Sunday, November 29, 2009

The Family Telescope: Orion Dobsonian or Edmund Scientific Astroscan … or Orion StarBlast?

I'm looking for advice - so please comment!

I would like to get a telescope for family astronomy (really, my 7yo daughter and I). Happily, unlike my high school days, I don't have to grind a mirror. We'll have to travel outside the city to see much, so ease of transport and setup is important.

I've more or less narrowed things down to two quite different devices:
Both devices have excellent reviews. The Astroscan is more rugged, requires no assembly, is very easy to transport, and provides great star field views. The Orion Dobsonian is better for planetary viewing.

Any thoughts?
Update 12/3/09: I ended up choosing none of the above, and went for a well regarded scope that’s a bit of both – the Orion StarBlast 4.5 and a separate 2x Barlow lens. I waffled about getting the same StarBlast with an equatorial mount, but ended up with the original mount because Amazon and Orion offered free shipping on the simpler scope, the equatorial is pretty finicky to assemble, setup, and transport (we live in the city, so viewing requires travel), storage space is an issue in our home, and the primary user is my daughter who’s still 7 yo size. I’ll post later about how I feel about that decision after we’ve used the scope a bit.
There’s also a StarBlast 6 now, though it’s not sold by Amazon. I felt that might be stretching the limits of the basic design, but clearly I’m no expert.
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Bad web sites, genetic fitness, and choosing a service provider

The way I found the current swim schedule at a community recreation, fitness and cultural center was to find the link to the future schedule, guess what the current link would be, and hand edit the URL. This isn't a new problem; their web site has been awful for at least five years.

I've written about why automotive sites are so bad, despite their vast economic value. None of those reasons apply in this case. So why has this facility had such an awful web site for so many years? On the face of it they have a very simple task; they need to put up pages with contact information, maps, PDF schedules, etc. Why does it go so wrong?

I'll get to that, but first I'll inflict some wisdom of the aged. Feedback won't help. When something is this bad even kindly suggestions won't help. They'll only cause hurt feelings. The problem must have deep roots.

My guess is that this rec center has fallen prey to one of the institutional weaknesses of the well meaning non-profit. Maybe it's become the job of someone who likes it but is unsuited for the task. Perhaps this person can't or won't be moved. Maybe it's become the job nobody wants to do. Perhaps its a form of passive-aggressive self-mutilation.

Good leaders figure ways out of these traps, so the persistence of this organization's problems suggests deeper leadership issues. We can think of an organization's web site as the equivalent of a biological organism's "fitness displays" -- such as big muscles or symmetric features. Web site weaknesses are a good measure of deeper institutional flaws.

Which brings me back to our automobile purchase, which has been stalled for the past month (the 2010 Subaru models do not impress). I'll look for the best automotive web site to guide our next cycle of car purchasing. Likewise if we were looking for a new swim facility, I'd look for a well organized web site.

A modern web site has a lot of meanings. It's hard for a dysfunctional organization to create and maintain a quality web experience. It's not a matter of money, it's a matter of the sorts of things that have to come together and stay together, and the many mistakes that have to be avoided. Web sites can be an important fitness marker for institutions; the good ones are both smart and pretty.
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Saturday, November 28, 2009

Fermi Paradox review article - 2005

A comment on a past post of mine referred me to a 2005 article: SETI and the Cosmic Quarantine Hypothesis.

The essay is a good summary of the Drake Equation and its relationship to the Fermi Paradox. The author is clearly an optimist, he imagines a benign super-civilization blocking aggressive expansionism. That was the theme of a famous 1970s-era science fiction series, except the interventions were not benign.

It's a pleasant thought, but it seems unnecessarily complex. A simpler explanation is that all technological civilizations run into singularities long before they can attempt serious star flight. Whatever happens thereafter, it doesn't involve any wandering we could see. (Charlie Stross included a clever variant in a book - he speculated the post-singular civilization couldn't abide the poor connectivity of wilderness living.)

Mr. Soter misses the singularity effect in his estimation of the lifespan of civilizations. He's right that mere eco-catastrophe would not eliminate humanity, but technological singularities are (imagined to be) a different sort of extinction/transformation event.

I did learn one new thing. The novelist Michael Crichton, in addition to despising concerns about global warming, also hated the Drake equation. He was a kind of anti-Gordon, but a bit richer and better known than I.
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Discovering medical prices and the problem with paying cash

Walecia Conrad has written a pretty good summary of the problems of price discovery in medical care services. She mentions several approaches, including online services, calling physician offices, and checking payor (insurance) sites.

None, of course, are satisfactory. I hope she'll dig a bit deeper into price discovery. There are two places she could learn from. One is the problem with discovering how much a medication costs in different forms through different vendors with different coverage plans. Good luck on that one.

The other topic is more amenable to digging. She almost got into it, but perhaps had to set it aside for another day. Ms. Conrad mentions that cash fees for medical services are usually much higher than the negotiated fees insurance companies provide (this is very relevant to health care reform of course).

What she missed is why.

My own recollection, for I no longer deal with this issues, is that payor (insurance) reimbursement is based on a fraction "list price". So imagine that Blue Scythe pays 50% of list price. If costs+margin means a services costs $50 physician must then set "list price" to $100 so they get $50 from Blue Scythe. The "list price" must be validated as a customary charge, so it must show up on bills -- including bills for people who pay cash.

This means people paying cash are providing a huge margin, but this is an unwanted embarrassment for most practices. In my day we wanted to charge people paying cash less, not more.

I think there may be ways around this now. My knowledge is at least fifteen years old! Still, this an area that deserves some journalistic effort.

Friday, November 27, 2009

Lagrangian finance and age of wonders

I had a relatively decent physics education for a non-major, but I'm pretty sure it didn't include discussions of the Lagrangian and its use in Newtonian mechanics. So I loved this brilliant exposition of the use of the Lagrangian.

Subtracting potential from kinetic energy? It feels like a measure of how much of a budget is unspent, how much is left to drive deviations from a trajectory...

That feels like finance. There ought to be applications of the Lagrangian to the world of financial modeling.

Once upon a time, that's where the thought would have ended. An idle speculation. Today, though, the answer is a few keystrokes away:

73,800 hits. Yeah, looks like there's an application or two.

We don't truly grok the web. Not yet.

Wednesday, November 25, 2009

Left Behind: Ludd, Beck and the non-tribal roots of tea party rage

It's easy to mock the Palinistas, the Beckians, and the very vanilla Tea Partiers.

Easy, but wrong. They have good reason to be afraid. Their future looks grim. They are also, I think, the misleading face of something bigger.

Misleading, because the melanin-deficiencies of the Beckians makes it too easy to think of their roots purely in terms of the white underclass. I think there's something bigger, more interesting, and more important going on than the historic passing of one particular tribe.

The world is becoming increasingly complex and, for many people, inaccessible. How smart do you have to be to learn and absorb the multiple manifestations and implications of modern mortgage contracts, American health care benefits, mobile phone plans and scams, mortgage derivatives and exotic financial instruments, iPhone synchronization, Facebook and Twitter privacy policies, dysfunctional security procedures, OpenID, Oauth and 200 passwords, modern India, China, tribal Pakistan, your flaky modem, and, for most non-Mac owning Americans, virus infested XP boxes with unpredictable behaviors?

A lot smarter than me.

Most of humanity is being Left Behind by an increasingly incomprehensible world of increasing complexity. We can function in it, we can even prosper in it, but our world is beginning to resemble the world of pre-industrial man. That is, a world of powerful and mysterious forces that may, without obvious reason, aid or smite a mere mortal.

I suspect, in their marrow, the Beckians, like the Luddites before them, feel this. It adds to their fear and anger. This will be something to watch.

See also:

My Saint Paul Minnesota speeding ticket – emergent solutions to emergent consequences

A few weeks back I got my first ticket in over 12 years, for speeding on a notoriously deceptive stretch of highway 35E (it even has a Wikipedia reference under speed limits). For a week or two around the time I was dinged that stretch of road showed caught cars every time I passed.

There were, of course, lots of mitigating factors, but the biggest one was that I’m really dependent on cruise control and mine broke about a month ago. Probably from overuse.

Once upon a time, if you had an average income, a speeding ticket was an painful annoyance. Then it began to dramatically increase insurance costs. Later, as the world became more risk-adjusted and networked, speeding ticket questions began to show up on applications for life insurance, foster care, and I suspect, many more forms.

So the secondary costs of a modern speeding ticket are much higher than the list price. I decided to poke around rather than pay immediately.

Google and the rest were not helpful. This search topic turns up mostly misinformation (it will be interesting to see if this post helps!). The searches did bring up ads for various legal services, and my first instinct was to pay for some professional advice. The more I looked, however, the less savory that industry seemed. In the end I decided to “contest” the ticket. This is the story of what I saw of the system, and how an “emergent” solution was developed to the secondary costs of speeding tickets.

There’s a common myth that when you contest a ticket you appear before a judge along with the accusing officer. At this time you can supposedly argue about radar technologies and so on, but if the officer doesn’t show up your citation will be waived. That’s not how it works in Saint Paul.

You phone a number (no web) on the ticket and you’re given a hearing date with an administrative official. You can change the date; I had to due to a travel conflict. If you run late there’s an extra $5 late fee. (I think you can “appeal” this decision and end up in a real courtroom, but I didn’t go that far.)

The hearings take place on 15 West Kellogg, in the city court house. It’s an imposing structure with a vast ceiling and black marble columns bearing the names of dead warriors. It reminded me of a scene from the movie Brazil.

I joined about ten others sitting in a mildly gloomy room. There’s a display showing names and appointments, on which my name did not appear. Turns out that’s for the court, not for traffic citation. Most everyone else there seemed to know what to do; at around 8am a set of metal windows crash upwards and you cue up for a hearing slot.

Despite being last in line I was called in at my appointed time. I’d rehearsed my responses, but this was the complete discussion: “The speeding was an accident, I have a good record …” “You mean you were accidentally speeding?” “Yes". “Give me your license”.

The system, it turns out, has developed a solution to the problem of the increasingly heavy consequences of a speeding ticket. The solution was that I agreed to pay $188 (I don’t know how the total was calculated, it might be more than the ticket price) and the citation, for the moment, no longer exists. If I get another ticket in the next year it will restored and I will have to pay both. So local government gets at least the money the ticket would have generated, and if I make another mistake they get double the money. On the other hand, I don’t bear the secondary consequences of a modern citation.

An emergent solution to a modern dilemma. Fascinating.

Plus ca change – Non. Twenty years of a solstice letter.

I’ve been writing a “solstice letter” for over 20 years.

During that interval a few things have changed. The first letter would have been written with WordPerfect 3 on a Panasonic* 8086 with a 20MB hard drive. Today my local storage total is roughly 2TB, or about 100,000 times larger. I had email then; I used Norton Commander’s superb MCIMail client with MCI’s pre-internet modem-based mail service. Today I use Gmail.

Oh, and now we have the web.

I’m more interested, however, in what’s not changed. After many years of experimentation I’m back to authoring in a word Processor (Word:Mac) and distributing as a PDF from one of my personal servers. I’d love to have a great web based authoring solution, but there isn’t one. I’d love to have a universal open file format, but there isn’t one.

In this area, progress is only measurable by microscope.

* The most over-engineered device I’ve every purchased. You could park a car on it. Panasonic was threatening to wipe out Compaq in those days, until Congress intervened to block Japanese computer exports. That “saved” US computer manufacturing until Taiwan took it away, and forced Japanese manufacturers to focus on laptops. Adjusting grossly for inflation, it was cheaper than a comparably “higher end” machine would be today. But I digress …

Sunday, November 22, 2009

The shocking truth - the birthers are almost right ...

The birther crackpots are still stumbling about. They'll never figure out the real story -- though it's been staring them in the face all along.

Of course Obama wasn't born in America, but he wasn't born in Kenya either. You see, he wasn't born at all ...

It does explain a lot.

529 plans can be rebalanced twice in 2009

I was surprised to see this when I visited our kids 529 plans to make a contribution. I assume this extra rebalancing is to compensate for funds damaged by the crash of 2010 ...
The Treasury Department and the IRS recently announced that for 2009 only, 529 plan account owners will be allowed to change Investment Options two times per year. This means that you can reallocate your investment to different investment options in your plan up to two times this year...
I've never done any rebalancing. I didn't realize that we are normally allowed to do that once a year. Something else to learn about!
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Lipid guidelines: Sometimes the emperor really is starkers

A year ago I had to review guidelines for managing elevated blood lipids. I concluded that the guidelines were incoherent and silly. It wasn't a problem of science, it was a problem of logic.

Today, reading a JAMA editorial by Gaziano and Gaziano (brothers), I see that medicine has caught up with me. The risk calculator approach makes sense, though the models may have problems.

It's a cautionary tale of the limitations of expert panels. I suspect a lot of practicing physicians thought the guidelines were dumb, but they weren't making policy.

Hey, someone has to give me credit!

PS. There are now serious proposals to put every male over 50 or so on a statin. That's because they're so safe and cheap. The last time we did something like this it was women and estrogen. It took 10 years to learn that was a very bad idea.

Saturday, November 21, 2009

Sparta and the disturbing flexibility of human culture

I remember a cartoon of Spartan life that I learned as a child. I don't recall thinking about it much further until this week's IOT programme on Sparta.

Spartan culture is as alien to modern American life as the sacrificial cultures of the Aztecs, but it endured for hundreds of years. Men did not live with women. Children were removed from their mothers at age 7 and raised in a harsh military environment including routine sexual abuse. Contrary to some stories, it appears they did not routinely visit their mothers after that time.

The Spartans practiced active eugenics, exposing unwanted children (though some were apparently rescued by others). They enslaved, oppressed, tortured and murdered their "Helot" kin for centuries. Spartan women, paradoxically, may have had more freedom and a better life then Spartan men. Birth rates were low -- perhaps the earliest evidence that educating women leads to lower birth rates (aka "demographic transition").

This culture was not a passing thing. It appears to have been stable for centuries. Presumably, humans could do it again.

Update 11/22/09: On reflection, if you could get past losing your male children at aged 7, this might not have been such a bad arrangement for Spartan women. Exercise, education, freedom, limited exposure to Spartan men ...

Chrome OS - the Parental Controls

I'm going to forget I read that Google imagines Chrome OS machines will sell for $400. That's clearly a ploy to sedate Microsoft.

I'll stick with my original expectation, that moderately crummy Google branded Chrome OS machines will sell for under $180 with battery.

If that happens then Chrome OS laptops will be huge in K-12 education, 23 years after I mercifully failed to sell a rural school district on a student Newton OS mini-laptop education model.

Huge, that is, if Google gets Parental Controls right. I ain't giving my kids Chromebooks unless I get full control over what they get to and what they do.

If we don't see Parental Controls emerging in Google App domains within the next six months, the Chrome OS may be missing an essential function.

When to accept an Apple OS update

I mostly agree with this Macintouch post ...
Snow Leopard
.... In my experience with Tiger & Leopard, a really usable version isn't available until around the .4 timeframe. My guess is the same will be true with SL. I play with a SL partition every now and then (whilst I test things like SoftRAID - great!), but I need a system that works.
SL ain't there yet, and once again, Steve Jobs and company thank us all very much for paying to be beta testers."
Apple's point OS updates, like 10.5 to 10.6, are dramatic; even those like 10.6 that add few marketed features.

Six months, or a .4 release, is a good rule of thumb. We're now at 10.6.2, I expect 10.6.4 after April 2010.

If you buy a system released after a point OS release, and stick with Apple or very mainstream products, you can probably get by with a .3 release.

If you have an older system that's still supported, you may need to wait for .5 or .6.
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Google's failures - and recent improvements

Good list of Google's more prominent failures. They are far from perfect, as any heavy duty Google user knows.

Time for me to update my Google Quick, Sick and Dead list. Here's the current list, I use pretty much everything except Android. I'm surprised to see that there have been more promotions than demotions over the past 10 months ...

The Quick
  • Search and Scholar
  • Android
  • Google Reader
  • Google Reader Comments and Shares
  • Gmail
  • Google Contacts
  • Google Mobile Sync
  • Chrome browser
  • Chrome OS
  • Picasa and Picasa Web Albums
  • Calendar
  • Maps
  • Earth
  • News
  • Browser toolbars
  • Translate
  • Gmail Tasks (promoted)
  • Custom search engines (promoted)
  • YouTube (promoted)
  • Mobile (promoted)
  • Google Talk (promoted)
  • Books (because they keep trying)
The Sick
  • Google Voice (iPhone web app frozen in time)
  • Google Sites
  • Google Apps
  • Google Video Chat (demoted)
  • Blogger (demoted)
  • Shopping
  • Google Checkout
  • Google Base
  • Orkut
  • Desktop
  • iGoogle
  • Knol (all-but-dead)
The Dead
  • Google Notebook
  • Google Page Creator
  • Google Browser Sync
  • Google Video
  • Google Groups (demoted)
  • Google Web Accelerator
  • Google Name Verification (Knol)
  • Google Gears
Update 12/4/09: I've added a few more items, such as Google Gears in the Dead category.
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Fans of Glenn Beck

By their fans ye shall know them ...
Glenn Beck -

... every person in the last 2 years that I have introduced to the WN [White Nationalist] Philosophy have come largely from Alex Jones, Glen Beck and the Scriptures for America founder Pastor Pete Peters ... Baby steps are required for people like these, but the trio Beck, Jones, Peters are the baby food that feeds potential Nationalists… Glenn Beck is not far behind as his Mormon background indicates to me as most Mormons I have met are not friends of Jews like the Church was years ago...
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Twilight of the mail

It's been a couple of months, so I went through my home paper mail. As usual there were about 3 items of interest, 3 periodicals for the bathroom, and a 2 journals for the office.

We know the periodicals and journals are going to move to some form of "ePad" in the next year or two. At that time I will get valued paper mail less than six times a year -- mostly from family over 80.

I get nothing at work.

Of course there's a trick. Emily gets all the bills and the Netflix DVDs, but fairly soon vendors will stop mailing paper. We're fed up with broken Netflix DVDs, so that will end within a few months time. (Suck it Netflix.)

Paper mail is going the way of paper news.
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Friday, November 20, 2009

Health IT Standards - what I would do

I almost never blog about anything that's work related. For example, if you visit my blog page you'll see a "label cloud" with 360 posts on Economics, but I'm no economist.

This post, written as a private citizen, is different. I'm going to write about something that I really do know quite well. It's a sufficiently obscure topic that there are probably only a handful of people who know it as well as I, and I doubt any of them have been invited to participate in the Health and Human Services IT standards process.

I wasn't invited, but I feel a moral obligation to contribute anyway. I can't see a good way to do that, so I'll post my contribution here. Sometimes these posts travel in odd ways.

My unusual expertise is in combining the realms of healthcare "accounting" (ICD-9-CM, HCPCS, CPT) and the realms of industrial ontology (gritty knowledge representation) such as SNOMED. I've been personally grinding these pieces together for over twelve years in various software systems. I know them rather better than I'd like.

The accounting systems matter. Their idiosyncrasies distort health care statistics, change people's insurance, impede and break computerized decision support, dictate care and determine how most clinicians define disorders. They are fashioned in obscure dark rooms, and they alter health care as surely as technical accounting dictates corporate software development.

They matter so much that they are deeply embedded and almost impossible to displace. ICD-9 was obsolete 30 years ago, but it staggers on. ICD-10-CM is a merely improvement that will cost many fortunes to implement.

On the other hand, SNOMED, a language for healthcare, is a very rich tool. Buggy, yes. Imperfect, yes. Even so, it's a powerful tool for anyone who wants to provide cost-effective decision support that will make all health care providers smarter and faster.

So why don't we implement things like SNOMED now? Are there technical issues? Well, there are some technical challenges, but they're not too big. The real problem is the deadweight of ICD-9, CPT and all that layers upon them, such as vast "medical necessity" (LRMP, medical coverage) databases. Since payment is closely bound to ICD and CPT coding, the easiest route to legal maximization of reimbursement is to stay close to ICD and CPT.

I don't think we have the energy to move America quickly to better health care standards like SNOMED CT. Maybe we do, but this kind of change is very hard. Even so, I think we can do it gradually. The trick is to keep the current system in place, while incrementally building up an alternative approach.

For example, consider the "coverage determination" database. This is a reasonably complex set of tables that define relationships between ICD-9-CM (aka "ICD" in the US) codes and CPT codes (AMA owns CPT btw). The tables express rules such as "we will pay for procedure X (CPT) if a patient has condition Y" (ICD).

I think those tables would be simper, and more internally consistent, if the rules were expressed using SNOMED CT. Medicare (CMS) could then publish rules in both SNOMED and, through things called "mappings", ICD-9-CM and CPT too. The transaction systems would still use the ICD and CPT codes of old, but developers could represent the rules internally using SNOMED, thereby facilitating SNOMED use in their clinical systems. This alone would remove a very large hurdle.

State governments could encourage clinicians to include SNOMED CONCEPTIDs (codes) in a new class of public health and/or payor transactions. This would be entirely optional, but transactions could have come with small payments and regulatory rewards.

We could express new ARRA reporting requirements in SNOMED as well as in the traditional ICD and CPT code sets. Again, accept either data set.

Lastly, we could accelerate implementation of SNOMED-founded ICD-11, perhaps even foregoing ICD-10-CM plans and doing an early partial implementation of the full ICD-11 vision.

It's very hard to move things as deeply embedded as ICD-9-CM and CPT. This deadweight is heavy weight. We can't do it all at once, but we could take doable steps that would provide us with better decision support and more portable electronic health records.

We now return you to the regular amateur hour ...
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How much is the gBook in the Window?

So yesterday Google does a presser on their coming Chrome OS ("chromestellation") netbook. Buried away, and rarely reported, Google's Sundar Pichai says ...
Q: Do you know what this Chrome OS netbooks will cost?
SP: You will hear that from our partners. They will be in the price range that people are used to for netbooks today. But it’s hard to predict a year from now. Also remember, they will be bigger.

The price range people are used to netbooks today?!

Err, that wasn't what I was expecting. What am I, wrong?!

Who cares about "bigger", we want cheap, cheap, cheap! We want that sucker under $150 (battery extra).

Not everyone heard Mr. Pichai ...
What ChromeOS Means For Netbooks And Why Microsoft Needs To Be Scared
... ChromeOS may not be powerful, it may not play Far Cry and it may not run Microsoft Office but it’s a game changer. The underpowered laptops that limped along under Vista, XP, or 7 will fly under a new ChromeOS regime and thin-and-light laptops will fall below the vaunted $199 mark as the so-called “Microsoft Tax” – basically the small cost manufacturers pay for OEM licenses – disappears."..
The XP tax, by the way, is less than $25.

If Google intends to sell a Netbook at $400 then Microsoft can relax.

I hate being wrong.

Thursday, November 19, 2009

A smart mind is a dangerous thing to waste

When I did my undergrad the USSR was a going concern. The military-industrial complex sucked in a lot of smart grads. Their work would be classified, and would add little to the greater good.

Then came the fall of the wall. For a magical decade smart minds had good work to do.

Somewhere along the way, though, smart minds started working on novel financial instruments, malign pricing innovations, games with insurance plans, and other emergent frauds. Instead of building better bridges and inventing new conservation strategies and clean energy sources, too many of our brightest minds have been investing in complexity attacks.

We need a cultural reform movement that values people not by what the money they take, but by the worth they make. Anyone see signs of this anywhere?
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Paul Graham on the price of the App Store

Apple needs to fix the App Store ...
Apple's Mistake

... I suppose Apple has a third misconception: that all the complaints about App Store approvals are not a serious problem. They must hear developers complaining. But partners and suppliers are always complaining. It would be a bad sign if they weren't; it would mean you were being too easy on them. Meanwhile the iPhone is selling better than ever. So why do they need to fix anything?

They get away with maltreating developers, in the short term, because they make such great hardware. I just bought a new 27" iMac a couple days ago. It's fabulous. The screen's too shiny, and the disk is surprisingly loud, but it's so beautiful that you can't make yourself care.

So I bought it, but I bought it, for the first time, with misgivings. I felt the way I'd feel buying something made in a country with a bad human rights record. That was new. In the past when I bought things from Apple it was an unalloyed pleasure. Oh boy! They make such great stuff. This time it felt like a Faustian bargain. They make such great stuff, but they're such assholes. Do I really want to support this company?
Start with allowing Google's products.

Health insurance: we're defeated by a complexity attack

It's time again to play spin the insurance wheel.

This year my employer is offering only a "HRA" (Consumer directed) plan. What we used to call a "medical savings account plan". My employer self-insures, so presumably this saves them money.

So we tried to figure out what plan makes sense. My wife and I are both physicians. I'm a wee bit of a computer geek. We have, between us, at least 35 years of post-secondary education.

The enemy has hundreds of analysts and extensive simulations. They can throw up pages of unreadable and meaningless computer generated descriptions.

It's really no contest. The best we can do is run the provided simulations through optimal, average, and disastrous scenarios and assume that the strange seeming results are accurate. The simulations, of course, don't ask about tax brackets, and they mix pre-tax dollars (our premiums) with post-tax dollars (out-of-pocket expenses).

We can offset the post-tax dollars by gambling on Flex dollars -- but then we run the risk of sending the Flex money back to yet another gambling corporation (and probably, eventually, to my employer).

In the end we'll probably pick the middle option and go light on the Flex.

This, like mobile phone services, is a complexity attack. I'm guessing if I worked this one through I'd put it in the large class of emergent frauds - an echo of the crash of '08.

We must, as a nation, figure out a way to beat this stuff back.

Update: EL has been working with pencil, and it now looks like
  • The graphical portion of the simulation is probably wrong.
  • Disregarding the graphical part, and parsing out rollover of the "HRA" part, and factoring in various combination of pre-tax and post-tax contributions and Flex guesses the plans are more similar than the appear -- but the numbers may be wrong
  • The numbers in one resource are quite different from the simulation/web site numbers. They don't add up. On the other hand, one of the simulation numbers is probably wrong.
See also:
Update 5/28/10: Our sense of doom was well justified. Midway through the year we found that mental health payments were not handled in the MSA-like plan. They're handled through a separate, traditional, indemnity plan. Since these payments constitute our major healthcare expense, our entire analysis was rendered moot. Needless to say, in all of our review neither my wife nor I saw this in the materials we were given.

AT&T “A List” – the gift that’s not

AT&T markets a new “A List” feature…

Enjoy unlimited calls to and from the phone numbers in your A-List. Your A-List can include valid domestic phone numbers for any domestic service provider - wireless or landline.

I’ve added my corporate conference call number to my AT&T “A List”. The list already includes my home landline and, especially, the Google Voice number that connects me to Canada for free.

Once this is effective my corporate conference calls shouldn’t use any of my minutes (even toll-free calls use minutes).

Since Google Voice and Google Talk combined with the A List mean my whole family uses less than 300 minutes a month, we no longer need our family plan of 1,400. I’ve be fine with only 550 minutes.

Wow! I could drop my bill from $80 to $40. What a great feature …

Ahh. But you know there’s a hook, don’t you?

The A list feature is only available for plans with 1,400 minutes and up.

AT&T isn’t stupid. Crooked, sure. Stupid, no.

Wednesday, November 18, 2009

The cat brain simulator. Game over?

I used to say that the day we had a computer roughly as smart as a hamster would be a good day to take the family on the holiday you've always dreamed of.

Today, two articles, both, oddly, from The Register (emphases mine) ...

... IBM said it has already simulated a cat-sized cerebral cortex — the area of the brain that's key to memory, attention, and consciousness — using a massive Blue Gene supercomputer at Lawrence Livermore National Laboratory in California.

This feline-scale cortical simulation, which was made with the help of researchers at Lawrence Berkeley National Lab, included 1 billion neurons and 10 trillion individual learning synapses. The simulation ran 100 to 1,000 times slower than real-time, said Dharmendra Modha, manager of IBM's Cognitive Computing unit at its Almaden Research Center, in a blog post.

and from a completely different direction ...

... According to Dean’s presentation, Google is intent on scaling Spanner to between one million and 10 million servers, encompassing 10 trillion (1013) directories and a quintillion (1018) bytes of storage....
The simulation, presumably, is not actually doing any cat like things. It merely represents a substrate upon which cat like intellect might operate.

So maybe the next step to the hamster-equivalent AI will be long, my prediction of singularity 2100 will hold, Kurzweil will be indeed wrong about 2045, and we really should worry about carbon emissions.

Or maybe not. In which case I hope Kashmir becomes peaceful quickly as I'd like to visit the Lakes before it's too late.

Oh, what does this have to do with Google Spanner? I'll leave that as an exercise.

See also:

Tuesday, November 17, 2009

The paradox of 21st century prosperity

I've had a post brewing for weeks that I'm still playing with. It's not quite right, and may never be, but this Reich comment is pertinent ...
Robert Reich's Blog: Obama, China, and Wishful Thinking About American Jobs

... The dirty little secret on both sides of the Pacific is that both America and China are capable of producing far more than their own consumers are capable of buying. In the U.S., the root of the problem is a growing share of total income going to the richest Americans, leaving the middle class with relatively less purchasing power unless they go deep into debt. Inequality is also widening in China, but the problem there is a declining share of the fruits of economic growth going to average Chinese and an increasing share going to capital investment...
I'd love to see either DeLong or Krugman dig into this claim.

See also

Monday, November 16, 2009

The world is going to get bigger

I don’t fly that much these days – maybe 10 flights a year. Yesterday I took one of my longer flights – from Minneapolis to San Francisco. On that flight I again thought about how the world is getting a bit bigger, and that it may get a lot bigger fairly soon.

That’s new. For most of my life the world got smaller. Air fare, especially as a percentage of average income, kept falling. Families spread out. My generation moved to take new jobs.

Air fares aren’t falling any more, and most people’s incomes aren’t rising much. When I consider increased costs of health insurance, my disposable income will be down this year – and I’ve been relatively fortunate.

On the other hand, air fare to Montreal (for example0 has more than doubled in the past nine months. The carriers reduced capacity, bought the competition, and now fly fewer but fuller planes at 2-3 times past fares.

Industry consolidation will continue to boost prices, but so will cap-and-trade carbon tax equivalents. There’s something much bigger coming though…

Energy security body calls for 'urgent' review of impact of oil shortages - Business – guardian

… Swedish academics unveiled their latest assessments of the numbers and came to even more gloomy assumptions. The study from Uppsala University entitled The Peak of the Oil Age estimated that by 2030 the world would be able to rely on only 75m barrels of oil a day, compared with the 105m forecast by the IEA.

Until relatively recently the agency was assuming the output figure would be as high as 120m and it still believes a peak of production could be reached in 2020, while Uppsala believes it might have already been reached…

I made my own “demand/supply peak light sweet” call in 2008 – in which I made wild ass claim that it would be apparent by 2015 that the demand/supply ratio for light sweet crude would cause prices to rise and crash and rise and crash their way to the $200/barrel mark (rise and crash because of secondary recessions, $200 because at that point serious conservation starts to align supply and demand).

Between some kind of carbon-tax-equivalent and “peak oil” of any form, air travel will at least double in cost over the next five years – even as profits continue to be squeezed.

That means a much bigger world to cross for the dispersed families of my generation. Maybe the next generation should stay closer to home base.

High speed rail, by the way, is looking pretty interesting.

Update 11/16/09: A follow-up article by The Guardian’s Monbiot: The one thing depleting faster than oil is the credibility of those measuring it - George Monbiot

Update 11/17/09: It occurs to me that a good measure of how real this stuff is would be to watch how very wealthy and smart people invest. I recall thatWarren Buffett recently bought some railways, and of course I'm not the only eccentric sort to make this connection ...

Saturday, November 14, 2009

There are only two fixes for the Apple iPhone App Store

Good essay with links to other good essays ...
Manton Reece: The only 2 fixes for the iPhone platform
... There are a lot of well-intentioned suggestions for improving the App Store, but the result will always be the same until we acknowledge the root problem. The only fix is for Apple to remove itself as gatekeeper, or let us route around them...
Apple is channeling the wrong side of 1984. Apple has become the enemy.
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Thursday, November 12, 2009

Mobile phone fraud - The accidental data charge and other scams

I experienced this with Sprint and AT&T alike. I now pay $5 or so a month for a the honor of tracking my son's phone use -- that includes disabling his data access.

Here's Pogue's expose
Verizon: How Much Do You Charge Now? - Pogue’s Posts Blog -

...Starting next week, Verizon will double the early-termination fee for smartphones...

...The phone is designed in such a way that you can almost never avoid getting $1.99 charge on the bill. Around the OK button on a typical flip phone are the up, down, left, right arrows. If you open the flip and accidentally press the up arrow key, you see that the phone starts to connect to the web. So you hit END right away. Well, too late. You will be charged $1.99 for that 0.02 kilobytes of data...

...Every month, the 87 million customers will accidentally hit that key a few times a month! That’s over $300 million per month in data revenue off a simple mistake!..

...Now, you can ask to have this feature blocked. But even then, if you one of those buttons by accident, your phone transmits data; you get a message that you cannot use the service because it’s blocked–BUT you just used 0.06 kilobytes of data to get that message, so you are now charged $1.99 again!...

“They have started training us reps that too many data blocks are being put on accounts now; they’re actually making us take classes called Alternatives to Data Blocks. They do not want all the blocks, because 40% of Verizon’s revenue now comes from data use. I just know there are millions of people out there that don’t even notice this $1.99 on the bill.”"
For the record, here's a list of the mobile phone scams I know of ...
  1. Early termination fees that exceed plausible costs
  2. The time eating pointless answering machine messages
  3. The "accidental" high priced data fees
  4. The surprise fees and taxes with just about any transaction
  5. The covert contract renewal with service changes
  6. Recipient pays SMS transaction fees
  7. The unusable cash card rebate fraud (AT&T settled with NY state on this one)
  8. Uninterpretable cell phone bills.
  9. Passive revenue from OAN Services and other cramming scams.
  10. Unblockable SMS marketing.
  11. Long distance interconnect fees.
Add them up and were talking billions of dollars in fraud. These scams didn't have to be planned out, all you need is fertile soil for emergent fraud.

See also:
Update 11/17/09: More on how complexity attacks are used by mobile phone companies (and, incidentally, by health care insurance plans).
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I add the despised comment captcha

I dislike Captcha (usually a text recognition test) as much as anyone -- but lately my email has been clogged with notices of blog comments to review. They're almost all spam.

So I had to turn on the Captcha test. If the spambots get bored I'll try turning it off again.

Tuesday, November 10, 2009

About that health care bill …

Joseph Paduda despairs ….

… I'm really disappointed with the Republicans. They are supposed to be the budget hawks, but instead they've spent their time railing against abortion funding, illegal immigrants, and death panels, along with scientific research and taxes on device manufacturers. Instead of attempting to govern responsibly, they've abandoned all morality in their quest to re-energize the lunatic fringe of their once-dominant party…

… While there's plenty of blame to pile at the door of the Republicans, it is the Democrats who are to blame for coming up with a huge entitlement program set up to do nothing but grow…

Well, yes.

The GOP decided that their one and only mission was to make Barack Obama look bad. That meant this bill would attract no more than 1-2 GOP rebels. That in turn meant no constituency could be offended, which meant no serious efforts to control costs.

If we had a less dysrational electorate, then we’d have a better GOP. But we’re stuck with the GOP we’ve got.

So any bill that can pass will give everyone everything they want.

It’s not even lying. Anyone capable of perceiving reality knows there will be a reckoning. This is about building the arena for the real battle to come.

Not pretty, but that’s modern America. It’s the best we can do, and it’s much better than nothing. In stage II, assuming we get this sausage made, we’ll be talking price.

Reason – it’s more than IQ

Temperament is what you’re born with. Character is what life does with temperament.

Things aren’t so clear with intelligence. It’s very likely that one’s maximal “IQ performance” is largely determined by genes and intrauterine environment, but even so we know that IQ measurements increase with test training. More than that, there are lots of smart people who seem unable to reason rationally.

Reason is more than IQ …

Rational and Irrational Thought- The Thinking That IQ Tests Miss- Scientific American

  • Traditional IQ tests miss some of the most important aspects of real-world intelligence. It is possible to test high in IQ yet to suffer from the logical-thought defect known as dysrationalia.
  • One cause of dysrationalia is that people tend to be cognitive misers, meaning that they take the easy way out when trying to solve problems, often leading to solutions that are illogical and wrong.
  • Another cause of dysrationalia is the mindware gap, which occurs when people lack the specific knowledge, rules and strategies needed to think rationally.
  • Tests do exist that can measure dysrationalia, and they should be given more often to pick up the deficiencies that IQ tests miss.

I’m excited by this analysis. I’d have more to say but the full article isn’t available online yet and I can’t find much extended commentary.

I can note that analyses of errors in reasoning are very old – at least as old as Greek analyses of rhetoric. In the 1970s and 1980s several excellent books on medical reasoning and diagnosis characterized common errors of cognition, and in the early 1990s my CogSci grad coursework plumbed the depths. We’ve developed an extensive language for talking about errors in reasoning.

Even so, this recent article’s explicit study of the persistently dysrational (a better term than “arational” or “dysreasonal”) feels like a useful way to reframe the discussion. From Bush to Rumsfeld to Climate change deniers we’ve seen some fairly smart to brilliant people stuck in dysrational modes. If we can understand what produces dysrationalia, and how to intervene in early life, we may take a big step towards enlightenment 2.0 and rational discourse though not universal agreement.

See also: Be the Best You can Be- IQ and reasoning - not quite the same thing

The ultimate take down of the disgraced Levitt and Dubner

The intelligentsia have been engaged for weeks in a ferocious competition to best capture the intellectual and moral vacuity of Levitt and Dubner's latest money churner.

Today, by acclaim, we have a winner -- “SuperFreakonomics” and climate change : The New Yorker - Elizabeth Kolbert. The smashing finale left no doubt ...
... To be skeptical of climate models and credulous about things like carbon-eating trees and cloudmaking machinery and hoses that shoot sulfur into the sky is to replace a faith in science with a belief in science fiction. This is the turn that “SuperFreakonomics” takes, even as its authors repeatedly extoll their hard-headedness. All of which goes to show that, while some forms of horseshit are no longer a problem, others will always be with us.
These men traded their reputations for wealth. A worthy trade for them, but they're not paying for the collateral damage

Next up: AAFP to endorse e-cigarettes

I had a real bad feeling when the American Academy of Family Physicians closed our once excellent web site to public access. So I wasn’t all that surprised by their latest move …

How the World Works – Family Doctors go better with Coke -

… directed to this story from the Cleveland Plain Dealer reporting that the American Association of Family Doctors has "a six-figure grant from the Coca-Cola Co. to create content about beverages and sweeteners for the academy's consumer Web site,"

From the AAFP press release: “The Consumer Alliance program is a way of working with interested companies to develop educational materials to help consumers make informed decisions so they can include the products they love in a balanced diet and healthy lifestyle," said AAFP President-elect Lori Heim, M.D., of Vass, N.C…

…The Consumer Alliance program also will create a new source of funding for AAFP, which, in recent years, has broadened its search for funding outside the pharmaceutical industry…”

I just sent these guys over $600 for my 1 year membership – to find out that the AAFP’s consumer health site is doing covert marketing. Next up – the health benefits of e-cigarettes.

Worst bit? Maybe this is an improvement over pharmaceutical funding.

I expect this will be my last year of AAFP membership.

Update: I received a standard response letter signed by AAFP President Lori Heim when I wrote the academy. It included a bit of further context ...

... I would finally note that this is not new territory for the AAFP. Over the past 4 years we have had funding relationships with Pepsi and McDonald's for support of the AIM program - and we have managed them very well in maintaining a positive image for the Academy while advancing our message about fitness, activity, and healthy choices. And Coca-Cola has been a corporate member of our Foundation for several years as well which is why we reached out to them initially.
So why not Philip Morris? These are publicly traded companies -- their mission is not public health. Their mission is to make money from people who buy Pepsi, Coke and McDonald's products.

The AAFP needs a reform agenda. It can't afford to live in the style it's grown accustomed to, so the AAFP needs to radically downsize.

Monday, November 09, 2009

Dems for a rationalist GOP - is there somewhere to donate?

Krugman is very worried about the 2010 triumph of the Tea Party ...
Op-Ed Columnist - Paranoia Strikes Deep -

Last Thursday there was a rally outside the U.S. Capitol to protest pending health care legislation, featuring the kinds of things we’ve grown accustomed to, including large signs showing piles of bodies at Dachau with the caption “National Socialist Healthcare.” It was grotesque — and it was also ominous. For what we may be seeing is America starting to be Californiafied...

...In fact, the party of Limbaugh and Beck could well make major gains in the midterm elections. The Obama administration’s job-creation efforts have fallen short, so that unemployment is likely to stay disastrously high through next year and beyond. The banker-friendly bailout of Wall Street has angered voters, and might even let Republicans claim the mantle of economic populism. Conservatives may not have better ideas, but voters might support them out of sheer frustration.

And if Tea Party Republicans do win big next year, what has already happened in California could happen at the national level. In California, the G.O.P. has essentially shrunk down to a rump party with no interest in actually governing — but that rump remains big enough to prevent anyone else from dealing with the state’s fiscal crisis. If this happens to America as a whole, as it all too easily could, the country could become effectively ungovernable in the midst of an ongoing economic disaster...
Krugman is not always right. Unfortunately, he's the best prognosticator we've got, even if he's better at forecasting doom than at coming up with practical alternatives (perhaps because we don't have a lot of practical options).

We can't make Palin/Bachman go away, because their constituency is right be afraid. Even if Bachman had lost her Minnesota seat (she almost did, it was surprisingly close) someone else would have taken her raving loon position.

Instead of focusing on the crazies we should be trying to build a Reason-based GOP. Liberal democracies need a dynamic tension between the genetically gifted and the neurotypical, between those who inherit wealth and those who inherit struggle, between the market and the wise, between the thrusting and the compassionate. If the powerful do not get their extra votes, they will crash the system (to their own detriment, but the powerful are not often insightful).

A rationalist GOP won't have my values of tolerance and compassion. It will, however, have a calculated interest in the survival of American (if not human) civilization, in educating productive workers, in reducing unprofitable and uncontrollable wars, and in clean air, water, and even beautiful spaces.

I wouldn't vote for or admire a rationalist GOP, but I would understand and respect its necessity. Without this kind of opposition, without the struggle for power, my Dem party will become a sewer of corruption (No, it's not a sewer yet. If you think it is you've led a protected life).

Today Newt Gingrich is the closest thing to a rationalist GOP -- which is pathetic. As feeble in Reason as he is, he's also powerless and all but forgotten.

We need to rebuild a post-Reagan rationalist GOP -- or we'll be governed by the likes of Palin and Bachman and human civilization will be a smoldering wreck.

Where do we start donating?
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Smart Smoker e-cigarette: From China without regulation

In the past 2-3 days I've noticed advertisements for "smart smoker" in several of the media sources I read including the NYT.

I haven't seen anything like this for years. Heck, I'd thought these ads were disallowed in the US.

Turns out these are "e-cigarettes", a drug delivery system that's marketed as reducing second hand smoke and as "legal to smoke anywhere". They are currently legal to advertise in the US, but not legal to import.

They are manufactured in China, and first become popular in the UK, where they've emerged from a "regulatory gap". The vendor web sites strongly imply these are "safer" than traditional cigarettes; that's not implausible per nicotine dose unit but it's certainly untested. They don't claim that they're "safer" than bungee jumping.

So how does one figure out who's behind these expensive ads (and, as it turns out, huge lobbying, marketing and legal initiatives)? In this case, Google is not a friend. Simple searches turn up vast numbers of results from a mixture of pro-smoking groups, retailers and spam blogs. A smoke screen, as it were.

On the other hand, and PubMed have almost nothing on "e-cigarette" or "electronic cigarette". This has come on too quickly for public health and research to respond.

My best source to date has been a single June 2009 NY Times article, which I only found by restricting my Google search to That's where I learned this innovation was made in China. The "smoke" is inhaled propylene glycol, an antifreeze component (see also poisoned toothpaste (Chinese diethylene glycol). Emphases mine:
Cigarettes Without Smoke, or Regulation - June 2, 2009 -
FALL RIVER, Mass. — During 34 years of smoking, Carolyn Smeaton has tried countless ways to reduce her three-pack-a-day habit, including a nicotine patch, nicotine gum and a prescription drug. But stop-smoking aids always failed her.

Then, having watched a TV infomercial at her home here, Ms. Smeaton tried an electronic cigarette, which claimed to be a less dangerous way to feed her addiction. The battery-powered device she bought online delivered an odorless dose of nicotine and flavoring without cigarette tar or additives, and produced a vapor mist nearly identical in appearance to tobacco smoke.

... the Food and Drug Administration has already refused entry to dozens of shipments of e-cigarettes coming into the country, mostly from China, the chief maker of them, where manufacture began about five years ago. The F.D.A. took similar action in 1989, refusing shipments of an earlier, less appealing version, Favor Smoke-Free Cigarettes.

“These appear to be unapproved drug device products,” said Karen Riley, a spokeswoman for the agency, “and as unapproved products they can’t enter the United States.”

But enough of the e-cigarettes have made their way into the country that they continue to proliferate online and in the malls.

For $100 to $150 or so, a user can buy a starter kit including a battery-powered cigarette and replaceable cartridges that typically contain nicotine (though cartridges can be bought without it), flavoring and propylene glycol, a liquid whose vaporizing produces the smokelike mist. When a user inhales, a sensor heats the cartridge. The flavorings include tobacco, menthol and cherry, and the levels of nicotine vary by cartridge.

Propylene glycol is used in antifreeze, and also to create artificial smoke or fog in theatrical productions. The F.D.A. has classified it as an additive that is “generally recognized as safe” for use in food. But when asked whether inhaling it was safe, Dr. Richard D. Hurt, director of the Nicotine Dependence Center at the Mayo Clinic, said, “I don’t think so, but I’m not sure anyone knows for sure.”

Of the e-cigarettes themselves, Dr. Hurt added: “We basically don’t know anything about them. They’ve never been tested for safety or efficacy to help people stop smoking.”

Public health officials also worry that the devices’ fruit flavors, novelty and ease of access may entice children.

“It looks like a cigarette and is marketed as a cigarette,” said Jonathan P. Winickoff, an associate professor at the Massachusetts General Hospital for Children and chairman of the American Academy of Pediatrics Tobacco Consortium. “There’s nothing that prevents youth from getting addicted to nicotine.”

Sales and use of electronic cigarettes are already illegal on safety grounds in Australia and Hong Kong, and some other countries regulate them as medicinal devices or forbid their advertising. So far the United States has focused only on stopping them at the border, although Senator Frank R. Lautenberg, Democrat of New Jersey, has asked the drug agency to take them off the market until they can be tested.

Distributors of electronic cigarettes fear that a bill making its way through Congress that would give the F.D.A. the authority to regulate tobacco could be used to put them out of business as well. The bill has passed the House and could be taken up by the Senate this week.

The only American study of electronic cigarettes, now under way at Virginia Commonwealth University and financed by the National Cancer Institute, deals not with the kind of safety questions raised by propylene glycol but rather with the amount of nicotine processed by the bodies of the products’ users.

Another study, conducted this year at the University of Auckland in New Zealand and financed by Ruyan, an electronic cigarette company, shows that users typically receive 10 percent to 18 percent of the nicotine delivered by a tobacco cigarette...
So what we have here is a novel unregulated drug delivery system involving inhaled propylene glycol that is manufactured in China, a nation famous for the quality and regulation of its regulated Heparin supply. It is perfectly designed for sale to children and to Darwin award wannabes.

The good news is that the GOP no longer controls the FDA. That doesn't mean we can go back to sleep. The GOP will be back, and with Palin and Bachman in control it will be worse than ever. This beast needs to be driven back into its cage.

See also:
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Forgotten things - Gypsies and Indians

My father remembers Indians in the 1920s rowing from Oka across the Lake of Two Mountains in birch canoes to sell small handmade toy birch canoes in Regaud Quebec.

My mother remembers Gypsies selling handmade clothes pegs in Manchester in the 1930s. Once she and her sister were home alone when the Gypsies called. They hid beneath a table, for they knew the Gypsies stole children and raised them as their own.
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Sunday, November 08, 2009

Angela Merkel's second crossing

I don't often wish for access to a TV, but this I'd like to see ...
Berlin's moment of freedom that turned world history | World news | The Guardian
...Later that night, a young East German scientist called Angela Merkel walked across the same crossing. Now the chancellor of united Germany, she will do the same again this afternoon, accompanied by a group of East German opposition activists, Mikhail Gorbachev, Lech Walesa and doubtless a media scrum."...
I knew Angela Merkel was Chancellor of course, but I'd forgotten that she was born in East Germany. She crossed over on the day East Germany was freed.

Saturday, November 07, 2009

Bad back better

It makes for a good family story, but really nobody was very happy with me. After a nearly 30 year run my strategy of ignoring my back pain wasn't working. I'd gotten pretty good with ice packs, advil, canes and early inline skating, but I'd advanced from an every 8 months problem lasting 3-5 days to every 4 months lasting 14-21 days.

Every doc knows where that story goes. So I bit the bullet, and I saw a doctor (other than myself and my wife that is). Specifically, I signed up with the marines of back rehab - Minnesota's Physicians Back and Neck Clinic (PNBC).

It worked. My back is better now than it's been for at least twenty years. That was probably the last time I went this long without a 'stuck to the floor' acute exacerbation.

It's been long enough now that I know they did right by me. My doc was a bit crispy after decades of doing bad back work, and I was a bit surprised he didn't even bother with a plain film (these guys do very little imaging), but the program he and his buddies established worked. I did about 2 months of PT driven core muscle training and eternal daily stretching routines. I'm still religious about the 10 minute daily stretching regimen. As per my colleague BF's husband, I do them before I get out of bed.

I haven't been as diligent with the maintenance Roman Chair back extensions they prescribe, so I know what I'll have to change if my pain returns. That's my problem though, not a problem with the PBNC program.

Yeah, it's n of 1, but these guys are pretty much smack in the center of evidence-based back pain management -- they're just meaner about it. For n of 2 I'll mention that my buddy ZH was facing grim cervical spine surgery when he went there. They fixed him good - no surgery, full activity, he's a fan.

It's perhaps not for everyone, but if you're in MN, and you've got a really bad back or neck problem, chronic or acute, this is the team to see. Just remember when they want 10 more reps - "Pain is weakness leaving the body".

See also:
Update 11/21/09: Something I'd forgotten when I wrote this post. For the first few months after treatment began my back often ached. I felt as though I'd spread the severe pain over time, as though the total had not changed but the distribution had improved. I was fine with that, it didn't stop me doing anything. It is only now that I realize that my tolerable legacy symptoms, slowly and without my notice, went away.

Update 7/3/2013 - six years after my summer 2007 injury

Around 2010 I had another episode of reasonably severe back pain and I returned to PNBC for another rehab session. In retrospect that was probably unnecessary, but it proved I'd done a bad job of maintaining my muscle tone.

I have been utterly reliable at my morning stretching exercises, which I credit for 60% of my prolonged remission. The rest is core muscle; I've done better at maintaining that, but it is possible to have too much of a good thing.  In June of 2013, while engaged in an arguably insane level of physical activity for non-elite 54 yo at CrossFit St Paul, I injured my back when I lost form doing my 16th front squat with a 120+ pound bar. (More on CrossFit in a 2013 post I think). Clean and jerk and squats likely voided my PNBC warranty. That pain resolved in about 24 hours, and 48 hours later the discomfort is mild.

It must be noted PNBC's aggressive strengthening program doesn't make one completely invulnerable. (That's a joke.) I'll go easy for the next six weeks, then keep my free weights under 90lbs for the next six months and focus on reps.

After 2009 PNBC was acquired by a local healthcare enterprise; I suspect it's lost a bit of the old intensity. Sadly, their 2009 approach to managing back pain is still radical.

Update 12/24/2015 - 8+ years later.

Over the past 4 years I've had 2-3 back strains related to pushing the envelope while weight lifting, most recently on the dead lift. I don't think one can complain about this sort of thing! So far they've all resolved fairly quickly with nothing like the severe pain I once new. So far :-).

Further notes:

Friday, November 06, 2009

How business stories are made - the inside scoop

Dan Lyons, writing as his alter ego "fake steve jobs", tells us how big glossy business magazine stories are made. It's a story everyone should know. (The "filthy hack" is Dan Lyons of course, and he's getting some revenge served cold ...)
The Secret Diary of Steve Jobs: Exclusive Story Opportunity...

...One of the filthiest hacks on the beat has been trying to curry favor with Katie, and she's playing along, pretending to be his friend, hoping we can maybe use him for something at some point. Katie calls this her "back pocket strategy," meaning it's always good to keep a few of these frigtards in your back pocket in case you need them someday....

...If you want to see the full version of the pitch letter you can find it here. I didn't want to fill up this post with the whole thing because it's pretty long. But it's also pretty hilarious reading, especially if you've ever wondered how those big features on giant companies end up in your magazine.

Little hint: The companies think them up themselves, and put together a complete package, with charts and statistics, phone numbers for analysts and "independent observers" (all of them fully prepped and totally on message) -- and then, when they've got the whole thing wrapped up with ribbons and bows, they go looking for a hack to write it up for them.

What makes this case especially ridiculous is that the hack who passed us this pitch has had a somewhat rocky relationship with the Original Borg. In fact, this hack was once on an O.B. blacklist...
Another time the two top flacks at IBM actually met with the top two editors at this hack's publication and demanded that the editors remove this hack from the IBM beat. Another times, an O.B. exec and his minions orchestrated letter-writing campaigns against this hack, bombarding the hack's publications with letters denouncing him. The O.B. exec wrote his own letters to the publication, too, and in his he demanded that the hack should be terminated...

Now they want a favor. Funny how that shit comes around, isn't it?
IBM won't be trying pitches to Lyons for a while. Must have been someone who didn't know the back story.

I gave up on business magazines decades ago. I haven't noticed their absence. Incidentally, Microsoft's effective ownership of the 1980s and 90s industry trade magazines was much more important than is remembered now.

Death by rosary bead - poisonous plants

I love the web.

When my science kid asked me about the deadliest plant, I asked Google. Google sent me to the "five most poisonous plants". Plant #3 was used to make Rosaries. I have a strong suspicion that the rosary my mother had 40 years ago was made with this seed ...
HowStuffWorks "Rosary Pea"
.... rosary pea seeds contain the poison abrin. The seeds are only dangerous when the coating is broken -- swallowed whole, the rosary pea doesn't present any danger. But if the seed is scratched or damaged, it's deadly. The rosary pea poses greater danger to the jewelry maker than to the wearer. There are many reported cases of death when jewelry makers prick a finger while handling the rosary pea...
Wikipedia has more on abrin, which, unlike its cousin ricin, has not been weaponized. It's impressive how many of these very poisonous plants are fairly common.

Great material for one of those medical mystery TV shows.

Note mushrooms are fungi, not plants. So they didn't make the list.

Why are automotive web sites so ugly and disorganized?

We need to replace our decrepit 12 yo Subaru Legacy wagon. It's done well -- geeky, plain, does the job. It'd be perfect but for the cup holders (problem with manual trans) and the mileage.

It's not easy. I can't find anything like it on the market today (all wheel drive wagon); if the 2005 Outback were still sold I'd buy it immediately (the 2010 model is awful).

So we've been visiting lots of automotive web sites, like Toyota's. As a rule, they're remarkably lousy in a remarkable number of ways. Aesthetically, they're ugly. Poor layout, weak icons, muddy fonts, garish colors, clashing boxes -- the web equivalent of geek clothing. Functionally they're mostly missing the kind of information we're looking for, and few have useful imaging (ex: would need to include human forms to provide scale information).

Why is this? The auto industry may be troubled, but it's a trillion dollar worldwide business. Surely they could afford a few million to hunt down the people who do Apple's web site* and hire them away.

Most large traded companies make very odd choices. Apple is the bizarre exception, probably because Jobs is a force of nature.

* Heck, they could just point someone at the site for the latest iMac, steal everything and paste in some auto images and text.

Update: In a weird bit of synchronicity, within hours of writing this, Daring Fireball linked to an explanation of why American Airlines web site design sucks. It's exactly what I imagine is true of most corporate web sites -- huge teams, lots of hands, lots of politics, lots of executives deciding aesthetics.
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Thursday, November 05, 2009

Eye Glasses and other iPhone health care related apps

I was sure someone would do this (blogged about it) but missed it was out ..
Medical Apps for the iPhone - Pogue’s Posts
... Eye Glasses. As an over-40-year-old, I’ve become addicted to this app. It simply turns the iPhone 3GS into a magnifying glass. Hold it in front of some tiny type—on a menu, a receipt, a ticket, a medicine bottle—and Eyeglasses, after a moment of autofocusing, shows you a magnified version of it on the screen. Keeping your hand steady is tough, and the 6X and 8X images sort of fall apart—but the 2X and 4X views have saved me more than once. ($3)...
I'll buy a copy for the fun factor alone. Nice job.

Pogue tells us there are 7,000 health care related apps, but he didn't find much of interest. The "Anatomy Lab" app might be worth some med school nostalgia points. (Update: Looking at the reviews it's nowhere near the level med students are tortured at.)