September 25, 2018

BehindTheMedspeak: Things providers and patients should question

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Just because your doctor says so doesn't make it true.

Far too often she or he is relying on knowledge gained in medical school but long since superseded by better practices.

Fifty-nine (59!) pages like the one above, chock-a-block with things you're likely to hear in a doctor's office that you should question.

That is, if she or he isn't so insecure that they react with anger or annoyance at your intrustion into what they consider their sacred space.

Don't be intimidated.

Besides which, you can always get a third opinion here.

Free, the way you like it.

Of course, it might be worth exactly what you're paying for it — don't be a hater.

Fair warning: there goes the day along with your doctor(s).

[via ChoosingWisely]

September 25, 2018 at 02:01 PM | Permalink | Comments (0)

There's always a parking space

In this exclusive boj©® World Premiere, I reveal to one and all my recent discovery of the mother of all parking Easter eggs: namely, that there's ALWAYS a spot even when the supermarket lot appears full.

You'll feel very smug when everyone else goes around and around and up and down the aisles of cars waiting for someone to leave, because you know your spot is ready for you whenever you are.

September 25, 2018 at 12:01 PM | Permalink | Comments (1)

The Sun's effect on skin — A controlled study


"The result of driving a truck for 28 years, exposing only half your face to direct sunlight."

[via estaticos.02 and reddit]

September 25, 2018 at 10:01 AM | Permalink | Comments (0)

Take a Break Mug


Double-walled ceramic.

5.5" x 4.3" x 4.2".


September 25, 2018 at 08:01 AM | Permalink | Comments (0)

September 24, 2018

A Cat's Map of the Bed


September 24, 2018 at 02:01 PM | Permalink | Comments (1)

You are the Kindle daily special!


Crack Rochester Correspondent©® Greg Perkins emailed me this morning with the news.

At first I got all excited, thinking Amazon had plucked my Kindle book

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out of the virtual wilderness (see Saturday's 10:01 a.m. post, which led with this graphic):


But no, it wasn't to be.

Instead, Amazon decided to flog some novel called "Book of Joe"


whose title I'm sure the author stole from me.


No worries.

September 24, 2018 at 12:01 PM | Permalink | Comments (0)

What to do in case of emergency



The subject of emergencies and their management is of particular interest to me because of my professional background and training as an anesthesiologist.

Long story short: an anesthetized patient — anyone, actually, but I'm not responsible for those I'm not anesthetizing — is five minutes away from permanent brain damage and death.

There is very little margin of safety afforded by mother nature to the oxygen–dependent cells of the cerebral cortex.

Yet if every time something went wrong in the OR it precipitated a panic attack in me because I envisioned a disaster just moments away, I wouldn't last long without stroking out myself.

So knowing when something is serious, or potentially so, and when it's a variant of normal, is critical.

It helps to have seen almost everything imaginable — almost — many times.

But no one is perfect and there may be a catastrophe waiting to happen the very next time I put someone to sleep.

But there are ways to mitigate the anxiety and decrease the chances of such a thing happening.

James Surowiecki, in his "Financial Page" column in the June 13/20, 2005 issue of the New Yorker, discussed this subject quite nicely in the scope of a single magazine page.

His piece follows.



In the early nineteen-eighties, American businesses discovered that they could manage crises, rather than merely stumble through them.

The gold standard was Johnson & Johnson, whose deft maneuvering, after seven people died from ingesting cyanide-laced Extra Strength Tylenol, helped create a new and lucrative subset of public relations known as crisis management, which was poised, as Time put it in 1986, to become "the new corporate discipline."

Practice — and lately there's been plenty of it — has not made perfect.

Companies may now have packs of super-flacks on hand, but in the glare of bad publicity they can still appear as helpless as possums in the road.

In the past few years, stalwarts like Firestone, CBS News, Tyco, and Marsh & McLennan have seen their reputations demolished, mainly because they did such a lousy job of dealing with bad news.

Most recently, Wendy's took a month to discredit a woman who claimed that she’d found a human finger in her chili. (She's since been arrested for putting it there.)

The delay cost millions of dollars in sales and did incalculable harm to the brand.

The term "crisis management" may seem like little more than a euphemism for "snow job," but there is an art to it.

Spin alone won't do the trick.

Without going overboard, the offending company needs to acknowledge that it has a problem, demonstrate that it has control over that problem, and then make a real attempt to fix it.

This holds true whether or not the company is at fault.

Johnson & Johnson defused the Tylenol crisis in large part because it recalled every Tylenol capsule in America, and then quickly introduced tamper-proof bottles.

In the end, the company was seen as the victim.

By contrast, when news broke, in 2000, that more than a hundred people had died in accidents involving defective Firestone tires, Firestone initially reacted by blaming drivers (for underinflating their tires) and Ford (whose S.U.V.s were involved in most of the accidents).

Dispirited by this strategy, Firestone's P.R. firm quit.

Eventually, Firestone recalled 6.5 million tires, but it was too late.

Sales plummeted, and claims mounted into the hundreds of millions.

Many companies have basic assumptions about public relations that can hurt them during a crisis.

They tend, as people do, to stonewall and deny.

But, as Ian Mitroff, a crisis-management specialist at U.S.C., has said, "There are no secrets in today’s world."

And if the truth is on your side you have to insure that it emerges quickly.

In 1993, when syringes ended up in Pepsi soda cans, allegedly as a result of a flawed canning process, the company, within a few days, produced videos of its entire canning process and denounced its accusers as frauds.

Wendy's, on the other hand, wasted a month investigating its entire supply chain, made little of the fact that the accuser had a long history of suing companies on dubious grounds, and, bizarrely, spent more than a week figuring out if the finger had been cooked.

In the meantime, parents took the kids to Roy Rogers.

It's easy to make intelligent decisions after the fact.

The real challenge is making them in moments of anxiety and panic, so, while crisis-management gurus don't always agree on what the strategy should be, they do agree that everyone should at least have one, before crisis hits.

Their clients tend not to listen.

Mitroff estimates that less than a fifth of big corporations have formal crisis-management plans.

The crisis plans that do exist vary in detail and scope — Dow Chemical had one that included the names of the people who would be responsible for running the copy machines — but, basically, they suggest vulnerabilities (and potential remedies), identify a crisis-management team, and lay out a general script.

Even a simple plan is valuable; though crises are, by definition, rare, they should not be unthinkable.

A study released last week by the Institute for Crisis Management found that just a quarter of business crises come out of the blue.

Most are "smoldering" rather than sudden, and are the result of mistakes that management has made.

Signs of trouble exist but are ignored or overlooked.

Many of the most famous crises are examples of what the sociologist Charles Perrow has called "normal accidents."

As technologies and organizations get more complicated, Perrow argued, they are more likely to break down, even in the absence of malice or intentional neglect.

Firestone, the Challenger explosion, Intel's flawed Pentium chip: you could argue that these were all, in one way or another, normal accidents.

Why are companies so often caught unaware?

It turns out that the events that create crises are usually those which most people have trouble taking seriously — that is, events with a low probability but a high cost.

We tend to treat low-probability events as if they were impossible.

Instead of preparing for them, we ignore them.

In the phrase of the sociologist Neil Weinstein, we are "unrealistic optimists."

This tendency is exacerbated when we think we're in control; we worry less about the dangers of driving than about those of flying because we think we determine what happens to us on the road.

Of course, unrealistic optimism, insofar as it's a byproduct of self-assurance, assertiveness, and conviction, may be a handy trait for those seeking success in business.

It will come as a surprise to no one that in most surveys executives are found to be consistently optimistic and overconfident.

Entrepreneurs are the cockiest of all.

It may be that the very qualities that help people get ahead are the ones that make them ill-suited for managing crises.

It's hard to prepare for the worst when you think you’re the best.


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I cannot praise Charles Perrow's 1999 book, "Normal Accidents," highly enough.

I read it a long time ago, and it made me a much better anesthesiologist.

If ever I were to return to academia, my first grand rounds would feature this book and its lessons.

It has much to offer anyone in terms of both their professional and personal lives.

Long book summarized in one sentence?

The more complicated or unusual something is, the more likely something is to go wrong.

But you'd do better to read the book.

September 24, 2018 at 10:01 AM | Permalink | Comments (0)

World's Most Expensive Smartwatch

TAG Heuer Connected Modular 45 Smartwatch

Pictured above, it's the TAG Heuer Connected Modular 45.

The 45-mm case is in 18K polished white gold with a total of 589 VVS (very very slightly, ranked under only flawless and internally flawless) baguette diamonds totaling 23.35 carats.

It costs $198,000.

Can they sell one to you?

Apply within.

[via Barron's]

September 24, 2018 at 08:01 AM | Permalink | Comments (0)

September 23, 2018

Haruki Murakami on parallel realities







Read "The Wind Cave" here.

September 23, 2018 at 12:01 PM | Permalink | Comments (1)

World Exclusive: iPhone XS Ringer Button Haptic Easter Egg

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I've only read about twenty reviews of Apple's new flagship in the past week.

It's what a fanboi* does.

On Friday I ventured over to Best Buy to see the new phones and spent some some time playing around with the Max, comparing it side-by-side to my X in various applications.

Conclusion: WANT.

I was expecting huge crowds and lines at the store but that wasn't the case: it looked like an ordinary day.

Contrast that with the mobs in Singapore waiting many hours to buy one.

There are some advantages to living in Podunkville.

Even though you have to wait weeks (should you order today) to get an XS or Watch 4 from Apple, you can walk right into my local Best Buy this very minute and buy either or both.

But you can't try the watch since they have no display models.

It's taking everything I have to resist until I can actually see the watch and try it on and play with it physically in an Apple store, so perhaps the next time I'm in Richmond for a race (I'm doing the half-marathon on Saturday, November 10) I'll stop by the Short Pump store to do just that.

Though it's more likely I'll be so tired and blown out from the race, I'll skip the stop and just head straight home to chill for the rest of the weekend with Gray Cat.

But I digress.

The Easter egg: 


The iphone XS/XS Max ringer on/off button (below)


makes a very satisfying and pleasant "thunk" when you turn it off. 

This is an excellent new feature, which I haven't read about anywhere.

With my X and previous iPhones, if you turned the ringer on or off without looking at it or the screen, you were never dead certain it really was off; if you're anything like me, you always turn the phone sidewise to actually see the red line indicating silent. 

For instance, reaching into your bag or pocket to mute it without anyone noticing up to now has been a crapshoot in terms of your being 100% certain you've turned it off.

A ring at the wrong time can result in very bad things ensuing. 

I'm thinking in court or in the O.R., with job interviews, movie theaters and playhouses, and innumerable other no-ring zones following close behind.

You're gonna love it.

Try it out the next time you see an XS and see if you don't agree.

If not, just let me know, and I'll refund every penny you paid for this tip.


*I rarely see "fanboi" used by anyone else but I think it's an apt extension of "fanboy," applicable to those who — like me — just slurp Apple. Kind of looks Japanese even though it's in English.

September 23, 2018 at 10:01 AM | Permalink | Comments (2)

Experts' Expert: Penn Jillette's favorite playing cards


Penn jillette experts' expert-cards

You can too!


Cheap at twice the $5.78 price.


[via the Wall Street Journal]

September 23, 2018 at 08:01 AM | Permalink | Comments (0)

September 22, 2018

Layers of London (Disambiguation: NOT about English chickens)

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From Ian Visits:


A map of London, as it was during the era of the Tudor monarchs (give or take a few decades) has been released by Layers of London.

It lets you add a layer to a standard modern map, and then zoom in and around London as the Henrys and Elizabeth would have known it.

Particularly visible on the map is the huge moat that ran around the outside of London.

This was the often-forgotten counterpart to the Roman wall (and its later civil war equivalent) that added a large ditch in front of the wall.

That made attacking the wall doubly difficult, as its effective height was then twice the original height as well as being more difficult to approach.

Also look for Ludgate and the then still open Fleet river; as you zoom around you'll start to realize why parts of London have such odd names.

Most of what is the LSE today was Ficken's Field, St. Katherine’s Dock is still a hospital, the Barbican was Le Barbycane, and Liverpool Street station was still the Bedlam Hospital.

Winchester Palace was in Southwark, from whence came "Winchester Geese," a nickname for prostitutes who worked the area outside the control of City of London authorities.

Along with the Tudor map you can view others, such as the Morgan map of 1682 or the Rocque Map of 1746.

Another mapping website of more modern but equal value is the Side-by-Side map from the National Library of Scotland, which covers most of the UK in 1914.

September 22, 2018 at 12:01 PM | Permalink | Comments (0)

So you wanna be a writer

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Don't quit your day job just yet, would be my advice.

September 22, 2018 at 10:01 AM | Permalink | Comments (0)

Marble Bowtie


Just the thing to wear with your cement overcoat.

But I digress.

From the website:



A series of bowties made from natural marble.


No two pieces will ever be exactly the same.


Hand-cut and polished natural stone.


5" x 2".



Though the website didn't mention it, I will: pretied.


September 22, 2018 at 08:01 AM | Permalink | Comments (0)

September 21, 2018

Sergio De La Pava — author of the superb novel "A Naked Singularity" — speaks

His wonderful book is nearly 700 pages long and I wished it were ten times longer. 

Above, he speaks on one of the themes of his 2012 novel.

A remarkable person.

Paul Ford's artful book review is here.

September 21, 2018 at 12:01 PM | Permalink | Comments (1)

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