Archive: October 1, 2008

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you can't script October

Wednesday,  10/01/08  07:03 PM

So I’m sitting on my couch with my guinea pig, watching the Dodgers start their series with the Cubs, and TBS’ tagline for their playoff coverage is “you can’t script October”.  Amen to that, I’m thinking; why just a week ago, although I was already sick, I thought I was recovering.  I thought I was heading to the College of American Pathologists' conference, enjoying a nice ride over the weekend, and then working normally this week, while eating and otherwise preparing for the Furnace Creek 508 next weekend.

Um, no.  Bzzzzzzt.

I was actually just about to get really sick, I just didn't know it.  I did attend the CAP conference (where I had an incredible "how did I get here moment", which I will share with you), but barely staggered through it, and upon my return Saturday I was toast.  I spent the weekend alternating between fever spikes as high as 103o and impressive coughing fits.  Turns out I have a fungal lung infection called "valley fever", must have caught it while riding the double century in Napa, with an immune system lowered by a preceding week of stress and no sleep, not to mention the exertion of the ride itself.  I *finally* saw my doctor on Monday, who prescribed Levaquil (a strong antibiotic) and Promethazine (an antihistamine), along with Codeine, and I am on the mend.  Today I actually worked in my office, instead of in bed, and though I am weak and woozy my brain is slowly reengaging, after being pretty well disconnected for a few days.  I am definitely not riding the 508 next weekend; even if I felt up to it, my doctor and Shirley would not allow it, and both have spent significant amounts of time saying so.

So be it.

Meanwhile the background is equally unscriptable, at Aperio I have a couple of colleagues dealing with far more serious medical situations than mine (fXf), and our next release remains on track for beta despite a flurry of last minute bugs.  And of course the world financial markets can’t figure out what to do, congress are debating the nature of the infinite while Wall Street burns, and the Presidential election has descended into farce.  Unscriptable.

Yet I am feeling better, and the baseball playoffs have started!  How bad could it be?



on the state of medicine, 2008

Wednesday,  10/01/08  07:57 PM

I've been sick, so I visited my doctor.  Being a patient is a unique experience for me, I never get sick, and when I do, I take a DayQuil or Motrin, and two days later I'm fine.  My doctor is the guy who conducts my annual checkups, annually.  As a result of my really lightweight brush with the state of medicine in 2008, I have a few observations.  These are not earth shattering and for those of you who have dealt with medical practice as a patient rather than a vendor, probably all too familiar.

First, there is really lousy communication.  My doctor is a GP, also involved in my case are a pulmonary specialist, a radiology lab, a lab where the blood analysis was done, and two pharmacies.  They are all colocated in one wealthy city.  You would think these entities would have an electronic way to communicate, but they don't.  Many phone calls are made, many faxes are sent (faxes!  In 2008!), and many data are manually transcribed.  Prescriptions are handwritten!  Worst of all, they all rely on me, the patient, to be the central repository of my information.  The pulmonary specialist asks me for my medical history, in great detail, when it is already sitting in my GP's files.  He asks me what drugs were prescribed, when the prescriptions were made by the GP.  The radiology tech asks me to describe my symptoms.  The pharmacy interprets a handwritten prescription.  The lab results are phoned and faxed.  Etc, etc.  In the case of a 49-year old with reasonable mnemonic capacity, these questions can be answered (although I could easily mis-remember drug names and dosages).  But what if I was older, sicker, less able to comprehend?  There is no excuse for this.  I have to believe a huge amount of efficiency could be gained and a large number of errors eliminated by some kind of physical repository for each person's medical history.  A thumb drive, for example.  We could carry them around with us from doctor to doctor, doctor to lab, doctor to pharmacy, with the requisite information stored and history updated.

Please someone!  Insert business plan here!

Second, the level of medical technology is amazingly uneven.  My doctor has a device the size of a shoebox used for measuring blood oxygen.  The pulmonary specialist has a similar device for a similar purpose, but it is the size of a large clothespin.  My doctor's nurses use their wristwatches for measuring pulse.  At the hospital, they have a device which clips to your earlobe, takes two seconds.  The hospital's X-ray machine writes film, which they digitize to store in their PACS (computer system).  My doctor actually asked me to drive to the hospital to pick up the film to take to the pulmonary specialist.  When I expressed shock that they weren't able to share the X-rays digitally, he expressed shock that doing so was possible.  (It was :)

It isn't just the technology, of course, it is knowledge of the technology.  Doctors spend a great deal of time doing CME (continuing medical education), but it seems to be disease and drug oriented, rather than technology oriented.  Maybe the doctors themselves choose this, I don't know.

Third, my doctors, labs, pharmacies, etc. do not share information with me, despite the fact that each of them seem to rely on me, the patient, to be the central repository.  The labs don't send me results, they send them to my doctors.  The pharmacies don't tell you about the drugs they make for you, or the devices they sell you.  The doctors consult with each other, but not with me.  It is like they all get together and collaborate on a diagnosis and treatment, and only then can the secret be revealed, as a single ground truth.  I am certainly not an expert in lung infections and would not presume to contribute to a discussion of possible diagnoses or treatments.  But there is some amount of debate, clearly, and I am not exposed to it.  Knowing that the radiology lab found X, and that doctor Y thinks this means Z, but doctor Q thinks this means R, that would be nice.  I do appreciate, medicine is sometimes art as well as science.

Enough!  I am complaining, but I should be grateful, because I do have access to the best in medicine, 2008, from doctors to labs to pharmacies, as a result of which I am feeling frisky enough to blog.  And that's what is really important!



the ultimate driving machine

Wednesday,  10/01/08  10:46 PM

I'm in San Diego, and I'm walking along the nice little boardwalk between the convention center and the bay, convalescing, and I see something up ahead...  what the heck is that?  ...  it looks like, huh ... holy crap, IT IS -- TRIZILLA!

Yep, right in front of me, there it was, good ‘ol BMW Oracle just arrived, and they let me walk into the compound and take pictures and everything.  Of course I only had my cameraphone so they’re crummy pics. 

The sheer size and scale of this monster are tough to grasp until you’re standing next to it.  I think the spar was the most amazing thing of all – seemed like it was ten feet wide, and two hundred feet long. 

Here is a picture of the bird in flight, you may remember from an earlier post:

90' long x 100' wide x 160' high.  It could go under the Coronado Bridge.  With 15' to spare :)

What an amazing craft. I’d sure love to take it for a test drive :)



Wednesday,  10/01/08  11:08 PM

Well, I'm baaack to blogging.  This is all done under the influence of strong drugs, you have been warned.

What do you do when all hell breaks loose in the world while you're sick?  You can't really comment on all that, right?  Right.  Well, you can comment on bits of all that.  The critical sections, you might say :)

I like this one from the WSJ: Congress lives up to its 10% approval rating.  I'm guessing at least 90% of us agree. 

I thought Slate summed up last Friday's debate perfectly: Tie goes to Obama.  Each side thought they won, but the undecideds in the middle thought Obama won, so he did. 

Here's some important analysis: how has the financial crisis affected the wine world?  At least some of the media are staying focused.  The answer: "bars, restaurants, and nightclubs have seen a sharp falloff in business, and many proprietors report that the customers who are showing up are purchasing fewer alcoholic beverages and less expensive ones. At the retail end, however, wine sales appear to be galloping along."  So be it.  Did I tell you about the Sea Smoke Pinot I had last week?  OMG. 

Something really great did happen on Sunday: SpaceX made orbit!  At 4:14PM PST their Falcon-1 spacecraft blasted off from their base at Kwajalein Atoll in the central Pacific Ocean, and 2:35 later the two stages separated, perfectly, at 3:05 the fairing separated, perfectly, and at 9:26 the second stage engine was cutoff, perfectly, leaving the spacecraft nestled in Earth orbit.  (click the link for video, it's cool.)  Congratulations to Elon Musk and his entire team, this is fantastic.  It presages a whole period of privately financed space exploration, I am sure of it... 

Actually next up is the F9, which has nine of the engines in the F1, and which can transport as much as 23,000lbs into orbit.  Orders for berth space on launches are going to be coming in now, and you can just imagine people being part of the cargo.  Of course that would [probably] require the capability to bring the spacecraft back, something SpaceX will do, but have yet to demonstrate.

The big winners in October so far are clearly Chicago and L.A., which each have both of their teams in the playoffs.  New York, oh for two.  San Francisco, zippo.  Neener neener.  Actually I must tell you that while I wasn't really paying attention, there was some great baseball last weekend, spilling into Monday, as the White Sox survived three must win games in a row, just to make the playoffs.  I'm rooting for them, well, until they meet the Angels.  And the Cubs have to be your sentimental pick, right?  I'm rooting for them, well, actually I'm not because too bad for them, they start out against the Dodgers.  Freeway Series baby, it will be great... 

Look, up in the sky, it's a bird, it's a plane, no, it's Fusionman!  That would be Yves Rossy, who Engadget helpfully point out is not Buzz Lightyear, flying across the English channel in a jet-wing.  "When asked if he was worried about risk, Rossy replied, 'I'm not worried about risk, I manage risk.'"  Sounds like a Wall Street investment banker!  At an estimated $190K, I can see quite a market for these things... 

Happy Birthday, Google!  They turned ten...  quite the tween.  I can still remember when I was working at Intuit, in 1999, at the old Sun campus in Mountain View, and there was this cute little startup called Google across the parking lot which used to have lots of parties.  Little did we know... 



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