financial rewards. But you will in every case get something just as substantial: Happiness. The more people who create in the spirit of Sharism, the easier it will be to attain well- balanced and equitable Social Media that is woven by people themselves. Media won’t be controlled by any single person but will rely on the even distribution of social networking. These “Shaeros” (Sharing Heroes) will naturally become the opinion leaders in the first wave of Social Media. However, these media rights will belong to everyone. You yourself can be both producer and consumer in such a system. Sharism Safeguards Your Rights Still, many questions will be raised about Sharism as an initiative in new age. The main one is copyright. One concern is that any loss of control over copyrighted content will lead to noticeable deficits in personal wealth, or just loss of control. 5 years ago, I would have said that this was a possibility. But things are changing today. The sharing environment is more protected than you might think. Many new social applications make it easy to set terms-of-use along your sharing path. Any infringement of those terms will be challenged not just by the law, but by your community. Your audience, who benefit form your sharing, can also be the gatekeepers of your rights. Even if you are a traditional copyright holder, this sounds ideal. Furthermore, by realizing all the immediate and emergent rewards that can be had by sharing, you may eventually find that copyright and “All Rights Reserved” are far from your mind. You will enjoy sharing too much to worry about who is keeping a copy. The new economic formula is, the more people remix your works, the higher the return. I want to point out that Sharism is not Communism, nor Socialism. As for those die- hard Communists we know, they have often abused people’s sharing nature and forced them to give up their rights, and their property. Socialism, that tender Communism, in our experience also lacked respect for these rights. Under these systems, the state owns all property. Under Sharism, you can keep ownership, if you want. But I like to share. And this is how I choose to spread ideas, and prosperity Sharism is totally based on your own consensus. It’s not a very hard concept to understand, especially since copyleft movements like the Free Software Foundation and Creative Commons have been around for years. These movements are redefining a more flexible spectrum of licenses for both developers and end-users to tag their works. Because the new licenses can be recognized by either humans or machines, it’s becoming easier to re-share those works in new online ecosystems. The Spirit of the Web, a Social Brain Sharism is the Spirit of the Age of Web 2.0. It has the consistency of a naturalized Epistemology and modernized Axiology, but also promises the power of a new Internet philosophy. Sharism will transform the world into an emergent Social Brain: a networked hybrid of people and software. We are Networked Neurons connected by the synapses of Social Software. This is an evolutionary leap, a small step for us and a giant one for human society. With new “hairy” emergent technologies sprouting all around us, we can generate higher connectivities and increase the throughput of our social links. The more open and strongly connected we social neurons are, the better the sharing environment will be for all people. The more collective our intelligence, the wiser our actions will be. People have always found better solutions through conversations. Now we can put it all online. Sharism will be the politics of the next global superpower. It will not be a country, but a new human network joined by Social Software. This may remain a distant dream, and even a well-defined public sharing policy might not be close at hand. But the ideas that I’m discussing can improve governments today. We can integrate our current and emerging democratic systems with new folksonomies (based on the collaborative, social indexing of information) to enable people to make queries, share data and remix information for public use. The collective intelligence of a vast and equitable sharing environment can be the gatekeeper of our rights, and a government watchdog. In the future, policymaking can be made more nuanced with the micro-involvement of the sharing community. This “Emergent Democracy” is more real-time than periodical parliamentary sessions. It will also increase the spectrum of our choices, beyond the binary options of “Yes” or “No” referenda. Representative democracy will become more timely and diligent, because we will represent ourselves within the system. Sharism will result in better social justice. In a healthy sharing environment, any evidence of injustice can get amplified to get the public’s attention. Anyone who has been abused can get real and instant support from her peers and her peers’ peers. Appeals to justice will take the form of petitions through multiple, interconnected channels. Using these tools, anyone can create a large social impact. With multiple devices and many social applications, each of us can become more sociable, and society more individual. We no longer have to act alone. Emergent democracy will only happen when Sharism becomes the literacy of the majority. Since Sharism can improve communication, collaboration and mutual understanding, I believe it has a place within the educational system. Sharism can be applied to any cultural discourse, CoP (Community of Practice) or problem-solving context. It is also an antidote to social depression, since sharelessness is just dragging our society down. In present or formerly totalitarian countries, this downward cycle is even more apparent. The future world will be a hybrid of human and machine that will generate better and faster decisions anytime, anywhere. The flow of information between minds will become more flexible and more productive. These vast networks of sharing will create a new social order−A Mind Revolution!

How is Sharism justified?

Sharism: A Mind Revolution With the People of the World Wide Web communicating more fully and freely in Social Media while rallying a Web 2.0 content boom, the inner dynamics of such a creative explosion must be studied more closely. What motivates those who join this movement and what future will they create? A key fact is that a superabundance of community respect and social capital are being accumulated by those who share. The key motivator of Social Media and the core spirit of Web 2.0 is a mind switch called Sharism. Sharism suggests a re-orientation of personal values. We see it in User Generated Content. It is the pledge of Creative Commons. It is in the plans of future-oriented cultural initiatives. Sharism is also a mental practice that anyone can try, a social-psychological attitude to transform a wide and isolated world into a super-smart Social Brain. The Neuron Doctrine Sharism is encoded in the Human Genome. Although eclipsed by the many pragmatisms of daily life, the theory of Sharism finds basis in neuroscience and its study of the working model of the human brain. Although we can’t entirely say how the brain works as a whole, we do have a model of the functional mechanism of the nervous system and its neurons. A neuron is not a simple organic cell, but a very powerful, electrically excitable biological processor. Groups of neurons form vastly interconnected networks, which, by changing the strength of the synapses between cells, can process information, and learn. A neuron, by sharing chemical signals with its neighbors, can be integrated into more meaningful patterns that keep the neuron active and alive. Moreover, such a simple logic can be iterated and amplified, since all neurons work on a similar principle of connecting and sharing. Originally, the brain is quite open. A neural network exists to share activity and information, and I believe this model of the brain should inspire ideas and decisions about human networks. Thus, our brain supports sharing in its very system-nature. This has profound implications for the creative process. Whenever you have an intention to create, you will find it easier to generate more creative ideas if you keep the sharing process firmly in mind. The idea-forming-process is not linear, but more like an avalanche of amplifications along the thinking path. It moves with the momentum of a creative snowball. If your internal cognitive system encourages sharing, you can engineer a feedback loop of happiness, which will help you generate even more ideas in return. It’s a kind of butterfly- effect, as the small creative energy you spend will eventually return to make you, and the world, more creative. However, daily decisions for most adults are quite low in creative productivity, if only because they’ve switched off their sharing paths. People generally like to share what they create, but in a culture that tells them to be protective of their ideas, people start to believe in the danger of sharing. Then Sharism will be degraded in their mind and not encouraged in their society. But if we can encourage someone to share, her sharing paths will stay open. Sharism will be kept in her mind as a memory and an instinct. If in the future she faces a creative choice, her choice will be, “Share.” These mind-switches are too subtle to be felt. But since the brain, and society, is a connected system, the accumulation of these micro-attitudes, from neuron to neuron and person to person, can result in observable behavior. It is easy to tell if a person, a group, a company, a nation is oriented toward Sharism or not. For those who are not, what they defend as “cultural goods” and “intellectual property” are just excuses for the status quo of keeping a community closed. Much of their “culture” will be protected, but the net result is the direct loss of many other precious ideas, and the subsequent loss of all the potential gains of sharing. This lost knowledge is a black hole in our life, which may start to swallow other values as well. Non-sharing culture misleads us with its absolute separation of Private and Public space. It makes creative action a binary choice between public and private, open and closed. This creates a gap in the spectrum of knowledge. Although this gap has the potential to become a valuable creative space, concerns about privacy make this gap hard to fill. We shouldn’t be surprised that, to be safe, most people keep their sharing private and stay “closed.” They may fear the Internet creates a potential for abuse that they can’t fight alone. However, the paradox is: The less you share, the less power you have. New Technologies and the Rise of Sharism Let’s track back to 1999, when there were only a few hundred pioneer bloggers around the world, and no more than ten times that many readers following each blog. Human history is always so: something important was happening, but the rest of the world hadn’t yet realized it. The shift toward easy-to-use online publishing triggered a soft revolution in just five years. People made a quick and easy transition from reading blogs, to leaving comments and taking part in online conversations, and then to the sudden realization that they should become bloggers themselves. More bloggers created more readers, and more readers made more blogs. The revolution was viral. Bloggers generate lively and timely information on the Internet, and connect to each other with RSS, hyperlinks, comments, trackbacks and quotes. The small-scale granularity of the content can fill discrete gaps in experience and thus record a new human history. Once you become a blogger, once you have accumulated so much social capital in such a small site, it’s hard to stop. We can’t explain this fact with a theory of addiction. It’s an impulse to share. It’s the energy of the memes that want to be passed from mouth to mouth and mind to mind. It’s more than just E-mail. It’s Sharism. Bloggers are always keen to keep the social context of their posts in mind, by asking themselves, “Who is going to see this?” Bloggers are agile in adjusting their tone−and privacy settings−to advance ideas and stay out of trouble. It’s not self-censorship, but a sense of smart expression. But once blogs reached the tipping point, they expanded into the blogosphere. This required a more delicate social networking system and content- sharing architecture. But people now understand that they can have better control over a wide spectrum of relationships. Like how Flickr allows people to share their photos widely, but safely. The checkbox-based privacy of Flickr may seem unfamiliar to a new user, but you can use it to toy with the mind-switches of Sharism. By checking a box we can choose to share or not to share. From my observations, I have seen photographers on Flickr become more open to sharing, while retaining flexible choices. The rapid emergence of Social Applications that can communicate and cooperate, by allowing people to output content from one service to another, is letting users pump their memes into a pipeline-like ecosystem. This interconnectedness allows memes to travel along multiple online social networks, and potentially reach a huge audience. As a result, such a Micro-pipeline system is making Social Media a true alternative to broadcast media. These new technologies are reviving Sharism in our closed culture. Local Practice, Global Gain If you happened to lose your Sharism in a bad educational or cultural setting, it’s hard to get it back. But it’s not impossible. A persistence of practice can lead to a full recovery. You can think of Sharism as a spiritual practice. But you must practice everyday. Otherwise, you might lose the power of sharing. Permanently. You might need something to spur you on, to keep you from quitting and returning to a closed mindset. Here’s an idea: put a sticky note on your desk that says, “What do you want to share today?” I’m not kidding. Then, if anything interesting comes your way: Share It! The easiest way to both start and keep sharing is by using different kinds of social software applications. Your first meme you want to share may be small, but you can amplify it with new technologies. Enlist some people from your network and invite them into a new social application. At first it might be hard to feel the gains of Sharism. The true test then is to see if you can keep track of the feedback that you get from sharing. You will realize that almost all sharing activities will generate positive results. The happiness that this will obtain is only the most immediate reward. But there are others. The first type of reward that you will get comes in the form of comments. Then you know you’ve provoked interest, appreciation, excitement. The second reward is access to all the other stuff being shared by friends in your network. Since you know and trust them, you will be that much more interested in what they have to share. Already, the return is a multiple of the small meme you first shared. But the third type of return is more dramatic still. Anything you share can be forwarded, circulated and republished via other people’s networks. This cascade effect can spread your work to the networked masses. Improvements in social software are making the speed of dissemination as fast as a mouse-click. You should get to know the Sharism-You. You’re about to become popular, and fast This brings us to the fourth and final type of return. It has a meaning not only for you, but for the whole of society. If you so choose, you may allow others to create derivative works from what you share. This one choice could easily snowball into more creations along the sharing path, from people at key nodes in the network who are all as passionate about creating and sharing as you are. After many iterative rounds of development, a large creative work may spring from your choice to share. Of course, you will get the credit that you asked for, and deserve. And it’s okay to seek financial rewards. But you will in every case get something just as substantial: Happiness. The more people who create in the spirit of Sharism, the easier it will be to attain well- balanced and equitable Social Media that is woven by people themselves. Media won’t be controlled by any single person but will rely on the even distribution of social networking. These “Shaeros” (Sharing Heroes) will naturally become the opinion leaders in the first wave of Social Media. However, these media rights will belong to everyone. You yourself can be both producer and consumer in such a system. Sharism Safeguards Your Rights Still, many questions will be raised about Sharism as an initiative in new age. The main one is copyright. One concern is that any loss of control over copyrighted content will lead to noticeable deficits in personal wealth, or just loss of control. 5 years ago, I would have said that this was a possibility. But things are changing today. The sharing environment is more protected than you might think. Many new social applications make it easy to set terms-of-use along your sharing path. Any infringement of those terms will be challenged not just by the law, but by your community. Your audience, who benefit form your sharing, can also be the gatekeepers of your rights. Even if you are a traditional copyright holder, this sounds ideal. Furthermore, by realizing all the immediate and emergent rewards that can be had by sharing, you may eventually find that copyright and “All Rights Reserved” are far from your mind. You will enjoy sharing too much to worry about who is keeping a copy. The new economic formula is, the more people remix your works, the higher the return. I want to point out that Sharism is not Communism, nor Socialism. As for those die- hard Communists we know, they have often abused people’s sharing nature and forced them to give up their rights, and their property. Socialism, that tender Communism, in our experience also lacked respect for these rights. Under these systems, the state owns all property. Under Sharism, you can keep ownership, if you want. But I like to share. And this is how I choose to spread ideas, and prosperity Sharism is totally based on your own consensus. It’s not a very hard concept to understand, especially since copyleft movements like the Free Software Foundation and Creative Commons have been around for years. These movements are redefining a more flexible spectrum of licenses for both developers and end-users to tag their works. Because the new licenses can be recognized by either humans or machines, it’s becoming easier to re-share those works in new online ecosystems. The Spirit of the Web, a Social Brain Sharism is the Spirit of the Age of Web 2.0. It has the consistency of a naturalized Epistemology and modernized Axiology, but also promises the power of a new Internet philosophy. Sharism will transform the world into an emergent Social Brain: a networked hybrid of people and software. We are Networked Neurons connected by the synapses of Social Software. This is an evolutionary leap, a small step for us and a giant one for human society. With new “hairy” emergent technologies sprouting all around us, we can generate higher connectivities and increase the throughput of our social links. The more open and strongly connected we social neurons are, the better the sharing environment will be for all people. The more collective our intelligence, the wiser our actions will be. People have always found better solutions through conversations. Now we can put it all online. Sharism will be the politics of the next global superpower. It will not be a country, but a new human network joined by Social Software. This may remain a distant dream, and even a well-defined public sharing policy might not be close at hand. But the ideas that I’m discussing can improve governments today. We can integrate our current and emerging democratic systems with new folksonomies (based on the collaborative, social indexing of information) to enable people to make queries, share data and remix information for public use. The collective intelligence of a vast and equitable sharing environment can be the gatekeeper of our rights, and a government watchdog. In the future, policymaking can be made more nuanced with the micro-involvement of the sharing community. This “Emergent Democracy” is more real-time than periodical parliamentary sessions. It will also increase the spectrum of our choices, beyond the binary options of “Yes” or “No” referenda. Representative democracy will become more timely and diligent, because we will represent ourselves within the system. Sharism will result in better social justice. In a healthy sharing environment, any evidence of injustice can get amplified to get the public’s attention. Anyone who has been abused can get real and instant support from her peers and her peers’ peers. Appeals to justice will take the form of petitions through multiple, interconnected channels. Using these tools, anyone can create a large social impact. With multiple devices and many social applications, each of us can become more sociable, and society more individual. We no longer have to act alone. Emergent democracy will only happen when Sharism becomes the literacy of the majority. Since Sharism can improve communication, collaboration and mutual understanding, I believe it has a place within the educational system. Sharism can be applied to any cultural discourse, CoP (Community of Practice) or problem-solving context. It is also an antidote to social depression, since sharelessness is just dragging our society down. In present or formerly totalitarian countries, this downward cycle is even more apparent. The future world will be a hybrid of human and machine that will generate better and faster decisions anytime, anywhere. The flow of information between minds will become more flexible and more productive. These vast networks of sharing will create a new social order−A Mind Revolution!

By explaining neural activity in the brain, what does the author of the article imply?

Sharism: A Mind Revolution With the People of the World Wide Web communicating more fully and freely in Social Media while rallying a Web 2.0 content boom, the inner dynamics of such a creative explosion must be studied more closely. What motivates those who join this movement and what future will they create? A key fact is that a superabundance of community respect and social capital are being accumulated by those who share. The key motivator of Social Media and the core spirit of Web 2.0 is a mind switch called Sharism. Sharism suggests a re-orientation of personal values. We see it in User Generated Content. It is the pledge of Creative Commons. It is in the plans of future-oriented cultural initiatives. Sharism is also a mental practice that anyone can try, a social-psychological attitude to transform a wide and isolated world into a super-smart Social Brain. The Neuron Doctrine Sharism is encoded in the Human Genome. Although eclipsed by the many pragmatisms of daily life, the theory of Sharism finds basis in neuroscience and its study of the working model of the human brain. Although we can’t entirely say how the brain works as a whole, we do have a model of the functional mechanism of the nervous system and its neurons. A neuron is not a simple organic cell, but a very powerful, electrically excitable biological processor. Groups of neurons form vastly interconnected networks, which, by changing the strength of the synapses between cells, can process information, and learn. A neuron, by sharing chemical signals with its neighbors, can be integrated into more meaningful patterns that keep the neuron active and alive. Moreover, such a simple logic can be iterated and amplified, since all neurons work on a similar principle of connecting and sharing. Originally, the brain is quite open. A neural network exists to share activity and information, and I believe this model of the brain should inspire ideas and decisions about human networks. Thus, our brain supports sharing in its very system-nature. This has profound implications for the creative process. Whenever you have an intention to create, you will find it easier to generate more creative ideas if you keep the sharing process firmly in mind. The idea-forming-process is not linear, but more like an avalanche of amplifications along the thinking path. It moves with the momentum of a creative snowball. If your internal cognitive system encourages sharing, you can engineer a feedback loop of happiness, which will help you generate even more ideas in return. It’s a kind of butterfly- effect, as the small creative energy you spend will eventually return to make you, and the world, more creative. However, daily decisions for most adults are quite low in creative productivity, if only because they’ve switched off their sharing paths. People generally like to share what they create, but in a culture that tells them to be protective of their ideas, people start to believe in the danger of sharing. Then Sharism will be degraded in their mind and not encouraged in their society. But if we can encourage someone to share, her sharing paths will stay open. Sharism will be kept in her mind as a memory and an instinct. If in the future she faces a creative choice, her choice will be, “Share.” These mind-switches are too subtle to be felt. But since the brain, and society, is a connected system, the accumulation of these micro-attitudes, from neuron to neuron and person to person, can result in observable behavior. It is easy to tell if a person, a group, a company, a nation is oriented toward Sharism or not. For those who are not, what they defend as “cultural goods” and “intellectual property” are just excuses for the status quo of keeping a community closed. Much of their “culture” will be protected, but the net result is the direct loss of many other precious ideas, and the subsequent loss of all the potential gains of sharing. This lost knowledge is a black hole in our life, which may start to swallow other values as well. Non-sharing culture misleads us with its absolute separation of Private and Public space. It makes creative action a binary choice between public and private, open and closed. This creates a gap in the spectrum of knowledge. Although this gap has the potential to become a valuable creative space, concerns about privacy make this gap hard to fill. We shouldn’t be surprised that, to be safe, most people keep their sharing private and stay “closed.” They may fear the Internet creates a potential for abuse that they can’t fight alone. However, the paradox is: The less you share, the less power you have. New Technologies and the Rise of Sharism Let’s track back to 1999, when there were only a few hundred pioneer bloggers around the world, and no more than ten times that many readers following each blog. Human history is always so: something important was happening, but the rest of the world hadn’t yet realized it. The shift toward easy-to-use online publishing triggered a soft revolution in just five years. People made a quick and easy transition from reading blogs, to leaving comments and taking part in online conversations, and then to the sudden realization that they should become bloggers themselves. More bloggers created more readers, and more readers made more blogs. The revolution was viral. Bloggers generate lively and timely information on the Internet, and connect to each other with RSS, hyperlinks, comments, trackbacks and quotes. The small-scale granularity of the content can fill discrete gaps in experience and thus record a new human history. Once you become a blogger, once you have accumulated so much social capital in such a small site, it’s hard to stop. We can’t explain this fact with a theory of addiction. It’s an impulse to share. It’s the energy of the memes that want to be passed from mouth to mouth and mind to mind. It’s more than just E-mail. It’s Sharism. Bloggers are always keen to keep the social context of their posts in mind, by asking themselves, “Who is going to see this?” Bloggers are agile in adjusting their tone−and privacy settings−to advance ideas and stay out of trouble. It’s not self-censorship, but a sense of smart expression. But once blogs reached the tipping point, they expanded into the blogosphere. This required a more delicate social networking system and content- sharing architecture. But people now understand that they can have better control over a wide spectrum of relationships. Like how Flickr allows people to share their photos widely, but safely. The checkbox-based privacy of Flickr may seem unfamiliar to a new user, but you can use it to toy with the mind-switches of Sharism. By checking a box we can choose to share or not to share. From my observations, I have seen photographers on Flickr become more open to sharing, while retaining flexible choices. The rapid emergence of Social Applications that can communicate and cooperate, by allowing people to output content from one service to another, is letting users pump their memes into a pipeline-like ecosystem. This interconnectedness allows memes to travel along multiple online social networks, and potentially reach a huge audience. As a result, such a Micro-pipeline system is making Social Media a true alternative to broadcast media. These new technologies are reviving Sharism in our closed culture. Local Practice, Global Gain If you happened to lose your Sharism in a bad educational or cultural setting, it’s hard to get it back. But it’s not impossible. A persistence of practice can lead to a full recovery. You can think of Sharism as a spiritual practice. But you must practice everyday. Otherwise, you might lose the power of sharing. Permanently. You might need something to spur you on, to keep you from quitting and returning to a closed mindset. Here’s an idea: put a sticky note on your desk that says, “What do you want to share today?” I’m not kidding. Then, if anything interesting comes your way: Share It! The easiest way to both start and keep sharing is by using different kinds of social software applications. Your first meme you want to share may be small, but you can amplify it with new technologies. Enlist some people from your network and invite them into a new social application. At first it might be hard to feel the gains of Sharism. The true test then is to see if you can keep track of the feedback that you get from sharing. You will realize that almost all sharing activities will generate positive results. The happiness that this will obtain is only the most immediate reward. But there are others. The first type of reward that you will get comes in the form of comments. Then you know you’ve provoked interest, appreciation, excitement. The second reward is access to all the other stuff being shared by friends in your network. Since you know and trust them, you will be that much more interested in what they have to share. Already, the return is a multiple of the small meme you first shared. But the third type of return is more dramatic still. Anything you share can be forwarded, circulated and republished via other people’s networks. This cascade effect can spread your work to the networked masses. Improvements in social software are making the speed of dissemination as fast as a mouse-click. You should get to know the Sharism-You. You’re about to become popular, and fast This brings us to the fourth and final type of return. It has a meaning not only for you, but for the whole of society. If you so choose, you may allow others to create derivative works from what you share. This one choice could easily snowball into more creations along the sharing path, from people at key nodes in the network who are all as passionate about creating and sharing as you are. After many iterative rounds of development, a large creative work may spring from your choice to share. Of course, you will get the credit that you asked for, and deserve. And it’s okay to seek financial rewards. But you will in every case get something just as substantial: Happiness. The more people who create in the spirit of Sharism, the easier it will be to attain well- balanced and equitable Social Media that is woven by people themselves. Media won’t be controlled by any single person but will rely on the even distribution of social networking. These “Shaeros” (Sharing Heroes) will naturally become the opinion leaders in the first wave of Social Media. However, these media rights will belong to everyone. You yourself can be both producer and consumer in such a system. Sharism Safeguards Your Rights Still, many questions will be raised about Sharism as an initiative in new age. The main one is copyright. One concern is that any loss of control over copyrighted content will lead to noticeable deficits in personal wealth, or just loss of control. 5 years ago, I would have said that this was a possibility. But things are changing today. The sharing environment is more protected than you might think. Many new social applications make it easy to set terms-of-use along your sharing path. Any infringement of those terms will be challenged not just by the law, but by your community. Your audience, who benefit form your sharing, can also be the gatekeepers of your rights. Even if you are a traditional copyright holder, this sounds ideal. Furthermore, by realizing all the immediate and emergent rewards that can be had by sharing, you may eventually find that copyright and “All Rights Reserved” are far from your mind. You will enjoy sharing too much to worry about who is keeping a copy. The new economic formula is, the more people remix your works, the higher the return. I want to point out that Sharism is not Communism, nor Socialism. As for those die- hard Communists we know, they have often abused people’s sharing nature and forced them to give up their rights, and their property. Socialism, that tender Communism, in our experience also lacked respect for these rights. Under these systems, the state owns all property. Under Sharism, you can keep ownership, if you want. But I like to share. And this is how I choose to spread ideas, and prosperity Sharism is totally based on your own consensus. It’s not a very hard concept to understand, especially since copyleft movements like the Free Software Foundation and Creative Commons have been around for years. These movements are redefining a more flexible spectrum of licenses for both developers and end-users to tag their works. Because the new licenses can be recognized by either humans or machines, it’s becoming easier to re-share those works in new online ecosystems. The Spirit of the Web, a Social Brain Sharism is the Spirit of the Age of Web 2.0. It has the consistency of a naturalized Epistemology and modernized Axiology, but also promises the power of a new Internet philosophy. Sharism will transform the world into an emergent Social Brain: a networked hybrid of people and software. We are Networked Neurons connected by the synapses of Social Software. This is an evolutionary leap, a small step for us and a giant one for human society. With new “hairy” emergent technologies sprouting all around us, we can generate higher connectivities and increase the throughput of our social links. The more open and strongly connected we social neurons are, the better the sharing environment will be for all people. The more collective our intelligence, the wiser our actions will be. People have always found better solutions through conversations. Now we can put it all online. Sharism will be the politics of the next global superpower. It will not be a country, but a new human network joined by Social Software. This may remain a distant dream, and even a well-defined public sharing policy might not be close at hand. But the ideas that I’m discussing can improve governments today. We can integrate our current and emerging democratic systems with new folksonomies (based on the collaborative, social indexing of information) to enable people to make queries, share data and remix information for public use. The collective intelligence of a vast and equitable sharing environment can be the gatekeeper of our rights, and a government watchdog. In the future, policymaking can be made more nuanced with the micro-involvement of the sharing community. This “Emergent Democracy” is more real-time than periodical parliamentary sessions. It will also increase the spectrum of our choices, beyond the binary options of “Yes” or “No” referenda. Representative democracy will become more timely and diligent, because we will represent ourselves within the system. Sharism will result in better social justice. In a healthy sharing environment, any evidence of injustice can get amplified to get the public’s attention. Anyone who has been abused can get real and instant support from her peers and her peers’ peers. Appeals to justice will take the form of petitions through multiple, interconnected channels. Using these tools, anyone can create a large social impact. With multiple devices and many social applications, each of us can become more sociable, and society more individual. We no longer have to act alone. Emergent democracy will only happen when Sharism becomes the literacy of the majority. Since Sharism can improve communication, collaboration and mutual understanding, I believe it has a place within the educational system. Sharism can be applied to any cultural discourse, CoP (Community of Practice) or problem-solving context. It is also an antidote to social depression, since sharelessness is just dragging our society down. In present or formerly totalitarian countries, this downward cycle is even more apparent. The future world will be a hybrid of human and machine that will generate better and faster decisions anytime, anywhere. The flow of information between minds will become more flexible and more productive. These vast networks of sharing will create a new social order−A Mind Revolution!

According to the author, why do people stop themselves from sharing as much as they could?

Sharism: A Mind Revolution With the People of the World Wide Web communicating more fully and freely in Social Media while rallying a Web 2.0 content boom, the inner dynamics of such a creative explosion must be studied more closely. What motivates those who join this movement and what future will they create? A key fact is that a superabundance of community respect and social capital are being accumulated by those who share. The key motivator of Social Media and the core spirit of Web 2.0 is a mind switch called Sharism. Sharism suggests a re-orientation of personal values. We see it in User Generated Content. It is the pledge of Creative Commons. It is in the plans of future-oriented cultural initiatives. Sharism is also a mental practice that anyone can try, a social-psychological attitude to transform a wide and isolated world into a super-smart Social Brain. The Neuron Doctrine Sharism is encoded in the Human Genome. Although eclipsed by the many pragmatisms of daily life, the theory of Sharism finds basis in neuroscience and its study of the working model of the human brain. Although we can’t entirely say how the brain works as a whole, we do have a model of the functional mechanism of the nervous system and its neurons. A neuron is not a simple organic cell, but a very powerful, electrically excitable biological processor. Groups of neurons form vastly interconnected networks, which, by changing the strength of the synapses between cells, can process information, and learn. A neuron, by sharing chemical signals with its neighbors, can be integrated into more meaningful patterns that keep the neuron active and alive. Moreover, such a simple logic can be iterated and amplified, since all neurons work on a similar principle of connecting and sharing. Originally, the brain is quite open. A neural network exists to share activity and information, and I believe this model of the brain should inspire ideas and decisions about human networks. Thus, our brain supports sharing in its very system-nature. This has profound implications for the creative process. Whenever you have an intention to create, you will find it easier to generate more creative ideas if you keep the sharing process firmly in mind. The idea-forming-process is not linear, but more like an avalanche of amplifications along the thinking path. It moves with the momentum of a creative snowball. If your internal cognitive system encourages sharing, you can engineer a feedback loop of happiness, which will help you generate even more ideas in return. It’s a kind of butterfly- effect, as the small creative energy you spend will eventually return to make you, and the world, more creative. However, daily decisions for most adults are quite low in creative productivity, if only because they’ve switched off their sharing paths. People generally like to share what they create, but in a culture that tells them to be protective of their ideas, people start to believe in the danger of sharing. Then Sharism will be degraded in their mind and not encouraged in their society. But if we can encourage someone to share, her sharing paths will stay open. Sharism will be kept in her mind as a memory and an instinct. If in the future she faces a creative choice, her choice will be, “Share.” These mind-switches are too subtle to be felt. But since the brain, and society, is a connected system, the accumulation of these micro-attitudes, from neuron to neuron and person to person, can result in observable behavior. It is easy to tell if a person, a group, a company, a nation is oriented toward Sharism or not. For those who are not, what they defend as “cultural goods” and “intellectual property” are just excuses for the status quo of keeping a community closed. Much of their “culture” will be protected, but the net result is the direct loss of many other precious ideas, and the subsequent loss of all the potential gains of sharing. This lost knowledge is a black hole in our life, which may start to swallow other values as well. Non-sharing culture misleads us with its absolute separation of Private and Public space. It makes creative action a binary choice between public and private, open and closed. This creates a gap in the spectrum of knowledge. Although this gap has the potential to become a valuable creative space, concerns about privacy make this gap hard to fill. We shouldn’t be surprised that, to be safe, most people keep their sharing private and stay “closed.” They may fear the Internet creates a potential for abuse that they can’t fight alone. However, the paradox is: The less you share, the less power you have. New Technologies and the Rise of Sharism Let’s track back to 1999, when there were only a few hundred pioneer bloggers around the world, and no more than ten times that many readers following each blog. Human history is always so: something important was happening, but the rest of the world hadn’t yet realized it. The shift toward easy-to-use online publishing triggered a soft revolution in just five years. People made a quick and easy transition from reading blogs, to leaving comments and taking part in online conversations, and then to the sudden realization that they should become bloggers themselves. More bloggers created more readers, and more readers made more blogs. The revolution was viral. Bloggers generate lively and timely information on the Internet, and connect to each other with RSS, hyperlinks, comments, trackbacks and quotes. The small-scale granularity of the content can fill discrete gaps in experience and thus record a new human history. Once you become a blogger, once you have accumulated so much social capital in such a small site, it’s hard to stop. We can’t explain this fact with a theory of addiction. It’s an impulse to share. It’s the energy of the memes that want to be passed from mouth to mouth and mind to mind. It’s more than just E-mail. It’s Sharism. Bloggers are always keen to keep the social context of their posts in mind, by asking themselves, “Who is going to see this?” Bloggers are agile in adjusting their tone−and privacy settings−to advance ideas and stay out of trouble. It’s not self-censorship, but a sense of smart expression. But once blogs reached the tipping point, they expanded into the blogosphere. This required a more delicate social networking system and content- sharing architecture. But people now understand that they can have better control over a wide spectrum of relationships. Like how Flickr allows people to share their photos widely, but safely. The checkbox-based privacy of Flickr may seem unfamiliar to a new user, but you can use it to toy with the mind-switches of Sharism. By checking a box we can choose to share or not to share. From my observations, I have seen photographers on Flickr become more open to sharing, while retaining flexible choices. The rapid emergence of Social Applications that can communicate and cooperate, by allowing people to output content from one service to another, is letting users pump their memes into a pipeline-like ecosystem. This interconnectedness allows memes to travel along multiple online social networks, and potentially reach a huge audience. As a result, such a Micro-pipeline system is making Social Media a true alternative to broadcast media. These new technologies are reviving Sharism in our closed culture. Local Practice, Global Gain If you happened to lose your Sharism in a bad educational or cultural setting, it’s hard to get it back. But it’s not impossible. A persistence of practice can lead to a full recovery. You can think of Sharism as a spiritual practice. But you must practice everyday. Otherwise, you might lose the power of sharing. Permanently. You might need something to spur you on, to keep you from quitting and returning to a closed mindset. Here’s an idea: put a sticky note on your desk that says, “What do you want to share today?” I’m not kidding. Then, if anything interesting comes your way: Share It! The easiest way to both start and keep sharing is by using different kinds of social software applications. Your first meme you want to share may be small, but you can amplify it with new technologies. Enlist some people from your network and invite them into a new social application. At first it might be hard to feel the gains of Sharism. The true test then is to see if you can keep track of the feedback that you get from sharing. You will realize that almost all sharing activities will generate positive results. The happiness that this will obtain is only the most immediate reward. But there are others. The first type of reward that you will get comes in the form of comments. Then you know you’ve provoked interest, appreciation, excitement. The second reward is access to all the other stuff being shared by friends in your network. Since you know and trust them, you will be that much more interested in what they have to share. Already, the return is a multiple of the small meme you first shared. But the third type of return is more dramatic still. Anything you share can be forwarded, circulated and republished via other people’s networks. This cascade effect can spread your work to the networked masses. Improvements in social software are making the speed of dissemination as fast as a mouse-click. You should get to know the Sharism-You. You’re about to become popular, and fast This brings us to the fourth and final type of return. It has a meaning not only for you, but for the whole of society. If you so choose, you may allow others to create derivative works from what you share. This one choice could easily snowball into more creations along the sharing path, from people at key nodes in the network who are all as passionate about creating and sharing as you are. After many iterative rounds of development, a large creative work may spring from your choice to share. Of course, you will get the credit that you asked for, and deserve. And it’s okay to seek financial rewards. But you will in every case get something just as substantial: Happiness. The more people who create in the spirit of Sharism, the easier it will be to attain well- balanced and equitable Social Media that is woven by people themselves. Media won’t be controlled by any single person but will rely on the even distribution of social networking. These “Shaeros” (Sharing Heroes) will naturally become the opinion leaders in the first wave of Social Media. However, these media rights will belong to everyone. You yourself can be both producer and consumer in such a system. Sharism Safeguards Your Rights Still, many questions will be raised about Sharism as an initiative in new age. The main one is copyright. One concern is that any loss of control over copyrighted content will lead to noticeable deficits in personal wealth, or just loss of control. 5 years ago, I would have said that this was a possibility. But things are changing today. The sharing environment is more protected than you might think. Many new social applications make it easy to set terms-of-use along your sharing path. Any infringement of those terms will be challenged not just by the law, but by your community. Your audience, who benefit form your sharing, can also be the gatekeepers of your rights. Even if you are a traditional copyright holder, this sounds ideal. Furthermore, by realizing all the immediate and emergent rewards that can be had by sharing, you may eventually find that copyright and “All Rights Reserved” are far from your mind. You will enjoy sharing too much to worry about who is keeping a copy. The new economic formula is, the more people remix your works, the higher the return. I want to point out that Sharism is not Communism, nor Socialism. As for those die- hard Communists we know, they have often abused people’s sharing nature and forced them to give up their rights, and their property. Socialism, that tender Communism, in our experience also lacked respect for these rights. Under these systems, the state owns all property. Under Sharism, you can keep ownership, if you want. But I like to share. And this is how I choose to spread ideas, and prosperity Sharism is totally based on your own consensus. It’s not a very hard concept to understand, especially since copyleft movements like the Free Software Foundation and Creative Commons have been around for years. These movements are redefining a more flexible spectrum of licenses for both developers and end-users to tag their works. Because the new licenses can be recognized by either humans or machines, it’s becoming easier to re-share those works in new online ecosystems. The Spirit of the Web, a Social Brain Sharism is the Spirit of the Age of Web 2.0. It has the consistency of a naturalized Epistemology and modernized Axiology, but also promises the power of a new Internet philosophy. Sharism will transform the world into an emergent Social Brain: a networked hybrid of people and software. We are Networked Neurons connected by the synapses of Social Software. This is an evolutionary leap, a small step for us and a giant one for human society. With new “hairy” emergent technologies sprouting all around us, we can generate higher connectivities and increase the throughput of our social links. The more open and strongly connected we social neurons are, the better the sharing environment will be for all people. The more collective our intelligence, the wiser our actions will be. People have always found better solutions through conversations. Now we can put it all online. Sharism will be the politics of the next global superpower. It will not be a country, but a new human network joined by Social Software. This may remain a distant dream, and even a well-defined public sharing policy might not be close at hand. But the ideas that I’m discussing can improve governments today. We can integrate our current and emerging democratic systems with new folksonomies (based on the collaborative, social indexing of information) to enable people to make queries, share data and remix information for public use. The collective intelligence of a vast and equitable sharing environment can be the gatekeeper of our rights, and a government watchdog. In the future, policymaking can be made more nuanced with the micro-involvement of the sharing community. This “Emergent Democracy” is more real-time than periodical parliamentary sessions. It will also increase the spectrum of our choices, beyond the binary options of “Yes” or “No” referenda. Representative democracy will become more timely and diligent, because we will represent ourselves within the system. Sharism will result in better social justice. In a healthy sharing environment, any evidence of injustice can get amplified to get the public’s attention. Anyone who has been abused can get real and instant support from her peers and her peers’ peers. Appeals to justice will take the form of petitions through multiple, interconnected channels. Using these tools, anyone can create a large social impact. With multiple devices and many social applications, each of us can become more sociable, and society more individual. We no longer have to act alone. Emergent democracy will only happen when Sharism becomes the literacy of the majority. Since Sharism can improve communication, collaboration and mutual understanding, I believe it has a place within the educational system. Sharism can be applied to any cultural discourse, CoP (Community of Practice) or problem-solving context. It is also an antidote to social depression, since sharelessness is just dragging our society down. In present or formerly totalitarian countries, this downward cycle is even more apparent. The future world will be a hybrid of human and machine that will generate better and faster decisions anytime, anywhere. The flow of information between minds will become more flexible and more productive. These vast networks of sharing will create a new social order−A Mind Revolution!

What do certain corporations lose by remaining closed off to sharing?

Sharism: A Mind Revolution With the People of the World Wide Web communicating more fully and freely in Social Media while rallying a Web 2.0 content boom, the inner dynamics of such a creative explosion must be studied more closely. What motivates those who join this movement and what future will they create? A key fact is that a superabundance of community respect and social capital are being accumulated by those who share. The key motivator of Social Media and the core spirit of Web 2.0 is a mind switch called Sharism. Sharism suggests a re-orientation of personal values. We see it in User Generated Content. It is the pledge of Creative Commons. It is in the plans of future-oriented cultural initiatives. Sharism is also a mental practice that anyone can try, a social-psychological attitude to transform a wide and isolated world into a super-smart Social Brain. The Neuron Doctrine Sharism is encoded in the Human Genome. Although eclipsed by the many pragmatisms of daily life, the theory of Sharism finds basis in neuroscience and its study of the working model of the human brain. Although we can’t entirely say how the brain works as a whole, we do have a model of the functional mechanism of the nervous system and its neurons. A neuron is not a simple organic cell, but a very powerful, electrically excitable biological processor. Groups of neurons form vastly interconnected networks, which, by changing the strength of the synapses between cells, can process information, and learn. A neuron, by sharing chemical signals with its neighbors, can be integrated into more meaningful patterns that keep the neuron active and alive. Moreover, such a simple logic can be iterated and amplified, since all neurons work on a similar principle of connecting and sharing. Originally, the brain is quite open. A neural network exists to share activity and information, and I believe this model of the brain should inspire ideas and decisions about human networks. Thus, our brain supports sharing in its very system-nature. This has profound implications for the creative process. Whenever you have an intention to create, you will find it easier to generate more creative ideas if you keep the sharing process firmly in mind. The idea-forming-process is not linear, but more like an avalanche of amplifications along the thinking path. It moves with the momentum of a creative snowball. If your internal cognitive system encourages sharing, you can engineer a feedback loop of happiness, which will help you generate even more ideas in return. It’s a kind of butterfly- effect, as the small creative energy you spend will eventually return to make you, and the world, more creative. However, daily decisions for most adults are quite low in creative productivity, if only because they’ve switched off their sharing paths. People generally like to share what they create, but in a culture that tells them to be protective of their ideas, people start to believe in the danger of sharing. Then Sharism will be degraded in their mind and not encouraged in their society. But if we can encourage someone to share, her sharing paths will stay open. Sharism will be kept in her mind as a memory and an instinct. If in the future she faces a creative choice, her choice will be, “Share.” These mind-switches are too subtle to be felt. But since the brain, and society, is a connected system, the accumulation of these micro-attitudes, from neuron to neuron and person to person, can result in observable behavior. It is easy to tell if a person, a group, a company, a nation is oriented toward Sharism or not. For those who are not, what they defend as “cultural goods” and “intellectual property” are just excuses for the status quo of keeping a community closed. Much of their “culture” will be protected, but the net result is the direct loss of many other precious ideas, and the subsequent loss of all the potential gains of sharing. This lost knowledge is a black hole in our life, which may start to swallow other values as well. Non-sharing culture misleads us with its absolute separation of Private and Public space. It makes creative action a binary choice between public and private, open and closed. This creates a gap in the spectrum of knowledge. Although this gap has the potential to become a valuable creative space, concerns about privacy make this gap hard to fill. We shouldn’t be surprised that, to be safe, most people keep their sharing private and stay “closed.” They may fear the Internet creates a potential for abuse that they can’t fight alone. However, the paradox is: The less you share, the less power you have. New Technologies and the Rise of Sharism Let’s track back to 1999, when there were only a few hundred pioneer bloggers around the world, and no more than ten times that many readers following each blog. Human history is always so: something important was happening, but the rest of the world hadn’t yet realized it. The shift toward easy-to-use online publishing triggered a soft revolution in just five years. People made a quick and easy transition from reading blogs, to leaving comments and taking part in online conversations, and then to the sudden realization that they should become bloggers themselves. More bloggers created more readers, and more readers made more blogs. The revolution was viral. Bloggers generate lively and timely information on the Internet, and connect to each other with RSS, hyperlinks, comments, trackbacks and quotes. The small-scale granularity of the content can fill discrete gaps in experience and thus record a new human history. Once you become a blogger, once you have accumulated so much social capital in such a small site, it’s hard to stop. We can’t explain this fact with a theory of addiction. It’s an impulse to share. It’s the energy of the memes that want to be passed from mouth to mouth and mind to mind. It’s more than just E-mail. It’s Sharism. Bloggers are always keen to keep the social context of their posts in mind, by asking themselves, “Who is going to see this?” Bloggers are agile in adjusting their tone−and privacy settings−to advance ideas and stay out of trouble. It’s not self-censorship, but a sense of smart expression. But once blogs reached the tipping point, they expanded into the blogosphere. This required a more delicate social networking system and content- sharing architecture. But people now understand that they can have better control over a wide spectrum of relationships. Like how Flickr allows people to share their photos widely, but safely. The checkbox-based privacy of Flickr may seem unfamiliar to a new user, but you can use it to toy with the mind-switches of Sharism. By checking a box we can choose to share or not to share. From my observations, I have seen photographers on Flickr become more open to sharing, while retaining flexible choices. The rapid emergence of Social Applications that can communicate and cooperate, by allowing people to output content from one service to another, is letting users pump their memes into a pipeline-like ecosystem. This interconnectedness allows memes to travel along multiple online social networks, and potentially reach a huge audience. As a result, such a Micro-pipeline system is making Social Media a true alternative to broadcast media. These new technologies are reviving Sharism in our closed culture. Local Practice, Global Gain If you happened to lose your Sharism in a bad educational or cultural setting, it’s hard to get it back. But it’s not impossible. A persistence of practice can lead to a full recovery. You can think of Sharism as a spiritual practice. But you must practice everyday. Otherwise, you might lose the power of sharing. Permanently. You might need something to spur you on, to keep you from quitting and returning to a closed mindset. Here’s an idea: put a sticky note on your desk that says, “What do you want to share today?” I’m not kidding. Then, if anything interesting comes your way: Share It! The easiest way to both start and keep sharing is by using different kinds of social software applications. Your first meme you want to share may be small, but you can amplify it with new technologies. Enlist some people from your network and invite them into a new social application. At first it might be hard to feel the gains of Sharism. The true test then is to see if you can keep track of the feedback that you get from sharing. You will realize that almost all sharing activities will generate positive results. The happiness that this will obtain is only the most immediate reward. But there are others. The first type of reward that you will get comes in the form of comments. Then you know you’ve provoked interest, appreciation, excitement. The second reward is access to all the other stuff being shared by friends in your network. Since you know and trust them, you will be that much more interested in what they have to share. Already, the return is a multiple of the small meme you first shared. But the third type of return is more dramatic still. Anything you share can be forwarded, circulated and republished via other people’s networks. This cascade effect can spread your work to the networked masses. Improvements in social software are making the speed of dissemination as fast as a mouse-click. You should get to know the Sharism-You. You’re about to become popular, and fast This brings us to the fourth and final type of return. It has a meaning not only for you, but for the whole of society. If you so choose, you may allow others to create derivative works from what you share. This one choice could easily snowball into more creations along the sharing path, from people at key nodes in the network who are all as passionate about creating and sharing as you are. After many iterative rounds of development, a large creative work may spring from your choice to share. Of course, you will get the credit that you asked for, and deserve. And it’s okay to seek financial rewards. But you will in every case get something just as substantial: Happiness. The more people who create in the spirit of Sharism, the easier it will be to attain well- balanced and equitable Social Media that is woven by people themselves. Media won’t be controlled by any single person but will rely on the even distribution of social networking. These “Shaeros” (Sharing Heroes) will naturally become the opinion leaders in the first wave of Social Media. However, these media rights will belong to everyone. You yourself can be both producer and consumer in such a system. Sharism Safeguards Your Rights Still, many questions will be raised about Sharism as an initiative in new age. The main one is copyright. One concern is that any loss of control over copyrighted content will lead to noticeable deficits in personal wealth, or just loss of control. 5 years ago, I would have said that this was a possibility. But things are changing today. The sharing environment is more protected than you might think. Many new social applications make it easy to set terms-of-use along your sharing path. Any infringement of those terms will be challenged not just by the law, but by your community. Your audience, who benefit form your sharing, can also be the gatekeepers of your rights. Even if you are a traditional copyright holder, this sounds ideal. Furthermore, by realizing all the immediate and emergent rewards that can be had by sharing, you may eventually find that copyright and “All Rights Reserved” are far from your mind. You will enjoy sharing too much to worry about who is keeping a copy. The new economic formula is, the more people remix your works, the higher the return. I want to point out that Sharism is not Communism, nor Socialism. As for those die- hard Communists we know, they have often abused people’s sharing nature and forced them to give up their rights, and their property. Socialism, that tender Communism, in our experience also lacked respect for these rights. Under these systems, the state owns all property. Under Sharism, you can keep ownership, if you want. But I like to share. And this is how I choose to spread ideas, and prosperity Sharism is totally based on your own consensus. It’s not a very hard concept to understand, especially since copyleft movements like the Free Software Foundation and Creative Commons have been around for years. These movements are redefining a more flexible spectrum of licenses for both developers and end-users to tag their works. Because the new licenses can be recognized by either humans or machines, it’s becoming easier to re-share those works in new online ecosystems. The Spirit of the Web, a Social Brain Sharism is the Spirit of the Age of Web 2.0. It has the consistency of a naturalized Epistemology and modernized Axiology, but also promises the power of a new Internet philosophy. Sharism will transform the world into an emergent Social Brain: a networked hybrid of people and software. We are Networked Neurons connected by the synapses of Social Software. This is an evolutionary leap, a small step for us and a giant one for human society. With new “hairy” emergent technologies sprouting all around us, we can generate higher connectivities and increase the throughput of our social links. The more open and strongly connected we social neurons are, the better the sharing environment will be for all people. The more collective our intelligence, the wiser our actions will be. People have always found better solutions through conversations. Now we can put it all online. Sharism will be the politics of the next global superpower. It will not be a country, but a new human network joined by Social Software. This may remain a distant dream, and even a well-defined public sharing policy might not be close at hand. But the ideas that I’m discussing can improve governments today. We can integrate our current and emerging democratic systems with new folksonomies (based on the collaborative, social indexing of information) to enable people to make queries, share data and remix information for public use. The collective intelligence of a vast and equitable sharing environment can be the gatekeeper of our rights, and a government watchdog. In the future, policymaking can be made more nuanced with the micro-involvement of the sharing community. This “Emergent Democracy” is more real-time than periodical parliamentary sessions. It will also increase the spectrum of our choices, beyond the binary options of “Yes” or “No” referenda. Representative democracy will become more timely and diligent, because we will represent ourselves within the system. Sharism will result in better social justice. In a healthy sharing environment, any evidence of injustice can get amplified to get the public’s attention. Anyone who has been abused can get real and instant support from her peers and her peers’ peers. Appeals to justice will take the form of petitions through multiple, interconnected channels. Using these tools, anyone can create a large social impact. With multiple devices and many social applications, each of us can become more sociable, and society more individual. We no longer have to act alone. Emergent democracy will only happen when Sharism becomes the literacy of the majority. Since Sharism can improve communication, collaboration and mutual understanding, I believe it has a place within the educational system. Sharism can be applied to any cultural discourse, CoP (Community of Practice) or problem-solving context. It is also an antidote to social depression, since sharelessness is just dragging our society down. In present or formerly totalitarian countries, this downward cycle is even more apparent. The future world will be a hybrid of human and machine that will generate better and faster decisions anytime, anywhere. The flow of information between minds will become more flexible and more productive. These vast networks of sharing will create a new social order−A Mind Revolution!

How does the author contradict their promises that sharing will produce a more equitable society?

Sharism: A Mind Revolution With the People of the World Wide Web communicating more fully and freely in Social Media while rallying a Web 2.0 content boom, the inner dynamics of such a creative explosion must be studied more closely. What motivates those who join this movement and what future will they create? A key fact is that a superabundance of community respect and social capital are being accumulated by those who share. The key motivator of Social Media and the core spirit of Web 2.0 is a mind switch called Sharism. Sharism suggests a re-orientation of personal values. We see it in User Generated Content. It is the pledge of Creative Commons. It is in the plans of future-oriented cultural initiatives. Sharism is also a mental practice that anyone can try, a social-psychological attitude to transform a wide and isolated world into a super-smart Social Brain. The Neuron Doctrine Sharism is encoded in the Human Genome. Although eclipsed by the many pragmatisms of daily life, the theory of Sharism finds basis in neuroscience and its study of the working model of the human brain. Although we can’t entirely say how the brain works as a whole, we do have a model of the functional mechanism of the nervous system and its neurons. A neuron is not a simple organic cell, but a very powerful, electrically excitable biological processor. Groups of neurons form vastly interconnected networks, which, by changing the strength of the synapses between cells, can process information, and learn. A neuron, by sharing chemical signals with its neighbors, can be integrated into more meaningful patterns that keep the neuron active and alive. Moreover, such a simple logic can be iterated and amplified, since all neurons work on a similar principle of connecting and sharing. Originally, the brain is quite open. A neural network exists to share activity and information, and I believe this model of the brain should inspire ideas and decisions about human networks. Thus, our brain supports sharing in its very system-nature. This has profound implications for the creative process. Whenever you have an intention to create, you will find it easier to generate more creative ideas if you keep the sharing process firmly in mind. The idea-forming-process is not linear, but more like an avalanche of amplifications along the thinking path. It moves with the momentum of a creative snowball. If your internal cognitive system encourages sharing, you can engineer a feedback loop of happiness, which will help you generate even more ideas in return. It’s a kind of butterfly- effect, as the small creative energy you spend will eventually return to make you, and the world, more creative. However, daily decisions for most adults are quite low in creative productivity, if only because they’ve switched off their sharing paths. People generally like to share what they create, but in a culture that tells them to be protective of their ideas, people start to believe in the danger of sharing. Then Sharism will be degraded in their mind and not encouraged in their society. But if we can encourage someone to share, her sharing paths will stay open. Sharism will be kept in her mind as a memory and an instinct. If in the future she faces a creative choice, her choice will be, “Share.” These mind-switches are too subtle to be felt. But since the brain, and society, is a connected system, the accumulation of these micro-attitudes, from neuron to neuron and person to person, can result in observable behavior. It is easy to tell if a person, a group, a company, a nation is oriented toward Sharism or not. For those who are not, what they defend as “cultural goods” and “intellectual property” are just excuses for the status quo of keeping a community closed. Much of their “culture” will be protected, but the net result is the direct loss of many other precious ideas, and the subsequent loss of all the potential gains of sharing. This lost knowledge is a black hole in our life, which may start to swallow other values as well. Non-sharing culture misleads us with its absolute separation of Private and Public space. It makes creative action a binary choice between public and private, open and closed. This creates a gap in the spectrum of knowledge. Although this gap has the potential to become a valuable creative space, concerns about privacy make this gap hard to fill. We shouldn’t be surprised that, to be safe, most people keep their sharing private and stay “closed.” They may fear the Internet creates a potential for abuse that they can’t fight alone. However, the paradox is: The less you share, the less power you have. New Technologies and the Rise of Sharism Let’s track back to 1999, when there were only a few hundred pioneer bloggers around the world, and no more than ten times that many readers following each blog. Human history is always so: something important was happening, but the rest of the world hadn’t yet realized it. The shift toward easy-to-use online publishing triggered a soft revolution in just five years. People made a quick and easy transition from reading blogs, to leaving comments and taking part in online conversations, and then to the sudden realization that they should become bloggers themselves. More bloggers created more readers, and more readers made more blogs. The revolution was viral. Bloggers generate lively and timely information on the Internet, and connect to each other with RSS, hyperlinks, comments, trackbacks and quotes. The small-scale granularity of the content can fill discrete gaps in experience and thus record a new human history. Once you become a blogger, once you have accumulated so much social capital in such a small site, it’s hard to stop. We can’t explain this fact with a theory of addiction. It’s an impulse to share. It’s the energy of the memes that want to be passed from mouth to mouth and mind to mind. It’s more than just E-mail. It’s Sharism. Bloggers are always keen to keep the social context of their posts in mind, by asking themselves, “Who is going to see this?” Bloggers are agile in adjusting their tone−and privacy settings−to advance ideas and stay out of trouble. It’s not self-censorship, but a sense of smart expression. But once blogs reached the tipping point, they expanded into the blogosphere. This required a more delicate social networking system and content- sharing architecture. But people now understand that they can have better control over a wide spectrum of relationships. Like how Flickr allows people to share their photos widely, but safely. The checkbox-based privacy of Flickr may seem unfamiliar to a new user, but you can use it to toy with the mind-switches of Sharism. By checking a box we can choose to share or not to share. From my observations, I have seen photographers on Flickr become more open to sharing, while retaining flexible choices. The rapid emergence of Social Applications that can communicate and cooperate, by allowing people to output content from one service to another, is letting users pump their memes into a pipeline-like ecosystem. This interconnectedness allows memes to travel along multiple online social networks, and potentially reach a huge audience. As a result, such a Micro-pipeline system is making Social Media a true alternative to broadcast media. These new technologies are reviving Sharism in our closed culture. Local Practice, Global Gain If you happened to lose your Sharism in a bad educational or cultural setting, it’s hard to get it back. But it’s not impossible. A persistence of practice can lead to a full recovery. You can think of Sharism as a spiritual practice. But you must practice everyday. Otherwise, you might lose the power of sharing. Permanently. You might need something to spur you on, to keep you from quitting and returning to a closed mindset. Here’s an idea: put a sticky note on your desk that says, “What do you want to share today?” I’m not kidding. Then, if anything interesting comes your way: Share It! The easiest way to both start and keep sharing is by using different kinds of social software applications. Your first meme you want to share may be small, but you can amplify it with new technologies. Enlist some people from your network and invite them into a new social application. At first it might be hard to feel the gains of Sharism. The true test then is to see if you can keep track of the feedback that you get from sharing. You will realize that almost all sharing activities will generate positive results. The happiness that this will obtain is only the most immediate reward. But there are others. The first type of reward that you will get comes in the form of comments. Then you know you’ve provoked interest, appreciation, excitement. The second reward is access to all the other stuff being shared by friends in your network. Since you know and trust them, you will be that much more interested in what they have to share. Already, the return is a multiple of the small meme you first shared. But the third type of return is more dramatic still. Anything you share can be forwarded, circulated and republished via other people’s networks. This cascade effect can spread your work to the networked masses. Improvements in social software are making the speed of dissemination as fast as a mouse-click. You should get to know the Sharism-You. You’re about to become popular, and fast This brings us to the fourth and final type of return. It has a meaning not only for you, but for the whole of society. If you so choose, you may allow others to create derivative works from what you share. This one choice could easily snowball into more creations along the sharing path, from people at key nodes in the network who are all as passionate about creating and sharing as you are. After many iterative rounds of development, a large creative work may spring from your choice to share. Of course, you will get the credit that you asked for, and deserve. And it’s okay to seek financial rewards. But you will in every case get something just as substantial: Happiness. The more people who create in the spirit of Sharism, the easier it will be to attain well- balanced and equitable Social Media that is woven by people themselves. Media won’t be controlled by any single person but will rely on the even distribution of social networking. These “Shaeros” (Sharing Heroes) will naturally become the opinion leaders in the first wave of Social Media. However, these media rights will belong to everyone. You yourself can be both producer and consumer in such a system. Sharism Safeguards Your Rights Still, many questions will be raised about Sharism as an initiative in new age. The main one is copyright. One concern is that any loss of control over copyrighted content will lead to noticeable deficits in personal wealth, or just loss of control. 5 years ago, I would have said that this was a possibility. But things are changing today. The sharing environment is more protected than you might think. Many new social applications make it easy to set terms-of-use along your sharing path. Any infringement of those terms will be challenged not just by the law, but by your community. Your audience, who benefit form your sharing, can also be the gatekeepers of your rights. Even if you are a traditional copyright holder, this sounds ideal. Furthermore, by realizing all the immediate and emergent rewards that can be had by sharing, you may eventually find that copyright and “All Rights Reserved” are far from your mind. You will enjoy sharing too much to worry about who is keeping a copy. The new economic formula is, the more people remix your works, the higher the return. I want to point out that Sharism is not Communism, nor Socialism. As for those die- hard Communists we know, they have often abused people’s sharing nature and forced them to give up their rights, and their property. Socialism, that tender Communism, in our experience also lacked respect for these rights. Under these systems, the state owns all property. Under Sharism, you can keep ownership, if you want. But I like to share. And this is how I choose to spread ideas, and prosperity Sharism is totally based on your own consensus. It’s not a very hard concept to understand, especially since copyleft movements like the Free Software Foundation and Creative Commons have been around for years. These movements are redefining a more flexible spectrum of licenses for both developers and end-users to tag their works. Because the new licenses can be recognized by either humans or machines, it’s becoming easier to re-share those works in new online ecosystems. The Spirit of the Web, a Social Brain Sharism is the Spirit of the Age of Web 2.0. It has the consistency of a naturalized Epistemology and modernized Axiology, but also promises the power of a new Internet philosophy. Sharism will transform the world into an emergent Social Brain: a networked hybrid of people and software. We are Networked Neurons connected by the synapses of Social Software. This is an evolutionary leap, a small step for us and a giant one for human society. With new “hairy” emergent technologies sprouting all around us, we can generate higher connectivities and increase the throughput of our social links. The more open and strongly connected we social neurons are, the better the sharing environment will be for all people. The more collective our intelligence, the wiser our actions will be. People have always found better solutions through conversations. Now we can put it all online. Sharism will be the politics of the next global superpower. It will not be a country, but a new human network joined by Social Software. This may remain a distant dream, and even a well-defined public sharing policy might not be close at hand. But the ideas that I’m discussing can improve governments today. We can integrate our current and emerging democratic systems with new folksonomies (based on the collaborative, social indexing of information) to enable people to make queries, share data and remix information for public use. The collective intelligence of a vast and equitable sharing environment can be the gatekeeper of our rights, and a government watchdog. In the future, policymaking can be made more nuanced with the micro-involvement of the sharing community. This “Emergent Democracy” is more real-time than periodical parliamentary sessions. It will also increase the spectrum of our choices, beyond the binary options of “Yes” or “No” referenda. Representative democracy will become more timely and diligent, because we will represent ourselves within the system. Sharism will result in better social justice. In a healthy sharing environment, any evidence of injustice can get amplified to get the public’s attention. Anyone who has been abused can get real and instant support from her peers and her peers’ peers. Appeals to justice will take the form of petitions through multiple, interconnected channels. Using these tools, anyone can create a large social impact. With multiple devices and many social applications, each of us can become more sociable, and society more individual. We no longer have to act alone. Emergent democracy will only happen when Sharism becomes the literacy of the majority. Since Sharism can improve communication, collaboration and mutual understanding, I believe it has a place within the educational system. Sharism can be applied to any cultural discourse, CoP (Community of Practice) or problem-solving context. It is also an antidote to social depression, since sharelessness is just dragging our society down. In present or formerly totalitarian countries, this downward cycle is even more apparent. The future world will be a hybrid of human and machine that will generate better and faster decisions anytime, anywhere. The flow of information between minds will become more flexible and more productive. These vast networks of sharing will create a new social order−A Mind Revolution!

The author promises all of the following returns from investing in Sharism EXCEPT for:

Sharism: A Mind Revolution With the People of the World Wide Web communicating more fully and freely in Social Media while rallying a Web 2.0 content boom, the inner dynamics of such a creative explosion must be studied more closely. What motivates those who join this movement and what future will they create? A key fact is that a superabundance of community respect and social capital are being accumulated by those who share. The key motivator of Social Media and the core spirit of Web 2.0 is a mind switch called Sharism. Sharism suggests a re-orientation of personal values. We see it in User Generated Content. It is the pledge of Creative Commons. It is in the plans of future-oriented cultural initiatives. Sharism is also a mental practice that anyone can try, a social-psychological attitude to transform a wide and isolated world into a super-smart Social Brain. The Neuron Doctrine Sharism is encoded in the Human Genome. Although eclipsed by the many pragmatisms of daily life, the theory of Sharism finds basis in neuroscience and its study of the working model of the human brain. Although we can’t entirely say how the brain works as a whole, we do have a model of the functional mechanism of the nervous system and its neurons. A neuron is not a simple organic cell, but a very powerful, electrically excitable biological processor. Groups of neurons form vastly interconnected networks, which, by changing the strength of the synapses between cells, can process information, and learn. A neuron, by sharing chemical signals with its neighbors, can be integrated into more meaningful patterns that keep the neuron active and alive. Moreover, such a simple logic can be iterated and amplified, since all neurons work on a similar principle of connecting and sharing. Originally, the brain is quite open. A neural network exists to share activity and information, and I believe this model of the brain should inspire ideas and decisions about human networks. Thus, our brain supports sharing in its very system-nature. This has profound implications for the creative process. Whenever you have an intention to create, you will find it easier to generate more creative ideas if you keep the sharing process firmly in mind. The idea-forming-process is not linear, but more like an avalanche of amplifications along the thinking path. It moves with the momentum of a creative snowball. If your internal cognitive system encourages sharing, you can engineer a feedback loop of happiness, which will help you generate even more ideas in return. It’s a kind of butterfly- effect, as the small creative energy you spend will eventually return to make you, and the world, more creative. However, daily decisions for most adults are quite low in creative productivity, if only because they’ve switched off their sharing paths. People generally like to share what they create, but in a culture that tells them to be protective of their ideas, people start to believe in the danger of sharing. Then Sharism will be degraded in their mind and not encouraged in their society. But if we can encourage someone to share, her sharing paths will stay open. Sharism will be kept in her mind as a memory and an instinct. If in the future she faces a creative choice, her choice will be, “Share.” These mind-switches are too subtle to be felt. But since the brain, and society, is a connected system, the accumulation of these micro-attitudes, from neuron to neuron and person to person, can result in observable behavior. It is easy to tell if a person, a group, a company, a nation is oriented toward Sharism or not. For those who are not, what they defend as “cultural goods” and “intellectual property” are just excuses for the status quo of keeping a community closed. Much of their “culture” will be protected, but the net result is the direct loss of many other precious ideas, and the subsequent loss of all the potential gains of sharing. This lost knowledge is a black hole in our life, which may start to swallow other values as well. Non-sharing culture misleads us with its absolute separation of Private and Public space. It makes creative action a binary choice between public and private, open and closed. This creates a gap in the spectrum of knowledge. Although this gap has the potential to become a valuable creative space, concerns about privacy make this gap hard to fill. We shouldn’t be surprised that, to be safe, most people keep their sharing private and stay “closed.” They may fear the Internet creates a potential for abuse that they can’t fight alone. However, the paradox is: The less you share, the less power you have. New Technologies and the Rise of Sharism Let’s track back to 1999, when there were only a few hundred pioneer bloggers around the world, and no more than ten times that many readers following each blog. Human history is always so: something important was happening, but the rest of the world hadn’t yet realized it. The shift toward easy-to-use online publishing triggered a soft revolution in just five years. People made a quick and easy transition from reading blogs, to leaving comments and taking part in online conversations, and then to the sudden realization that they should become bloggers themselves. More bloggers created more readers, and more readers made more blogs. The revolution was viral. Bloggers generate lively and timely information on the Internet, and connect to each other with RSS, hyperlinks, comments, trackbacks and quotes. The small-scale granularity of the content can fill discrete gaps in experience and thus record a new human history. Once you become a blogger, once you have accumulated so much social capital in such a small site, it’s hard to stop. We can’t explain this fact with a theory of addiction. It’s an impulse to share. It’s the energy of the memes that want to be passed from mouth to mouth and mind to mind. It’s more than just E-mail. It’s Sharism. Bloggers are always keen to keep the social context of their posts in mind, by asking themselves, “Who is going to see this?” Bloggers are agile in adjusting their tone−and privacy settings−to advance ideas and stay out of trouble. It’s not self-censorship, but a sense of smart expression. But once blogs reached the tipping point, they expanded into the blogosphere. This required a more delicate social networking system and content- sharing architecture. But people now understand that they can have better control over a wide spectrum of relationships. Like how Flickr allows people to share their photos widely, but safely. The checkbox-based privacy of Flickr may seem unfamiliar to a new user, but you can use it to toy with the mind-switches of Sharism. By checking a box we can choose to share or not to share. From my observations, I have seen photographers on Flickr become more open to sharing, while retaining flexible choices. The rapid emergence of Social Applications that can communicate and cooperate, by allowing people to output content from one service to another, is letting users pump their memes into a pipeline-like ecosystem. This interconnectedness allows memes to travel along multiple online social networks, and potentially reach a huge audience. As a result, such a Micro-pipeline system is making Social Media a true alternative to broadcast media. These new technologies are reviving Sharism in our closed culture. Local Practice, Global Gain If you happened to lose your Sharism in a bad educational or cultural setting, it’s hard to get it back. But it’s not impossible. A persistence of practice can lead to a full recovery. You can think of Sharism as a spiritual practice. But you must practice everyday. Otherwise, you might lose the power of sharing. Permanently. You might need something to spur you on, to keep you from quitting and returning to a closed mindset. Here’s an idea: put a sticky note on your desk that says, “What do you want to share today?” I’m not kidding. Then, if anything interesting comes your way: Share It! The easiest way to both start and keep sharing is by using different kinds of social software applications. Your first meme you want to share may be small, but you can amplify it with new technologies. Enlist some people from your network and invite them into a new social application. At first it might be hard to feel the gains of Sharism. The true test then is to see if you can keep track of the feedback that you get from sharing. You will realize that almost all sharing activities will generate positive results. The happiness that this will obtain is only the most immediate reward. But there are others. The first type of reward that you will get comes in the form of comments. Then you know you’ve provoked interest, appreciation, excitement. The second reward is access to all the other stuff being shared by friends in your network. Since you know and trust them, you will be that much more interested in what they have to share. Already, the return is a multiple of the small meme you first shared. But the third type of return is more dramatic still. Anything you share can be forwarded, circulated and republished via other people’s networks. This cascade effect can spread your work to the networked masses. Improvements in social software are making the speed of dissemination as fast as a mouse-click. You should get to know the Sharism-You. You’re about to become popular, and fast This brings us to the fourth and final type of return. It has a meaning not only for you, but for the whole of society. If you so choose, you may allow others to create derivative works from what you share. This one choice could easily snowball into more creations along the sharing path, from people at key nodes in the network who are all as passionate about creating and sharing as you are. After many iterative rounds of development, a large creative work may spring from your choice to share. Of course, you will get the credit that you asked for, and deserve. And it’s okay to seek financial rewards. But you will in every case get something just as substantial: Happiness. The more people who create in the spirit of Sharism, the easier it will be to attain well- balanced and equitable Social Media that is woven by people themselves. Media won’t be controlled by any single person but will rely on the even distribution of social networking. These “Shaeros” (Sharing Heroes) will naturally become the opinion leaders in the first wave of Social Media. However, these media rights will belong to everyone. You yourself can be both producer and consumer in such a system. Sharism Safeguards Your Rights Still, many questions will be raised about Sharism as an initiative in new age. The main one is copyright. One concern is that any loss of control over copyrighted content will lead to noticeable deficits in personal wealth, or just loss of control. 5 years ago, I would have said that this was a possibility. But things are changing today. The sharing environment is more protected than you might think. Many new social applications make it easy to set terms-of-use along your sharing path. Any infringement of those terms will be challenged not just by the law, but by your community. Your audience, who benefit form your sharing, can also be the gatekeepers of your rights. Even if you are a traditional copyright holder, this sounds ideal. Furthermore, by realizing all the immediate and emergent rewards that can be had by sharing, you may eventually find that copyright and “All Rights Reserved” are far from your mind. You will enjoy sharing too much to worry about who is keeping a copy. The new economic formula is, the more people remix your works, the higher the return. I want to point out that Sharism is not Communism, nor Socialism. As for those die- hard Communists we know, they have often abused people’s sharing nature and forced them to give up their rights, and their property. Socialism, that tender Communism, in our experience also lacked respect for these rights. Under these systems, the state owns all property. Under Sharism, you can keep ownership, if you want. But I like to share. And this is how I choose to spread ideas, and prosperity Sharism is totally based on your own consensus. It’s not a very hard concept to understand, especially since copyleft movements like the Free Software Foundation and Creative Commons have been around for years. These movements are redefining a more flexible spectrum of licenses for both developers and end-users to tag their works. Because the new licenses can be recognized by either humans or machines, it’s becoming easier to re-share those works in new online ecosystems. The Spirit of the Web, a Social Brain Sharism is the Spirit of the Age of Web 2.0. It has the consistency of a naturalized Epistemology and modernized Axiology, but also promises the power of a new Internet philosophy. Sharism will transform the world into an emergent Social Brain: a networked hybrid of people and software. We are Networked Neurons connected by the synapses of Social Software. This is an evolutionary leap, a small step for us and a giant one for human society. With new “hairy” emergent technologies sprouting all around us, we can generate higher connectivities and increase the throughput of our social links. The more open and strongly connected we social neurons are, the better the sharing environment will be for all people. The more collective our intelligence, the wiser our actions will be. People have always found better solutions through conversations. Now we can put it all online. Sharism will be the politics of the next global superpower. It will not be a country, but a new human network joined by Social Software. This may remain a distant dream, and even a well-defined public sharing policy might not be close at hand. But the ideas that I’m discussing can improve governments today. We can integrate our current and emerging democratic systems with new folksonomies (based on the collaborative, social indexing of information) to enable people to make queries, share data and remix information for public use. The collective intelligence of a vast and equitable sharing environment can be the gatekeeper of our rights, and a government watchdog. In the future, policymaking can be made more nuanced with the micro-involvement of the sharing community. This “Emergent Democracy” is more real-time than periodical parliamentary sessions. It will also increase the spectrum of our choices, beyond the binary options of “Yes” or “No” referenda. Representative democracy will become more timely and diligent, because we will represent ourselves within the system. Sharism will result in better social justice. In a healthy sharing environment, any evidence of injustice can get amplified to get the public’s attention. Anyone who has been abused can get real and instant support from her peers and her peers’ peers. Appeals to justice will take the form of petitions through multiple, interconnected channels. Using these tools, anyone can create a large social impact. With multiple devices and many social applications, each of us can become more sociable, and society more individual. We no longer have to act alone. Emergent democracy will only happen when Sharism becomes the literacy of the majority. Since Sharism can improve communication, collaboration and mutual understanding, I believe it has a place within the educational system. Sharism can be applied to any cultural discourse, CoP (Community of Practice) or problem-solving context. It is also an antidote to social depression, since sharelessness is just dragging our society down. In present or formerly totalitarian countries, this downward cycle is even more apparent. The future world will be a hybrid of human and machine that will generate better and faster decisions anytime, anywhere. The flow of information between minds will become more flexible and more productive. These vast networks of sharing will create a new social order−A Mind Revolution!

How does the author appeal to readers to convince them to align themselves with Sharism?