Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Posts Tagged ‘Apple’

Sunday musings 7/2/17

Sunday musings…

1) Calisthenics. From the Greek: “kalos” meaning beauty, and “thenos” meaning strength.

2) Size. Someone always as a bigger boat.

3) Anoesis: A state of mind which consists of pure sensation or emotion, devoid of any cognitive content.

I am on vacation this week, seeking the elusive state of anoesis.

4) Independence Day. July 4th, 1776. Brexit v1.0, if you will. In honor of the day I will re-read the Declaration of Independence, the document that we celebrate today. While I’m at it I think I will read the Constitution in its entirety. If I’ve done so in the past I have surely forgotten the experience.

Both efforts will surely be at cross purposes with my anoesis pilgrimage.

5) Somebody. Incognito (no bow tie; kept my mouth shut), I was out and about with Mrs. bingo yesterday. Nevertheless, I was recognized several times. “Aren’t you somebody?” Or even better/worse: “Weren’t you somebody?” In a see and be seen society these questions are asked with great regularity. The asking and the answering are equally amusing.

“Aren’t/weren’t you somebody?” Both questions are really rather bold and intrusive, don’t you think? What does it even mean to be a someone, anyway? If you ARE a someone what’s it like when somebody sees that you are someone but can’t figure out just who? I wonder if it’s hard, or maybe a little bit sad, someone remembering that you were once upon a time a someone and you aren’t any more.

The world of CrossFit has grown so much that there are actually FEWER somebodies nowadays. In the earliest days of CrossFit there were so few of us that it was relatively easy to be a “somebody” of a sort. Heck, there were so few of us around that no one was more than 2 degrees of separation from anyone else, including Coach. Really big CrossFit Central “somebodies” were at the other end of an email address or a cellphone number, and they responded to pretty much any CrossFitter who reached out. Gone from sight are OPT, Hari and Damnit, MattG and his flame wars. No more Appolloswabbie and Dale dueling with Barry or Prole on Rest Day. Brendan G is now part of a growing family with Allison_NYC, both only barely on the grid where once they were daily companions for most everyone CrossFit. Seriously, when is the last time you saw an update on one of the “Nasty Girls” Eva T, Annie, or Nicole? Someone needs to send out an APB.

Growth in the CrossFit world has decreased the number of household “somebodies” while at the same time dramatically changing those that remain into SOMEBODY.

There is nothing that is uniquely CrossFitty about this transition, of course. Any rapidly growing “new, new thing” will encounter this phenomenon. I once likened discovering CrossFit to not only living in Seattle in the earliest days of grunge metal, but of actually being in the audience when Nirvana or Pearl Jam were singing for beers. Hewlett and Packard left behind just as many early adopters and colleagues as did Gates and Jobs, people who were real “somebodies” in the earliest days of Silicon Valley tech. In the journey to “used to be someone” it matters little whether you stepped off the train or were jettisoned, you are now “used to be” either way.

At best I have never been more than a C-List somebody, here or anywhere. I doubt if anyone will ever seriously ask me: “didn’t you use to be…?”

I’ll see you next week…

–bingo

Gratitude May Be An Essential Part of Success (From Sunday musings…)

So much we could talk about this morning. Religious extremists and their violence. Intolerance of various kinds expressed in various ways and in various places. Friendship, and those who would impose restrictions thereupon. Financial models both micro and macro, and how they affect those downstream from the “decisioners”. I could go on and on before I even start.

Rather than contemplate any of these in the kind of depth they deserve, let’s rather consider a bigger theme and look at it from different altitudes. My friend Dave posted a little thoughtlet on “success”, and it started a very nice conversation about what actually constitutes success and why. Thinking about success may provide us with a platform from which we might think about the other issues that may be orbiting our little personal planets.

Dave’s post was this: “Successful people have a sense of gratitude. Unsuccessful people have a sense of entitlement.” To parse this one must begin with a definition or at least an understanding of what success is, and equally importantly, what it is not. There are many terms that are often associated with success, things like wealth and power and fame. Is it necessary to have any, or all, of these to be a success? Can you be successful in the absence of any, or all, of these? Where would one fall on the gratitude/entitlement continuum if one were to have any, or all?

This is really tricky, and I’m afraid that when I’m done you will likely have more questions than answers, maybe even more than you had when you started. That may actually be the point now that I think of it. Success probably relates to what I shared last week about “All” or Everything” in that the proper definition of success emanates from within, not without, and this I think is what Dave is implying when he makes the distinction based on gratitude vs. entitlement.

Let’s use an example, a very famous example, to try to illustrate this and prompt some thought: Steve Jobs. Mr. Jobs as you know was cut down in the prime of his life by a disease that has no known cause. Was he a success? He was wealthy, famous, and wielded great power both inside and outside his company. He was married to his only spouse, and together they had healthy children (2, if memory serves). A life to be envied, no? One to which many (most?) might aspire.

A deeper dive at least suggests another story, though. It appears that Mr. Jobs, unlike his one great peer Bill Gates, had few if any close friends. Indeed, within his company and his industry he left behind a trail of despair. All one reads about is how hard it was to work with or for him. He won…for sure he won way more than he lost…but did he succeed? Was he successful? I never once read or heard anything from Mr. Jobs that implied that he was grateful for either any of his wins, or any of the spoils of his victories. There were a couple of whispers about an end of life wistfulness about a paucity of connection, though.

I don’t mean to pick on Mr. Jobs, and Heaven knows his family surely misses him. I think his example might soften the “entitlement” part of the equation a bit as I never really got a sense of that from him (as opposed to, say, your favorite rich and famous Kardashian). Being grateful, however, bespeaks connection, a very certain acknowledgement that the concrete parts of success–money, fame, power–are without any real value unless they somehow allow you to share them. This, in turn, brings with it the humility that comes from realizing that you can’t be truly successful if success is only something you can count rather than something you can feel.

No one is entitled to victory, let alone success. In order to feel successful you must be able to admit that you neither did it alone, nor can you truly enjoy it alone. The gratitude felt by the successful is one born of thankfulness for the opportunity you must have been given, and borne aloft by the desire for your success to be one that is felt by not only you, but by others you are thankful to have in your life.

What does being successful mean to you? Rich or poor, famous or anonymous…are you successful?

 

Choices: Eating Healthy OR…

“Eating healthy is too expensive.” How often have you heard some version of that phrase. Whether it be Zone, Paleo, Whole 30, or just “stay out of the middle of the grocery store”, this is uttered with some degree of exasperation and oppression with a kind of mind-numbing, self-fulfilling frequency. There is an overarching sense of deprivation here, a feeling that it’s just impossible to find the money to eat lean protein or fresh fruits and vegetables.

How so? Per the folks at Whole Foods, regularly skewered for being too expensive (seriously, they sell fancy potatoes), on average we in America spend 7% of our disposable personal income–that’s SEVEN–on food. 50 years ago that number was 16%. We now spend less than 1/2 of our after-tax income on food compared with what we spent 50 years ago.

And eating well is too expensive.

If we dig deeper into that stat alone we see that modern food production has decreased the cost of food relative to both income and inflation. The cost of producing food of all kinds has risen much more slowly than income. Why? Partly because junk carb-laden food is cheap. High-fructose corn syrup costs a fraction of grain sugar. Corn-fed protein with or without pharmaceuticals is grown faster and cheaper than grass-fed. Stuff like that. Less expensive to produce/incomes risen over 50 years at a greater rate across the entire spectrum, top to bottom.

How then is it too expensive to eat a more healthy diet. We have 9% of our after-tax income to play with, right? Even I can do that math. Is some other necessity (shelter, transportation, medical care, etc) eating that up? What are we doing with that 9% that we can’t find some of it to eat better? Ah, Grasshopper, now we begin to see. It’s a ‘Nando thing, it’s superficial. It’s not how healthy you are, it’s how you look, or feel, or something like that.

Some stuff might be more expensive; it probably really is more expensive to put a roof over your head in Manhattan nowadays, both the Island and the Beach. The seemingly obvious culprits are actually false targets (eg. healthcare which for this audience represents only a tiny % of new cost compared with 50 years ago because of insurance, govt. programs, etc.). Nope, it’s how we CHOOSE to spend that freed-up 9% .

Think about that household in the 1960′s or even the 70′s. Average of 6 people under that roof. One car. One TV. One radio. Once purchased all data was free. A pair of shoes and a pair of boots. Sneaks if you were a jock. You didn’t get your hair done if you were a guy, you got a haircut. You didn’t get your acrylics touched up every 2 weeks; if you wanted long nails you grew ‘em. Stuff like that.

Fast forward to today and think about the stuff you’ve acquired, stuff you are convinced you can’t live without, stuff that costs money, cash that you choose to spend every single day. The ratio of drivers to cars in a household is seldom less than 1.5/1. The ratio of phones to people over the age of 10 is seldom less than 1/1, often more than 1/1 if you add in a landline upstairs, downstairs, and in every bathroom.  It’s not enough to have a cellphone, or even a cellphone with an unlimited text plan, nope, it’s gotta be a SMARTphone that will let you post your thoughts on today’s weather in Bimini to FB. Right now, from anywhere. If you don’t have Netflix available on each of the 4 flat-screen TV’s in the house you are considered a Luddite.

Listen, I certainly am not saying that all that stuff isn’t great, that it’s not a ton of fun and really convenient (as I type on one of the Apple products that literally litter our household, through my WiFi network, in front of my LightBright lamp, in the bathroom), or anything like that. What I most certainly AM saying, though, is that people who whine about how hard it is to afford to eat better almost always do so via a FB post from their iPhone 5 while sitting in the salon having their hair done, hungover from too much Bellevedere they consumed last night while noshing on Doritos smothered in Cheez-Wiz.

9 %. The stark reality is that we have let our things become more important than ourselves. We are choosing Apples alright, just not the ones we find in the outer aisle of Whole Foods.

 

Why No Real Innovation In EMR?

Apple just released a smaller Tablet, the iPad Mini, and was razzed by the cognoscenti because it broke no new ground. “Reactive.” “The first  time Apple plays defense.” “Nothing to see here, people. We’re walking…we’re walking.” While the Apple Fan Boys (and Girls) were lining up to add to their Apple quivers, the rest of the consumer world reacted with a communal shrug. Why? No real innovation, and that was a surprise in the world of consumer electronics recently dominated by Apple’s serial innovation.

It makes you wonder a bit, doesn’t it, why there’s so little innovation in the world of medicine when it comes to the storage and transfer of information. With all of the cool stuff already available (voice recognition, “pens” that convert script to text, intuitive “next step” software), why do we have such stodgy, clunky software attached to yesterday’s hardware in all of our EMR choices? For heaven’s sake, we don’t even have a universal platform upon which the various and sundry products are built, and so we continue to have interoperability issues more than 10 years after folks started putting this stuff into play. Why is that?

Every computer product I’ve bought and used over the last 10 years has been easier to use than the one it replaced. Each one has allowed me to do more, and usually with a smaller and less expensive gadget. I know it’s a cliche by now, but my phone has more computing power than the first SERVER I bought to run an entire medical business. For $400. I can talk to it, order it to do stuff, and get all kinds of help I never needed faster than I could realize I needed it, and it fits in my pocket. Yet in a medical office state of the art consists of serial drop-downs and mandatory field entries that may or may not include anything germane to my patient. Able to chat with my cell phone through a bluetooth headset, my EMR demands my full, undivided attention, with gaze fixated on screen.

How come?

In the world of consumer electronics the game is all about predicting what the next, big “gotta have it” gadget or service will be. The most exciting and successful products almost invariably carve out new territory and then go on to viral-like growth because they fulfill a need. This kind of technological progress is so powerful that the people who buy this stuff abandon perfectly functional gadgets that do everything one needs or wants in favor of that next, new-better gadget. This phenomenon in turn drives the makers of consumer electronics to create, to innovate. But not in medicine.

Why is this so?

The so-called “market” for EMR is simply non-existent. The power of innovation, either in response to consumers established, stated needs and desires or in anticipation that something new and better will simply take off in the marketplace is non-existent. The kinds of companies that seemingly come out of nowhere were bludgeoned by government mandated requirements that tiny, bootstrap companies just couldn’t fund the effort. Big companies that innovate like a tiny start-up and create whole, new categories, like Apple, simply didn’t. They all just doubled down on old tech and old ideas, an entire industry making iPad mini’s and calling it progress. The perceived danger of innovating and then having a revolutionary product found to lack “meaningful use” stifled the entire industry. Innovation in EMR was DOA.

And now? Now we have the largest medical institutions in the country abandoning their own efforts at software development and marching like lemmings to the Epic sea. The real-world analogy would be the government saying that you could create any type of gadget you could think of to listen to music, but you can only sell record players and vinyl albums on which you must listen to the songs in the exact order in which they appear on the disc to be assured that the check would clear. Oh, and the doc or nurse could only listen through noise-cancelling headphones that would need to be removed in order to talk to a patient.

It doesn’t have to be like this, of course. All it takes is one company with a little vision and some gumption to find a single big-name player with the courage to see that the status quo is sick. Sure, the vast governmental bureaucracy needs to fix a target and then get out of the way so that something that looks like a real consumer electronic product can emerge. That’s all, really. One product that feels like as “0f course” as the iPod, discovered and purchased by one person who folks watch like TechCrunch, a dispassionate and largely uninterested government standing to the side, idle.

A 7″ computer that could power my company 7 years ago hits the market to a collective yawn? Is it really so much to ask for this type of innovation in EMR?

 

Tiny Memories

I had an apple for lunch today. A MacIntosh Apple. Remember them? Remember when “apple” was the SECOND word in a phrase, when it was a “something” apple, not an Apple “something”? All alone at home, save for the pet menagerie, I had a MacIntosh apple for lunch and I was transported back in time, born aloft on the wings of tiny memories.

We always talk about the big things when we talk about memories, don’t we? We just assume that the bigger the event the bigger the memory, and the bigger the memory the more it must resonate. Beth and I just celebrated our 25th wedding anniversary, and this of course prompted us to reminisce about our wedding day. We had an absolutely spectacular wedding, one that our friends and family still talk about, still compare with other weddings. It’s funny, though, when I look back on that magnificent day all of the really big things that you’d think I would remember are really kind of running “fast forward” and filmed through a slightly out of focus lens. I remember them, I really do, the bigness is just kind of… big! What I DO remember though is every tiny detail about my first date with Beth. I burned the scallops! And yet many’s the night when I sit down to dine with my “netty empster” partner, just the two of us, and a tiny memory of that first date alights.

Tiny memories are different like that. Take that Apple I had for lunch. A McIntosh apple, the kind of apple that pretty much everyone I know thinks of when they think of an apple from childhood. I just started buying them again; I have no idea why. I don’t think I’ve bought any real Macintosh apples for some 15 years or so. Do you remember the apples of your childhood? I sure do. My mom wasn’t really a great cook, if you define greatness by complexity or the use of fresh ingredients plucked from some farm stand or specialty shop somewhere. My Mom was an expert at foods that created tiny memories, though.

We only ever had MacIntosh apples in the house. All by themselves they were something better than good. Every now and then there would be something a little bit special. Maybe Mom put the salt shaker out and we remembered to shake a little bit of Morton’s goodness on our Apple. Perhaps she whipped up a little bit of cinnamon sugar to sprinkle on the apples. This was usually REALLY special because cinnamon sugar apples were almost always sliced in a bowl! When she made apple crisp… even without ice cream apple crisp was an event.

I find that tiny memories can be triggered by equally tiny things, and those tiny memories always seemed to transport me back in time to to a warm and happy place. It’s not always a trip to childhood, although the first stop on the trip may indeed a be a place I knew as a child. It’s not that these places or that these memories evoke a better time or anything like that. I’m truly convinced that the best day of my life so far was today. No, it’s something else, something a little less and something a little more. The best of the tiny memories seem to be crystal clear in their details, kinda viewed in HD.  Tiny portraits or little scenes whose details are surrounded and framed by happiness. Perhaps even by love.

Do you have these? These tiny memories that flit and fly across your consciousness like so many tiny sprites, floating aloft on wings so delicate they can’t be seen? No matter how hard your life might have been, I’ve yet to meet anyone who doesn’t have at least of few of these tiny memories. I can’t land at O’Hare or Midway without at least a little smile. Going to Chicago! That’s what I chanted when I traveled through the kitchen in the turkey basting pot. Who knows why Chicago. Every successful landing in Chicago comes with one of my tiny memories.

I wonder, as I get older, what will become of my tiny memories. Will they be the ones that will remain? Will they be the ones I’ll hang onto, call upon, resurrect as I plow on? I sure hope so. I sure hope that the first barefoot step on a beach, new or old, will still make me hear the screen door slam at the beach house in Manasquan. I hope I have to climb over someone on my way to the “way back” of some great big SUV, so that I can remember the epic climb over my brother and sisters to the back of that Chevy wagon my Mom drove. I hope I’m standing on the tee at some golf course watching some guy wiggle and waggle and generally make a fool of himself as he gyrates through his pre–shot routine, and I hope a tiny memory of my Dad barking at me or my brother floats in for a landing. “Quit farting around!”

Dad said FART!

Yup, I was home today for lunch, just me, the dogs, and Thug, the world’s biggest rabbit. I had a MacIntosh apple for lunch. Not sure which was sweeter, that wonderful, nearly perfect apple, or that tiny memory of a time long ago, the details in HD, so vivid. The details–the memories–surrounded by love.

I smiled. Someone had left the salt out.