The Haversian Canal

There's an article in the New Yorker on valedictorians. The article focuses mainly on the debate about whether or not valedictorians are appropriate in the bell-curve-driven world. This, however, I thought, was a particularly insightful aside by the author:

Dedicated to the well-rounded ideal—to be a valedictorian, after all, you must excel in classes that don’t interest you or are poorly taught—the valedictorians had “used their strong work ethic to pursue multiple academic and extracurricular interests. None was obsessed with a single talent area to which he or she subordinated school and social involvement.” This marks a difference, Arnold said, from what we know about many eminent achievers, who tend to evince an early passion for a particular field.

Ouch! A friend at work just informed me that MSN reports New Orleans is the least healthy of the US Census Bureau's 50 largest Metropolitan Statistical Areas (MSAs).

James Allen and John Littlefield have collected, over 20 years, the lynching photographs of America. They were recently involved in the passage of Senate Resolution 39 of the 109th Congress, in which the Senate apologizes for failing to pass anti-lynching legislation in the 1930s. Travis Smiley interviewed James Allen on NPR.

Machines constantly cache the Internet's contents. Published for a second is published for eternity. Even in the event of nuclear war, freak asteroid, tsunami, Los Angeles falling into the ocean, there's a good chance somebody, somewhere, has a cached copy of that tirade about your boss in a RAID level one archive. Ten years ago most people hadn't contemplated the possibility of being named and associated with their every action in an uncontrollable, public, permanant way. Now everyone who knows someone who writes a blog is subject to that possibility. So every blogger has a tremendous power to violate the confidence of their dearest friends and family. Yes, the assumption must be that everything observed is disclosable, however, it would do bloggers well to assume their associates are in their confidence unless an observed action is reasonably the blogger's to report or the matter is otherwise already understood to be part of the public record. Just as everyone has the write to take photographs of anything that happens in public, and the right to publish is equally protected under THE LAW, that only means the blogger can't be sent to jail. Fired? Yes. Divorced? Sure. Castigated and villified beyond all imagination, pursued to the ends of the Earth and left to die in the desert? Absolutely. So that's the privacy aspect of being a public figure.

The responsibility aspect of being a public figure is the assumption that people listen to you. That is, people can reasonably expect public figures to be consistent, and failure to be consistent in statements and actions will cost the public figure some credibility.

Anyone who chooses to enter the public arena is well advised to also assume they will be identified. Think of Ted Kazinsky, or Jessica Cutler (aka Washingtonienne). Anonymity in the public domain is essentially you withholding information from everybody else. Bad odds.

The safest rule is simple: don't publish anything you wouldn't want your family and friends to read on the front page of the New York Times. That doesn't mean you can't publish bad news, or say controversial things, but you better believe in them when you're stone sober. Anybody, including you, may be believe something when angry, sad, or giddy. Tthat's what the "Draft" bin is for on Movable Type.

antedeluvian: before the flood. Specifically: 1) Before Noah's Ark purportedly floated: 2) before Katrina.

One of our faculty, a retired pediatric general surgeon, came in from New Orleans this week, having spent the last six weeks with the New Orleans Police Department. He said there had not been a single rape, armed robbery, or murder in the city since the storm. This is in a city that used to have a murder a day.

I couldn't talk to my wife because the cell phone doesn't work in the condo where I stay during the work week. The cell phone doesn't work because the condo's skin is corrugated sheet metal, a nice gaussian box. So I got in the car and called her back. While I was driving around I went to McDonald's because it was 10 pm and I hadn't eaten dinner yet (screwed up sleep cycle leads to a screwed up eating cycle) and McDonald's was the only thing open. The man at the first drive-through window (pay first, get the grease at the next window) had a headset on. The headset was held together with duct tape. So this guy had duct tape in his hair. And I'll bet he wasn't the first one to have that duct tape in his hair. I bet that duct tape has traveled many a head. Any idea how many lice and other tiny critters are running around that thing? He was very courteous and prompt and intelligent enough to be normal and trustworthy enough to have the register. With used duct tape in his hair. Here but for chance go I.

This Wall Street Journal Opinion article has some interesting ideas, but the analogy between Wasabism and Protestantism is a bit flawed. I talked to a classmate who was a religion major and studied wasabism first-hand while serving as the resident assistant for the muslim floor of his dormitory (he's muslim). Basically, unlike Martin Luther and his ilk, who went 'back to basics' by looking for a deeper, simpler idea man's relationship with God, abstracting all unnecessary traditions, the Wasabists go 'back to basics' by looking for the most literal possible interpretation of the Koran, trying to live as much as possible in the short, nasty, brutish world that the Prophet lived in and, presumably, worked to reform.

Am I misrepresenting this? If so, please contact me.

The Afgahn poet Nadia Anjuman, a member of the Herat Literary Circle during the Taliban's rule, is dead, aged 25 years. Her husband has been arrested in connection to her death.

Geena recently advocated for calling an ambulance if experiencing a possible heart attack or stroke. In the US this is a very good idea. In France, I'm not so sure. I recently attended a lunch lecture by Dr Kenneth Maddox, who detailed the final hours of Princess Diana. Basically he presented a strong case to suggest that she wasn't dead but was beyond hope after the accident, however, he took the opportunityy to discuss her transport to the hospital, which was a couple miles away but took several hours. He basically summarized the situation thusly: French ambulances are basically station wagons: there's no room for paramedics to work on the patient while in the vehicle, so their protocol is "stay and play" rather than the US protocol, which is "load and go". This is part of an overall different system of health care where the emergency medicine needs are largely met by anesthetists. Anesthetists. Anesthetists. Anesthetists.

I understand the philosophical desire to die in peace with dignity and grace; anesthetists would be good for that sort of thing. Personally, I'm more a rage-against-the-dying-of-the-light sort of guy and want a herd of trauma surgeons meeting me at the door of the ED. Load and go. If that means calling an ambulance in the US, so be it. If it means getting someone besides French EMS to take me, that's what I'll do. In fact, if I ever get stationed in France, you can bet I'll be making arrangements with my neighbors regarding this.

Roll Wave! Isaiah Washington, aka Preston Burke, will be wearing a Tulane t-shirt in an upcoming episode of Grey's Anatomy! Sweet. I don't even watch the show, but I might now. Sunday at 10, 9 central.
-----------
Ed: Thanks to Molly for correcting me: Burke was established as a Tulane undergrad in the first episode, and no affiliation with Tulane's School of Medicine has been made on the show.

Susan Sontag's son, David Rieff, recently wrote an article in the New York Times Magazine that included this picture.

There are a number of interesting things to see here: a library full of books, book boxes, presumably full of books, fountain pen ink, a letter holder, gobs of post-its, which mainly contain phone numbers, and a computer. This is all about intense information. One gets the sense the computer was a productive tool, synthesizing information gleaned from all the other sources (books and personal conversations) and she prized the ability to get thoughts directly out of her mind when pen-and-ink writing was required because fountain pens, without a ball and with thin ink, create a very intimate and permanent connection between the author's eye-brain-hand system and the recording media. I particularly like the ladder, which indicates books where most people would have stopped. I can't comment on Sontag's work, as I haven't read it, but I like her desk.

Here's a pet peeve of mine: introductions used as a platform for the host to push their own issue. Well, isn't that what the speaker is doing? Why else were they invited to speak?

The best introductions I ever heard were by General John Allen, who could made his best effort to make everyone he introduced sound like a national hero.

Brian Chase is the man that wrote in Wikipedia that John Seigenthaler Sr., a former editor of The Tennessean in Nashville, had been involved in the assasination of Robert Kennedy. It was a prank that caught national headlines when Mr Seigenthaler came across the misinformation, couldn't track down the culprit, and then wrote about it in USA Today. Daniel Brandt, a critic of Wikipedia, started digging for the Wikipedia source, which led him to Rush Delivery. There was some tension in the office after Mr Brandt called inquiring. The effect of that call was sufficient for Mr Chase to hand deliver a letter of apology to Mr Seigenthaler and the two have talked. Mr Chase resigned from Rush Delivery because he felt so bad. Even Mr Seigenthaler has urged Rush Delivery to rehire Mr Chase.

So far no word from Rush Delivery on rehiring Mr Chase.

If ever there was an opportunity to demonstrate that reconciliation is the right thing to do, Rush Delivery has the chance to do so by rehiring Mr Chase. Give them a call.

I called and talked to Ken, who was pleasent, succinct, and thanked me for my input. If somebody finds out a decision has been made, please comment.

Commenter John Graham makes a good point about Rush exercising restraint in not firing Chase. Rush exercised restraint in not firing Chase. Good point. I agree. Their restraint was not necessary, though it was certainly more than sufficient. The point is Rush has an oppurtunity to establish a reputation of benevolent leadership in the community. This isn't about Chase. This is about Rush Delivery and the Nashville community.

Dmitriy at healthvoices advised me that Dr Hsien-Hsien Lei recently wrote about the ethics of medical bloggers in which she proposed we should (among other things?) answer these ten questions from The National Center for Complementary and Alternative Medicine. I took a very good class at the University of Maryland from Carol Pontzer, an immunologist at NCCAM, and I have to say I think the scientists there are pretty ready to blow the whistle on pseudoscience. We spent a fair part of that class learning to assess the quality of evidence presented in journals. She was passionate about it. So, I'll be happy to answer these questions.

1. Who runs this site? Me
2. Who pays for the site? Me
3. What is the purpose of the site? Genuflection and interaction with everyone else.
4. Where does the information come from? Me and sources I assess to be legitimate.
5. What is the basis of the information? My experiences, my studies, my research, my opinions.
6. How is the information selected? With the trained judgement of a Navy lieutenant, married father of two with a mortgage, and a medical student.
7. How current is the information? I lag the extreme recency bias of the internet.
8. How does the site choose links to other sites? With the same judgement exercised for question 6 above.
9. What information about you does the site collect, and why? My hosting company has lots of site traffic monitoring set up. My main interest is seeing what use I am to the world through the statistics. I've never used the information to chase someone down, though I suppose I could. The only reason I can imagine for doing that would be to make contact with an interesting person.
10. How does the site manage interactions with visitors? I've just recently figured out the commenting module in Movable Type. I now know that before this I was too liberal with trackbacks and too conservative with comments. Anyone can now comment, though I will screen unregistered commentors, and I allow no trackbacks, sorry.

White House to Double Spending on New Orleans Flood Protection - New York Times

$1.5 billion is a step in the right direction, but more will be needed. That magic 'Category 5' issue is going to have to be addressed.

This was the single biggest issue behind the dean having to fire 140 faculty. They were primarily clinical faculty, because there just aren't enough people. There aren't enough people because there have been no assurances regarding the levees. Is it enough? I've heard as much as $32 billion. That's 21 times more. I think the numbers are going to have resolve somewhere in the middle. I just hope they don't give the money to the state.

Dispute Over Historic Hospital for the Poor Pits Doctors Against the State - New York Times

The premise of the article is that untrustworthy state officials are money-grubbing for a new Charity hospital for New Orleans. The doctors who have worked in Charity are countering by saying the building is fine and, aside from major mechanical repairs, should remain the cornerstone of New Orleans' indigent care. Particularly, I was interested to read the doctors feel this is not the time to take down available beds in Orleans parish. Based on the numbers from our new dean, this is a great time to take some beds offline in New Orleans. The dean's numbers, by the way, jive with what my wife has learned about the area as she looks to regain an occupational therapy job in the city. The claim that the city's poor have been trying to reestablish themselves, and thus need Charity's free healthcare, is at odds with my general impression thus far that the people who have reoccupied so far are principly professionals who have the money to finance their return.

Should the state be begging for money? Yes. Should they be rallying around the idea of tearing down the old Charity? I think not. However, Charity does need to be completely gutted and rebuilt if it is to remain the center of healthcare in New Orleans and Louisiana. The generators need to be safe from floodwater, provisions need to be thought out, a helipad should be added (a trauma center without a helipad!?), and, if you've ever been in Charity, you know it was in need of some serious renovation.

From the Tulane Daily News

In a one-hour premiere on Tuesday, Jan. 10, at 7 p.m. central time on PBS (check local listings), NOVA sciencenow will introduce viewers to Tyler Curiel, professor and chief of hematology and medical oncology at the Tulane University School of Medicine. Curiel worked heroically in the aftermath of Hurricane Katrina to try to rescue the irreplaceable research from his lab.

During the segment, Curiel recounts the dramatic and moving story of working under extreme conditions in an attempt to save key scientific research and preserve the memory of his friend, Andy Martin. Martin was a Tulane medical student who had been diagnosed with sinonasal undifferentiated carcinoma (SNUC), a rare form of cancer.

Up to the time of his death, Martin had worked tirelessly in Curiel's lab at the Tulane medical school to extract the only known living cell line of SNUC in the world. Were Curiel's extraordinary efforts enough to save this invaluable research, which could one day lead to breakthroughs in treatment for the disease?

TerraPass: for-profit, expensive, and well designed and marketed. Wharton School in Philadelphia.

DriveNeutral: not-for-profit, inexpensive, and poorly designed and marketed. Presidio School of Management in San Francisco.

Edit 15 January 2007: DriveNeutral has redesigned. They're my clear favorite at this point.

I'm in the room for an address from the President of Tulane University, Dr Cowen, who is also a commissioner of the Bring Back New Orleans Commission, responsible for the education committee. [ed: here's the audio of the address (56 min, 13 MB, low volume)]. Seven reports from the seven committees are due out to the larger commission and the public next week.

The big issue, according to Dr Cowen, is the levees, and I addressed that in a previous post. The second issue is housing. The two main options are

• Level select neighborhoods, like the lower ninth ward. While perhaps the most responsible thing to do, he didn't think the politicians had the stomach for it.

• Offer a one-year right of return where people have one year to go back. If a neighborhood can consolidate and demonstrate a plan, it can stay, otherwise, option one is executed. He thought this was most likely.

• The third option is on the front page of the New York Times: A Big Government Fix-It Plan for New Orleans. This is obviously out of the task force's control. Basically, the government will buy back property at no less than 60% of the pre-Katrina value and then sell the titles back to developers in the future.

Other news, from zee presidente: the furloughs from LSU have topped 500. Lusher, one of the crown jewels of New Orleans otherwise abysmal educational system, is now chartered by Tulane and 1000 students, K-12, will be in class next week.

The clinical faculty recruiting effort in the committee is producing results. 25 students will be placed at Ochsner, and others are being placed in hospitals around the city, like Touro.

The big news was hearing from a commissioner of the Bring Back New Orleans taskforce that those really are the three urban planning options on the table. There's of course been speculation, but hearing it from a commissioner is different.

From the Washington Post: Displaced Students Return To La. for 2nd College Try

Terry Hartle of the American Council on Education said university administrators don't want to be seen as poaching students from the hobbled Gulf Coast schools.

I knew this was the position of the medical schools, I didn't realize it applied to universities generally.

"Not too many operations in the city have as much economic clout as the university," said Professor Richard Teichgraeber,

Tulane was the largest private employer in the city before the storm, now they're the largest employer period. By far.

I was actually in New Orleans yesterday, so I could have observed this reunion first hand, but, alas, I drove in during the day, then had a meeting at 5:30, then came down with the flu! Needless to say, the drive back to Houston today was not pleasent.

This one I really enjoyed:

"I felt like I was cheated out of a semester of the college experience," said freshman Thomas Gibbs, who lived with his parents in Alexandria last semester, commuted to classes at Georgetown and missed months of workouts with the Loyola baseball team.

Waah.

Tulane University Magazine - Bring New Orleans Back Commission's Education Committee Report

The commission heard the education committee's report on the 17th.

After the presentation by Cowen, the committee voted to turn over the recommendations to the mayor.

Forgive me if that makes me less that optimistic about the chances of these recommendations actually seeing implementation. All but one of the committee 'final reports' for Mayor Nagin's commission are out. Most are in PowerPoint. The report on levee recommendations is the lone exception. Otherwise, not a paragraph to be seen. That makes me feel safe. No. Really.

A story to keep your eyes on:

Google Resists U.S. Subpoena of Search Data - New York Times

Nicholas Wade, in the New York Times, paraphrases Emilie Marcus, editor of Cell, regarding the use of photo-editing software in the preparation of images for publication:

Rather than having journal editors acting as enforcers, she said, it may be better to thrust responsibility back to scientists, requiring the senior author to sign off that the images conform to the journal's guidelines.

While on staff at the Naval Academy I was involved in the disciplinary system. One thing that I think every staff member there comes to realize over their tour is that midshipmen do dishonorable things. Those who are caught are not necessarily the worst. The presence of a system of discipline creates conversations about integrity — applied, theoritical, deontological, consequentialist. The effect of the system extends far beyond the walls as the graduates develop through their careers as leaders in uniform, public service, and the private sector. The occasional scandal, while sad, does help reinvigorate those conversations around the country.

However, it also becomes quite clear that no prescriptive solution exists because the concievable scenarios are infinite. In fact, the set of all possible scenarios is a continuous, unbounded infinity. Quite large indeed. While guidelines and a system of discipline are appropriate, it doesn't make much sense to me to require people to be signing agreements that they have acted with integrity. It is the conversation, the thinking, that prepares each individual mind to navigate the seen and unseen ethical, dare we say, moral, challenges encountered every day. Moral crimes may be adjudicated in high courts with pomp and circumstance, but the crimes are typically committed through a series of poor judgements during the course of one's daily routine.

So I disagree that authors should sign off on some guideline. Integrity should be assumed and lapses should be dealt with swiftly and harshly. To further the conversation.

Here's the op-ed piece from The Hill written by my Congressional Representative, U.S. Representative Bobby Jindal, on 1 February.

My mother-in-law gave me a great gift for my birthday: a donation to Habitat for Humanity. If, like most Americans, your relatives aren't starving and seem to have a glut of personal possessions, maybe, just maybe, the best thing you can give them is an honest-to-goodness good, it's-the-thought-that-counts, thought-provoking, I-feel-good sort of gift.

I hope the nay-sayers take a moment to recognize this point of good news: Tulane had to separate 400 staff members, but the university has rehired 70 for different jobs and is trying to fill 175 vacancies with separated employees wherever possible. Bittersweet, no doubt, but a heck of a lot better headline than "Worst Natural Disaster in Nation's History Hits New Orleans". This is good news. Take it at face value.

From: The People’s Hurricane Relief Fund and Doctors Without Hospitals

Place: OUTSIDE Charity Hospital in downtown New Orleans (Map)

Speakers:
1. James Moises, MD, Charity Hospital emergency room physician
2. Jeff Wiese, MD, chief of medical service at Charity Hospital
3. John Dreyfous, grandson of Charity Hospital’s original architect
4. Brad Ott, Charity Hospital patient
5. James Carter, attorney and candidate for council district C

On March 25, 2006, at 2 p.m. CST, several hundred doctors, residents, medical students, nurses, hospital employees, politicians, and political activists will be meeting outside Charity Hospital in New Orleans, Louisiana to protest the closure of this esteemed public hospital. Considered the oldest continuously running public hospital in the country, Charity has cared for millions of members of the New Orleans community for two centuries. These New Orleans residents are now largely without access to healthcare and forced to rely entirely on understaffed emergency rooms for basic health needs, such as monthly prescriptions and routine medical complaints. This shift has caused a healthcare catastrophe in the New Orleans metropolitan area and will be the focus of this rally, along with a discussion of the future of Charity Hospital and the fate of this city’s uninsured.

18 March: Hospital Leaders: System Cracking (WBRZ)
17 March: Closure of Charity strains Jeff Hospitals (Times-Picayune)
15 March: New Orleans Hospitals in Critical Condition (ABC News)

What lessons have you learned that you think people ought to know?

Revel in the suckiness: it will be over sooner than you know it and five or ten years from now you'll regret it if you don't record things. Write. Take pictures. Paint. Compose. Something. I really wish I had some pictures of me and the English professor, Charlie Whisky, with our Chinese friends in Ecuador buying $3000 hats for $50 in Monte Cristo while frozen shrimp, which we'd gotten from the fish warehouse an hour inland, which was guarded by men with automatic weapons, thawed in the bed of the pickup. At the time I was just really hot and the entire port city of Manta, where we'd come from, where my ship was, smelled of rotting tuna due to the transportation strike. Which is why we needed the owner of the Chinese restaurant to drive us to Monte Cristo, and why we were willing to help him load and unload shrimp.

Fresh produce in West Bank grocery stores is usually picked over early in the morning. Go shopping at 6:30 am.

Restaurants on the West Bank have two hour waits. Every day.

There are apparently no soda machines in the new medical school building yet. Should we set up an honor-system pay-as-you-go gedunk room?

Be flexible. Revel in the suckiness.

I'll think of more later. If you know any tidbits like this, please post them in the comments, e-mail me, something. I'll post them in the body of this entry, with due credit.

One of the second-years put out a call to for a road ride this morning, to kick of a weekly Tuesday, Thursday, Saturday routine. I raced in college and ride my bike to school, so I was game. Plus, the seven thirty start time ensured I'd get up early. I really do my best on about six-and-a-half to seven hours of sleep, but the thought of studying just isn't enough to get me out of bed. One reason I suppose I preferred morning classes. Anyway, thirty miles, on this route, and it was so nice. Steady 19 mph pace, good heart rate, mixed road conditions, though generally smooth asphault. There was a two- or three-hundred yard section that was Paris-Roubeux rough but the pavement was heaven compared to the Fort Worth armorcoat.

I do need to work with these guys on pace-line technique, but we'll get there.

MSNBC has probably provided the single most valuable file currently found on the internet: the New Orleans mayoral debate. Full length. Check out.

Wading Toward Home - New York Times, by Michael Lewis. 9 October 2005.

Our patio was a petri dish when we bought it and neither Katrina nor a year of non-occupancy helped. Litchens, molds, at least four different species of funk that I could count. I called Brad Cazenave, who has a sign up on a post on South Carollton in front of the seminary. He did a great job powercleaning the patio, and for a reasonable price. He drove all the way from Kenner, too. So if you need a patio, driveway, sidewalk, whatever cleaned, in the New Orleans area, give him a call: (504)952-0289, or fax (504)464-0726. Address is 2841 Sharon St, Kenner LA 70062. Apparently, he knows how to play soccer too.

Officials restate the obvious when they say the levees aren't 'magic' and nothing is 'invulnerable' but, really, Denmark's levees are 'invulnerable'. There is a higher standard here people. Come on. The question should be when we will get to that standard.

One of the nice things about living in New Orleans these days is you get to enjoy a lot of national-quality press about your city. The cultural reporters especially have found themselves, perhaps for the first time, with a real mission: to preserve this period of New Orleans cultural revival. We were listening to NPR on the radio on Saturday evening, driving around looking for a park Dr Kahn had recommended to us, when we heard a segment about Elizabeth's Resaurant and their praline bacon. So we went there for a Father's Day breakfast. Expecting it to be packed, it was just right - almost full, but no line. Jim Hart is the new owner, having bought it from the previous owners, staff and all. Everyone is on good terms, and the old owner, Stewart, still drops in. Jim Hart, the new owner, got his law degree from the University of Arkansas and has travelled quite a bit since then as an insurance adjuster. A big man wearing a black golf shirt, black hair, and black resin glasses, he looked like a seasoned restauranteur. I congratulated one of the more senior waiters, Karen, who I'd mistaken to be manager, on the NPR segment. She was delighted to hear we'd come based on the segment brought Jim over, recommending perhaps they should ask everyone that came in if they'd heard the segment. Our waitress, Emily, was nice. She's a student at UNO; she wants to go into genetics.

The food? Excellent.

Think before you let your friend or child buy those firecrackers.

Image courtesy of A Medical Student in Clinical Rotations

Howard Reich's piece in today's Chicago Tribune, Crisis of culture in New Orleans, has an excellent piece about the cultural challenge New Orleans faces. If you live outside of New Orleans and want your child to learn trumpet, sax, clarinet, trombone, piano, bass, guitar, or any other jazz instrument, check locally, even circulate an ad in the classifieds, for a New Orleans
musician. You may be saving jazz, America's greatest cultural tradition.

My wife got a new laptop because she's finding some need for it at her new job, but we didn't get Microsoft Office. Actually, it was the laptop that Tulane negotiated with Dell to sell to students. It seemed like a great deal, until we got it and realized Microsoft Office wasn't installed. So, with the missus needing to get working ASAP, in desperation I loaded OpenOffice 2.0. After about 30 seconds of using it my wife said, incredulously, "This is free?!" Checking back an hour later, I asked her how it was going and she said she liked it.

Thank youuuuuuuuuuuu, Sun Microsystems and the OpenOffice contributors.

My kids aren't old enough for e-mail yet, but I got them gmail accounts with their names before those accounts were taken. I've started sending them links to things I might find interesting when they are old enough, like I sent my daughter a link to these pictures of a dancer in blue. Is that weird?

Zopa is the first borrowing and lending exchange. It is essentially microcredit on an unlimited, web-enabled scope. To give you a sense of the goodness of this thing, Muhammad Yunus and his Grameen Bank just won the Nobel Peace Prize (not the Economics prize, the Peace prize) for developing microcredit. And Zopa is leveraging the web to bring it to the people.

Zopa has 100,000 members in the UK right now, and they're coming to the US soon.

Link via reddit.

Go give WWNO some money. I recommend waiting until the 7-8 morning hour or the evening rush hour when they're doing one of the donor-matching periods, but, regardless, you listen. Do your part!

At first I was fairly sure this Northern Iowan article was plagarizing from the Dallas Morning News because I'm the guy that was interviewed, and here's my blog's record copy of the story by Holly Hacker from the Dallas Morning News.

Then I noticed this the original link in the Dallas Morning News was in a directory called /sharedcontent. So, I guess newspapers sell their content to other outlets who can then wrap *their* advertizing around the work as well? The MBAs are clearly hard work finding out how little actual journalism can actually be done to produce the maximum profit. So, all those newspapers you think are out there? After you discount AP and Knight-Ridder, and this /sharedcontent stuff, how many active journalists do we actually have in this country?

I had the opportunity to meet a couple of the AMA trustees today, Dr Ardis Hoven (pdf bio) and Dr Robert Wah (pdf bio). They're on a roadshow, talking to students at various schools, and, I gather, some other audiences as well.

Here are the questions I asked and their responses, as best I can remember them:

1) Responding to Dr Hoven's opening question (What do you, the students, think is the number one question in medicine?), I said information control. Dr Wah responded. He was the chief Health Information Systems officer in the Department of Defense before retiring recently. The military has had a world-wide integrated database for years, but he doesn't believe that other populations really need such a requirement (ed. what about the mobility of the US population: moving on average every seven years?). He questioned the wisdom of keeping the old model of physicians being the custodians of patient data. Instead, he invisioned perhaps custodians should exist on the free market and physicians would the rent data from the custodian for the patient's benefit. (ed: of course, the cost would ultimately be passed on to the patient). Alternatively, perhaps the growing non-system of disparate (ed: and dysfunctional) electronic medical record systems at every hospital and doctor's office will become the norm.

2) Given that drug companies purchase portions of the AMA Physician Master File and also purchase physician prescribing information from pharmacies, and correlate the two data sources to tailor marketing to individual physicians, had the AMA considered acting on behalf of its members to get the same prescribing data from pharmacies (big pharmacies, like Walgreens, and CVS) and provide their members, even on a fee-for-service basis, with their own prescribing data, with perhaps intraspecialty and local trend comparisons? Dr Wah fielded this also, indicating that this sort of data warehousing was not one of the AMA's core competencies, and it would probably be on the table for discussion, but would probably be farmed out to a third party, perhaps a pharmacy managment firm.

3) Someone else asked a question I've been dying to find the answer to: how many physicians belong to the AMA? Dr Hoven indicated about 250,000 were members and she went on for a couple of minutes stumping for people to sign up. I seem to recall a recent article indicating there are about 891,000 physicians in the US.

4) How does the AMA's insurance reform plan compare to the recently passed Massachussetts plan? Dr Hoven said the AMA plan has 3 pillars (ed. don't they all?): health insurance portability, tax credits (she thought vouchers might be a better word), and insurance market reform. The AMA differed with Massachussetts in the second two. With respect to the vouchers, instead Massechussetts used an employer mandate. Interestingly, Dr Wah seemed to come out in favor of the employer mandate, citing that had, since the 1940s, been a component of the US system (ed. See Paul Starr's The Social Transformation of American Medicine). I also question these vouchers, because they really are tax credits, which means they really a form of investment, so where's the government going to get that money? I think keeping the employers in the loop of responsibility makes a lot of sense. As for insurance market reform, the AMA's plan called for starting subsidies for people making less than 500% of the poverty line, which would cover 11% of the existing uninsured; Massechussetts set the bar at 300% of the poverty line, which covers roughly 90% of those currently without insurance (Steinbrook, NEJM 354:2095-2098). These differences, 500% vs 300% and tax credits vs employer-mandate, make the AMA plan essentially a clone of the Republican plan, or is the Republican plan a clone of the AMA plan (some comparative stats here)?

One or more. The United Nations is shooting for a billion.

It's not going to be happy birthday for me any more: Mayor Nagin will be declaring January 27th Fats Domino Day!

You hear the radio news announcer reports there has been a toxic spill on the river and residents are advised to limit their squirrel intake to no more than one a day.

Check.