b.cognosco
Where leaping to conclusions is my primary form of forward motion.
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Zen and the Art of the Backup
It's Not a Rate Increase, It's a Reclassification
Should a President Expect Congressmen to Read the Bills They Pass?
My Trademark Attorney is a Blues Fan
How To Think About A Presentation
Private Intelligence and the Sovereign Individual
Wednesday, May 9, 2007
Why Your Doctor Should Read Wired Magazine
I’m often complaining about doctors, the archaic practices of med school, and healthcare in general. But some doctors actually get past the drudgery and pain of spending half their waking hours dealing with dysfunctional bureaucracy with enough imagination intact to actually keep getting better at what they do. How do you know if your doctor has imagination and energy for growth? Maybe they read Wired magazine, or even have a blog like Clark Venable. The sad thing is this stands out because it is so rare.
I'm a Better Anesthesiologist Today Than A Year Ago
At the end of this busy week I began to reflect on how this week was different than an average week would have been even a year ago. It was different both for me and for a significant number of my patients. Hopefully, it was as good for patients as it was for me.
For the first ten years after I finished my training I did not believe nerve blocks for extremity surgery were worth doing. Surgeons didn't want to wait for me to do them or for the blocks to 'set up.' Blocks failed a certain amount of the time. There were complications that just didn't happen when 'numbing the big nerve.'
My thoughts on all this changed, not because of a journal article or discussions with a colleague, but because of an article in Wired magazine. The Painful Truth was an article on the use of regional anesthesia to improve medical care to our wounded soldiers in Iraq and Afghanistan:Now Buckenmaier is leading a group of army doctors and nurses determined, as he puts it, "to drag the military kicking and screaming into the 21st century." His team believes the future of wartime pain control is a new form of anesthesia called a continuous peripheral nerve block, which takes a more targeted approach by switching off only the pain signals coming from the injured limb, leaving patients' vital signs and cortical functions unimpaired.The applicability to civilian anesthesia was obvious. In my hospital, when someone gets a knee replaced, the surgeon usually blindly injects a large amount of local anesthetic in the general vicinity of the femoral nerve and we dope them up with morphine. Patients are in the hospital for three days largely for pain control issues, all the while at risk for nausea, vomiting, respiratory depression, etc.
I took a second look at regional anesthesia and decided to use it in my practice again. This week two elderly ladies had total shoulder replacements after having interscalene blocks. They were pain free for the rest of that day. Six of my patients had knee replacements after femoral and sciatic blocks. They had no pain until the next morning.
With catheter techniques, these pain-free intervals will be measured in days instead of hours. The surgeons are giving us the time to do these techniques because they are hearing about how good they are for patients at their own national meetings. My colleagues who 'didn't do blocks' have learned to do simple femoral nerve blocks and want to learn others.
It was a good week for me because I love seeing patients do well. It was a good week for my patients (whether they knew it or not) because they trusted me enough to let me poke them with a needle once or twice to make their recovery that much easier. By next year I hope to be placing catheters and doing infusions. Thanks, Trip Buckenmaier.
Terry Frazier at 10:39 PM
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Zen and the Art of the Backup
Brent Ashley reminds us all that backups are essential to peace of mind. Which reminds me... I've been living off my laptop for more than a year since my last workstation went up in flames (gawd, I hate computers) and I really need to back it up to an external drive like, right now.
The path to serenity is via regular backups
Michael O’Connor Clarke’s recent brush with near-data-death had a happy ending, and he credits my backup advice with helping to save the day. I figure now is as good a time as any to make that advice more widely known.
The ONLY successful backup strategy is one that actually gets your system backed up regularly. This means taking it out of the hands of the procrastinator and into the hands of the automator.
In my opinion the only truly workable restore strategy is to have a disk image to restore. If you have to spend untold hours loading your OS and programs, searching for license keys and farting around with settings, passwords, adding users etc etc, just to get to the point where you can restore your backed-up data, you are wasting time and money.
A regularly scheduled disk-image backup will save your otherwise very sorry ass many many times.
I use Acronis True Image to back up my laptop. The Home version suits my needs, but the Workstation and Server products are stellar as well for a business environment.
Acronis makes a compressed image of selected partitions on your hard drive. It does this in the background while you are still using your computer. You can schedule it to happen regularly so you don’t even have to think about it.
With Acronis you can:
- Make a full image of your drive
- Make multiple incremental images against a full image
- Save the image locally or over the network, split to multiple files or CDs/DVDs
- Access the images for read or restore
- Mount any full or incremental image to access a snapshot of your drive via a drive letter
- Restore your machine from any full or incremental state via disk, cd, network
- Restore your machine from bare metal with a rescue boot CD
- Schedule backups
- Automate backups so you don’t have to think about them
- Define pre and post commands to run
Those are the basics you need. Beyond that you can use the rescue CD to back up and restore non-windows partitions, too - Linux and BSD for instance. There are many other features too.
I have a scheduled task set up to back up my laptop every Monday and Thursday at 2am to my home server. If my laptop is plugged into my network at home at those times, it will save a full disk image to the server. If the target directory already contains a full image, it will build an incremental image.
At the start of each month, I delete the contents of my LastMonth directory and move the current image and incrementals there. I should really write a batch to invoke pre-task to do this automatically, since this is the only thing I still have to remember to do.
I’m pretty serious about my backups. On my server, I have two 250Gb hard drives that I synchronize daily using rsync. I also copy certain critical files off to a NAS device that’s at the other end of the house and take sporadic file backups to a USB drive to take offsite. You don’t have to get that crazy about it, but for the sake of your long-term sanity, by all means set up a regular image backup of your main machines.
Terry Frazier at 10:23 PM
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Monday, May 7, 2007
It's Not a Rate Increase, It's a Reclassification
The new AT&T - "We're back. And it's just like nothing has changed."According to the article, no one regulates phone card rates. Not the state of MO, not the FCC, nobody.AT&T now charges eight minutes for one of these one-minute calls in Missouri
Jo Ann Weitkamp knew something was wrong. The minutes on her prepaid telephone calling card were disappearing faster than she was talking.
Weitkamp, 72, lives in an apartment for seniors in Warrenton. Every few months, she visits a Sam's Club store and pays about $28 to add 1,000 minutes to her calling card. She's found that an inexpensive way to keep in touch with family members.
Until now.
Since February, AT&T has been charging Missouri customers eight minutes on their prepaid calling cards for each minute they talk to someone in Missouri.
The charge formerly was one minute for each minute called.
[...]
"We're following the law, and this is something we're required to do by the FCC," said Amanda Ray, a spokeswoman in Dallas for AT&T.
She says the change is not a rate increase.
"It's a reclassification," Ray said. [...]
The problem here isn't the rate, it's the deception. AT&T wants to be allowed to change rates without state permission. Fine. Do that. But don't lie about it. Don't throw in some bogus multiplication factor when you agreed to provide per-minute charges.
There are two industries that deserve to be uttelry destroyed - the music industry and the telcos. They are both saturated with an entitlement mentality that defies description, and are populated by lying rat-bastards of the highest order. Good riddance to them both.
Terry Frazier at 11:10 AM
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Wednesday, May 2, 2007
Should a President Expect Congressmen to Read the Bills They Pass?
Politico.com is having a public poll to help determine questions to be asked of candidates in tomorrow's Republican Presidential Candidate Debate. I just cast my vote for the question:Do you believe that Congress should have to read the bills they pass? In other words, do you support adoption of the "Read the Bills Act"?There are many important issues but, frankly, none of them matter if we don't get some way of forcing politicians to actually read, understand, and acknowledge the full contents of bills for which they vote. At present, Congress camouflages bills with euphemistic, patriotic-sounding names that are completely irrelevant to the contents and impact. But the name is just about all most Congressmen know about a bill before they vote on it.
Whether your issue is Iraq, torture, WMDs, global warming, or whatever you should understand that as long as Congress keeps score by how many bills they pass, and that in most cases they have absolutely no clue what's actually in the bills on which they vote, your issue is never, ever going to be treated in the open fashion any and every serious issue deserves.
If you're interested, go to Politico.com and cast your vote for the questions you think are important, or submit one of your own.
Terry Frazier at 3:28 PM
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My Trademark Attorney is a Blues Fan
Marty Schwimmer is my trademark attorney. I never met him except via The Trademark Blog. Turns out he’s a blues fan. Cool.
After the Blogging Thing, Kingston Mines Tonight
After the blogging get-together tonight at the Billy Goat Taven (which, I am told, is below street level so look for the stairs), a bunch of us are meeting up at Kingston Mines (a blues club), 2548 N. Halsted.
How To Think About A Presentation
My friend and colleague Sean Murphy, who is a great synthesizer and sensemaker, came up with an excellent presentation idea a while back. He’s done this a few times now and if you’re in the San Jose/Silicon Valley area and have a chance to see Sean’s “12 Books for the Busy CEO” you should do so. Links to his next session is below:
Crucial Marketing Concepts for Consultants @ PATCA May 10
I will be presenting a revised and improved version of the “12 Books for the Busy CEO” presentation on Thursday May 10 at 6pm at the PATCA monthly dinner at the Embassy Suites Santa Clara - Silicon Valley on 2885 Lakeside Drive in Santa Clara.I will cover a dozen books and offer a synthesis of the key marketing concepts (this is not a sequence of twelve book reports) that they offer. I will have an article on crucial marketing concepts that I will give out for attendees. There is good content here for entrepreneurs, whether they are starting out as consultants or embedding their expertise in software or a SaaS offering.
Spend an hour and leave with a summary of key marketing insights and some rules of thumb for successful innovation in Silicon Valley. You may even identify one or two books that you haven’t read that will be worth your time. I will cover a dozen books that form the basis for conventional wisdom on marketing in Silicon Valley. They provide the terms, the metaphors, the parables–in short the language–that successful high technology firms use to develop their plans and monitor their execution. Some of these books are old–most have stood the test of time, which in Valley years is a decade or more–but still provide succinct guidelines for new product introduction and sales.
I want to thank Mark Duncan for helping us turn a set of black and white PowerPoint slides that were primarily text bullets into a colorful and illustration rich article.
Terry Frazier at 9:53 AM
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Private Intelligence and the Sovereign Individual
In The secret service for the rest of us, Matt Mower writes:I've often wondered how feasible it would be for us to setup an intelligence service to watch them (most recently I was wondering whether there are intelligence services at work in Second Life). After all; What is an intelligence service other than an organization that collects data from the edge and analyzes it for the benefit of its customers?
Blogs and other read/write web tools give us all the ability to gather data and, in our own fashion, analyze it and pass it on. We are each miniature intelligence services for a varied clientelle and, although we too are biased, our bias can be adjusted for since it is more easily determined (over time).
More than a decade ago two futurists – James Dale Davidson and William Rees-Mogg – wrote of the coming breakdown of state-based security and the growth of independent, individual security forces in their books “The Great Reckoning” and “The Sovereign Individual.” They were ridiculed pretty widely at the time and the books were considered fodder for bunker-dwellers, albeit rich bunker-dwellers. Much of what they projected was based on cultural and social models already visible at the time in Latin countries dominated by drug cartels. 15 years and the meteoric rise of technology have changed the landscape of what can be done but, if anything, the predictions of Davidson and Rees-Mogg seem more tangible than ever. If they were guilty of anything, it was merely being too far ahead of their time.
Current futurists and military analysts like John Robb (my source for the original story) are busily deconstructing the projected fall of the nation-state, peak oil, the rise of non-state entities, etc all of which is important. But no one seems to be thinking about my problems in the way that Davidson and Rees-Mogg did – deciphering what all this chaos means to the individual – and more importantly what to do about it.
How do we predict the unpredictable? How do we assess probability and impact? How do we, as individuals, make the right choices for where to live, where to put our money, how to prepare for the unexpected, how to protect our family, our friends, ourselves? Packing the basement full of survival rations, bottled water, duct tape and gas masks is a shallow, and rather ineffectual, approach.
What we really need is analytic intelligence for the individual. Governments – no matter who’s – are unreliable sources of information for the individual (if they can be considered reliable sources for anything at all save waste and corruption.) But to get such intelligence will be very difficult. Matt is right, current social software tools provide a glimpse of what may be possible, and many of the tools are being deployed within intelligence communities. But that is the key. Could we, as individuals, build our own intelligence communities?
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