Learning from Linguistics Vale Tudo | Yuko Takeda, Dean, Faculty of Nursing and Medical Care
October 26, 2021
On the recommendation of an editor friend from my college days, with whom I drink online, I read *Linguistics Vale Tudo* (by Ai Kawazoe, The University of Tokyo Press). The subtitle is "Round 1: Can AI Understand 'Don't Ever Press It'?" and I felt compelled to start reading. I found there was much to learn amidst the laughter, so I decided to make it the topic for this Okashira Diary.
The book mentions that it "received complaints" that "there is no explanation at all for the term *vale tudo*," so I would first like to introduce it with a quote.
This book, a publication commemorating the 70th anniversary of The University of Tokyo Press, is a compilation of a series from a monthly booklet called "UP" (for University Press). The series title originated from the editor in charge saying, "You can write about anything you want," and thus became "Vale Tudo," which means "anything goes" in Portuguese. This sounds plausible enough, but as both the author and the editor are martial arts fans, and "vale tudo" is a term for a genre of martial arts with "minimal rules and fouls," it seems they adopted it as the series title without a second thought. This naming itself raises the reader's expectations, even for those unfamiliar with martial arts.
The book contains 16 chapters, and from these, I would like to focus on "Can AI Understand 'Don't Ever Press It'?" which is also the book's subtitle. It discusses "meaning" (the dictionary definition of each word or the content expressed by the sentence itself) and the "intention" that the speaker wants to convey to the listener. The "gap between meaning and intention" is common in daily life and causes confusion, and the hot water bath gag from the title is given as a prime example (in this case, of opposite meanings).
The book states that for an AI learning through language, arriving at the correct "intention" is quite difficult. This is because when we infer intention, we use "common sense, knowledge about the situation, the other person, and the culture, as well as the preceding context." "No matter how much you teach an AI the meaning of the words themselves, that alone is insufficient for inferring intention," and if "the clues for identifying the intention are not contained within the meaning of the words themselves," an AI cannot deduce the intention, no matter how much it learns.
In clinical nursing, one must interact with various people, and this requires the ability to grasp "intention" rather than superficial "meaning." Nurses pride themselves on being in the closest position to patients in a medical setting and strive to deeply understand the patients for whom they should act as advocates, but patients do not always express their thoughts and feelings frankly. Even if they have worries, dissatisfaction, or distrust, they often respond to busy healthcare professionals with phrases like "I'm fine" or "No change." It seems that healthcare professionals often take this at face value (?) as "I'm fine (no problems)" or "No change (no discomfort)," or they may not probe deeper because the patient said so themselves. The patient's true feelings might be, "I'm fine (because I'll just endure it since you wouldn't understand anyway)" or "No change (in that it's just as painful as yesterday)."
Expert nurses, when hearing "I'm fine" or "No change," do not judge based on the patient's response alone. Instead, they grasp the tone of voice, facial expression, the course of the illness so far, and the person's personality traits. Based on this, they can say things like, "Are you pushing yourself too hard?" "You've been trying so hard," "The XX has been continuing since yesterday, how is it?" or "You don't have to go through this alone." Hearing these words, the patient may think, "They noticed. Maybe they are really looking after me..." If the nurse's concern is conveyed, the patient will naturally begin to share their true thoughts and feelings, starting with, "Actually..."
Amidst the growing adoption of AI and whispers of a crisis where many intellectual professions may be replaced by it, the practice of using all five senses to perceive the person holistically and respond with deep insight is the key to nursing work that maximizes the patient's own strengths. This is something I want to cherish as the art of nursing, an area distinct from AI.