This is a work of fiction.
This article was retrieved from the (pre)archives of Forward Health Quarterly Review, Issue 31, October 2032. Thanks to the Supreme Court’s Anaya v. Lacey decision eleven months prior, all articles authored by algorithms are no longer considered intellectual property and must therefore be made available to the public prior to their scheduled publication. In other words, non-human literature should be leaked. As human-centered as a company like Forward claims to be, even it relies on AIs to churn out online content to compete with the likes of Mayo Clinic, Healthline, and WebMD. I couldn’t resist– I searched for anything on privacy & disclosures to see whether Mr. Aoun et al were planning to further disrupt. Here it is for your information.
Ever since the COVID-19 Pandemic over a decade ago, we have all learned that in a globally-connected world, our personal health decisions affect more than ourselves– they affects others too. Here at Forward we have always put patients first, empowering them through self-knowledge, and we never stop looking for opportunities to make preventative care easier using personalized, scientific data. But it is one thing to measure the health of a single person, another thing entirely to measure that of a group. Our COVID pods are more than just lists of family and friends– they are small social ecosystems. And this is exactly what makes human beings special– we build social networks based on common knowledge and trust. And for the past 35 years tech companies have attempted to commodify that trust into scalable data-based products and services. But new times call for new measures. What if the answer were not more data, but less?
A few months ago my own pod got together to celebrate a friend’s engagement. We rented out a section of Hotel Bijou on a Friday night when many other people were expected to be there flouting quarantine rules, and the hosts came up with a simple but brilliant plan to keep interlopers out of our space: everyone on the guest list got a neon yellow tyvek wristband upon entering. Anyone without one was not allowed into the party. Midway through the party I noticed a friend of mine had both the yellow and another blue wristband on, so I joked “Where’s the other party?” not realizing the blue one was a token for charity. And that’s how the idea for RiskBands was born. The idea is simple: you get a wristband of a certain color delivered to you every week, via a subscription scheme, and every color stands for your current level of “COVID comfort,” or how willing you are to interact with strangers and the world at large.
Many of my colleagues will roll their tired eyes of hearing this for the umpteenth time from me this year, but we all can agree that the United States government has become bloated and directionless to a point that it can’t effectively solve society’s biggest problems. Companies like Forward provide the spark, the vision, and razor-sharp focus that we need to make meaningful progress. We are proud to be working with the Health Departments of New York and San Francisco to pilot this program in the coming year. It is a low-cost, low-tech solution for safeguarding public safety and making it easier for everyone to know what they are getting into when meeting each other out in public.
I don’t mean to belittle our partners at the DOH, and I hope they remember I have been plain with them since the start of our partnership that healthcare in this country needs disruption. What if the answer were not more order, but less? What if I didn’t have to go to CDC.gov every time I’m planning to hang out for a friend’s baby’s birthday party in the park?
In fact, that’s what I tried out. I went home after that office party and cut 20 wristbands from an old pack of multicolored construction paper I had lying around from my son’s preschool. I gave myself and my three closest friends five of each color. Red for “I am only leaving the house for groceries. Mask on outside. All sense of reality lost.” Yellow for “Currently hanging out with my pod only. Mask on outside. Highly judgmental of others exhibiting looser behavior.” Green for “Will see friends but practicing safety guidelines, social distancing and abundant caution. I believe I have the highest moral ground.” Blue for “Pandemic? What pandemic?”
Little Lachlan’s birthday party the following weekend was the perfect test case. And by pure coincidence, all four of us pod members wore the same wristband: yellow. Furthermore, an even more fortuitous thing happened at that party: Rob & Lily invited another couple outside the pod. They were a smart Asian couple working in healthcare, who were clearly there under some duress, which I broke by telling them about the RiskBands we all had on. As soon as I finished my pitch they asked if I had extras, which of course I did. Suffice to say I left the party giddy that my product passed its beta tests with flying colors!
The next test was more difficult. The same Asian friends, impressed by my idea, invited me to an backyard barbecue in San Ramon. I had no idea what to expect, so I brought an extra 50 wristbands with me. The house was handsome, the American flags abundant, the pool filled with young women, the unsanitary patriarch was grill master, and I had never seen that many different cuts of short stained with that many different shades of sauce before. Thank goodness I had put on a blue wristband in the car before coming in. All the partygoers were exceedingly kind people (to my surprise), and were also taken by the simplicity of my idea. “I like it,” said one man, “It’s to the point.” “This is great,” said another. “It says to the world: I decide what to do with my body and my health.” He had a beer belly and a mustard-slathered hot dog. Most of them liked the single blue stripe, for reasons I only surmised afterward, walking out of the party across the front lawn. Many only took blue ones, the rest I felt accepted the other colors from my eager hands the way passers-by accept flyers from Humane Society fundraisers on Market Street. To tell you the truth, though I wore blue that day, I wasn’t mentally ready for blue. After so much handshaking and shoulder patting I felt radioactive for days.
When I say radioactive I am not exaggerating. I have made no bones about the fact that I am germophobic. In fact it may be what has given me spidey-sense about infections, and what drives our prevention-focused culture at Forward. For the next 80 hours I wore two RiskBands: one red and one purple (to represent “infected”) and held the right half of my body away from everything like it was a smelly sock.
Nonetheless I pressed on. At home that night, I asked Lachlan to cut out one hundred more RiskBands out of the rest of the construction paper the nanny had purchased for his craft projects. Since I still didn’t have use of my right arm it was particularly challenging to supervise him using the scissors. Later that week, at my regular Wednesday microdose power lunch, I bumped into my good friend KP Gaiser, VP at FistUp Capital. He always wears a suit. Meanwhile I still carried my arm like it was radioactive. Nonetheless, I pitched him my idea. “Look,” I said. “I realize talking to you now that the only thing holding me in a funk since that party is my own insecurity. All it took to overcome my pandemic was an attitude change. Think about it: how many of us could return to normal and go back to fulfilling our potential if we just realized that our health is up to us as free individuals? Could we cut through the red tape and snap it onto our wrists?” And I saw in his eyes that I had found something really scalable. After we secured our first round of funding, we’ve also expanded our color palate. Orange for “Only seeing immediate family. I likely have an at-risk contact whom I am trying to protect. Nonetheless I occasionally break my own rules because why the hell did I move to the big city in the first place?” Brown for “I have recently tested positive. How recently I won’t say.” Gray for “I am a registered independent.” The designations are always available for reference on our mobile app.
Less than a month into our official launch, I began seeing them appear all over. At the BART station, in the neighborhood Chipotle at lunchtime, in dog parks, and across a noteworthy socioeconomic spectrum. I don’t say anything when I see them– even when I see a color that clearly doesn’t correspond to the way that the person is behaving (orange in the office elevator?)– I want this process to grow organically, I want their presence to spark conversations between people, I don’t want to dig myself into the “Zuckerberg hole” at the bottom of which is nothing but oversight boards and metaverse escapism. What if people start to invent their own colors and meanings? I don’t have the answers– I’m still dealing with my arm. Since the incident in San Ramon, I had become effectively impaired, the doctor unable to diagnose me with anything concrete other than “psychosomatic radiation.” My arm was trying to socially distance itself from the rest of my body. At times it stuck out almost horizontally in a painless cramp, fingers splayed out, lifted by an unknown anti-gravitational force.
Seeing that launch was a success and market penetration was sufficient, I took some time away from the project in late summer 2022 to focus back on our core clinical products, handing RiskBands over to two of my top managers. Then one day, over a mindfulness breakfast of chia pudding and curated fruit salad, I was watching the news when I thought I saw Governor Newsom wearing a blue RiskBand– it peeked out from under his crystalline white shirt like a child forced to greet unwelcome visitors while he addressed the press about reforming California’s healthcare system. As the camera panned over his shoulders I caught glimpses of several bands on the folded wrists of his entourage. Was I hallucinating? I turned on full screen mode but it was still too subtle to tell for sure through the flood lighting and unfaithful color rendition. The next news story was about corporate America– the B-roll featuring shots of various company headquarters. For a moment I thought each logo’s color palate matched perfectly to that company’s pandemic response: Amazon and its proud blue band across every last-mile warehouse, McDonald’s ruinous reds reflecting their failure to adapt, Big Lots’ orange looking cautiously optimistic. Had we tapped into a set of rules that society had been following all along? The weather report came on, backdropped by a shot of the city from Alamo Square with the Painted Ladies in the foreground. I imagined each lady with its own attitude based on its color, from impudent to impervious to in denial. Did we create a multimillion-dollar investment out of universal color theory?
But business goes on. The RiskBand team here at Forward is constantly at work ironing out details and responding in old-fashioned real-time to user feedback. One of the main complaints is that one week is too slow for a “decision cadence.” In other words, you want to be able to change your color more frequently. What if I decide on Monday that I’m green but then get infected on Tuesday? What if I realize I was too conservative choosing yellow on Monday and would rather not miss that office party on Friday? It’s obvious that we all have issues with commitment, even to our own health choices. We wear our convictions on our sleeves but our sleeves need washing. I hate to think that this program has held our loyal customers back, has prevented you from living your lives to their fullest and emerging safely from this pandemic. I hate to think of the potential millions in lost business sales around the Bay Area. So, we are working on an enhanced subscription model in partnership with Amazon which lets you choose same-day RiskBand delivery. GrubHub and UPS have expressed interest in exchange for branding opportunities, owing in part to their recent sluggish market performance.
Despite the movement in this space, time waits for no one. My friends and associates were starting to move to greener pastures (their words). Oregon, Arizona, Texas. Dallas is seeing very strong growth in tech. Taxes are low, land is cheap, and heart disease is high. It’s a space ripe for disruption– as much as Texans chafe at being called a “space.” Secretly even the most buttoned-up Stanford grad dreams of throwing on a pair of Carhartts and fencing out a ranch peppered with IoT sensors. Even KP, my early investor, upped sticks to Salt Lake City. “I just can’t deal with the phalanx of homeless people every day,” he told me over the phone. “And anyway, that’s the heart of the cryptobelt. All the way from Bozeman to Albuquerque there’s been an explosion of DAOs. I’m working with some guys there to set one up to disrupt municipal finance and how, you know, taxes are collected.” I wish him the best of luck. San Francisco meanwhile is morphing into a wilder, scrappier version of itself, like the streets have turned into a huge paintball arena. Everyone wears a backpack or utility belt, I hear travel suitcases rattling the asphalt around every corner. Along the Embarcadero people hold their dogs’ leashes tight to the hip like they’re training a bloodhound to hunt rabbits. Flyers taped to light posts now have more relevant information than digital displays. At least lines are forming outside the Forward clinics. All of it, I realize now, are necessary qualities of the world in which my ideas can become reality. What we offer is the real protection of good health, an armor stronger than anarchy. Is that the world order I wish to fight in?
After one particularly exhausting fundraising event at Barebottle Brewing on Cortland Avenue, full of foreign friends’ faces and belly laughter almost designed to drown out the world around it, I started to believe my associates were avoiding and ignoring me because of my arm. They treat it as a disability. Some of them begrudged me mentioning RiskBands in my keynote, telling me afterwards I should let sleeping dogs lie and does my CFO not know what a negative carry is. I decided to walk around the immediate neighborhood instead of packing into an Uber with people I no longer recognized. I’m not scared of streets, I told myself, I want to prove to all those people in there that, despite my Ivy League credentials and inherited wealth, I can walk among the middle class without compunction. After all, face-to-face contact is meant to help return us to face-to-face normalcy again. Bernal Heights homes are, to my surprise, quite nice. I followed my wobbly legs up- and downhill like a slow rollercoaster, dodging parking signs and street trees, slowing to a waddle somewhere along Banks Street. Just as my legs gave out, I looked up and saw something strange. It was a peach tree. I’m no botanist, but seeing those few ruddy fruits hanging in a coastal Mediterranean climate like this was uncanny. A man sat on the front stoop, the top of his buzzcut head absorbing the last of the day’s sunshine. A sleeveless shirt and jeans seemed like not enough clothing even for the balmy evening, but his wrinkled bronzy skin was like its own tight bodysuit. He hummed a tune and had a cigarette stuck in a gap in his teeth. A chihuahua which more resembled a decomposed squash slept next to him. He looked up at me.
“You alright there son?” His eyes met my arm. By now I had grown numb to it. The staring and the thing itself. That is to say, dear reader, that it had become an autonomous being with a will of its own whose purpose or intention was completely foreign to me. If before Xxx, then now yyy.
“I’m alright, yeah.”
“You seen a doctor about that?”
“Not that he’d have all the answers. But hey, it’s their job.”
I thought for a moment about what our proprietary biometric scanners at Forward would say about my arm.
“Not sure even they’d know what to do.”
The man smiled at that.
“You look young and employed. Which means you got insurance. If they give it, take it.” He took a drag on his cigarette. “How else are we gonna survive in this fucking city?”
“Tried working honest jobs, doing the right thing…” I spoke, almost picking up his sentence up from where it left off.
“But what does playing by the rules mean anymore? Huh?” He glared toward me but not at me. “Playing by the rules means you get steamrolled. It’s like they want you to break the rules to get yours. It’s like they know it’s all gone to hell.”
“What do you do, if I may ask?” I asked, with nicety. “What are you trying to disrupt?”
“Electrician. Self-made. Used to re-wire folks’ garage doors when I was in college. Now I’m the foreman for all those shiny new clinics. What are they called?”
“Forward. That’s it.” He shook his head. “You won’t believe the technology they fit into a screen nowadays. But all that tech and all those servers gotta draw from someplace– you should see the Eaton transformers they’re having us order from Turkey. Quality gear. And do I know some good guys in Nebraska who could build them even better? Maybe. But hey, these clinics are helping us get around the rotten healthcare system. And they’re one of the few guys that take non-union labor around here, God bless ’em. Helping a lot of us pay our bills.”
“There’s give and take.”
“Yes, sir. I see you’re in that web too,” he said, pointing to my hoodie that had the Forward logo on it. “We’re not so different. Think about it. All your fleece-vested friends moving out to the sticks, they’re driving prices up over there. They don’t really want to change their lifestyle, they just want to be left alone. You hate taxes as much as I do. But we’re still here. Why? Because we know when something’s being lost, you stay put and fight for it.”
“I agree,” I said. It felt like an exhale.
“I’m Jimmy the Mayor.”
“Saw you looking at my peach tree. You want one?”
I yanked a low-hanging one and rubbed it on my right arm. “Thank you.”
“You want to come in for a beer?”
I politely shook my head.
“Well, you’re always welcome. Everyone’s home in the mayor’s house.”
A breeze lifted off the avenue beyond, sweeping both me and Jimmy the Mayor’s tattered, decades-old American flag into motion. Suddenly, my right arm rose up as well. Its elbow was cocked as the back of the wrist approached my sweaty face. The band on it had the same bloodless color as the limb– red at first glance, but blue underneath, with layers of purple and small splotches of green that shifted under close inspection.
It wiped my forehead.
“Whew!” I heard the mayor say with a chuckle behind me.
As the eternal calm of Bernal Heights receded, making way for the familiar chaos of the Mission, I caught sight of my reflection is a tinted glass storefront. My face was flushed and moist. My arm was purple. My sweatshirt was blue. My khakis were orange in the evening light. It seemed all of the colors of the RiskBand had bled into me. Just like it was meant to be, right?
“…here at Forward, we want everyone to take control of their own health. Because once your health is in your hands, the rest of your life can follow.” I mouthed the words of the speech I had memorized for my meeting with the director of The Department of Public Health tomorrow.
A French bulldog croaked at me as it passed by with its master.
This is the world my ideas need to be born. I am just selling you the armor.
Adrian Aoun is the Chief Executive Officer of Forward.