Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

Cape Cod

The Stages of Exuberance Sunday musings…1/13/19

1) Toddler. We are hosting the Man Cub for a few days as his parents prepare to move into a new house.

I. Am. Exhausted.

2) Strategy. Trample the wounded and hurdle the dead is neither a growth strategy nor is it a viable marketing tactic.

3) Snowpocalypse When I sit down to write I enjoy looking out over the lake as I wait for inspiration to sit down and chat. At the moment my view is blocked by 1/2″ of ice on all north facing windows at Casa Blanco.

The Ice Man cometh.

4) Irrational. Whenever a new technology or concept surfaces it is often met with irrational exuberance. Early adopters behave more like acolytes than simple adherents. Potential issues with the new idea are swept aside and those who propose that all is not so new or wonderful are labeled as too dense or simple to understand the brilliance of the new new thing. In a similar vein behavior by the creator of the new idea that would otherwise be a possible signal that all is not as it seems is either ignored or explained away without any real investigation. This particular phase is more intense and tends to last longer if it is associated with something that contravenes, and more so actively seeks to disrupt the status quo. A “cool kid” factor also magnifies the exuberance.

Rare is the new idea that does not then enter a phase one could call irrational dissaffectation in which both early adopters who become disillusioned and outsiders who become interested by the buzz created by the exuberance begin to look closely at not only the idea or product itself, but also at the behavior of both the “inventor” and the company that provides the service/product. The vehemence of this response is directly related to the buzz and fervor that exists among those who continue to be excited about the new thing. During this phase it is quite likely that there will continue to be newcomers to the technology who exhibit many, if not all of the characteristics of those people who claimed “first flag” discovery enthusiasm in the earliest days of adoption.

What comes next is either some degree of general acceptance of the new thing with a concomitant adoption into general use, or a slide into irrelevance as it becomes little more than a footnote in whatever historical space it inhabited.

As it happens both my professional life and a very large part of my non-professional activity each have a very significant player/thing that is entering this third phase. You may recall that I am an eye surgeon, in particular one who operates on the front of the eye. My expertise is in surgeries that both improve vision and liberate individuals from the need to wear glasses or contact lenses. In the LASIK world what was largely a PR battle between mechanical “flap makers” and those that created the LASIK flap using a laser was eventually won by the makers (and early users) of the laser. While I still feel that the introduction of the femtosecond laser to make a LASIK flap was a solution to a problem that had already been solved by 4th generation mechanical devices, the allure of an “all-laser LASIK” proved too powerful in the marketplace. Any “bad behavior” in the middle phase was marketing related. Even though it was more expensive, the laser won.

Cataract surgery also has a femtosecond laser entrant in the game. While the technology is actually quite stunning FLACS has never been shown to be more than slightly superior (if even that according to the most recent studies) to what it was developed to replace (the surgeon’s hands). Similar fear-mongering to the LASIK experience in the middle phase was buried in an avalanche of data reiterating the treasure trove of safety statistics and outstanding outcomes achieved with “traditional” surgery. Some really nice people got run over by some not so very nice people as companies were bought and sold. The most likely outcome as FLACS enters the third phase is that it becomes a niche procedure where hopefully the surgeons push back against industry in order to shield patients from predatory pricing; this laser is more expensive, and that has been its downfall.

When thinking about my non-professional activities over the last 12 or 13 years CrossFit is the obvious topic. In my entire life I have never been a part of anything quite so exciting as the first several years I spent in the CrossFit world. When I first found CF in 2005 there were about 100 gyms and maybe 5000 of us doing it on a regular basis. We were self-proclaimed fitness infidels, rising up against a cynical entrenched fitness orthodoxy and industry. Man, it was cool, and we were cool because of that. Not only did (does) it work if done properly, but we all had that same kind of first flag planted buzz you get when you discover something that becomes a phenomenon. Think being in your local in the 80′s and Nirvana is the house band kind of cool. It was like that.

CrossFit, too, is now in the earliest days of its own third phase. Having turned away from the strong (at least outward appearing) emphasis on CrossFit as sport, the company has pivoted back to something that sounds and feels more like what we all were doing prior to 2010 or so. Quite frankly I was personally too close to many of the primary personalities in phases 1 and 2 to objectively assess the players and how they played. Where CrossFit places its emphasis now is where I always felt it belonged, high intensity functional fitness as health rather than as sport. Which “laser” will CrossFit emulate as it leaves the stages of exuberance? What kind of laser company will CrossFit, Inc. be like if it, like the femtosecond laser, is proven to be only one among several ways to achieve the desired outcome in fitness and health?

In my day job phase three means a femtosecond laser for LASIK but not for cataract surgery. I am largely indifferent to the companies involved.

 

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