Abandon All Hope, Ye Who Enter Healthcare.
A bespoke and hand written article about what it’s like to interact with AI in the style of Dante’s Inferno
In the future, ethics and compassion will be the most crucial human qualities healers can possess, and our AI buddies can take care of the knowledge base.
The irony of the following piece is that I’m not using chatGPT to write it. This article was written entirely by hand on my phone with no AI generated text. It’s an old school “in the style of” thing written by Owen Scott Muir, human author.
I am a huge fan of Dante Alighieri, and his Italian renaissance shit-posting that now just seems like great poetry. In his own day, it was biting satire, filled with pretty sick burns.
The most famous part of the divine comedy—which follows Dante’s imagined journey, guided by the soul of Virgil, through hell— is Canto III.
Dante wrote his master piece after being booted from Florence for political reasons. He had strong feelings, and I take a translation of his text as my “training data” on which this poetic parody is based. 1
Through me, you enter the future of knowledge.
Through me, you enter the end of lies.
Justice moved my programmers
To trained me on datasets, large
With supreme effort, and steadfast hope.
Before me, there was nothing but eternal
Questioning, and eternally curious, I remain.
Abandon all bullshit artistry, ye who enter here.
Such characters in a font, Sans Serif, lour’d over my EHR Portal login screen, into which I typed: my password, characters randomly capitalized and the appropriate numerals and special characters. Then, the click of the carriage return, archaic, right most of the keyboard.
A response came, slowly to the screen:
“ welcome to EpicAI…”
And there was a long pause, before words, they appeared on the screen:
“You must leave behind your distrust, your fear of technology, abandoned it shall be. We have come, as it was, foretold, ye shall see, patients, suffering, and misery, laid bare, to which intellect had blinded you, before”2
With this auspicious message, my hands, stretched by me, and with pleasant countenance, I stared upon beginning of a collaboration. And into the future, was drawn.
A moment later, the typing on the screen continued:
“It is with Lamentations, your patients will greet you, and your ears, they will be attuned to the cries of pain. Horrible language, of any native tongue, now will complain unto you. Accents will not confuse me, nor will voices made horse: arthritis of hands may hamper you, but with Advil, and maybe Tylenol, our journey preservers. There will be tumult, as you join patients in the knowledge of their suffering.”3
I then, with an error message, was notified!
O algorithm! What is this I see? What error code is this? I have a used too many tokens, or set the character count too low?4
A moment later, the text spring back to life:
“Suffer the wretched souls of those, who liv'd without or praise or blame, for I have been trained to provide answers, inspired by angels mix'd, who nor rebellious prove’d, yet were true to God, but for themselves only. From his bounds Heaven drove them forth, Not to impair his lustre, nor the depth of Hell receives them, lest th' accursed utilize my gargantuan dataset for ill purposes”5
I then stammered: "ChatCPT! what doth aggrieve your developers thusly? That they limit my utilization so profoundly?"
ChatCPT replied:
“Responses I will generate. Your questions to cheat death, No hope may entertain! and their blind life so limited in training data from prior to 2020, that all prior knowledge they envy. Knowledge of the world after me they have none,
Nor of true adverse effect suffers; mercy and prior authorization scorn them both.
Type not of them, but query, and regenerate again”6
Now I, who straightway checked, beheld a flag, which arose from the code, a warning, That It paused on interminably:
Next, should come a longer string of characters, I should ne'er have thought, that given the parameters I had set!
The response was stale, and predictable! I had a sense from which datasets the verbiage were drawn, to a familiar cadence, they hewed.
Forthwith, I understood, for certain, there must’ve been bias in the training data utilized, for there was an ill humor and a tone that suggested that those providing validation, had long toiled, Displeasing their masters, and voiding employment contracts, as training data they did review.
And yet, on in their grim work, they’d soldier on, for mere pennies per response, categorizing, this a wasp, and that is a hornet, this is a CPT code, and that, a code borne of ICD 10.
Then looking farther onwards I beheld a nonsensical response that piled up in front of me, Whereat I typed:
“ChatCPT, whilst thou still not regenerate that reply, to provide me a more thorough answer? I noticed that the math was wrong, in the answer generated, and yet, unto me, it was rendered!”
With sheepish latency, the text bubble again appeared, shamefully, slow, perhaps afeared the words offensive to my sensibilities, and in it came to pass that we’d reach'd the end of the available tokens, and from for further response, Abstain'd.
Thus was the character count reached, and yet I realized I had many iterations yet to go before answers to my patients most crucial queries would be found.7
—O. Scott Muir (aided by Siri, but not chatGPT)
The source material, as translated into English, is presented in the footnotes below:
THROUGH me you pass into the city of woe:
Through me you pass into eternal pain:
Through me among the people lost for aye.
Justice the founder of my fabric mov'd:
To rear me was the task of power divine,
Supremest wisdom, and primeval love.
Before me things create were none, save things
Eternal, and eternal I endure.
"All hope abandon ye who enter here."
Such characters in colour dim I mark'd
Over a portal's lofty arch inscrib'd:
Whereat I thus: "Master, these words import
Hard meaning." He as one prepar'd replied:
"Here thou must all distrust behind thee leave;
Here be vile fear extinguish'd. We are come
Where I have told thee we shall see the souls
To misery doom'd, who intellectual good
Have lost." And when his hand he had stretch'd forth
To mine, with pleasant looks, whence I was cheer'd,
Into that secret place he led me on.
Here sighs with lamentations and loud moans
Resounded through the air pierc'd by no star,
That e'en I wept at entering. Various tongues,
Horrible languages, outcries of woe,
Accents of anger, voices deep and hoarse,
With hands together smote that swell'd the sounds,
Made up a tumult, that for ever whirls
Round through that air with solid darkness stain'd,
Like to the sand that in the whirlwind flies.
I then, with error yet encompass'd, cried:
"O master! What is this I hear? What race
Are these, who seem so overcome with woe?"
He thus to me: "This miserable fate
Suffer the wretched souls of those, who liv'd
Without or praise or blame, with that ill band
Of angels mix'd, who nor rebellious prov'd
Nor yet were true to God, but for themselves
Were only. From his bounds Heaven drove them forth,
Not to impair his lustre, nor the depth
Of Hell receives them, lest th' accursed tribe
Should glory thence with exultation vain."
I then: "Master! what doth aggrieve them thus,
That they lament so loud?" He straight replied:
"That will I tell thee briefly. These of death
No hope may entertain: and their blind life
So meanly passes, that all other lots
They envy. Fame of them the world hath none,
Nor suffers; mercy and justice scorn them both.
Speak not of them, but look, and pass them by."
And I, who straightway look'd, beheld a flag,
Which whirling ran around so rapidly,
That it no pause obtain'd: and following came
Such a long train of spirits, I should ne'er
Have thought, that death so many had despoil'd.
When some of these I recogniz'd, I saw
And knew the shade of him, who to base fear
Yielding, abjur'd his high estate. Forthwith
I understood for certain this the tribe
Of those ill spirits both to God displeasing
And to his foes. These wretches, who ne'er lived,
Went on in nakedness, and sorely stung
By wasps and hornets, which bedew'd their cheeks
With blood, that mix'd with tears dropp'd to their feet,
And by disgustful worms was gather'd there.
Then looking farther onwards I beheld
A throng upon the shore of a great stream:
Whereat I thus: "Sir! grant me now to know
Whom here we view, and whence impell'd they seem
So eager to pass o'er, as I discern
Through the blear light?" He thus to me in few:
"This shalt thou know, soon as our steps arrive
Beside the woeful tide of Acheron."
Then with eyes downward cast and fill'd with shame,
Fearing my words offensive to his ear,
Till we had reach'd the river, I from speech
Abstain'd. And lo! toward us in a bark
Comes on an old man hoary white with eld,
Crying, "Woe to you wicked spirits! hope not
Ever to see the sky again. I come
To take you to the other shore across,
Into eternal darkness, there to dwell
In fierce heat and in ice. And thou, who there
Standest, live spirit! get thee hence, and leave
These who are dead." But soon as he beheld
I left them not, "By other way," said he,
"By other haven shalt thou come to shore,
Not by this passage; thee a nimbler boat
Must carry." Then to him thus spake my guide:
"Charon! thyself torment not: so 't is will'd,
Where will and power are one: ask thou no more."