Page 110 - Journal of Special Operations Medicine - Spring 2017

the performance of others more effectively. They noted where trying to understand a causal link among genes,
that such models would depend on several developments environments, and performance will necessarily be re-
to lead to what we are calling P2, including advances in fracted, like light through a prism, by multiple sources
methods to collect large amounts of data on individu- of variance across biological, psychological, and social
als and trustworthy analytic methods that can provide worlds. Understanding and incorporating these inter-
valid, reliable, and actionable insights and conclusions. actions to help optimize performance may be the ulti-
Hence, it was with some irony, perhaps, that Blackhurst mate goal of P2; in the meantime, just getting a better
and Stone, only 5 years later, commented on the strik- handle on which variables matter most could offer
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ing comparison between how we measure platforms and near-term advantage.
how we measure warfighters. Their article juxtaposed
the measurements taken on an airplane and those taken
on the pilot: Compared with the more than 1,500 mea- Moving Ahead: Figuring Out What Matters Most
surements taken each second across multiple aircraft
parameters to monitor a fifth-generation jet fighter, the “The first principle is that you must not fool
pilot has only one sensor: one to monitor and determine yourself—and you are the easiest person to
whether he/she is alive. fool.”
—Richard Feynman
As part of an effort to redress this situation, Ford et al.
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outlined a sense–assess–augment framework that might Clearly, P2, as both a concept and an applied approach,
be used to guide the application of HPO or human per- is in its infancy, as are many of the technical and method-
formance augmentation into systems engineering across ological advances likely to enable it. Yet there are reasons
the services. Similarly, Department of Defense (DoD) to be optimistic about possibilities for, and potential pay-
laboratories (e.g., Telemedicine & Advanced Technol- offs from, collecting, analyzing, and integrating growing
ogy Research Center, US Army Research Institute of En- amounts of higher quality data to begin to tailor HPO ap-
vironmental Medicine, Air Resources Laboratory and proaches to optimize any given individual’s performance.
Army Research Institute, US Special Operations Com- P2, if realized effectively, could presumably contribute to
mand, Air Force Research Laboratory, Naval Health the effectiveness and well-being of all SOF and those who
Research Center, Naval Medical Research Center, Con- provide support to them. Furthermore, P2 is likely to
sortium for Health and Military Performance, and De- align well with at least some elements of the DoD’s plans
fense Threat Reduction Agency) and other groups have to maintain competitive military advantage through the
begun to take strides toward enabling P2 by investing in “Third Offset,” which is part of DoD’s plan to ensure
research in relevant areas (e.g., telemedicine, wearable our service members, and, in particular, SOF, remain the
efforts, biomarkers, genomics, proteomics). world’s finest fighting force. Among other elements of
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the Third Offset, one is an increasingly clear realization
Yet humans present perhaps unique challenges when that the most effective organizations will be those that can
compared with understanding and optimizing the per- quickly adapt to evolving circumstances and challenges.
formance of physical and materials systems, many of A key factor in adaptability will be the extent to which
which are reflected in the current state of P2. First, humans and machines can most effectively work together,
where fighter jets and other platforms are, in principle, leveraging each other’s strengths and complementing each
wholly understandable (they were designed and come other’s relative weaknesses. It is not difficult to see how
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with blueprints), humans and their variability are the a P2 approach could enable better and more-integrated
products of simultaneous and dynamic interactions human–machine interactions and systems by identifying
among biological, psychological, physical, and social and using, rather than ignoring or averaging, important
worlds; our brains and bodies do not, as far as we can individual performance differences.
tell, come with blueprints beyond the tantalizing, but
still frustratingly complex and incomplete, information This, of course, begs the question of which individual
being discovered in our genetic material. Further, as differences are actually the most important for factor-
we have illustrated in this article, our differences are ing into HPO programs as well as human–machine
influenced by variations in structure and function at teaming. Clearly, some differences are likely to be more
almost every level: from the composition of our gut significant than others, and this significance may vary
microbiomes shaped by environmental experiences and across different conditions and in different contexts.
exposures, to our injury histories, inflammatory pro- Hence, which differences matter most, and when and
files, and genetic predispositions, to even the dynamics for whom, should almost certainly be an integral part
and characteristics of our social networks and envi- of any P2 program. In turn, this raises the question of
ronments. This complexity makes human individual how individualized is “individual enough”? At what
differences a wicked game of “Chutes and Ladders,” point are there diminishing returns in P2, where the

86 Journal of Special Operations Medicine Volume 17, Edition 1/Spring 2017