Wayne Haythorn https://haythorn.us Mon, 04 May 2020 03:29:01 +0000 en-US hourly 1 https://wordpress.org/?v=5.0.11 Designing User Interfaces for Users https://haythorn.us/?p=115 https://haythorn.us/?p=115#respond Sat, 12 Apr 2014 06:36:23 +0000 http://haythorn.us/?p=115 Read More ...]]> A software user wants to do something, so she is looking at a screen. How does she get to the right screen, and then recognize how to get the program to do what she wants?  This is the important part of user interface design – it’s about finding and recognizing.  There’s a general consensus understanding of how menus should work, and operating systems have UI standards, so most programs are OK at this.  We expect, when we pick up a new program, to be able to figure out how to get around, without taking a course or even reading the manual carefully.

Occasionally, a command gets really misplaced, and we spend a half an hour looking for the button, only to discover it’s in a context menu – you have to right-click in just the right place on that screen you never go to.  This can mostly be eliminated by doing user interface inspections – it happens because the project gets rushed into creating functionality and nobody much thinks about how the user will find the command.   So that’s what happens when you don’t think about interface at all.  But even programs with well designed UI can place subtle burdens on their users.

Lately I’ve been working on a program to support David Allen’s Getting Things Done, or GTD method. This is a personal planning method, designed to get us out from under the burden of planning. His website banner reads, “Your mind is for having ideas, not holding them.” He describes his goal as “mind like water.”  The first step in the approach is “Capture” – make sure everything that needs to be remembered goes into the system. The better the capture system, the more the user is freed from having to worry or remember.  Some other steps in his process are “Organize” and “Engage” – aAll of them are described by strong verbs.  There is a one-page summary of the method is here.

The leading program implementing this system is OmniFocus, which is only available on Apple. Here is their opening screen:
Omni 2 iphone 02
This opening screen is a menu.  To capture a thought, or a phone number, or a promise you’ve made, or whatever, you open the inbox and leave a note there.  This is a file-centric approach to what the program is doing. What I mean is, the first 3 items in the list are the files you need to use in order to implement David Allen’s method.  There are dozens of programs implementing the GTD method – I have looked at 8 of them, and they all take this file-centric approach.  OmniFocus has the best interface among them because it gives us a clean view of those files. But it is up to you, the user, to know how those files relate to the GTD system, and it’s up to you to use them correctly.

I don’t know about you, but I don’t always want to be thinking about a file system.  In fact, in the “capture” phase and in the “do” phase, I just want to focus on the task at hand, and I want the program to do its job, but I also want it to disappear entirely.  The Clarity user interface is designed with this in mind – it is user-centric rather than file-centric. The main menu is not a list of files that you work with, it consists of “Capture”, “Organize”, “Do”.  These are the steps in the GTD process, so they are the ways that you will use the program. Instead of being on a screen by itself, this main menu appears at the bottom of all of the screens:

Clarity capture

The  program opens in Capture mode.  This screen provides one-click access to capture of text, audio, speech-to-text, recording of phone call, camera. video,  and url. The url capture is not a simple bookmark – it uses Zotero, which can take a snapshot of the web page and can also store files.

What you do not see on this page is the inbox.  You don’t have to “open” it in order to put things into it.  This means one less decision, and one less click for the user.

The user of the program is insulated from the file structure during the Capture and Do phases.  We only see the files during the “Organize” phase.  The inbox shows up here with all of the notes we have dropped into it.  To do items are organized in terms of projects and contexts.  It is here, in the organize phase, that the user herself is interested in the structure of things, so it is here that she can see the files.

130 Clarity organize inbox.fw

 

Here are some reasons why I think this is a better approach.

1.  If we think about the user using the program, she wants to be able to say what she is doing, and be given the appropriate information and choices.  When she doesn’t want to be thinking about the file system, she doesn’t have to think about the it – it just does its job.  In the GTD system, during the capture and engage phases, the program should be completely transparent.  In the capture phase, this means making a variety of notetaking modes available.  In the Do, or Engage phase, if the user has organized the inbox appropriately, she will only see the actions that are appropriate for the context she is in.

Users become proficient in translating their thoughts into the language of a program, so it doesn’t take a lot of thinking but it does take thinking.   One of the classic experiments in cognitive psychology involved the “velocity of rotation of mental images”.  Subjects asked to tell if a pair of figures were the same, but rotated in space.

ShepardandMetzler.fw

From Wikipedia:

Roger Shepard and Jacqueline Metzler (1971) originally discovered this phenomenon. Their research showed that the reaction time for participants to decide if the pair of items matched or not was linearlyproportional to the angle of rotation from the original position. That is, the more an object has been rotated from the original, the longer it takes an individual to determine if the 2 images are of the same object or enantiomorphs (Sternberg 247). Shortly afterwards, Robert Sekuler and David Nash (1972) demonstrated that a pair of mental transformations, size scaling and rotation, produced additive effects on reaction time, consistent with serial processing of these transformations

This has to do with decision fatigue – that the mind can only make so many decisions in a day.  There is a cost for making a translation in the mind.   Maybe I’m being too dramatic.  It isn’t really that hard for users to know what file they want to work with.  My point is that it is not their problem.   A good interface is an invitation to action, not a problem to be solved.

2. Because the interface is organized around the actions that the user will take, functionality is almost always available in fewer keystrokes.  You can see how good OmniFocus is, in the fact that they provide a separate launch icon that will start up with the inbox open.  With two icons, they get exactly the same keystroke efficiency as Clarity gets with one.  In fact, Clarity gets the user to the commands in the the same or fewer keystrokes than in Omnifocus, for every use case that I’ve prototyped.  The larger the granularity of use cases, the better Clarity does.  At each stage of the GTD process, several files are involved, so with a file-centric approach, the user has to switch back and forth between files.  Clarity’s action centric interface results in less page switching, a dramatic reduction in keystrokes.

3. Rather than having to recall the process, users are guided through it.  GTD is a strongly directive process – things go into an inbox, to get them out of the inbox you file them or decide that it’s actionable.  If it’s actionable, you can do it immediately, delegate it, schedule it, and so on.  By organizing the program around what the users do, Clarity shows them how to do it.  

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The Programmer’s Picture Book https://haythorn.us/?p=103 https://haythorn.us/?p=103#respond Tue, 08 Apr 2014 04:32:51 +0000 http://haythorn.us/?p=103 Read More ...]]> The Programmer’s Picture Book is a prototype for a software documentation system. The picture book treats program code as a graphic object.

We are used to thinking of programs as text, and this doesn’t really work for software documentation. The problem is that there are a lot of different things a reader might want to know about a piece of code. Looking at a function, we might want to know what it does, or how to call it, or why it is called, or what are the alternatives. The reader might want an overview, or one of several kinds of detail. The communication problem is dense and multidimensional, but straight text can only present one narrative at a time. So the same topics are addressed over and over in different ways. The descriptions are all longer than they should be, because you have to repeat things in order to establish context, and do a lot of cross referencing. Authors get to feeling bad about what a long slog it all is, so they make it longer with attempts at humor and conversational style. The reader is faced with hundreds of pages of text that is mostly irrelevant to her problem

Similar problems in statistical graphics design have been tackled by Edward Tufte, who has written a series of books about how to put meaning into graphics. His fundamental idea is to put more information on each page. He writes, “If the visual task is contrast, comparison, and choice – as it so often is – then the more relevant information within eyespan, the better.” If the reader has to flip back and forth between two pages, comparisons will be harder to make and relationships harder to see. If it is well designed, a single diagram shows more than two diagrams with the same information. Of course, the reader can get lost in too much information, so there is a design problem – how to show more without creating confusion. That’s the goal of good graphic design.

The problems with text explanation of code are exactly the problems that Tufte identifies in bad graphics. Because of low information density, comparison and understanding are more difficult because the data is spread out across multiple pages. In software textbooks we are always having to flip pages, forward and back, between a code example and the text that explains it. What if we treat code and its explanation as graphics objects? Then for example, the code and its explanation can be put on the same page, using colors and shading to separate them.

In this article I want to show you two pages of the programmer’s picture book, from a description of database access in Microsoft’s ADO.NET. These examples illustrate four of Tufte’s techniques:

Micro-macro readings – Put enough information in each graphic, that the viewer can see detail, but also draw back and see how the detail fits into something larger. Show the detail and the larger context at the same time.
Small multiples – “Small multiples resemble the frames of a movie: a series of graphics, showing the same combination of variables, indexed by changes in another variable.” This is a way to put a lot of information on a page, and allow comparison and pattern understanding,
Data/Ink maximization – Ink attracts the eye. Ink that is not showing information gets in the way of understanding. Tufte spends a lot of time showing how removing and lightening grid lines makes a graph easier to understand. “Non-data-ink: less is more. Data-ink: less is a bore.”
Layering and separation – “Confusion and clutter are failures of design, not attributes of information. And so the point is to find design strategies that reveal detail and complexity … Among the most powerful devices for reducing noise and enriching the content of displays is the technique of layering and separation, visually stratifying various aspects of the data.”

The first example is from the overview. The graphic on this page is a variation of the UML class diagram, showing objects and their relationshiphs. It demonstrates the use of small multiples – using the shape of the diagram to help readers understand the components of the library and their purposes.

The second example is a code page – it shows how to solve a particular problem – in this case, how to call a SQL stored procedure. This single page contains all of the information in a 22 page chapter of a textbook on the subject. It makes extensive use of layering and separation, to put a code example and a variety of explanatory comments into one eye span.
Excluding trivial bits like the page title, this diagram has six layers of information:

The code example itself
The narrative of what is happening, in the blue comments to the left
Miscellaneous comments in the amber text to the right
Highlighting points out code that is specific to the topic on this page
The class diagram in the upper right hand corner shows where this code fits in the library (micro-macro reading)
Links to other explanations and related material

The arrows that anchor the commenting are made as light as possible, so they can be followed, but you can read the code without being distracted by heavy lines. In an automated environment, it would be nice to hide the arrows when they are not being used.

These techniques are not amazing or unprecedented, but applying them deliberately results in a remarkable compression and clarity of information. With this approach the ADO.NET library can be shown in detail in just under 30 pages. Trade textbooks on the subject run between 300 and 400 pages, and contain less information. Perhaps some people prefer 400 pages of meandering repetitive slop. I like this approach. The principles from Tufte are

– Put as much information as possible within eye span
– Use color and other typographic elements to create layers, so that the varieties of information can be distinguished.
– Eliminate ink which does not convey data.
– Show detail and context in the same graphic.

I’ve made a few rules of my own, to show in one page as much as possible of what a programmer needs to know on a topic.

– Show both the call and the function called.
– When a parameter is passed, make sure the information on data types is accessible.
– Always show enough of the code to make clear where this code fits in the overall program.

That’s the programmer’s picture book. I’m currently creating diagrams manually. The goal at this phase is to produce some examples, and to develop a specification for a software environment to make this kind of documentation more automatic.

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Website design https://haythorn.us/?p=88 https://haythorn.us/?p=88#respond Sun, 06 Apr 2014 23:36:12 +0000 http://haythorn.us/?p=88 Read More ...]]> I’ve done enough website building to feel comfortable with the territory. I like simple and clean designs with all the buttons working.  Here are some examples of my website work:

Tao Soup, built in Flash for Scott Kelman, 2006

Flash image with embedded videos to promote a performance of Scott Kelman’s Tao Soup, presented at the Electric Lodge in Venice, California.

Oregon Women’s Caucus for Art, built in Dreamweaver, 2010

The visuals of this site were created by Jan Carpenter. I think it’s a nice looking page and I’m proud to have helped her put it together.

The Practice Blog, built in WordPress for Nan Narboe, 2014

This is a wordpress site I built this year, based on a child theme of twentyten. It expresses the graphics vision of Nan Narboe, the site owner. It is surprising how much you have to tweak the CSS to get a site to look this clean.

The Mankind Project Northwest

I’m working with Bob Jones, the driving engine of this website. Bob is a demon for new technology, so I’m going along for the ride. We haven’t thought much about the UI – this site is a prototype to solve all the programming issues.

]]> https://haythorn.us/?feed=rss2&p=88 0 Communications Engineering, Hong Kong, 1995 https://haythorn.us/?p=84 https://haythorn.us/?p=84#respond Sun, 06 Apr 2014 22:28:15 +0000 http://haythorn.us/?p=84 Communications Engineering, C++ 1995

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Training https://haythorn.us/?p=62 https://haythorn.us/?p=62#respond Sun, 06 Apr 2014 22:05:26 +0000 http://haythorn.us/?p=62 Read More ...]]> Whenever we step outside of our well worn ruts, we find a new world.  When I took my first programming course as a freshman in college, I got the idea that I would write each of the lab problems in every language that was available at the University of Michigan.  A strange thing to do, but it meant that I got to learn Lisp two years after it was invented, and I was well positioned to understand subsequent developments in programming language design.  I use this understanding to make things clear to students.  A programming language represents a vision of how computing should be done.  A good class shows the students this vision, so the language can be seen as a tool.  Here’s a link to one of my C++ classes.

Lately I have learned the statistical language R, which is very powerful and also quirky and irritating.  For everyday jobs I’ve learned a variety of website tools including PHP, WordPress, Thesis theme, and related technologies like AJAX and jQuery.  PHP is a mess, WordPress and Thesis are really good software, all in all the web is an interesting place.

 

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Communications Engineering, Hong Kong, 1994 https://haythorn.us/?p=79 https://haythorn.us/?p=79#respond Sun, 06 Apr 2014 21:51:20 +0000 http://haythorn.us/?p=79 Catalog description for Communications Engineering Ltd., Hong Kong, 1994

Catalog description for Communications Engineering Ltd., Hong Kong, 1994

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User interface design https://haythorn.us/?p=55 https://haythorn.us/?p=55#respond Sun, 06 Apr 2014 07:05:47 +0000 http://haythorn.us/?p=55 Read More ...]]> Good user interface design is not that complicated, but you have to pay attention.  So, for example, user interface inspections are a great tool for validating an interface design, and they’re simple to do – get some users of the program, sit them down in front of the screens, and watch them work through it.  Notice when they get confused or lost.  That’s really all there is to it.  You can ask questions like, “OK, what are you looking for on this page?”  “What are your assumptions?”.  Find out what some of your users are thinking and wanting when they use the program, by watching them and talking to them.  This is not rocket science.

But it is rare, and when it isn’t done, the resulting user interfaces can be incredibly frustrating to learn and use.  I have some rules that I find useful for creating good programs, but they are odd rules because they are not things you can just do.  To get anything out of them, you have to commit to them, and continually re-commit.

1) Center the program on the user experience.

One thing this means is that we begin the project by describing use cases and interfaces.  This is commonsense, and it follows a long tradition that says “think about requirements first”.  Programmers talk about “use cases”, and use the concept of use cases, but often this is done haphazardly.  The use case list is on the backs of envelopes, and the screen designs are block drawings with what it’s fair to say is not a lot of detail.  On a small project, the idea of having a published list of use cases, that is intended to be complete, with written descriptions and linked to a complete set of detailed screen designs – this requires a lot of discipline.  At the beginning of a project, what’s most salient in programmer’s minds is the technologies that they are going to have to learn.  So they describe that use case, and a few others, and immediately start tackling the technical challenges.  This isn’t irrational, but it generally means that there is never a complete, considered list of use cases, and there isn’t really any design of the screens – they are “designed” as they are being coded.

This is one of the advantages of agile programming.  It lets you have your cake and eat it too, in that you can develop a small group of use cases in a logical order – starting with interface descriptions and proceeding through code and test.  So you can follow a user centered process and still address technical questions early.

This rule – center the program on the user experience – is always new.  For example, as code is finished, we want to do code reviews.  It’s often useful to start a code review at the user interface level.  We ask what is the use case?  Why is this code being activated?  Get that clear in your minds.  Then look at the code.

2. Be proactive about getting user input.  Do UI inspections.

You’re going to be listening to users sooner or later – why not take the initiative and do it early?

I don’t know why people don’t do this more.  If the program is seen as a user experience, you have to do user interface inspections – that’s just a matter of basing your design on evidence.  So why doesn’t everybody do it?

Really, it’s just outside of the path that programmer’s minds take when they start thinking about a problem.  They will be responsible for the code, and they are hired to solve code problems, so that is what they think about.  Unless a management decision builds in the user voice, it won’t guide the design, and what you’ll get will be a bunch of menus grouped according to some pattern, with the command you want just not there.

There is one caveat here – I have seen projects in which a “user” is added to the design team, and that person takes a leading role in actually designing the interface.  There is no reason to assume that such a person will take the needs of all the users into account.  If that person is opinionated or status conscious, she can bring office politics into the design in a destructive way.  Watching and consulting with a variety of users is better than obeying one of them.

3. Be complete in your description of use cases.

A name is not a description.  A lot of programmers are very sketchy in their descriptions of use cases.  I don’t know what to say about this.  The thrill of solving intricate puzzles gets old.  Writing programs that work for people doesn’t get old.  Write out the use cases.  Draw the screens.  Get down to the details.  Use paper.  It’s better to have details on paper than a fancy screen prototype that leaves things out.

 

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Active Listening https://haythorn.us/?p=30 https://haythorn.us/?p=30#respond Sun, 15 Dec 2013 23:28:01 +0000 http://haythorn.us/?p=30 Read More ...]]> Active Listening – the Empathic Response

“Listening first aid” – this is useful when the speaker is

    • unable to think clearly about the problem, and
    • not receptive to outside input

The listener’s role is to

    • help the speaker to say what she means
    • help the speaker to know that she has been understood and has a right to be understood

The speaker should

    • say what she means
    • check to see that her message has been understood

The listener should

    • try to understand
    • respect pauses and do not interrupt
    • show that he understands with responses which:
      • are brief
      • restate the speaker’s message in the listener’s words
      • may probe or guess at deeper aspects of the speaker’s view

Questions can be used to help the speaker begin speaking or recover from a break in the communication. Some ways to help the speaker take control of the conversation are

    • investigative questions (elicit more information)
    • analytical comments (for example, if the speaker is expressing conflict, try to clarify the conflict)
    • summary of what has been heard
    • an invitation for the person to say more
    • body language that shows interest
    • empathic comments.

Some forms these actions can take are

    • dangling or fill in the blank questions (“You are worried because …?”)
    • repeating a phrase or keyword in the same tone of voice (“You’re worried he will be angry.”)
    • repeating what was said in different words (“So, what I’ve heard you say is —”)
    • questions about feelings (“Did that upset you?”)
    • body language

All of these are skills which must be practiced to develop. A good listener has sufficient confidence in himself to be able to listen to others without fear. In contrast to a diagnostic approach to helping, the listener:

    • takes an empathic posture (motivates the other to speak without feeling judged)
    • does not use pauses as an excuse to interrupt
    • permits the speaker to direct the conversation

 

“Empathic listening skills require a different subset of proficiencies than conversing, and it is certainly an acquired skill. Many individuals, at first, find the process somewhat uncomfortable. Furthermore, people are often surprised at the exertion required to become a competent listener. Once the skill is attained, there is nothing automatic about it. In order to truly listen, we must set aside sufficient time to do so. Perhaps the root of the challenge lies here. People frequently lose patience when listening to another’s problem. Empathic listening is incompatible with being in a hurry, or with the fast paced world around us. Such careful listening requires that we, at least for the moment, place time on slow motion and suspend our own thoughts and needs. Clearly, there are no shortcuts to empathic listening.”

http://www.cnr.berkeley.edu/ucce50/ag-labor/7article/article40.htm

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Medical Marijuana – the Knowledge Base https://haythorn.us/?p=16 https://haythorn.us/?p=16#respond Sun, 15 Dec 2013 01:28:42 +0000 http://haythorn.us/?p=16 Read More ...]]>
Acids and Cannabinoids

The scientific name for marijuana is cannabis. Cannabis plants contain more than 60 acids which are not found in any other species. They have very strong anti-inflammatory action, and since the beginning of written history, people have ground the plant up and plastered it on bruises and swollen knees. Inflammation is a problem today, but we don’t use these medicines because of something else that one of them does. When they are heated, they all undergo a chemical change. Carbon dioxide is released, and what’s left are 60 new compounds – cannabinoids. One of the cannabinoids – THC – can get you high. In clinical terms, it causes a state known as “mild euphoria”.

THC was identified in 1964 by Raphael Mechoulam at Hebrew University in Jerusalem. His team found many of the acids and cannabinoids, and showed that out of all of them, only THC has a psychoactive effect. The rest of the world figured they had found “the active ingredient” of marijuana. Dr. Mechoulam and other scientists continued to investigate.

Marijuana Activates a Body Wide Protective System.

Knowing that THC was the agent, biologists could watch where it goes in the body. They found that THC attaches to receptors – proteins on cells that recognize changes in the environment and trigger the cell’s response. Reasoning that if a receptor exists there must be a signaling molecule that matches it, they looked to see what else besides THC binds to those receptors. They found a family of signaling molecules – the endogenous, or “endocannabinoids”. AEA was the first of these to be found. THC is very similar to AEA in its action at the receptors. Another endocannabinoid, 2AG – is stronger than either AEA or THC.

So by the middle 1990’s, scientists had a rough picture of the biochemistry of cannabis signaling – the messenger molecules and receptors. They asked the next logical question – what does this signaling do? In seeking the answer to that, they uncovered a previously unknown, body-wide protective system.

The first clue to the importance of the endocannabinoids is how early they appeared in animal evolution. So far as we know, every animal that has a nervous system produces AEA and 2AG. They are found in jellyfish, the most primitive animals that have skin and nerves. AEA is involved in their feeding, and 2AG serves as an anti-oxidant.

Animal life depends on processing a lot of oxygen, and oxygen is a very toxic substance, so our cells perform a continuous balancing act, running a high level of oxidation, and struggling to control it. Many of the cannabinoids are very strong anti-oxidants. 2AG is produced when cells are under stress, and it immediately protects the cell from oxidative damage.

The cannabis receptors evolved later. The first cannabis receptor appeared in an ancestor of the vertebrates. Jellyfish don’t have them, nor do invertebrates like worms and insects. But everything that has a nerve down its backside has cannabis receptors – mammals, birds, reptiles, fish, even sea squirts, that came before fish [photo by Stephen Chow].

seasquirt

Since cells produce 2AG in response to stress, a cell with cannabis receptors can tell when one of its neighbors is under stress. So vertebrate cells can signal to each other about stress states. And every part of you that is different from a sea squirt evolved with this capability already in place.

Where in the body can cells find a use for this kind of signaling? Almost everywhere. According to a recent review, “Changes in endocannabinoid levels and/or CB2 receptor expressions have been reported in almost all diseases affecting humans, ranging from cardiovascular, gastrointestinal, liver, kidney, neurodegenerative, psychiatric, bone, skin, autoimmune, lung disorders, to pain and cancer, and modulating CB2 receptor activity holds tremendous therapeutic potential in these pathologies.”

For example, bone density is maintained by two kinds of cells – osteoblasts that create bone and osteoclasts that remove it. Both of them have cannabis receptors. Stimulating the receptors activates osteoblasts and inhibits osteoclasts. So in this little system, cannabis signaling causes bone growth. Invertebrates, which do not have these receptors, do not have our flexibility in skeletal growth.

Osteoporosis is a failure of bone growth, so could a cannabis based medicine treat osteoporosis? It’s been tried in mice, and it works. Normally, the next step would be clinical trials on humans, but there has been no next step. All of the preclinical evidence is positive, but there cannot be clinical trials, because it is illegal to study any possible benefits of marijuana.

The Federal Prohibition on Research

NIDA, the National Institute on Drug Abuse, has veto power over marijuana research in America, and NIDA only allows research if it is designed to show harmful effects of the plant. If your purpose is to find any benefit from this plant, you can’t do research in the U.S.

Now, if you want to study cell chemistry, you can be fuzzy about your reasons, but if you want to do clinical trials on a medicine for humans, you have to admit that you’re looking for a benefit from the plant. And if you admit that, you can’t do the research.

Cannabis based medicines are unique in being blocked this way. Even for heroin or cocaine you only need Food and Drug Administration approval to do research. But FDA approval is not enough to do research on marijuana. The FDA has approved clinical trials for cannabis medicine twice, once for migraine and again for PTSD. In both cases NIDA vetoed the study.

A Body Wide System

Cannabis receptors are very common in the brain. They are also found in the intestines, liver, kidneys, bones, the linings of our blood vessels, and our reproductive organs. The egg and sperm use cannabis signaling to find each other and manage conception. Then the fertilized ovum uses cannabis signaling toimplant itself on the mother’s uterine wall. Arguably, your first act as a genetic individual was to initiate cannabis signaling. That’s how deeply it is built into human physiology.

Regulating the Immune Response

Signaling about cell damage is necessary for the immune system to work, so every cell in the immune system has cannabis receptors. The most prominent thing that the immune system does with cannabis signaling is to control inflammation and plaques. Plaques are small plates or blankets, made of a protein or a fat like cholesterol. When the body is attacked or injured, the immune system responds by promoting inflammation and building plaques and fibrous mats. This stops infection, but if this first line of defense is not carefully controlled we get autoimmune diseases – low level inflammation causes tissue damage, accompanied by plaques and fibrosis. This process is a major health problem. It is common to Alzheimer’shardening of the arteriesmultiple sclerosis,rheumatoid arthritisCrohn’s disease and many others. And there is plenty of evidence that marijuana can help with all of these conditions, from biochemistry, animal models, and patient testimony. But we can’t get scientific proof that it works in humans because clinical trials are blocked by the federal prohibition.

How well would you guess this kind of science is working for us? For a good case study, let’s look at cancer.

Marijuana and Cancer

Almost 40 years ago, in 1974, researchers at the National Cancer Institute discovered that two plant-based cannabinoids, THC and CBN, could slow the growth of tumors and extend the lives of mice with cancer. This happens for a number of reasons, in particular, cannabis signaling is involved in initiating programmed cell death, or apoptosis. Apoptosis fails in cancer cells, so they don’t die when they should. Cannabinoids can restore one of the biological pathways leading to apoptosis, causing the tumor cells to self destruct. Since cannabis signaling is merely restoring normal biochemistry, it does not damage nearby healthy cells.

You would think that a cheap medicine that selectively kills cancer cells would be worth investigating, but there was no follow up to this research – it was effectively suppressed for 24 years. To repeat, Congress decided that the plant is bad, so NIDA does not allow research into possible benefits of the plant.

The ability of cannabis to kill cancer cells was rediscovered in 1998 in Spain. At Complutense University in Madrid, a team led by Manuel Guzman, Guillermo Velasco and Christina Sanchez wanted to study the biochemistry of cannabis metabolism. They decided to work with cancer cells because you can buy cancer cell lines from a laboratory supply company. These cell lines are cheap and once you have them they just go on reproducing and never die. But when Dr. Sanchez put cannabinoids on the cancer cells, they died. After verifying that it was the cannabis that was killing them, the Spanish researchers looked into the scientific literature, where they learned that the U.S. Government had found the same thing 24 years earlier.

The Spanish researchers did what American scientists did not – they began looking for ways to turn this laboratory result into a treatment. For study, they chose glioblastoma multiforme, a brain cancer that has no cure. THC slowed the growth of these tumors, but did not stop them. In this regard, THC is the same as other, approved anti-cancer drugs. The best we can do today is slow these tumors down and extend the patient’s life by a few months.

But looking at the biochemistry, the Spanish team found that THC complements the action of an approved drug, Temazolomide. Working with mice, they tested a combination of THC and Temazolomide. The two drugs together not only stopped tumor growth – the cancers began to shrink. The following graph shows the size of the tumors over time. The rapidly climbing line on top shows how tumors grow when they are left untreated. The two lines in the middle show growth under each medicine alone. The line at the bottom shows the tumors shrinking, when THC and TMZ are used together.

thcandtmz

This is what it does in mice. Would it work on humans? We don’t know. The law is, no good can come from this plant. Last year 571,950 Americans died of cancer. This same story is repeated for disease after disease. Cannabis medicine slows the progression of atherosclerosis in mice. The evidence is strong enough that for any other substance, clinical trials would have begun long ago. Last year about 870,000 Americans died of atherosclerosis. More than 2 million suffered osteoporosis fractures. How many of these people are victims of the war on drugs?

The Knowledge Gets Out

While clinical science is blocked, the medical marijuana community has responded to these findings. A key development was the realization that THC is not the only “active ingredient” in the plant.

First there are the raw plant acids, which have anti-inflammatory action even though they are not psychoactive. In fact, much of the historical use of cannabis as medicine has been as raw plant extract, in poultices, teas and tinctures.

Raw plant extract has been championed by Dr. William Courtney in northern California, who says “Cannabis is a vegetable, and a dietary essential.” Dr. Courtney’s patients make juice from young plants and drink it daily. Using the plant this way, there is 60 times less effect on the mind, so these patients can take large doses without getting stoned.

Then, when the acids are converted, it turns out that THC is not the only active cannabinoid. The most abundant cannabinoid in wild plants is CBD. CBD was thought to be inactive because it doesn’t get people high. But once the biochemistry could be investigated, it was discovered that CBD is a partial antagonist at the cannabis receptors. It blocks the effect of THC, so a plant can contain THC and still not be psychoactive, if it also has enough CBD.

With THC stimulating the receptors, and CBD blocking them, different strains of marijuana can have opposite effects. For example, one of the longstanding mysteries of marijuana has been its effect on anxiety. Users consistently report that smoking relaxes them, but anxiety attacks (“paranoia”) also happen. How can a medicine reduce anxiety sometimes, and increase it other times? We now know part of the answer – it isn’t just one medicine. THC increases anxiety, CBD reduces it. Mixing the two produces a variety of energizing and calming states. It’s important to know the chemistry of the individual plant.

With CBD we can start to think about more sophisticated tuning of the endocannabinoid system. CBD is an anti-convulsant, an anti-psychotic, and it prevents diabetes in mice. THC and CBD can work together – in England, GW Pharmaceuticals has shown that a 1 to 1 balance of THC and CBD is better for multiple sclerosis than either chemical alone.

The Dispensaries Respond to Knowledge

The dispensaries and cannabis physicians in California responded to these discoveries by starting ProjectCBD. The state’s largest dispensary, Harborside Health Center in Oakland, began testing to measure the percentage of THC and CBD in the marijuana they sold. A search began for high CBD varieties. With reliable and consistent testing, it became possible to survey patients to find out which cannabinoid profiles are effective for which conditions. Down the street from Harborside, Oaksterdam University emerged as a focus for spreading this information.

The Government Responds to Knowledge

On April 2, 2012, federal agents raided Oaksterdam University and seized computers and records. Oaksterdam is not a dispensary and did not distribute marijuana – they do training. The government “would not comment on the purpose of the raid”.

In July, the US Attorney moved to shut down Harborside Health Center by seizing the buildings where Harborside operates. Harborside has been a leader in making this medicine safe and in helping patients to know what they are getting. Harborside pioneered testing for cannabinoid profiles, and before that they pioneered testing for fungus and insecticides. The prohibition police are deliberately targeting the people who do it right. This is a war on medical knowledge.

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