Whatever you say in public – and this is as public as I get – tempts providence . It follows therefore that one should tempt providence properly , and bring down a whole building on one’s head rather than a mere ceiling . So here goes:

” I know the successor to Facebook ”

There , it is really quite easy . And it came to me naturally while contemplating the plainly inadequate oarsmanship of the Brothers Winklevoss and the demise of BeBo , suffocated in its sleep by the new regime at AOL . The twins , litigants in the Facebook case and winners of a $65 million dollar bonus for losing , are plainly seekers after Lost Causes . Thus they were rowing in the Oxford boat defeated by Cambridge in the recent Boat Race . I am not sure if they were connected to their lawyers and launching an appeal against the race judges while still rowing , but I am pretty sure that their mobiles were close by , and that their stay in the UK has been an intensively networked experience . And that is where , if they truly want to defeat Mr Zuckerberg , they should be investing their winnings . For the successor to Facebook is lurking out there in the mobile networks even now , built for the network , and not adapted to it as Facebook was .

Over at News Corp , the senior strategists are doing all-nighters to work out what AOL just got : neither MySpace or BeBo will make it . I could save them so much time . The answer is : Go and buy www.foursquare.com . Here is a made for the network social media environment that lets users rate the places that they visit , put them into the social media context , give them credit and points for discovering things ( I could be “mayor” of my local pub if I was’t too busy drinking there ) , and above all , like Facebook , give them credit in the eyes of their peers .

Amazingly then , tomorrow’s social media on the mobile/cell network appears to be a close relation of a number of web-based antecedents . Craigslist for a start . Mobile networking is all about spatial awareness and recommendation . Other parallel players might be the splendid www.brownbook.com , derived from the recommendation directory world , or Qype in Hamburg , Germany. If you are too late to buy FourSquare then there might be some ideas here . The latest BrownBook release now lists 34 million commercial entities globally where you can make comments and recommendations .

Once FourSquare is up and away bigtime ( sorry , the language goes with the subject) , you will want to create the real time links that show you when your friends are checked in to the bar or restaurant or hair salon or pub that you are just approaching on the street outside . Then the fun begins , but early investment before concept maturity is advisable . And only a few things remain to be said . One is that having discovered this I seem to have let the cat out of the bag before buying a major ( or any) stake . Which is why I am poor . Secondly , I seem to be saying that the future of social media and directories are inextricably linked , which is not where I thought I was going to end up . Lastly , if the history of the network is about constant innovation , then BeBo , MySpace and FaceBook can all be described as players who innovated once , and then stuck to the knitting . Which is why they will all be overtaken by the Next New Thing . And , guess what , you read it first here !

Everyday , like the janitor of an apartment building sweeping the hallways , I protect my readers from posted comments inviting them to sample special car insurance offers  , free animal sex movies , or cheap supplies of drugs from Canadian pharmacies . This last area has now turned into a torrent. I deleted nine today. And having watched the crowds last night during a five hour wait for treatment in a Parisian hospital I see and feel just how compulsive a business health is : the workflow of life itself . So small wonder that web life mirrors real life , and that consumer healthcare is a rapidly growing area . And given the size of the topics , and what you need to know to begin to explore the muttered hints given by your doctor or specialist , it is small wonder that a great deal of current content flatters to deceive , or is found too opaque or too dense for effective consumer use . What the field needs is a coherent way for consumers to understand themselves and their conditions in a context which is their property , and which forms a part of their self-knowledge which they bring into play when they have consultations with experts . In fact , an analysis of their starting point on life’s workflow which contextualizes everything else that happens to them .

Well , anyway , it passed the time , did this thought . And recalled a splendid conversation with my daughter , who is planning to set out on a medical education , which took place some days ago . I had alluded to www.23andMe.com , the very interesting start-up site which should be known because it is bringing a new look to genetic analysis ( and is known because its founder , Anne Wojcicki, is the wife of Sergey Brin ). This service , for a price of between $399 and $599 , sends you a saliva test , analyses your sample , finds your relatives out as far as fourth cousins , and then gives you guidance on conditions that may be inherent in your genetic make-up . All fairly crude , of course , but enough to be compulsive -or dangerous.

My daughter opted for the latter . Donning the mantle of an aspiring professional , she could see only too clearly the dangers of knowing enough to be frightened and not enough to be fully informed . And what about employer discrimination , and insurance company refusals to insure known risks ? Clearly it was a minefield and it was best if amateurs ( I qualify here ) kept clear . But I still wonder. I see citizens of the future carrying and trading this type of information as part of a restoration of the balance in their relationships with the medical profession . I feel certain that the avoidance of risk will become a powerful factor in decisions about having children , and I have little confidence left in doctors or politicians when they know best .

And if there is any value in this thought , then it points a finger directly at medical publishing and medical informatics in regard to the communication job that they carry out at present . We all laughed at the very idea in the early days of Open Access that the woman on the Idaho omnibus would be able to make sense of a research article on her child’s cancer . www.23andMe.com has the same problem . Fine graphics , videos and cartoons got us over the ealy explanatory stages ( I loved the English English voice over – an American voice in this context suggests marketing ? ). Then we are in citation country , and gene-talk is very hard to follow . For example , I would need to be paid $599 to understand this :

“Although a variety of factors influence a patient’s ideal dose of warfarin, the genetic variations in the CYP2C9 and VKORC1 genes reported by 23andMe play an important part. In January 2010 the FDA updated warfarin’s label to say that information on these variants can assist physicians in selecting a starting dose of the drug. The agency also provided initial dosage recommendations for patients with different variant combinations. The FDA does not, however, require that genetic testing be done before prescribing warfarin.

Versions of the CYP2C9 gene known as *2 and *3 can slow down the body’s ability to break down warfarin. This causes the drug’s concentration in the bloodstream to decrease more slowly, so the patient needs a lower dose to begin with. Each T at rs1799853 indicates a copy of CYP2C9*2. Each C at rs1057910 indicates a copy of CYP2C9*3.

The normally functioning version of CYP2C9 is called *1.”

But this will change . Our genetic heritage may well be the health equivalent of internet banking . If it is , then medical publishers will need to explain themselves to a much wider readership – or maybe , in instances like Nature Publishing taking on the management of  Scientific American , this is already happening . As I walked out of Hotel Dieu into a Spring evening in the square outside of Notre Dame I could already imagine the disintegration and re-integration of medical publishing as we know it , all built around lifetime alerting services updating us on knowledge about research into the subject that most concerns us – ourselves .

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