When I’m driving I sometimes watch other swiveling heads perched over their windows. Their horizontal turning subtends an angle of about 120 degrees. With help from mirrors and other devices, human heads survey the autoscape in front their eyes, computing positions and trajectories of other cars in their little world. This has been the scheme for driving vehicles controlled by the human head for well over 100 years and horse-drawn carts before that.
The locus of control in America at least, is in the left front seat – the eyes and brain of the driver. Other body parts provide added feedback. Promised soon are self-driving vehicles. This is a paradigm shift. Driverless vehicles weren’t at all designed by reverse engineering the brain. Computerized driving had to be conceived as entirely different from its human counterpart, even as the same task is accomplished better by a computer. Get us from point A to point B more efficiently an in with greater safety, what we all want.
Now we all experience a lot of pleasure in driving that includes, figuring out how we are going to get places. The act of driving is social including other persons both inside and outside your car. Guys have the pleasure of being in control of a powerful machine. You may want to show off your vehicle, as a matter of social class, eating and smoking in your car, even if that is not good for you, or just escaping going out for a drive instead of a walk. In a matter of a few years, many of the things that we have gotten used to will fall by the wayside and other pleasures will supervene. The driver will have other entertainments in his vehicle, or unoccupied drivers may again fall into a state of torpor or boredom as is occurring with everything else. Certain occupations, like being a truck driver, will be no more. And trucks will be repaired by geeks, not mechanics.
For sure, the computer driven vehicle works in a different way than the person driven vehicle. The model for human control of a car is a swiveling head and what is that but focusing attention? That big truck swerving into your lane grabs your attention since you need to avoid an accident.  
The computerized vehicle has no head. Oh, it may have a nerve center which makes decisions, but the sensory system over the surface of a computer car aren’t concentrated in the front seat. They’re widely distributed over the skin of the vehicle. Over top and sides and bottom are cameras and distance sensing devices that feed into decision-making modules, enabled, provided everything is working right, to prevent accidents with fallible humans. The human driver with a personal map of the autoscape planted in his mind, works by focusing on a thing at a time. In fact, the main cause of traffic accidents is distraction. Attention is drawn to the wrong thing or an inability to focus on two things at once or with no focus at all. For neurologists the inability to focus attention defines encephalopathy. Alcohol alters focus and causes a lot of vehicular deaths. A computer vehicle, on the other hand, simultaneously processes information from everywhere and needs to decide to change procedures when one factor, that swerving vehicle, overrides others. It does not work by focusing attention. In a way the computer vehicle has turned into its own entity, very nearly a living thing, and why not? It possesses sensors all over its skin, rather than what we have now, just a machine with a swiveling head at its center. But a computer has no attentional or intentional mechanisms as a brain does.

Writing about chess and the match between IBM’s Deep Blue and Garry Kasparov 20 years ago, I was struck with a similar problem. Back then it was the classic match of man v machine which excited me.   Kasparov defeated Deep Blue at first and many of us saw this as the redemption of the human mind. Nowadays when even unsophisticated computer chess programs defeat the best human players or even on Jeopardy, we rationalize by noting that Chess is primarily a mathematical game played on a limited 8X8 board. Let a computer try to make his way in the real world of 3 or 4 or 10 dimensions. The biological entity with a brain will beat the computer every time.

The Deep Blue computer scientists, as far as I know, never went about their business talking to neurologists or brain scientists. They were not interested in reverse engineering a brain. The computer utilized a different strategy for winning at chess than humans do. It took advantage of processing speed,  the ability to examine in very short time, thousands of alternatives.  A huge number of possible outcomes of each and every possible move could be explored over a miniscule timeframe and organized according to a scheme of increasing value.  The objective examination of huge numbers of outcomes and carrying them to their completion is known as the brute force approach. Kasparov wasn’t capable of doing that.  Even if he wanted to,  he could not examine more than a few alternative moves on the chessboard and carry those to fruition,  but he mostly didn’t do that. The fact that he, and other chess masters could play many games at a time with different opponents proves that his strategy was not to compare alternatives like a computer does.  Kasparov worked by a process of heuristics or rules he had come up with as an expert in chess with all his experience. Hopefully, at any given point, he had been in an analogous situation before, and would know what and where to move next. Each of Kasparov’s possible moves was also associated with a value, in his case arrayed on a scale of emotion-laden scheme in his limbic system, which is why certain players in losing chess matches have been known to break the board over the head of the victor,  or maybe the reason for road rage. Sorry to say this is the way doctors think according to the current state of the art.

Computer programs long ago won out against humans in the limited test space of an 8 by 8 chessboard. Computer vehicles will surely replace human drivers in the not distant future. The frustrating part, especially for the neurologist, is that computational reconstructions do not resemble processes within living brains which strongly depend on attentional mechanisms and heuristics, the development of a personal set of rules of the road that have been jelled by massed practice and experience,  the reason why older seasoned drivers get into fewer accidents than inexperienced ones.

In medical practice we are reaching a tipping point where the influence of experience is about to topple before an onslaught of computer generated rules and algorithms. I have no doubt that doctors will be replaced by simple application of technology and computer driven headless healthcare.  Later on even nurses are scheduled to be replaced by robots.  The question is where we are now in this process and growing pains we are all having in this process. Gone is the fun of driving you own car with your own swiveling head.