Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Posts Tagged ‘bingo’

Tone Across the Service Line

Ever listen to how people address folks on the providing side of the customer service continuum? Do you ever stop to listen to yourself, or think about how you will sound before you speak? Fascinating. In North America we are moving ever more swiftly to an economy that is majority a service economy; we don’t really make stuff so much anymore, we help people use stuff someone else made, or provide assistance based on a knowledge base or skill set. Listening to people on the receive side of the equation is fascinating.

We have been forced to change our EMR at SkyVision. Our office is running behind schedule because of this. My ears are on high alert for how our patients are reacting. I’m prompted to this line of thought by three interactions in the office that happened while I was loitering at the reception desk. Three individuals not so much requesting a service but demanding it, doing so with a tone that implies not only a deep sense of entitlement but also a deeper lack of regard for the individual who will provide that service. Both in tone and content the to-be-served make it clear to the service provider that he or she is there to serve only them. In fact, the servers only reason to exist is to serve, as if the to-be-served were some kind of different, superior version of the species. It’s loathsome, actually.

I spend every waking moment of each working day on the “serve” side of the equation, whether I am a SkyVision plying my profession or CFB coaching. Having achieved some measure of expertise in both it’s very rare that I am on the receiving end of this type of behavior, but it does happen. More often is the case that it is someone lower on the org chart who gets this. The receptionist, phone operator, or check-out person who gets this “lower life-form” treatment, not the doctor or business owner.

Life can be hard for these front line people in a service business. There’s not only a “customer is always right” mentality on the other side of the interaction but also a sense that being a customer who will get what they want is as much as human right as Life or Liberty. That’s what it sounds like, anyway, if you are off to the side listening. No matter how frustrated one might become from a service situation gone wrong it’s important to remember that there is no continuum in the relationship when it comes to the inalienable rights, nor is there any evolutionary hierarchy across that desk or over that phone line.

Danny Meyer, the great NYC restauranteur, is probably closest to correct when he says “the customer is not right all of the time, but mostly right most of the time. A customer [only] has the right to be heard.” How you express yourself when you are on the “receive” side of the customer service experience is not only an important measurement of how you value the person across from you providing the service, but frankly is probably also a predictor for how likely you are to be successful in being heard. It’s instructive that none of the three SkyVision clients who made difficult (bordering on unreasonable) requests in an unpleasant manner were accommodated because doing so would have required an extraordinary effort which may not have been successful in any event.

Sorry, no pithy statement to wrap it up this week. In the end we all want what we want, and we all need to be heard. It helps to look at the person on the other end of the service divide as if you were looking in a mirror. Would you say that, like that, to the person in the reflection?

Someone Is Keeping Your Receipts

Once upon a time records were kept prospectively in order to support some sort of existence. Transactions of some sort or another would be the most common example. Of course, if one wished to avoid or deny the existence of some sort of transaction, or indeed to deny the existence of some event, one simply had to avoid the creation of a “paper trail” which documented some part of that event. Receipts involved commerce, and if you spent just the tiniest bit of time thinking about it you could limit the number of receipts that were out there.

Now? Not so much. A “receipt” is now any type of irrefutable documentation of some event. Sure, that credit card receipt puts you in that Uber at 0200 in SoHo, but so does the Tweet that mentioned you in passing. Or the pic your companion SnapChatted and was saved as a screenshot. The ultimate, all-time greatest receipt was a certain dress that never made it to the dry cleaners, but nowadays scandals as great or orders of magnitude tinier are rendered factual by the seemingly banal.

Thinking back it’s funny, how I got to be “bingo” here and elsewhere. In those early days of online communication one gave reasonable thought as to whether it was prudent to use your own name online. Heck, my prenup consists of a single line: “Darrell will not run for elected office” so that the family would be spared the scrutiny of an election. To be anonymous in today’s world it takes either herculean effort (try to find something about the family that owns Perdue Pharma, for example), or a complete indifference to that which seems to drive western societies (think bridge troll). What was once the “paper trail” became the “digital footprint” and is now a ubiquitous “universal map” of your life. Does it even matter? One wonders in this day of Alexa and Siri and paying for the privilege of placing the equivalent of Big Brother v1.0 in your own home.

I have endeavored, here and elsewhere, to make kindness the currency of my transactions. Indeed, CrossFit.com (and my blog) have been little “behavioral gyms”, if you will, where I have practiced making kindness the irreducible movement in my interactions. The on-line world in its earlier days was kind of a mulligan for folks of my generation. Not a day goes by that one or another of us sighs in relief that cellphone cameras and social media had yet to be invented when we were young. Now? Now it’s a running tab, a veritable windfall for the social accountants who tally up the score. They are everywhere, and it matters not how many degrees of separation they are from you and Kevin Bacon.

Someone always keeps the receipts.

 

Pygmalion

In the big city, in a big meeting, both teeming with swarms of humanity, in the same location but not necessarily in the same space…

‘Twas a time not so very long ago when phrases such as “proper” and “polite company” had very specific and essentially universally understood definitions. Forming a foundation for this proper behavior were equally well-understood, nearly universal concepts like “private” and “reserved”.

Neither “proper” nor “polite company” was confined to a specific economic stratum or other social circumstance, although both had a certain aspirational aspect. Whether “low born” or “high born”, one was taught the meaning of each. Both were considered essential elements for a functioning society. One needn’t have a mentor or sponsor to behave in a proper manner so that one could travel in polite company, one only needed to have a grandmother.

The concepts of “proper”, “polite company”, “private” and “reserved” have no less a place in a society dominated by social media and cell phones than they once did in one of salons and stationary. I could certainly provide you with examples and definitions, but that seems to smack too much of what it is I protest. You should know this, no matter how old you are, without either me or Buzzfeed offering you a link to the Top 10 Lessons from “My Fair Lady”.

If you need a refresher course remember this: it’s not proper to text or to PM your elders on Facebook or Twitter to talk about it.

Sunday Protests

One of my all-time, never fails thrills is a pre-game flyover. I get serious chills and a full coat of goosebumps every single time. Doesn’t matter what event follows, or why I’m watching. Unexpected, surprise fly-overs are an even more special treat, that “oh, you’re kidding…I get to see this even AND I get a fly-over?” It’s like getting dessert first at a Michelin starred restaurant. Never having served in any of the branches of our military I have no special call to feel this way. Yet goosebumps arrive on cue whenever a particularly moving rendition of our National Anthem is played, or if I hear Kate Smith or Ray Charles singing one of our other patriotic anthems.

It should come as no surprise, then, that I am quite completely conflicted about the recent protesting of professional athletes done during these tiny interludes of observing our shared nation. I do get, as should all thinking individuals, that the protests themselves are not directed at either the anthem or the flag, and certainly not toward the men and women who have served in the defense of the historical values that these symbols represent. I truly love these tiny moments of patriotic sentimentality. They are, for me, similar to saying “Grace” before our evening meal: a tiny vestige of a once much larger experience.

Sporting events of all kinds used to be a much bigger presence in my life than they are today. Whether playing or watching, it was weird to not have some sort of game front and center. Once I hung up my various sporting implements, and even when I moved away both literally and figuratively from the teams of my youth, I could usually find some sort of sporting event to have on as background noise on a given day. The fact that I watch fewer games, and almost no football, at a time of unprecedented activism on the field is therefore purely coincidental.

Still, I do think about sports, and major sporting events are still a rallying point (or at least a conversation starter) in most walks of my life. To say that this next statement has me conflicted doesn’t really measure up to the truth: the on the field activism of athletes makes me avoid the discussion of sports entirely. It’s not that I feel the athletes have no place expressing their opinions, nor that I necessarily disagree with the opinions they are expressing. The heartfelt conviction that a particular group has been singled out for mistreatment is a righteous cause to which very public individuals could lend their support. By choosing the venue of a sporting event they have removed my ability to choose whether or when I will engage the topic.

By choosing to do it in the manner that they have chosen prevents me from experiencing a tiny thrill that used to at least feel like it was free.

So what? Isn’t that the point of protest, to make the safe and the secure a little bit uncomfortable? Sure, I get that. I really do. It makes little difference to those protesting to learn that people like me really do set aside time to consider the merits of their grievance; creating discomfort is part of the point. Having twice scrubbed my own workplace of all political activity, making it clear that our team is to avoid the creation of similar discomfort in our clients, I sort of feel like my patronage is being abused I guess. Kind of like that old joke “I went to a fight and a hockey game broke out”, except it’s a political expression upending my expectation. Certain jobs just don’t mesh with political action in the workplace. Who wants to see their local police officers in uniform and protesting anything at all? Can you imagine listening to your surgeon expound on some controversial topic just as you slip under anesthesia?

You could very well read this and say that my bleating is nothing but one more example of “White privilege” (funny, given my name), the smug mutterings of someone safe and secure and as close to immune from the dangers being discussed. I would understand your position. I would disagree, but I would understand, and more than that I would inherently realize that no amount of discussion on our mutual parts would change your mind. All good. I’m uncomfortable, and a little bit unhappy, and maybe that was always the point.

The risk is that my discomfort may make me stop listening. That’s probably not what the protesters are aiming for.

Contentment, Complacency, and My Fitness Tracker

Where does being content end and being complacent begin? As an older athlete this question is just dogging me. The parallel question might be where is the line between being content and capitulating? These are both, of course, extensions of some of my recent thoughts on balancing the effects of relatively high intensity workouts with the countervailing effects on recovery, plus or minus injury.

There might be a more scientific answer to these, at least in so far as fitness is concerned, and it would come from of all places the fitness tracker world. As it turns out my latest tracker(s) have the ability to measure the beat-to-beat variation in heart rate (HRV). This measurement is a proxy for autonomic nervous system activity. A lower HRV means autonomic stress. If correlated with the previous day’s workout that would argue for either a lower intensity session or rest.

Is HRV ready for prime time? Well, world class endurance athletes and many professional athletes in other sports certainly think so. How about for us, the regular folks hoping to improve our fitness and along with that our health? Dunno. I’m impressed and frankly a little depressed to find that my HRV responded so classically to what was for me an intense WOD yesterday. For this to work one must have the discipline to dial it back if your HRV is low on a particular day (be content with your work), but also the discipline to ramp it up when your HRV is high (fight complacency and go to work).

In a busy life it is likely the second part that will prove the more difficult.

Of Tradewinds and Science

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die.” –Max Planck

So very much of what we encounter as we seek any kind of guiding truth is not science at all, but strongly held opinion forcefully presented. Think about it for a moment. Think about a few of the really big issues orbiting the intellectuosphere. Climate change. Health. Fitness. The search for the cure for cancer. Heck, the decision on what to have for lunch. So many opinions…so much money…so little true science.

Even more than that, scientific truth is continually bludgeoned by the one-two punch of politics and commerce. True science has always been held hostage by those who have vested interests in what constitutes the prevailing truth at any given time. How many promising avenues of inquiry have been blocked, and how much time has been lost because of the failure to pursue additional lines of inquiry that ran counter to “consensus”? One need only think of inflammation in vascular disease or alternatives to “fat in the diet is unhealthy”, both squelched along with the careers and reputations of their proponents while the single consensus theory was pursued. Why? Alternate theories or parallel theories would siphon the spoils from those who fed at the consensus trough.

It’s quite tempting to hold that this is all relatively new, that it is a function of our highly developed Western societies. Tempting, but ultimately false. Has there ever been a time in recorded history when a new scientific truth has upended orthodoxy and there has NOT been an attempt by the entrenched to not only stop an new line of inquiry but also destroy those inquiring? Think Galileo. From where I sit it seems as if a substantial majority of truly disruptive new scientific truth has arisen from the ranks of those who stood aside the prevailing winds and charted their own course.

What does this mean for each of us as we sit in our own little boats and sail along? The trade winds of consensus are strong, and it seems the weaker the science behind them the stronger they blow. It’s fine to allow these to fill your sails, of course, for the majority of them do in fact propel us along a true course. The best course, however, may lie in the breezes that cross the trade winds. Those tiny little gusts that represent the true essence of real science–skepticism accompanied by inquiry, followed by proof–will ultimately propel us to the proper destination despite the power of the commerce attached to the trade winds.

Every now and again the Newport to Bermuda race is won by a rebel who went off alone and discovered a new truth about sailing. We should be open to the possibility of a new scientific truth in all parts of our lives, lest we find ourselves far behind, capsized in its wake.

Or worse yet gone, as Planck suggests, long before we ever had a chance to benefit.

Evaluating Risk in the Mature Athlete

“Achieving a risk level of 0.00000% is costlier than 0.0%.” –Saurabh Jha (on Twitter)

Think about that for a minute. It was written in the context of medicine and medical care, but we should think about risk in the context of our CrossFit or fitness practice, too. Beth and I had a really nice conversation with my sister-in-law Amy (of Champlain Valley CrossFit, home of Games champion Matt Fraser) about CrossFit for the masses. The specific topic was how many CrossFit WODs should regular folks, especially–ahem–more mature regular folks be doing each week and what sort. In a way it was a discussion about managing risk.

As I’ve gotten older my ability to challenge my body without incurring minor injuries has declined. At the same time, my ability to recover from those injuries has declined apace. A far more mundane, but equally actionable observation is that I do not recover from the intensity of the WOD as quickly as I did 5 or 8 or 10 years ago. In other words, there is some risk in continuing to do CrossFit in the same way that I did in years past.

There is a flip side to this, of course. Prior to embarking on my Crossfit odyssey I would be incapacitated with back pain 2 or 3 times each year. Since January 2006 that has occurred precisely once, and that was because I deviated from standard-issue CrossFit to join a friend in his Oly workout while visiting. I am struggling to create a regular workout schedule since CrossFit Bingo/Comet CrossFit closed. Without question I am not as healthy as I was at this time last year.

Each of us is a study group of one, each with a personal risk/benefit ratio that can only be discovered by at the very least coming right up to the edge of “too much”. The more experience you have the more confidence you probably have in your own ability to determine where that is. Others can, and should, put the responsibility for charting that course in the hands of their CrossFit or other trainer. Once identified, though, it makes little sense to flirt with the flame of “too much” when there is so much to be gained from “enough”.

For me what that means is continuing to pursue at least the maintenance of my functional strength by continuing to follow the latest version of CFSB from The Brand X Method(R). I find that 2 high intensity WODs, 3 at the most, is what I can handle each week. As much as I hate to admit it, long brisk walks are becoming a staple of my fitness and health plan. I should probably ask Abbie the Wonder Dog to join me on those.

Nothing is completely safe; seeking yet another zero after zero after the decimal point before starting treatment means never starting. Once effective dosing is established, in medicine or in CrossFit, one must judiciously minimize risk, but not to the extent that the benefit cannot be achieved.

Better Understanding Conflict of Interest By Studying Bias

So much strum und drang in the air. So many panties in a bunch. The offensitive are on the warpath about, well, everything. We seem to have a surfeit of ethicists among us, proclaiming in nearly real time where anything and everything fits on some mythical ethics grid. To them I offer my own filter, the question I ask before I expend an iota of energy of any kind on the type of “news” that has them all so agitated:

Is what I am viewing unethical, or simply unseemly?

Ethics is a synonym for morals. As such it should be universal and timeless. Ethics should bear nothing in common with fashion.

Speaking of which, it is fashionable in pretty much any field in which expertise can be obtained and the label “expert” attained to lay waste to those so acclaimed by accusing them of having a “conflict of interest”. Traditionally this meant that one might enjoy some sort of tangible gain by trafficking in one’s area of expertise, thereby rendering the expert’s stated opinions somehow tainted. Of late it means that being employed by someone with whom your critic has a beef means your standing to hold an opinion at all is nullified.

Nonsense.

We would be a wiser society if we instead made an effort to sort through the biases held by experts in any field. To demand that one not express any opinion that would support your employ should disqualify the individual who holds such a position, not the expert. To look at the bias that may be present in any expert opinion allows the audience to better evaluate both the veracity of the opinion, as well as its relevance to their own situation. For example, in my day job I have a strong bias to treat any condition that produces meaningful symptoms in my patients.

In truth, in many of the general categories that I cover my remuneration is identical whether or not I treat. Those who bleat on about conflict of interest would seek to nullify all of my thoughts simply because I make my living in the arena on which I opine. Again, this is silly. It is far more useful to read my professional writing through the prism of my pro-treatment bias. In so doing it is far easier to compare and contrast my public opinions with others in my space who may differ. Do they differ on substance, or do they differ because or a countervailing bias?

This is not to say that conflicts of interest do not exist, or that if they do exist that they are never a problem. If you have invented a medical device and choose to use your own device rather than a competitor’s you have a COI. Disclosure of your COI should be mandatory (I disclose all consulting contracts around prescription drugs, for example). If they are of equal quality (equal safety, equivalent outcomes), the COI is mooted. If your device is much more expensive (thereby generating much more income to you), your conflict of interest is unseemly but not necessarily unethical. It should be obvious on its face that using your invention if it is less effective (or Heaven forbid, unsafe) is unethical.

Expertise exists everywhere. Here, on CrossFit.com in the fitness world. Would you disqualify Greg Glassman because CrossFit has been a successful business? How about Jeff and Mikki Martin who have launched a business in the same space? Is their competition a conflict that nullifies their contributions to youth fitness? Among the bureaucrats at the EPA in the care of the environment. Do they not have a contribution to make despite their tax-supported position? Is their (presumed) anti-business bias a reason to dismiss all federal policy? Among the various and sundry talking heads on all of the financial offerings on cable news channels. Don’t you really want them to be rich and successful, especially if you are going to follow their advice?

If we seek to understand the biases that exist underneath the opinions of experts we can better evaluate the conflicts of interest that they inevitably carry along with those opinions. From there is is an easier task to evaluate the character of those conflicts, and better decide whether or not we accept their guidance.

Getting paid to be an expert and to share your expertise is only a meaningful conflict of interest if it is unseemly or unethical, not just unfashionable.

 

Essential Tech? Really?

The author of an article in last week’s Sunday Times asserted that Google and Facebook are “essential tools.” Jonathan Taplin states that everyone has “no choice but to use them.”

Facebook as an essential tool. He really said that, presumably with a straight face and no irony intended.

The reality of the developed world is that search is indeed essential at some point in most lives. Google owns 90% of search traffic, but there are at least 3 other search engines that are adequate at worst, and likely comparable in terms of information acquisition (if not ad awareness) with Google. Facebook, on the other hand, is little more than a toy in the hands of its users, and likely a dangerous one at that. The nameless, faceless scientists behind the curtain in Oz…er, Facebook…want to get you there, keep you there, and control what you do there. Facebook (and its kissing cousin Instagram) is purposely addictive, and face it, the super-majority of what you may do there is far, far from essential.

It’s very helpful to be able to call up information at the touch of the finger (a sales guy answered a complex, archaic golf question for me yesterday in about 27 seconds). Quite frankly I’m at a loss to think of a single essential aspect of FB in daily life.

My dentist still puts out magazines to help me kill time in the office.

 

We Will All Become Orphans

Sadly, I have had numerous opportunities over the last year or so to note that there is not a single language on earth that has a word or name for a parent who has lost a child. Words exist to describe a surviving spouse, and of course we have a word in most languages for a child without parents: orphan. The word conjures up Dickensonian images of waifs and wastrels in varying degrees of distress and underdress, under-fed and unloved. In reality, despite the ubiquity of this stereotype, there are many, many ways that one becomes an orphan. Indeed, in a proper order of events, each of us will be orphaned by the loss of a second parent.

It is somewhat amazing to me how many people have lost a parent early in life through abandonment. A mother or a father simply ups and leaves. No forwarding address or email, just gone forever. It hurts just to type those words. What must it feel like to live them? Still others lose a parent for years on end before that parent actually dies. Mental illnesses of all sorts, most commonly the various types of dementia, essentially wipe a loved one’s personhood off the planet long before the empty shell passes on. It’s a rather cruel joke, that, to see what looks like your Mom or Dad sitting across from you like some kind of reasonable facsimile, an avatar perhaps, but not really Mom or Dad. Mourning begins years or decades before anyone sits Shiva.

In the end, though, orphanhood comes for us all, in one way or another. My friend Bill, the surgeon, expresses surprise and a sense of something that is a bit more than frustration, though slightly less than anger, at what he calls the “final reckoning” deathbed visit. Why, he so often wonders, do so many people, so many sons and daughters feel the need to achieve some sort of closure, some sort of final peace in the last waning hours of a life? Mind you, this is a man who practices “live and death” medicine; his point, forged so close to the fire, ought not be missed.

Mothers and fathers are no more or less flawed than any other humans. For most of us their flaws lie cloaked behind the curtains of devotion in our childhood. As we ourselves age, certainly if we become parents, those curtains part and we begin to see more of the whole person who makes up Mom or Dad. Blessed are we who find more to like and love behind those curtains. One hopes at worst that what we find does not dim the glow of childhood memory. Bill’s point, or at least what I think he is saying, is that we should know that orphanhood is inevitable. There is nothing that you can say or do on death’s doorstep that cannot be said or done long before you approach the threshold of your own orphan status. Bill would say that closure is important, that he understands and supports the compulsion to make sure that your parents know that you love them. It’s just the timing he’s wondering about.

Why wait until the cusp of orphanhood? Why not discharge regrets and express your love and gratitude when you and Mom and Dad can might have time to enjoy what comes next? Together.