515 karma · joined June 8, 2010
Specialist in net-negative commits.
t: @mattrudel h: http://mat.geeky.net e: mat@geeky.net p: TO/Waterloo
"The Niagara Peninsula became free of the ice about 12,500 years ago. As the ice retreated northward, its melt waters began to flow down through what became Lake Erie, the Niagara River and Lake Ontario, down to the St. Lawrence River and on to the Atlantic Ocean. There were originally five spillways from Lake Erie to Lake Ontario. Eventually, these were reduced to one, the original Niagara Falls, at the escarpment at Queenston-Lewiston. From here, the falls began its steady erosion through the bedrock."
Crazy to think that it's gone all that way (a little over 10km) in just 12,500 years.
(Picture Fry meme:)
Can't tell if sarcasm, or sincerity.
One thing that I've always wanted it to do is to be able to horizontally move/scale the frequency domain plot. Most of the time I'm using it, I only really care about the low frequency (vocal range) component.
https://www.iana.org/assignments/dns-parameters/dns-paramete...
Poor and elderly people, for a start. Spend a bit of time by the entrance to a major hospital and observe how the other half uses taxis as a lifeline; you might just change your tune.
It may come as a surprise to many people here, but taxis aren't just there to transport privileged rich folks to and from parties. They're an integral part of any well functioning city's transportation system, and handing the keys over in the name of disruption is naive at best and outright dangerous to some of society's most vulnerable populations at worst.
Disclaimer: as a card carrying member of the privileged elite, I've used Uber in the past and will probably do so in the future. I'm merely trying to point out that the taxi industry doesn't exist in a vacuum.
[1] http://www.toronto.ca/legdocs/mmis/2013/ls/bgrd/backgroundfi...
It's tough to give justice to this insight, except to say that it really helped crystalize the jump between the theoretical side of CS (which had always been clear to me, if never terribly 'real'), and the applied side of CS (which had always seemed to have evolved in some sort of semi-influenced paralel universe to theory).
I don't know that it's the enlightenment you're looking for, but it's the one that eventually found me.
Something like clean water is probably a closer analog to health care than food is, since clean water is something that can't be created purely by labor alone.
Honestly, I find it incredible that there's even debate about this. Nobody thinks twice about things like transportation infrastructure or monetary policy being publicly administered, but the second health care is involved, all sense seems to go out the window. How someone can think that health is less of an inalienable right than access to roads or free markets is beyond me.
- Not all medical systems are the disaster described here. We elected to move back from the US to our native Canada to undergo treatment, and our experience in ward (pre and post-op as well as on the oncology floor) was a dream (at least given the circumstances). We experienced nothing but exemplary inter-disciplinary cooperation, compassion for the patient (and family) experience, and a professionalism driven by clinical need rather than liti-mitigation. These qualities were exhibited even more strongly during the initial phases of treatment post-discovery, which unfolded along a timeline similar to the one discussed here.
- Academic hospitals are exhausting. My spouse ended up being the real hero in this story (she was still breastfeeding at the time, and only one parent was allowed to overnight in the room). My job was to make sure she and our daughter had recovered enough each day to make it through a night of vitals, endless beeping, and the occasional overnight chemo administration (don't even get me started about that).
- The need for patients and their families to drive the narrative of their hospital experience and be their own champion is critical. I had worked in healthcare for many years before this nightmare began (my old office was at the hospital across the street from her room) and knew the system very, very well. We divided up responsibilities so 'I looked outward, and [my spouse] looked inward', meaning that I spent my time making sure that the relevant referrals happened, that medications were administered on time and on dose, and so on. My wife looked inwards towards our daughter, making sure she was fed, entertained, and comfortable. This setup worked very well for us, and was a likely contributor to our level of care.
- The power of parents to be strong in the face of terrible (often inevitable) odds is truly inspiring. We were lucky enough to know with reasonable certainty fairly early on that we would one day be leaving the hospital and resuming a normal life. Many, many families we met were not so lucky. To see a parent express joy and love in the face of such long and terrible odds is a truly unique experience. I myself am a measurably better parent for having witnessed it.
Hand washing: I didn't work in this area directly -- many of my colleagues did, however. The principal output of their work was the Human Factors Hand Hygiene Toolkit at http://www.handhygiene.ca/English/Tools/Pages/Human-Factors-...
Positive patient ID: The PPID work that I've been exposed to was targeted at in-hospital evaluations of various vendor systems; I'm not aware of it having been published externally. If you're interested I can follow up with members of the team who worked on this to see if anything public came out of it.
Medication errors: Lots of work here. Presented link-list style: http://www.hubmed.org/display.cgi?uids=20724398 http://www.hubmed.org/display.cgi?uids=22103759 http://www.hubmed.org/display.cgi?uids=20427310 http://www.patientsafetyinstitute.ca/English/research/cpsiRe...
Blaming healthcare providers for not washing their hands is like blaming John Q Public for the housing crisis. The reality is much, much more complicated, and solutions to the problem are equally so. Healthcare is an incredibly complicated ecosystem, and even things are simple as hand washing are affected by dozens of factors, many of which are non-obvious at first. Root cause analysis and a judicious application of process change can help greatly, but the reality is that even simple things such as this do not change overnight in healthcare. It's harder than you think.
If I had to nominate three low hanging fruits with respect to medical errors, they would be:
- Hand washing. Colleagues of mine have researched and written extensively about this issue; study after study bears out the numbers people are quoting here. I'll source some references and reply with them.
- Positive patient ID. The high flying stories about operating on the wrong patient, or on the wrong limb are one thing, but much more sinister is the issue of mislabeled blood work, specialist reports that are delayed due to mismatched paperwork, and medication mis-administration (more on this later). The degree to which healthcare professionals operate in an environment of mislabeled, misattributed, and simply missing documentation is astounding.
- Medication Administration. A close colleague of mine has made a career around studying the practice of chemotherapy administration and the reduction of errors therein. The feedback she gets when presenting to practitioners is both very encouraging (they, of course, genuinely want to improve their practice), and also disheartening (very simple changes to process have simply never occurred to many front-line staff. They're consistently amazed that the idea of process improvement is even a thing).
If you've ever been in the unfortunate position of having to see chemo being (properly) administered, you get to see firsthand how rigorous process controls are supposed to work. Every bag that gets hung is triple checked via different calculation paths, every patient's identity is re-confirmed every time (even patients that have been on the ward for months), and every interaction with infusion pumps is double checked by at least two nurses after every action. It's a great thing to witness; it's just sad that it isn't the norm everywhere in healthcare.
What worries me most is an inability to set Nortel aside in the ongoing historical narrative of tech in this country. The seemingly inevitable decline of RIM may well put us over a tipping point in this regard, putting us in a situation where we're so paralyzed as a nation by what's happened in the past that we can't bring ourselves to look to the now, much less to the future. We can't get over Nortel in the same way that we continue to look back at the Summit Series year after year after increasingly annoying year; adding RIM onto the pile of failed Canadian tech stories is going to make a mountain that will take decades for us to come to terms with, all the while distracting us from getting shit done.
As a country, if we continue to look to the past for lessons about how to build success, we're going to be building a country that is cribbing off the skeletons of failure. Sadly, looking towards the lessons of the past and staying in the shallow waters that result are very much a part of the Canadian way. I worry that we'll be spending so much time wringing our hands over Nortel and RIM (especially outside the sector, which is where most of the money comes from) that we'll be unable to spot the next big thing.
There's an obsession verging on dogma in much of the hacker world that rationality is the only path to correct action; that by virtue of being hackers we are all somehow divested of otherwise human frailties like emotion, love, and irrational behaviour. As one of the commenters on this thread so wonderfully said:
> No, you're not some amazing savant that has popped up out of the mass of mediocrity that is humanity.
We are, every single one of us, a fallible creature full of fault, vanity, and ego. To argue that I am under the 'influence of cognitive dissonance' because I am falling prey to one of life's most unstoppable impulses is perhaps the strongest example I've yet seen of the absurdity of rational behaviour as the highest truth.
There is a time to be rational and to appeal to such sensibilities, and as hackers we live in those times more than most people. Crafting, debugging, and similar work pleads for rationality; indeed it is a necessary ingredient for much of the work a hacker does. But its applicability has definite limits, and as with any tool it's critical to know where those limits lie.
The core act of deceit comes when, drunk on the power and clarity of thought that rationality brings, the hacker mind tries to apply this tool to matters of the heart or soul. To pretend that the behaviour of a parent towards their child has its basis in rational thought is to presume rationality is a more human trait than love, or than the desire to express one's will on the world.
When parents say things like 'I love my kid so much that it makes my heart hurt', they aren't being flowery; that's actually what it feels like. A feeling so grounded in the core of our existence as a species that it's inseparable from physical pain; to try and apply rationality to that is the height of naivety. Likewise, when people say things like 'you can't understand unless you've had a child yourself', they aren't being dismissive. Parenthood isn't just another mouth to feed or diapers to change. It is a rewiring of your mind and your soul so complete and severe that it can turn love into physical pain. It is perhaps the most human event that has ever occurred in my life, and I suspect most other parents would say the same.
I have weeped openly for days in both happiness and fear for my daughter's well being. I have walked away from a life that took me a decade to build in order to ensure her health, and I never once questioned the correctness of that decision. Many of my decisions as a parent have been made in the face of rationality, made on a balance of many factors of which the rational course of action was just one. Walking that razor edge between the rational way and the biological imperative is an essential skill of any parent. It is a path impossible to describe yet clear as day if you just know where to look.
The only objective truth is that there are no objective truths. I won't pretend to say that my perspective is any more or less correct than anyone else's, but I will say this: rationality is a double edged sword. It is a potent weapon against bugs, suits, and dogma, but it is also capable of separating you from that which makes you human. Like any tool, it's up to you to decide how to wield rationality. Please just know the consequences before you start swinging it.