Has Bill Gates become a fundamentalist?

The New York Times > National > Microsoft Comes Under Fire for Reversal on Gay Rights Bill

Hmm. First Gates supports Bush over Clinton in the 2000 elections -- thought then it seemed to be over the Fed's antitrust win, which Bush pulled after he won. More recently the Gates Foundation supports the creationist agenda. Now Microsoft retreats from a Gay Rights Bill.

Yes, it could all be commercial calculation -- except the creationist funding. That changes the equation a bit. I wonder if either Gates and/or Ballmer have undergone a mid-life conversion of sorts.

The slow advancement of ambulatory medical practice

Medical Notes: TOC

Eons ago, when I created the personal notes I'm linking to above, I was a real physician (GP basically, usually called an FP nowadays). Now I work in healthcare IT, but I continue to do the CME (continuing medical education) required to retain my licensure -- though I wouldn't see real patients without some supervised retraining. It's been more than 10 years since I was a country doc.

I've just completed two days of the Minnesota Academy of Family Practice's CME program.As I reflect on my notes, it's easiest for me to compare what I read to what I practiced in 1994 (I've done lots of CME since then, but it's in day to day practice that book learning becomes knowledge). I'm struck by one remarkable observation -- things haven't changed all that much.

I'm not talking about out-of-date docs practicing the medicine of their residency days. The faculty are state-of-the-art academics, including many subspecialists, all introducing the latest best practices. It is however true that a course like this only samples a few subjects. We didn't cover HIV management for example -- an area in which there's been great change. Like oncology, most HIV management is really a specialists domain. Where FPs care for cancer and HIV patients, we are usually working someone else's plan.

Some of the more remarkable changes in the past 10 years, are, in fact, retreats. We used to know how to manage the menopause (ERT), now we really don't. (Testosterone is popular now for female sexual dysfunction -- tell me that won't come to grief.) We used to try hard to identify reversible dementia -- no-one talks much about that any more. Alzheimer's is part of aging -- we are all touched by it in some measure, there are no effective preventive interventions, no good treatments (yet), just good management approaches. PSA used to be wonderful, now it seemed to a bit gauche.

The major breakthrough, compared to 1994, was in the management of erectile dysfunction. That's a pleasure to hear about (I'm not being ironic, it's great to be able to do something about this age-old problem), but there wasn't much else in the same league. Type II diabetes management is finally catching up to what many of us suspected 10 years ago (insulin is a double-edged sword), but the changes are not revolutionary. The preventive cardiologist and endocrinologist want everyone on statins, but there's still some nervousness in the audience about effects on neuronal membranes. Sure -- Lipitor for the diabetic or the patient with known heart disease -- but do want ever American male with a waist over 40" on high dose Lipitor?

Given my lack of practice and my aging brain, I suspect that 1994 JF with 1994 knowledge would do better on today's exams than I could. Yes, stroke management is somewhat changed and the old antibiotics don't work so well (be afraid -- they don't have easy replacements), but much of day to day healthcare seems to be changing more slowly than most people imagine. One big change was the source of much complaining -- noone likes their medical record computer system very much.

Planning a family bike outing via Google Maps

Google Maps - ice cream

Our family bike outings are structured around rewards -- of which Dairy Queen is the optimal currency. Since I'll be solo tomorrow in a new area with our 3 young children and my son's friend I needed som advance scouting. A bike trail map gave me the general idea, Google Maps located the Dairy Queens around the target zone. I found I could trace the bicycle trails from the satellite images; the trails are narrower than streets and they never have cars on them. Sometimes the trail narrows into invisibility when the trees are thick, but it can be seen emerging a bit later. This particular image is centered on the intersection of the 'Gateway/Vento' trail and the Lake Phalen cross trail. Using Google's satellite navigation I'm able to trace the bike trail route we'll take and identify problematic cross-streets.

I've already asked Google to think about how they could add bike trails to these maps. Perhaps regional bicycle groups could submit data in a pre-defined format so that Google could display bicycle and skating trails over their maps.

Now you can go camping with a digital camera

The New York Times > Technology > Circuits > Professional Cameras, Made for the Amateur. Go Ahead, Say Cheese.

The new Nikon D70s ought to work quite well, even on a one week camping trip.

Battery life is nearly endless; the Rebel XT's new smaller battery is nonetheless still good for 600 pictures a charge, compared with perhaps 200 on a typical digital camera. The D70S's new battery extends this to a delirious extreme: each charge can power the camera for a staggering 2,500 photos. You can go weeks between charges.

Remote photography was one of the last strongholds of film cameras.

Hydrogen sulfide gas causes mice to enter a hibernation-like state

BBC NEWS | Science/Nature | Mice put in 'suspended animation'

Once every two weeks I read something that makes my jaw drop and my eyes bug out. This is happening more often, so either I'm getting more sensitive with age or the world is moving way fast. This announcement qualified.

...The researchers from the University of Washington and the Fred Hutchinson Cancer Research Center in Seattle put the mice in a chamber filled with air laced with 80 parts per million (ppm) of hydrogen sulphide (H2S) - the malodorous gas that give rotten eggs their stink.

Hydrogen sulphide can be deadly in high concentrations. But it is also produced normally in humans and animals, and is believed to help regulate body temperature and metabolic activity...

....Dr Roth and his colleagues found that the mice stopped moving and appeared to lose consciousness within minutes of breathing the air and H2S mixture.

The animals' breathing rates dropped from the normal 120 breaths per minute to less than 10 breaths per minute.

During exposure their metabolic rates dropped by an astonishing 90%, and their core body temperatures fell from 37C to as low as 11C.

After six hours' exposure to the mixture, the mice were given fresh air. Their metabolic rate and core body temperature returned to normal, and tests showed they had suffered no ill effects.

Mice can enter a similar state when they are starving. Human's don't have a physiologic state like this, so I'm betting this won't work in humans. Nonetheless, it is stunning.

Google's search history function - at last

Google - My Search History

About 8 years ago I wrote Alta Vista asking them to do this. I'm sure my email got a lot of attention :-):

My Search History lets you easily view and manage your search history from any computer. This feature of Google web search enables you to find information you thought you lost. And over time, you'll see an increasing number of relevance indicators in your search results that help you find the information you want.

And one ring to bind them ...

PS. Google services are tied to a Google identity. Unfortunately I have two identities -- one I use with Google Groups/Usenet and one bound to my Gmail account. Of course there's no way to merge the two. Google strongly favors having a single identity; I've run into a number of problems due to my "multiple identity disorder".

The limitations of lifestyle changes

The New York Times > Week in Review > The Body Heretic: It Scorns Our Efforts

Other than smoking cessation, the health benefits of lifestyle changes for middle-aged adults has probably been oversold:

At most, Dr. Kramer said, the effect of changing one's diet or lifestyle might amount to 'a matter of changing probabilities,' slightly improving the odds. But health science is so at odds with the American ethos of self-renewal that it has a hard time being heard. Here, where people believe anything is possible if you really want it, even aging is viewed as a choice.

Genetics and experience have determined the health fate of most people by middle-age. Other than smoking cessation, other interventions may have limited benefit. Maybe weight loss and excercise could help, but very few adults can start managing weight or activity effectively so "late" in life. In any case, much of the damage done cannot be reversed.

Smoking cessation, drugs and surgery -- that's the message for the middle-aged.

Now for the young -- there we ought to be focusing on lifestyle changes, particularly exercise. Alas, our public policies and our social behaviors are not helping.

Fallows on what's cool in tech

The New York Times > Business > Your Money > Techno Files: An Update on Stuff That's Cool (Like Google's Photo Maps)

Skype, Google Maps and more. A fun overview.

The Land of Rand

The New York Times > Business > Your Money > The Insurance Scandal Shakes Main Street

Another day, another massive corporate scandal:

[Doctors and lawyers discover they don't have malpractice coverage after all ...] [two of the] men had coverage from a company called Reciprocal of America. Their lives, and those of thousands of other doctors and lawyers in the South and the Midwest, have been in flux since Reciprocal cratered about two years ago amid a tangled web of business transactions that regulators describe as fraudulent...

... Regulators contend that Reciprocal, aided by outside business partners - including General Re - used financial gimmicks to mask serious problems and benefit insiders for more than a decade, until the company foundered...

... Reciprocal's former chief executive, Kenneth R. Patterson, and a former executive vice president, Carolyn B. Hudgins, have already pleaded guilty to federal fraud charges...

... Executives involved in the dizzying matrix of offshore accounts, secret transactions and financial sleight of hand that defined Reciprocal's business often struck deals in luxurious surroundings, even as Reciprocal itself was falling apart, according to the lawsuits. Executives, the lawsuits say, sometimes convened at fancy resorts and on other occasions cemented deals while cruising Chesapeake Bay aboard the Scottish Lass, a yacht owned by a Reciprocal executive. Reciprocal managers referred to the summer boating excursions as 'Chesapeake Audits,' according to one lawsuit.

And how about that AIG (emphases mine):

Mar 17th 2005 | NEW YORK
From The Economist print edition
Regicide in the insurance industry

FEW leaders of big American companies dominated their firms as completely as Maurice “Hank” Greenberg; few stood so large in their industry. It is often said, only half in jest, that American International Group (AIG) had a flat management structure, with 90,000 employees all reporting to Mr Greenberg...

... The most commonly held theory is that Mr Greenberg was laid low by transactions he personally arranged in 2000 with General Re, a reinsurer now owned by Warren Buffett's Berkshire Hathaway, that had the appearance of boosting AIG's reserves without actually doing so...

... This is not AIG's only problem. Four former employees have pleaded guilty in a bid-rigging case centred on Marsh & McLennan, the world's largest insurance broker. (Marsh's chief executive, Jeffrey Greenberg, Hank's son and formerly his chosen successor at AIG, had to resign last October. Hank's other son, Evan, also once his designated successor, is chief executive of ACE, another large insurer being investigated in the bid-rigging scandal.) In the past two years, AIG has reached settlements, without admitting guilt, with the Securities and Exchange Commission and the Department of Justice over the sale of insurance policies to PNC Financial, a bank, and Brightpoint, a technology company. The regulators had said that these masked financial performance rather than providing insurance.

Regulators are also scrutinising Mr Greenberg's attempts to put pressure on specialists on the floor of the New York Stock Exchange (NYSE) to support AIG's share price in 2001, while it was consummating the acquisition, paid for with stock, of American General. Mr Greenberg's efforts included lobbying the NYSE's then chief executive, Richard Grasso. At the time, Mr Greenberg sat on the compensation committee of the NYSE. Mr Grasso's pay is the subject of its own investigation...

... During most of Mr Greenberg's tenure, AIG was the rare insurer that managed to combine fast growth with apparently low risk

The question now is whether AIG is finally losing its aura of impregnability. During most of Mr Greenberg's tenure, AIG was the rare insurer that managed to combine fast growth with apparently low risk. Wall Street analysts fell over each other to praise the company and it was one of the very few to enjoy top credit ratings from all the main agencies. This enthusiasm sprang partly from admiration for AIG's remarkable performance, but there was a darker side as well. Mr Greenberg was infamous for browbeating not only analysts who questioned AIG, but their bosses too. One analyst who told The Economist that AIG's shares were over-valued relative to its competitors received an unscheduled visit from the company's lawyers, who brought a pre-written retraction for him to sign (he declined). The company parcelled out its legal work among all the top law firms. This created a conflict of interest for any such firm representing anyone in legal action against AIG...

... With the agencies pondering and regulators probing, there may be more reason for analysts, investors and others to ask questions about the details of AIG's business. Although AIG has responded to criticism by becoming more open in the past two years, its operations remain fairly murky... because AIG pools its results from foreign operations, it is difficult to understand precisely how, and where, it makes money...

... AIG's opaque compensation scheme for senior managers, administered through a Panamanian corporation named Starr International, will ensure some loyalty. There are, it is said, several billionaires besides Mr Greenberg in its top ranks and others worth hundreds of millions. The scheme has some odd quirks, in as much as Starr International is controlled by Mr Greenberg and it is not clear that he must surrender this role...

Okay, so we have Enron and its ilk, AIG and its brethren, the SEC knee-capped by Bush, and a stench of corruption oozing about American capitalism. Not to mention the problem with index funds. Which is why this NYT Magazine article is so timely:

... A law professor at the University of Chicago, [Richard A.] Epstein was notorious in legal circles for his thesis that many of the laws underpinning the modern welfare state are unconstitutional. Thomas tried to assure Biden that he was interested in ideas like Epstein's only as a matter of ''political theory'' and that he would not actually implement them as a Supreme Court justice. Biden, apparently unpersuaded, picked up a copy of Epstein's 1985 book, ''Takings: Private Property and the Power of Eminent Domain,'' and theatrically waved it in the air...

... As Epstein sees it, all individuals have certain inherent rights and liberties, including ''economic'' liberties, like the right to property and, more crucially, the right to part with it only voluntarily. These rights are violated any time an individual is deprived of his property without compensation -- when it is stolen, for example, but also when it is subjected to governmental regulation that reduces its value or when a government fails to provide greater security in exchange for the property it seizes. In Epstein's view, these libertarian freedoms are not only defensible as a matter of political philosophy but are also protected by the United States Constitution. Any government that violates them is, by his lights, repressive. One such government, in Epstein's worldview, is our government. When Epstein gazes across America, he sees a nation in the chains of minimum-wage laws and zoning regulations. His theory calls for the country to be deregulated in a manner not seen since before Franklin D. Roosevelt's New Deal. [jf: would Epstein argue that the ancestors of slave owners are owed reparations?]

Which brings one back to the Land of Rand. Ayn Rand, the novelist and philosopher was the public face of what we now call 'Libertarianism' (she called it Objectivism); Rand's most famous living disciple is Alan Greenspan. Rand wrote like a journeyman romance or science fiction novelist; like most science fiction novels her stories are remarkable for the utter absence of children and the disabled. In Rand's world the "market" rewards the "fit" and punishes the "unfit", and good is what the market defines (the roaring sound you hear is the spinning of Charles Darwin's body). Rand, Lenin, and Marx seem to share both atheism and a fetish for recreating God and Devil as Market and State -- though the assignments varied.

Rand's philosophy can best be summarized in two words "caveat emptor". Let the buyer beware. In an Objectivist world there are few if any rules, save those that arise from a mystical market that's magically sustained by ... ummm... errr ....

Roughly (very) speaking then, Randian Libertarianism is a cross between 'God as Market' and early 20th century social darwinism. The Bush party is likewise very committed to social darwinism with a Calvinist spin, and has a strong 'God as Market' wing (the christian conservatives belong to the rather similar 'Market as the Will of God' coalition). From a different direction we have silicon valley bazillionaires who are often fond fans of Rand (her books are a paeon to their wonderfulness). Putting all of that together, and given the news of the past five years, it's fair to say that the US is becoming the Land of Rand.

I don't think this will work very well for the weak.

The reform of Manhattan - how important was abortion?

The New York Times > Opinion > John Tierney: The Miracle That Wasn't

The city of New York (Manhattan, Bronx, etc) went from one of America's most violent cities to one of our safest towns. Why?

Tierney describes a debate on the question between Steven (Freakonomics) Levitt and Malcom (Tipping Point) Gladwell. Alas, Tierney assumes one is pretty familiar with the particulars of the debates. My tentative reconstruction is that during the early 90s it was believed that social policing was a critical factor that "tipped" the murder rate from a persistently high rate to a relatively low rate. More recently some have argued that New York's early legalization of abortion, and the high rate of abortion in Manhattan, played a critical role.

My completely uninformed suspicion is that this is a multifactorial equation (shocking, I know). Any of the significant factors (policing techniques, police numbers, new software, long sentencing, decreasing unemployment, rising home costs, demographics/abortion rates, crack use, abortion rates, social attitudes) could be important, and in isolation might be considered solelyl responsible. Perhaps the question, and maybe this is what the debate are really about, is whether the equations are linear or non-linear. A linear regression means that the crime rate will change in a smooth and continuous fashion (though possibly exponentially), a non-linear model means that the the transitions may be "sticky" -- that crime rates may persist at one "pole" or another. I've historically favored non-linear explanations, but I don't have that strong a bias (and it's completely uninformed anyway -- non-linear is just "sexier".)

The policy questions are:

1. What is the most cost effective and socially acceptable way to replicate this drop? Is there one intervention to begin with (since all the terms of the equation interact)?
2. What does New York need to do to keep murder rates low?
3. How big a factor is abortion? If abortion use falls and birth rates rise, is there any way to keep murder rates low? Could any other form of birth control compensate? (Abortion has been an infamously popular form of birth control in locations where it's easily available -- such as Russia.)

Bill Frist: Theocrat

The New York Times > Opinion > Editorial: Bill Frist's Religious War

Bill Frist has declared himself. He is a theocrat of the christian fundamentalist variety.

Senator Frist is to appear on a telecast sponsored by the Family Research Council, which styles itself a religious organization but is really just another Washington lobbying concern. The message is that the Democrats who oppose a tiny handful of President Bush's judicial nominations are conducting an assault 'against people of faith.' By that, Senator Frist and his allies do not mean people of all faiths, only those of their faith.

The problem with index funds

The New York Times > Business > Media & Advertising > While Shares Fell, Viacom Paid Three $160 Million

I've long been an index fund investor. Historically, that's where the smart money has gone. But are times changing?

The top three executives at Viacom Inc. received total compensation last year valued at about $52 million to $56 million each in salary, bonus and stock options, the company disclosed yesterday.

And then there's AIG, a company that threatens to make Enron look good and send Warren Buffett into retirement.

The power of index funds is that they benefit from low operating costs and the distributed "intelligence" of the market. But what if corruption is rampant in the economy, and more than a few companies are making a transition from symbiotic to parasitic relationships? If that's true, then index fund investors are simply feeding funds to corrupt organizations. But where are the index fund managers? Vanguard and Fidelity, large index fund managers, had their chance 4 years ago to help clean the mess, but they chose to stand aside.

Perhaps we'll discover that index funds work best in a relatively honest and transparent marketplace. Maybe we'll learn that funds like Calvert will become more effective in a relatively corrupt marketplace. Perhaps and maybe are great weasel words, but we'll be accelerating moves into Calvert (though I hate adding complexity to my investment world).

Introduction to blogs and bloglines

tecosystems: How to Get Into Blogs, 101

This tutorial focuses on my preferred blog reader: the bloglines web client. I'll be pointing quite a few people here.

Amazon.com Most Wished For: iPod madness

Amazon has a new feature -- a summary of the the 'most wished for' items across their customer base. A ridiculous percentage of the top 25 electronics items are iPod related. The full iPod lineup is in the top 10, accessories populate much of the rest of the top 25.

Clearly, the iPod craze has reached a kind of lunatic level. It has nowhere to go but down now ...

BTW, I do like my iPod.

Tours open now for the virtual world: Google maps and eyeballs

Notes: Interesting Google Satellite Maps

This page will likely be slashdotted soon, but it will return eventually. A number of people are discovering interesting things in Google's satellite images. It's the spying equivalent of open source -- many eyes means much discovery.

In 10/01 I proposed the DOD outsource satellite imagery of Afghanistan to US desktops. Let millions of eyes spy the terrain and analyze the data. I also suggested using large numbers of automated drones circulating in controlled areas, and allowing thousands or millions to view the data on their desktop. There are obvious risks to such a strategy, but I think they might be manageable (ex. mix fake data with real data to confuse spies, etc -- only the DOD knows what's real) ...

This phenomena is the merest beginning of the brave new world of mass surveillance and virtual tourism -- tourism that will mix the real world with the virtual. Imagine hundreds of 'avatars' "flying" and exploring the imaged terrain of the grand canyon -- with older and new images seamlessly mixed together.

PS. Of course Verner (singularity, fast times at fairmount high) Vinge and David (transparent society) Brin have already described all of the above and more. It is amazing to see it all starting however.

Update: I'm so slow in my old age. Way behind the curve. I think Google needs to post a sign on their lab page: Danger, singularity ahead.