YSM Issue 97.1

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FOCUS Social Medicine GIVING VOICE TO THE VOICELESS The Black Youth Mental Health Crisis BY AIDEN WRIGHT IMAGE COURTESY OF AMANDA CALHOUN In October 2021, experts in youth mental health declared the mental health crisis among children and young adults a national emergency. At the time, Amanda Calhoun ’11, now Chief Resident of the Yale Albert J. Solnit Integrated Adult/ Child Psychiatry program, was focused on studying the status of mental health outcomes for one group in particular: Black youth. Recent studies have revealed that Black youth face rising suicide rates. Calhoun noted that previous psychiatric research has also focused on how external factors like poverty, stigma towards mental health, and lack of education inhibit Black youth’s ability to access mental health care. However, Calhoun’s concerns went in a different direction. “As a psychiatry fellow, I couldn’t stop thinking about the medical racism Black youth and families face when they do access care,” Calhoun said. With this critical observation, Calhoun established the Black Youth Mental Health Clinical Case Conference Series at Yale. The case conference series, which began in January and concludes in June, seeks to interrogate real cases of anti-Black medical racism. At the center of every event lies a desire to humanize Black youth. One way Calhoun achieves this is through storytelling. “I wanted everyone to be able to relate to the struggle this child was having no matter what their background is,” Calhoun said. “I want people to feel like these children are in the room with us.” At the first case conference, Calhoun shared the compelling story of Christina, a young Black girl who was admitted to the hospital due to “out of control” behavior. During her stay, Christina’s already precarious situation was exacerbated by incidents of racism from her predominantly white medical team. Importantly, narratives like Christina’s illuminate how medical racism manifests itself. When white medical providers comment that Christina’s hair is “wild” or refer to her as the “Tasmanian devil,” they invoke a history of anti-Black medical racism. By sharing narratives like Christina’s, the case conference series emphasizes an important point: her story is not unique. Anti-Black racism is deeply embedded in the American medical system, and without a concerted effort, Black youth seeking mental health care will continue to be victimized. Notably, the cases discussed in the conference series are anonymized to ensure medical providers do not face retaliation. Calhoun herself is no stranger to the backlash that can arise from speaking out against medical racism. In 2021, after giving the keynote speech at the White Coats for Black Lives demonstration at the Yale School of Medicine, Calhoun was the target of multiple death threats. “The death threats were not the most difficult part of being an activist. […] What’s more difficult is getting people to stand up against racism,” Calhoun said. This encapsulates the ethos of the case conference series: to not only raise awareness but also to find solutions to medical racism. Another integral feature of the case conference series is the commentary of three expert discussants. Though the conference delves into issues of mental health, not all of the expert discussants are required to have a background in psychiatry. “We try to pull from diverse backgrounds,” Calhoun explained. “Most children will never see a child psychiatrist, […] but they will see their teacher, maybe their counselor, maybe their religious leader.” By inviting experts who hail from a variety of disciplines, the conference takes an interdisciplinary approach, harnessing diverse perspectives to tackle a complex issue. The conference is also designed to reflect this same diversity of thought in the audience; it is free to register, open to the public, and has a hybrid format to encourage attendance. In the future, Calhoun hopes the conference will be even more widely attended and lead to tangible initiatives and solutions. She also plans to consolidate all of the insights and discussions from the case conference series into a book that can be used as a reference for healthcare professionals. “It feels gratifying to take these stories and write [them] on paper. It feels like giving voice to the voiceless and giving space to stories that have been silenced,” Calhoun said. “There’s a lot of racist behavior in the medical system, and it needs to change, and one of the ways to do that is to start calling it out.” ■ 10 Yale Scientific Magazine March 2024 www.yalescientific.org

Social Technology FOCUS I AM ALAN TURING How Opera Uses AI to Tell Turing’s Story BY XIMENA LEYVA PERALTA IMAGE COURTESY OF JEAN-FRANÇOIS MONETTE C omposer Matthew Suttor and the team of artists and programmers behind the experimental opera I AM ALAN TURING have welcomed artificial intelligence (AI) as a collaborator. The opera’s libretto blends human-generated and machine-generated lyrics and dialogues to explore the life and ideas of brilliant computer scientist Alan Turing. Supported by Yale’s Center for Collaborative Arts and Media (CCAM), the project presents a new model for creating opera in the information age and explores what it means to be human in light of AI. Suttor, program manager at CCAM and senior lecturer in Theater and Performance Studies at Yale, was amazed by Turing’s insights on AI while exploring the archive at King’s College, Cambridge, a few years ago. In his 1951 lecture “Intelligent Machinery, A Heretical Theory,” Turing argued that it is possible to construct machines that closely simulate human behavior. Yet, humans should not be afraid of being replaced. “There would be plenty to do, trying to understand what the machines were trying to say,” Turing wrote. Renowned for his work on deciphering Nazi codes during World War II, Turing laid the groundwork for modern computing and AI. In 1936, he introduced the first theoretical description of a computer, the Turing machine. In 1950, he proposed the Turing test, which gauges how well a machine can think like a human. If a human cannot distinguish between the answers of a machine and another human, then the machine has passed the test. Suttor first proposed the opera to a group of collaborators in 2019. “Right from the very beginning, there was this idea of the opera being some kind of Turing test for the audience, so it had this meta kind of framework,” Suttor said. It was then that Smita Krishnaswamy, associate professor of genetics and computer science at Yale, introduced Suttor and his team to representatives of OpenAI. At the time, GPT-2 was OpenAI’s latest large language model (LLM)— an AI trained to understand and generate natural language—but it lacked chat capabilities like its famous successor, ChatGPT. With assistance from Yale University Library’s Digital Humanities Lab, Suttor’s team created an interface to interact with GPT-2. Through Zoom calls in 2020, the team trained the model on various large text datasets and fine-tuned www.yalescientific.org it using Turing’s writings. They then posed direct yet philosophically profound questions to the model, such as “Can computers think?” They experimented with different settings of temperature—the randomness of the output—and the number of characters produced, and they almost immediately obtained interesting answers. The team embraced the AI as an artistic collaborator. “Asking questions is also a form of training,” Suttor said. “Interacting with an LLM forces you to ask better questions.” Discussing the AI’s outputs was extremely valuable for the team from a pedagogical point of view and was a powerful exercise in collaboration. The opera’s title originated from one of their earliest conversations with GPT-2. When asked to produce lyrics for a “sexy” song about Turing, the AI came up with “I’m a Turing machine, Baby.” The AI is so integrated into the opera that even Suttor and his team cannot tell machine-generated text apart from human-generated text. Beyond the libretto, the opera incorporates AI and aspects of Turing’s work in other areas. Some AI-generated images of Turing, Suttor, and his team are used throughout the production. GPT-2 was also used to write code snippets for creating animations featured during the performance. Even Turing’s later works on mathematical biology come into play. Based on Turing’s diagrams of spiral patterns in sunflower seeds, Suttor created unique harmonic progressions by tracing equivalent spirals onto the circle of fifths, a method of organizing pitches in music theory. These progressions underpin much of the opera. Suttor and his team recently presented a work-in-progress performance of I AM ALAN TURING at the CCAM as part of the Machine as Medium Symposium: Matter and Spirit. The event explored how AI and creativity intersect and give rise to new approaches to timeless questions about human existence. In its current form, the opera spans eight music pieces across various genres, but there’s still more work to be done. Suttor is excited to see how the project continues to evolve through workshops and collaborations between humans and machines. In light of the latest AI surge, I AM ALAN TURING serves as a testament to Turing’s enduring influence and the boundless possibilities when art and technology converge to explore the essence of humanity. ■ March 2024 Yale Scientific Magazine 11

Social Technology<br />

FOCUS<br />

I AM ALAN<br />

TURING<br />

How Opera Uses AI to<br />

Tell Turing’s Story<br />

BY XIMENA LEYVA PERALTA<br />

IMAGE COURTESY OF JEAN-FRANÇOIS MONETTE<br />

C<br />

omposer Matthew Suttor and the team of artists and<br />

programmers behind the experimental opera I AM ALAN<br />

TURING have welcomed artificial intelligence (AI) as a<br />

collaborator. The opera’s libretto blends human-generated and<br />

machine-generated lyrics and dialogues to explore the life and ideas<br />

of brilliant computer scientist Alan Turing. Supported by Yale’s Center<br />

for Collaborative Arts and Media (CCAM), the project presents a new<br />

model for creating opera in the information age and explores what it<br />

means to be human in light of AI.<br />

Suttor, program manager at CCAM and senior lecturer in Theater<br />

and Performance Studies at Yale, was amazed by Turing’s insights on AI<br />

while exploring the archive at King’s College, Cambridge, a few years<br />

ago. In his 1951 lecture “Intelligent Machinery, A Heretical Theory,”<br />

Turing argued that it is possible to construct machines that closely<br />

simulate human behavior. Yet, humans should not be afraid of being<br />

replaced. “There would be plenty to do, trying to understand what the<br />

machines were trying to say,” Turing wrote.<br />

Renowned for his work on deciphering Nazi codes during World War<br />

II, Turing laid the groundwork for modern computing and AI. In 1936,<br />

he introduced the first theoretical description of a computer, the Turing<br />

machine. In 1950, he proposed the Turing test, which gauges how well a<br />

machine can think like a human. If a human cannot distinguish between<br />

the answers of a machine and another human, then the machine has<br />

passed the test.<br />

Suttor first proposed the opera to a group of collaborators in 2019.<br />

“Right from the very beginning, there was this idea of the opera being<br />

some kind of Turing test for the audience, so it had this meta kind of<br />

framework,” Suttor said. It was then that Smita Krishnaswamy, associate<br />

professor of genetics and computer science at Yale, introduced Suttor<br />

and his team to representatives of OpenAI.<br />

At the time, GPT-2 was OpenAI’s latest large language model (LLM)—<br />

an AI trained to understand and generate natural language—but it lacked<br />

chat capabilities like its famous successor, ChatGPT. With assistance<br />

from Yale University Library’s Digital Humanities Lab, Suttor’s team<br />

created an interface to interact with GPT-2. Through Zoom calls in 2020,<br />

the team trained the model on various large text datasets and fine-tuned<br />

www.yalescientific.org<br />

it using Turing’s writings. They then posed direct yet philosophically<br />

profound questions to the model, such as “Can computers think?” They<br />

experimented with different settings of temperature—the randomness<br />

of the output—and the number of characters produced, and they almost<br />

immediately obtained interesting answers.<br />

The team embraced the AI as an artistic collaborator. “Asking<br />

questions is also a form of training,” Suttor said. “Interacting with an<br />

LLM forces you to ask better questions.” Discussing the AI’s outputs was<br />

extremely valuable for the team from a pedagogical point of view and<br />

was a powerful exercise in collaboration.<br />

The opera’s title originated from one of their earliest conversations<br />

with GPT-2. When asked to produce lyrics for a “sexy” song about<br />

Turing, the AI came up with “I’m a Turing machine, Baby.” The AI is<br />

so integrated into the opera that even Suttor and his team cannot tell<br />

machine-generated text apart from human-generated text.<br />

Beyond the libretto, the opera incorporates AI and aspects of Turing’s<br />

work in other areas. Some AI-generated images of Turing, Suttor, and his<br />

team are used throughout the production. GPT-2 was also used to write<br />

code snippets for creating animations featured during the performance.<br />

Even Turing’s later works on mathematical biology come into play.<br />

Based on Turing’s diagrams of spiral patterns in sunflower seeds, Suttor<br />

created unique harmonic progressions by tracing equivalent spirals onto<br />

the circle of fifths, a method of organizing pitches in music theory. These<br />

progressions underpin much of the opera.<br />

Suttor and his team recently presented a work-in-progress<br />

performance of I AM ALAN TURING at the CCAM as part of the<br />

Machine as Medium Symposium: Matter and Spirit. The event explored<br />

how AI and creativity intersect and give rise to new approaches to<br />

timeless questions about human existence.<br />

In its current form, the opera spans eight music pieces across various<br />

genres, but there’s still more work to be done. Suttor is excited to see how<br />

the project continues to evolve through workshops and collaborations<br />

between humans and machines. In light of the latest AI surge, I AM<br />

ALAN TURING serves as a testament to Turing’s enduring influence<br />

and the boundless possibilities when art and technology converge to<br />

explore the essence of humanity. ■<br />

March 2024 Yale Scientific Magazine 11

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