You probably weren’t wondering how to manage nerds. If you’re Ryan Markoe, you already know how. For anyone left, there’s Managing Nerds:
They know when I reach to pull the hoodie over my head
that I’ve successfully discarded all distractions on the
Planet Earth and am currently communing with the pure
essence of whatever I’m working on.
It’s irrational and
it’s delicious.
A bunch of gems here. Let me re-refer you to the Nerd Handbook, a Very True collection of facts about folks like me. That is, folks who believe the whole system is knowable and seek to understand it.
A shocking report released Monday by the Internal Revenue
Service revealed that more than 65 percent of the money
donated at churches across the world never reaches God.
“Unfortunately, almost half of all collections go toward
administrative expenses such as management, utilities,
and clerical costs,” said Virginia Raeburn, a
spokesperson for the Lord Almighty…
The U.S.-based CEO of one of the world’s largest hedge
funds told me that his firm’s investment committee often
discusses the question of who wins and who loses in
today’s economy. In a recent internal debate, he said, one
of his senior colleagues had argued that the hollowing-out
of the American middle class didn’t really matter. “His
point was that if the transformation of the world economy
lifts four people in China and India out of poverty and
into the middle class, and meanwhile means one American
drops out of the middle class, that’s not such a bad
trade,” the CEO recalled.
By the end of today, I was so annoyed with things in general that the sound of someone walking up the stairs at the Rec Center was enough to drive me bonkers. Clomp clomp clomp. ARRRRGGGHHHH! It all started this afternoon.
Things started going poorly when I called Dr. Klein over. Well wait, I guess it all started last month, when I was in admissions clinic with a schizophrenic patient. She was well-controlled (said she didn’t hear voices anymore, which was more blunt than I had expected), but the side effect of well-controlled schizophrenia tends to be… reduced faculties. Like, the person is there, but they aren’t there. It’s difficult for patients to think through the drugs.
So. Dr. Meyer loves to ask patients about their med history… A1C if they have diabetes, INR if they’re on blood thinners, their blood sugar that morning, etc. I tend to not ask for these specifics because (a) patients just make up what they think you want to hear and (b) they get things wrong. So, anyhow, it’s a few months ago and Dr. Meyer asks my schizophrenic patient about her medication.
“How are you antipsychotic drugs working?”
“Oh, fine. They worked and I stopped taking them.”
The patient was clearly STILLON her medication. This was verified by the patient’s chaperone from her managed care facility. I tried to communicate to Dr. Meyer with a significant look that let’s not ask her more questions and WHYDOWEALWAYSDOTHIS.
Fast forward to today. Patient is back, and I’ve just spent a half hour in the chair checking and re-checking findings in the patient’s mouth. Dr Klein comes over:
“What are you doing today?”
“Treatment planning appointment; there’s just a few…”
“Where’s your group?”
“In IFC.”
“You should go work with them.”
“But I was scheduled here in this cubicle—”
“You should go work with them.”
“So I should… move this appointment?”
“Move everything to IFC.”
“I… ok.”
The appointment had already started late. Now, I had just been told, in the middle of it, to pick up everything, all the sterilized instruments, radiographs, the whole set up and move to ANOTHERFLOOR?! For absolutely no good reason. For no. Good. Reason.
Down in IFC there weren’t any chairs free, so I had to grab an old cubicle with one of the original dental school chairs in it. From the 1970s. Yay. I rushed, got everything set up, and grabbed an extra chair, because my patient was with her adult chaperone from her managed care facility. By the time I got them back to the cubicle, the chair I had grabbed was gone. I went over and got another chair, sat everyone down, and left to let Dr. Larson know I was ready to see him. By the time I got back, my chair was gone. AIIEIIIEEEE.
Dr. Larson saved my afternoon. He walked me through managing dry mouth in medicated patients and generally was awesome.
But somebody better explain the floor moving in the middle of an appointment thing.
The Green Hornet looks AWESOME. I hope I’m not proven wrong, but boy that looks like a fun movie. Who wants to see it? Well, let’s wait for the results from Metacritic (or Rotten Tomatoes). Then you can let me know.
For about the past twelve months, I’ve been convinced that I could design a better tumbledry than the one you see in front of you. With help from Mykala, Hoefler & Frere Jones, and Dive Into HTML5, that idea of improvement is becoming reality. I’m excited.
If you want to understand corporate America and/or nationalized healthcare it is critical that you read this four year-old-piece. Three years before GM went bankrupt, Malcolm Gladwell clearly articulated their problem in his New Yorker article “The Risk Pool”:
If the retiree obligations of Bethlehem Steel had been
pooled with those of the much younger industries that
supplanted steel—aluminum, say, or plastic—Bethlehem
Steel might have made it. If you combined the obligations
of G.M., with its four hundred and fifty-three thousand
retirees, and the American manufacturing operations of
Toyota, with a mere two hundred and fifty-eight retirees,
Toyota could help G.M. shoulder its burden, and thirty or
forty years from now—when those G.M. retirees are dead
and Toyota’s now youthful workforce has turned gray—G.M.
could return the favor. For that matter, if you pooled
the obligations of every employer in the country, no
company would go bankrupt just because it happened to
employ older people, or it happened to have been around
for a while, or it happened to have made the
transformation from open-hearth furnaces and ingot-making
to basic oxygen furnaces and continuous casting. This is
what Walter Reuther and the other union heads understood
more than fifty years ago: that in the free-market system
it makes little sense for the burdens of insurance to be
borne by one company.
The fundamental issue is the number of pensioners for each active worker. What’s particularly fascinating to me is that, during the strong times for unions in the 1950s, they (the unions) were overwhelmingly in favor of a government plan that managed their pensions and healthcare. They got it: a pension funded by diverse sources due to a generalized pool always has far far less risk than a pension dependent exclusively on the long term stability of a single company.
