Donuts (quick nibbles)--from across social media |
“The principles of true art is not to portray, but to evoke.”
The quote above is by novelist Jerzy Kosinski. I love the power of art. I use art as a prod to encourage my workshop audiences to observe differently--and more deeply. I don't want to lose folks that are pursuing data literacy or the art of data visualization by boring and unimaginative slides or discussions we can all find online for free.
If the goal is to evoke--well done Frans Snyders! I like to use examples from Snyders, a Flemish painter from the 16th and 17th centuries. Typically to demonstrate how we group objects or how to articulate order in a visualization, I invite students to view either or both of these paintings.
The discussions might seem to be only about the pieces of art but when we gather following the discussions, patterns of how we view images become quite familiar.
A striking similarity can be seen if we think of the hierarchy of certain foods. On the right, Still Life with Fruit and Vegetables at first glance seems to be a random assortment. Until we observe how the root vegetables are arranged at "ground" level and the other more highly prized fruits are either raised off of the floor or displayed on top of the table.
When we view graphics are we aware of how elements of data are displayed? Is it possible that we might make inferences, either subconsciously or consciously about the importance of variables based on where they are placed in a visualization?
Perhaps now you can see how subtle biases might lurk beneath the original intent of a graphic.
Take a look at picture on the left, Market Scene on a Quay. How are items grouped? Which meats appear to be more highly prized or valued? A new found awareness of visual limitations yield to discussions of actual graphics pulled from the headlines. See what you notice now when you consume or create your next graphic...
If the goal is to evoke--well done Frans Snyders! I like to use examples from Snyders, a Flemish painter from the 16th and 17th centuries. Typically to demonstrate how we group objects or how to articulate order in a visualization, I invite students to view either or both of these paintings.
The discussions might seem to be only about the pieces of art but when we gather following the discussions, patterns of how we view images become quite familiar.
A striking similarity can be seen if we think of the hierarchy of certain foods. On the right, Still Life with Fruit and Vegetables at first glance seems to be a random assortment. Until we observe how the root vegetables are arranged at "ground" level and the other more highly prized fruits are either raised off of the floor or displayed on top of the table.
When we view graphics are we aware of how elements of data are displayed? Is it possible that we might make inferences, either subconsciously or consciously about the importance of variables based on where they are placed in a visualization?
Perhaps now you can see how subtle biases might lurk beneath the original intent of a graphic.
Take a look at picture on the left, Market Scene on a Quay. How are items grouped? Which meats appear to be more highly prized or valued? A new found awareness of visual limitations yield to discussions of actual graphics pulled from the headlines. See what you notice now when you consume or create your next graphic...
The first and greatest victory is to conquer yourself...
The first and greatest victory is to conquer yourself; to be conquered by yourself is of all things most shameful and vile.--Plato
Did you ever attempt something so big and beyond what you thought you could do that it remains intensely personal and private?
A few years ago Andrea Pitera owner of Mojo’s On the Harbor in BHI was selling lottery tickets to help raise money for a terrible storm in British virgin islands. I may have the details wrong but I do know that other winners won helicopter rides, weekends in DC—relaxing vacation destinations and excursions.
I won an entry into the Badwater Cape Fear 50 mile/50k race that loops through the wynds of Bald Head Island, through maritime forest trails culminating in either a ~20 mile run along the beach or an extra loop of the beach for the full 50 miler. For reference, the tag line of Badwater is “World’s Toughest” and they deliver.
This weekend I completed the 50k. It didn’t go as planned but maybe it did, who knows. My resting heart rate had been elevated all week. Typically between 42 and 44 bpm it seemed to hover between 55 and 60—a sign indicating overtraining or definitely in need of rest.
The last few weeks of taper were off as well. My legs should be feeling rested but they did not. The morning of the race they were stiff and sore and I never reached my typical cadence. I would be a liar if I didn’t mention I thought of quitting. I was in over my head.
I was the last runner headed into the forest and mainly alone for this stretch of the race. Alone with thoughts of doubt and distress but also tenacity. I know this island. I have been coming here for a decade or more. I also know long training runs and out of nowhere you can get a surge of energy or finally find your rhythm.
The Badwater crew is like no other. I was told that I looked strong and was helped to snacks at the checkpoint as I headed off to the beach. The winds were epic—too bad I was not a kite. Keeping my head down to avoid sandblasting my face or losing my hat I figured well at least in 10 miles I can turn around and the whipping wind would be at my back. That is the crazy stuff you accept as a plus at a Badwater event.
So perhaps the final 10 miles brought relief from wind—but it also brought the tide which means packed sand is now buried beneath the waves. I also had swollen hands and a bit of blood in a place you prefer not to have blood so I decided to walk/run, mostly walk the last 5 miles.
A few years ago Andrea Pitera owner of Mojo’s On the Harbor in BHI was selling lottery tickets to help raise money for a terrible storm in British virgin islands. I may have the details wrong but I do know that other winners won helicopter rides, weekends in DC—relaxing vacation destinations and excursions.
I won an entry into the Badwater Cape Fear 50 mile/50k race that loops through the wynds of Bald Head Island, through maritime forest trails culminating in either a ~20 mile run along the beach or an extra loop of the beach for the full 50 miler. For reference, the tag line of Badwater is “World’s Toughest” and they deliver.
This weekend I completed the 50k. It didn’t go as planned but maybe it did, who knows. My resting heart rate had been elevated all week. Typically between 42 and 44 bpm it seemed to hover between 55 and 60—a sign indicating overtraining or definitely in need of rest.
The last few weeks of taper were off as well. My legs should be feeling rested but they did not. The morning of the race they were stiff and sore and I never reached my typical cadence. I would be a liar if I didn’t mention I thought of quitting. I was in over my head.
I was the last runner headed into the forest and mainly alone for this stretch of the race. Alone with thoughts of doubt and distress but also tenacity. I know this island. I have been coming here for a decade or more. I also know long training runs and out of nowhere you can get a surge of energy or finally find your rhythm.
The Badwater crew is like no other. I was told that I looked strong and was helped to snacks at the checkpoint as I headed off to the beach. The winds were epic—too bad I was not a kite. Keeping my head down to avoid sandblasting my face or losing my hat I figured well at least in 10 miles I can turn around and the whipping wind would be at my back. That is the crazy stuff you accept as a plus at a Badwater event.
So perhaps the final 10 miles brought relief from wind—but it also brought the tide which means packed sand is now buried beneath the waves. I also had swollen hands and a bit of blood in a place you prefer not to have blood so I decided to walk/run, mostly walk the last 5 miles.
I thought the cut off time was 8 hours and realized there was no point risking further injury or discomfort for a cut-off that wasn’t possible at this point. This wasn’t about a medal. It was about finishing. Not quitting. Digging deep. Checking my phone to see how much battery remained I saw the messages. My family, my friends, and I knew I wasn’t alone. I now realize the cut-off for a medal was 9 hours—I just missed it by about 30 minutes. No regrets here. Finishing is finishing.
My dear friend Robin had been at the start of the race and was waiting for me at the end. I can’t even type this sentence without becoming emotional. She was my rock. Andrea at the last checkpoint before the final 5 mile stretch was basically a lighthouse in the storm of almost being done. She was out in the whipping winds encouraging all of us as a volunteer for over 10 hours. She is a force of nature. It was her encouragement at my back as I hobbled toward the finish.
It was the kindness of the other Badwater runners saying hello, waving, smiling, and sharing the journey—and the knowing. It is hard to communicate about the experience to people not there. Not bearing witness to the struggle and defeat of many that had to end their journey and dream of next year.
I finished. I was lucky, grateful, and encouraged over the finish line reaching for something more valuable than a medal. I was a flipped horseshoe crab able to live to see another day—and perhaps to race again—next year. Thank you to Chris Kostman, Keith and his brilliant tutu, and all the other beautiful faces of the Badwater community. It was an epic journey—and a milestone for something bigger.
My dear friend Robin had been at the start of the race and was waiting for me at the end. I can’t even type this sentence without becoming emotional. She was my rock. Andrea at the last checkpoint before the final 5 mile stretch was basically a lighthouse in the storm of almost being done. She was out in the whipping winds encouraging all of us as a volunteer for over 10 hours. She is a force of nature. It was her encouragement at my back as I hobbled toward the finish.
It was the kindness of the other Badwater runners saying hello, waving, smiling, and sharing the journey—and the knowing. It is hard to communicate about the experience to people not there. Not bearing witness to the struggle and defeat of many that had to end their journey and dream of next year.
I finished. I was lucky, grateful, and encouraged over the finish line reaching for something more valuable than a medal. I was a flipped horseshoe crab able to live to see another day—and perhaps to race again—next year. Thank you to Chris Kostman, Keith and his brilliant tutu, and all the other beautiful faces of the Badwater community. It was an epic journey—and a milestone for something bigger.
Do you trust your data?
Have you learned a new language? Unless you were raised bilingual, most of us learned a second language beginning perhaps in elementary school or even high school. I studied spanish for 4 years and spoke quite regularly while living in California for ~ 7 years. I was surprised when traveling to Madrid--I seamlessly began thinking in spanish. It was easier to keep the language of my destination near the surface for quick and reliable retrieval.
Data literacy is the same thing. We stop and think--often moving slowly--as we seek to understand and apply data language to personal and business needs. The goal should be to become comfortable deriving meaningful information and insights from data gaining the skills to argue with our data. Alberto Cairo reminds us that charts and visualizations are nothing more than little arguments.
Data literacy is the same thing. We stop and think--often moving slowly--as we seek to understand and apply data language to personal and business needs. The goal should be to become comfortable deriving meaningful information and insights from data gaining the skills to argue with our data. Alberto Cairo reminds us that charts and visualizations are nothing more than little arguments.
Human nature seems to seek complexity. Navigating social media we are nudged to seek thousands and thousands of followers or be viewed as not particularly relevant or integrated. I disagree. I have less than 1000 followers and trust me--if I post something the least bit controversial tweeps abandon ship. But here is what I have learned.
The numbers you should care about are how many view your posts, do they visit your profile, are they mentioning you in their tweets?
I value engagement more than I value eyeballs.
The numbers you should care about are how many view your posts, do they visit your profile, are they mentioning you in their tweets?
I value engagement more than I value eyeballs.
Let's move over to LinkedIn. I value online data courses for "just in time" refreshers on tools and rely on easy communication from people seeking to engage. I like reading messages from followers and peers. I don't like trolls that comment within blogging platforms so I closed that channel. How many ads for Ray Bans does a busy professional need to read anyway?
The Social Selling Dashboard is sort of interesting. I create insights through data literacy, data visualizations, and communicating complex ideas so observing how I rank within my industry (clinical medicine, health policy, health economics) and also within my network is interesting. I don't know what "Find the right people" measures since I don't hire so doubtful that metric will ever increase but establishing brand, engaging with insights, and building relationships seem relevant.
The Social Selling Dashboard is sort of interesting. I create insights through data literacy, data visualizations, and communicating complex ideas so observing how I rank within my industry (clinical medicine, health policy, health economics) and also within my network is interesting. I don't know what "Find the right people" measures since I don't hire so doubtful that metric will ever increase but establishing brand, engaging with insights, and building relationships seem relevant.
The Tableau 2018 conference is happening right now. If you want motivation to begin your data journey, watch the opening keynote. I hope you view it as an important step in your personal and professional life.
Do you know if your data is useful?
Do you trust what you create?
It's a new data rich world.
“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”--Max Planck
Do you know if your data is useful?
Do you trust what you create?
It's a new data rich world.
“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”--Max Planck
Chihuly magnificence in the mountains of North Carolina
Have you been to the Biltmore Estate in Asheville North Carolina? I live in North Carolina and over the years as family visited and children grew we made the visit many times. Naturally it is quite breathtaking especially at Christmas and in autumn. A group of friends decided to go after a package deal, so 18 of us arrived from across the country all united by our love for a small "Island" off the coast of North Carolina, accessible by a ferry ride from Deep Point Marina to Bald Head Island North Carolina.
I snapped this unique perspective of the mansion (all 4 internal acres of it) from a morning run on the trails throughout the 8,000 acre estate (once 125,000). Not sure what happened to my deadline focused brain but since I always travel with at least my laptop (and often a second monitor to simplify work with databases) I was shocked to realize that although my computer bag was with me--I neglected to slide the laptop into the protective sleeve. It remained on my desk back in Greensboro slightly less than 3 hours away.
Planning to see what I could accomplish in the business suite, I quickly leaned into spending time with friends new and old and tried my best to welcome the unexpected 3 day vacation from work. Okay, okay, I was down but not out--easily communicating via smartphone but you get the picture.
Our gathering was motivated by a rare opportunity to view Dale Chihuly's masterful glass sculptures on display in the gardens of the Biltmore Estate.
Planning to see what I could accomplish in the business suite, I quickly leaned into spending time with friends new and old and tried my best to welcome the unexpected 3 day vacation from work. Okay, okay, I was down but not out--easily communicating via smartphone but you get the picture.
Our gathering was motivated by a rare opportunity to view Dale Chihuly's masterful glass sculptures on display in the gardens of the Biltmore Estate.
“Since I was a little boy I always loved glass... One night, I melted some glass... and blew a bubble... Since that moment I have spent my life as an explorer searching for new ways to use glass and glassblowing to make forms and colors and installations that no one has ever created before...” –Dale Chihuly
Traveling for business has evolved in the last 6 months. I decided to no longer speak, participate or travel to conferences that did not include a representative sample of women on panel discussions or as keynotes on the agenda. Period.
Unfortunately or what ended up being fortunately, what evolved was a lighter demand on my time. Your highest value commodity is indeed time. The currency you use to trade should give you time left to not only smell the roses--but to stand in awe at their beauty. |
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The interrobang...Its all in the telling
The parent corporation for data & donuts is Grapheme Consulting Inc. Years ago I needed to be a corporation to win a contract with global affiliates so there you go. I picked the name because the sound of words is a phenome--the writing is a grapheme. For example, the word beach, has 3 graphemes b-ea-ch.
One of my favorite books on the topic, Shady Characters The Secret Like of Punctuation, Symbols, & Other Typographical Marks by Keith Houston is quite revelatory on the historical origins and challenges of joining the ranks of well respected punctuation. Read below Houston's introduction to the fate of the pilcrow.
One of my favorite books on the topic, Shady Characters The Secret Like of Punctuation, Symbols, & Other Typographical Marks by Keith Houston is quite revelatory on the historical origins and challenges of joining the ranks of well respected punctuation. Read below Houston's introduction to the fate of the pilcrow.
Graphemes can also be other marks like symbols or punctuation. All of this is a long-winded way to introduce you to the interrobang. If you have ever read copy you will already know that we don't say "exclamation point" but "bang" for short. The interrobang is a question mark--exclamation point hybrid. Listen to Roman Mars from 99% Invisible describe 2 relatively obscure punctuation marks--one that remains in relative obscurity and another with an unexpected rise to fame and glory--the octothorpe.
Medicine is a science of uncertainty and an art of probability--William Osler
I was listening to Seth Godin's new podcast, Akimbo today. The one about Hitsville. The part that resonates with me describes how hits are made. What does it mean to be the best at something. Should that be our goal? Maybe what you are creating isn't meant for everyone. I like what Seth says--people like us, do things like this.
The most popular beer in the US is bud light. If you want to create something consumed by everyone strive for the middle of the road. The big part of the bell curve. But is that what you want? I don't think there is a drinkable beer in the top 20 listed in the graphic. Maybe there is room for the folks in the "tails" of the normal curve. We aren't a big group but I would argue the craft beer industry is up late into the night counting their cash too. Overall U.S. beer volume sales were static in 2016, whereas craft brewer sales continued to grow at a rate of 6.2% by volume, reaching 12.3% of the U.S. beer market by volume. Craft production grew the most for microbreweries. I like allegory. When I saw the beer data, the first thing I thought about the economics--this isn't me. Medical data is not that different. We see the statistics and we identify with the populations in the estimate--often to our detriment. I think it was Ben Bernanke that said, aggregate statistics can sometimes mask important information.
It is okay to question medicine, policy, economic theories or data that seems questionable. You can also write about medicine from multiple perspectives. Find your audience and be true to the uncertainty of a wider narrative. Write for the edges. Art makes you see people as individual, unique human beings. Art, in that way, allows us to see each other in particulate, as opposed to in aggregate.--Dee Rees |
What are you?
The biggest thing you may not appreciate (unless you are more than one race) might be the frequency of being asked, "What are you?"
I write about race because I am intrigued that although proven to be a social and political construct, race still shapes categories in medical research--as if there was still a latent biologic correlation. I am also curious about the variable of my identity. What is my genetic makeup? Having a black father and white mother doesn't breathe a hint about geographic origins or risk factors associated by ancestry--not skin color. As a survey expert and data professional I have no idea what to do with data about skin color. We lack the degree of genetic variation needed to splinter humans into racial categories. We are all part of the human race. What does a "checked box" tell me about physiological variation not being measured or social correlates of health that roll up in a vague placeholder? I decided to find out. A little saliva in a tube and voila, I am on my way to understanding not only what I am, but who I am. I wrote about my findings here... |
The American Community Survey
In my ongoing attempt to share useful and usually free data resources--behold the American Community Survey.
The U.S. Census Bureau today released its most detailed look at America’s people, places and economy with new statistics on income, poverty, health insurance and more than 40 other topics from the American Community Survey.
Many states saw an increase in income and a decrease in poverty rates between 2015 and 2016. During that same period, the percentage of people covered by health insurance increased in most of the largest 25 metropolitan areas. The findings are from the Census Bureau’s 2016 American Community Survey, the nation’s most comprehensive information source on American households. Today’s release provides statistics on more than 40 social, economic and housing topics for U.S. communities with populations of 65,000 or more.
“The American Community Survey allows us to track incremental changes across our nation on how the nation’s people live and work, year-to-year,” Census Bureau Social, Economic, and Housing Statistics Division Chief David Waddington said. “It’s our country’s only source of small area estimates for social and demographic characteristics. These estimates help people, businesses and governments throughout the country better understand the needs of their populations, the markets in which they operate and the challenges and opportunities they face.”
Lessons we keep not learning...
This podcast from You Are Not So Smart--Pandora's Lab is filled with insights to be consumed immediately. There are several big ideas here that could generate engaging blog posts and discussions--but alas I am a wee bit buried at the moment. The main purpose of these "quick nibbles" is to keep the conversations going. If you are feeling exploratory I typically use SAMHSA data as a place to begin my opioid data stories. There is a contextual conversation around opioids and synthetic forms of drugs creating the current crisis.
(When time permits I will step you through the data access and visualization of SAMHSA data and how you can begin your analysis--follow along here.)
Here is a snippet of a description from the brilliant and always engaging Dave McCraney.
The facts don't speak for themselves. Someone always speaks for them.
From the opioid crisis to the widespread use of lobotomies to quiet problem patients, celebrity scientists and charismatic doctors have made tremendous mistakes, but thanks to their fame, they escaped the corrective mechanisms of science itself. Science always corrects the problem, but before it does, many people can be harmed, and society can suffer.
In this episode, we sit down with Dr. Paul Offit to discuss how we can get better at catching those mistakes before they happen and mitigating the harm once Pandora's Lab has been opened.
(When time permits I will step you through the data access and visualization of SAMHSA data and how you can begin your analysis--follow along here.)
Here is a snippet of a description from the brilliant and always engaging Dave McCraney.
The facts don't speak for themselves. Someone always speaks for them.
From the opioid crisis to the widespread use of lobotomies to quiet problem patients, celebrity scientists and charismatic doctors have made tremendous mistakes, but thanks to their fame, they escaped the corrective mechanisms of science itself. Science always corrects the problem, but before it does, many people can be harmed, and society can suffer.
In this episode, we sit down with Dr. Paul Offit to discuss how we can get better at catching those mistakes before they happen and mitigating the harm once Pandora's Lab has been opened.
If not now, when?
I think we need mentors. Maybe they don't even know they are serving the purpose. Someone who has a similar story, work ethic, or vision. I shouldn't say this is even more important for women--but it is more important for women. We are labeled differently for similar behavior when compared to men. You don't have to believe me but in my tenure in healthcare--I have had a specific experience.
Analytics and data informed content are so popular and in high demand--there are many folks willing to do it for less. Never compete on price. What is your value add? Are you only offering a commodity or is it an actionable solution to a problem?
Analytics and data informed content are so popular and in high demand--there are many folks willing to do it for less. Never compete on price. What is your value add? Are you only offering a commodity or is it an actionable solution to a problem?
The podcast, The Secrets, Tactics, And Creative Processes of High Performers And Achievers--Debbie Millman, is a follow-up discussion (Q&A) from the link in the previous "nibble" below.
She answers a variety of questions in a concise and informative format with actionable activities like "the intentional first impression"...
She answers a variety of questions in a concise and informative format with actionable activities like "the intentional first impression"...
Infographs: the listicles of the data world...
I believe I have made my view of listicles known. To truly appreciate their inherent danger you need to at least acknowledge how Google aggregators work when you use a search engine. I am willing to risk oversimplification to tell you it basically takes the garbage everyone else is looking at it--creates an average of low hanging fruit--and BOOM you see the results at the top of your search.
Years ago I was looking around for a few podcasts for my morning run. I stumbled upon Design Matters with Debbie Millman. In the same way that 99% invisible is about architecture but not at all about architecture, Design Matters is all about design, and at the same time, about so much more. I recently listened to one of my favorite interviews of Debbie by Tim Ferriss. Tim is many things--most of them are stunningly interesting--but his book, Tools of Titans: The Tactics, Routines, and Habits of Billionaires, Icons, and World-Class Performers is incredible.
But I digress. Debbie is also editorial/creative director of PRINT. A magazine about visual interfaces, creativity, typography, graphics, and let's be honest--a sense of style. When we write or create something from nothing we might think our ideas bubble up from our own well of "special" but I argue the fumes of creation or invention are generated from our surroundings. What you read, eat, listen to, and even leisure pursuits.
Maybe we don't know what great design looks like but we know when we don't like something. I read a Daniel Pink book describing the new knowledge and creative economy. I think it was Daniel Pink!? He listed a few things to help generate creativity. One recommendation was to read Dwell Magazine. It seemed like an odd request at the time but when you hold something beautiful you start to develop your own aesthetic. PRINT is the same experience.
Years ago I was looking around for a few podcasts for my morning run. I stumbled upon Design Matters with Debbie Millman. In the same way that 99% invisible is about architecture but not at all about architecture, Design Matters is all about design, and at the same time, about so much more. I recently listened to one of my favorite interviews of Debbie by Tim Ferriss. Tim is many things--most of them are stunningly interesting--but his book, Tools of Titans: The Tactics, Routines, and Habits of Billionaires, Icons, and World-Class Performers is incredible.
But I digress. Debbie is also editorial/creative director of PRINT. A magazine about visual interfaces, creativity, typography, graphics, and let's be honest--a sense of style. When we write or create something from nothing we might think our ideas bubble up from our own well of "special" but I argue the fumes of creation or invention are generated from our surroundings. What you read, eat, listen to, and even leisure pursuits.
Maybe we don't know what great design looks like but we know when we don't like something. I read a Daniel Pink book describing the new knowledge and creative economy. I think it was Daniel Pink!? He listed a few things to help generate creativity. One recommendation was to read Dwell Magazine. It seemed like an odd request at the time but when you hold something beautiful you start to develop your own aesthetic. PRINT is the same experience.
Complexity is an inherent feature of our existence--the world is rich in information that can be combines in endless ways. |
I love the smell of chlorine in the morning...
Don't get your small violins out just yet but oh man what a week. This week launched my training schedule for triathlons in the spring. So far I was rendered nauseous by a P90X2 yoga workout--don't laugh unless you have done it--without puking. If that wasn't bad enough, my heart monitor attacked me and left a huge raw spot in a rather delicate location. Nonetheless I have been walking around my home office "unfettered" if you get my drift.
The swim has been going better than usual. I start with a half mile to ease back into the discipline but to be honest--things don't usually start falling apart until after the first mile. Give me time. I will let you know when I am ready for the Adagio in E major.
It was about this time I got the notice from a large professional society denying my media credentials for attending a Clinical Immuno -Oncology Symposium. Here it is:
To qualify as online media, you must represent a commercial Web site (emphasis mine) that posts original editorial news coverage at least once per week. The Web site must extend beyond forums, personal Web sites, personal analysis, or opinion. Long format video interviews or video blogs do not qualify as original editorial news coverage.
The reason I was interested in attending? I will already be in Orlando covering HIMSS17. I looked up the definition of commercial website. The consensus seems to be, "If your site takes in any form of revenue - i.e. advertising, adsense, membership fee, even donations for bandwidth, it is commercial."
I am not sure why you need to be serving commercial interests to have an active voice in discussions about clinical immuno-oncology. Silly me. I thought perhaps my experience working with several oncology thought leaders, community oncologists, advisory councils, and a recent pharma client would contribute to the narrative.
It is hard to invite all perspectives to the dialogue when access becomes an endurance event.
The swim has been going better than usual. I start with a half mile to ease back into the discipline but to be honest--things don't usually start falling apart until after the first mile. Give me time. I will let you know when I am ready for the Adagio in E major.
It was about this time I got the notice from a large professional society denying my media credentials for attending a Clinical Immuno -Oncology Symposium. Here it is:
To qualify as online media, you must represent a commercial Web site (emphasis mine) that posts original editorial news coverage at least once per week. The Web site must extend beyond forums, personal Web sites, personal analysis, or opinion. Long format video interviews or video blogs do not qualify as original editorial news coverage.
- Editorial content must be independent of advertising and sponsorship.--yes
- The site and its content must be overseen by an editorial board.-- no
- If the Web site is sponsored, it must be sponsored by more than one entity; all sponsors must be clearly identified as such on the Web site.--intentionally non-sponsored
- Only outlets that have been in continuous operation for at least six months will be considered.--yup
- All registrants must submit traffic data from a third party (Quantcast, Sitemeter, Technorati, etc.) in order to be considered--yup
The reason I was interested in attending? I will already be in Orlando covering HIMSS17. I looked up the definition of commercial website. The consensus seems to be, "If your site takes in any form of revenue - i.e. advertising, adsense, membership fee, even donations for bandwidth, it is commercial."
I am not sure why you need to be serving commercial interests to have an active voice in discussions about clinical immuno-oncology. Silly me. I thought perhaps my experience working with several oncology thought leaders, community oncologists, advisory councils, and a recent pharma client would contribute to the narrative.
It is hard to invite all perspectives to the dialogue when access becomes an endurance event.
"A man without a vote is a man without protection"
Listen to the words of Noam Chomsky and ask your own questions. Not the sound bites or marketing messages. In the quiet space--there is reason and hope. I summarized the points but the time to watch the short documentary is well spent.
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I am quietly putting these words here. We all have subjective truths that model our perspectives and how we move in the world. The interesting part of all that is if we boil away the "fat" what remains is the foundational skeleton--a framework of sorts that can recalibrate our internal conversations and hopefully radiate out into the world--and offer possibility.
You can blindly support one candidate over another but know this. Our economy and political system was written in the white spaces of The Wealth of Nations by Adam Smith in 1776. There have been costume changes of course but the identification of Masters of Mankind as the power elite predates the current hateful rhetoric by at least 240 years. A few modern notions from our complicated history (brief points from documentary "Requiem for the American Dream") 1. We have 2 choices for our fundamental society. We can reduce inequality (think Aristotle and notions of a welfare state) or concentrate power in the hands of the wealthy, hereby reducing democracy (James Madison). This mirrors the nuanced differences between leading ideology of our two party system. 2. We have never had a financial crash during times of regulation 3. Most large corporations make more profits by manipulating markets and moving assets than selling goods or services. 4. If you don't know what regulatory capture is--you better google it. 5. 14th amendment? Corporations are people--undocumented workers are not. 6. A large electorate is too difficult to control by force--control their beliefs and attitudes. Create unfocused anger against each other and they will not democratize and drive real change. Please vote...the future of our beautiful imperfect democracy needs your voice. |
The blessing is outside your comfort zone
I am not a woo woo mystical or metaphysical person but I work hard at bringing awareness and dedication to all that I do. You often need to use every spare minute of time especially if you are a solo entrepreneur or small business owner.
My favorite time hack is to queue a long list of podcasts. I typically run anywhere from 1 to 2 hours in the early morning and can learn a lot before most folks are beginning their morning commute. The New York Public Library Podcast, 99% Invisible, and Monocle 24: Culture with Robert Bound are recent favorites. On Being is a quiet place to land after a busy week.
Some weeks are stressful. This week has been specifically gut twisting. Disappointment in a former colleague/"friend", multiple data queries on a wide variety of platforms, book proposal submittal, and as always--deciding the types of projects to take on.
Don't we all have challenges every week? I have learned to think of them as choices instead of burdens. If I pick "this" and not "that" how will I feel? What can I uniquely bring to client A that perhaps client B wouldn't need or appreciate? Every day--for that matter every moment--is a decision. I choose to run. I also choose to challenge the status quo. Because when I meditate on a run or in a swimming pool or sit down in my office and write the words and paragraphs--the blessing is always outside my comfort zone.
My favorite time hack is to queue a long list of podcasts. I typically run anywhere from 1 to 2 hours in the early morning and can learn a lot before most folks are beginning their morning commute. The New York Public Library Podcast, 99% Invisible, and Monocle 24: Culture with Robert Bound are recent favorites. On Being is a quiet place to land after a busy week.
Some weeks are stressful. This week has been specifically gut twisting. Disappointment in a former colleague/"friend", multiple data queries on a wide variety of platforms, book proposal submittal, and as always--deciding the types of projects to take on.
Don't we all have challenges every week? I have learned to think of them as choices instead of burdens. If I pick "this" and not "that" how will I feel? What can I uniquely bring to client A that perhaps client B wouldn't need or appreciate? Every day--for that matter every moment--is a decision. I choose to run. I also choose to challenge the status quo. Because when I meditate on a run or in a swimming pool or sit down in my office and write the words and paragraphs--the blessing is always outside my comfort zone.
The genetic fallacy. Whom should you trust?
You can't swing a pencil without hitting a genetic fallacy screaming from the headlines or open maw of somebody paid for their opinion.
The fallacy may be better recognizable as ad hominem although this type of logical fallacy is only part of the story. An argument is often made invalid if when we successfully label the source of the information as a blathering idiot. This logic can swing both ways.
How often do we accept scientific findings because they are reported in the NEJM or an other credible source? This is a type of genetic fallacy. Stakeholders in healthcare and medicine fall for this one all the time. A quick scan of the literature, a recognized and respected author, and a higher tier journal are the perfect storm for hasty decisions about credibility and context.
The fallacy may be better recognizable as ad hominem although this type of logical fallacy is only part of the story. An argument is often made invalid if when we successfully label the source of the information as a blathering idiot. This logic can swing both ways.
How often do we accept scientific findings because they are reported in the NEJM or an other credible source? This is a type of genetic fallacy. Stakeholders in healthcare and medicine fall for this one all the time. A quick scan of the literature, a recognized and respected author, and a higher tier journal are the perfect storm for hasty decisions about credibility and context.
A pet peeve of mine, tangentially related to genetic fallacy targets writers and healthcare communicators of all types. Have you noticed how large writing organizations, marketing platforms, and societies are all describing listicles to optimize your audience, increase your email list, or get that post circulated in front of the most eyes?
They boldly offer items in front of a paywall but discreetly nudge you into paid content. Why is this problematic? I get it. We all need to make a living. The disconnect for me is advice and expertise rendered from someone safely cashing a biweekly paycheck as an employee of a marketing or communications juggernaut.
I don't know about you, but that isn't my world. You can't build a brand on beige content that everyone can digest. If you lack a unique perspective and are part of the "me too" economy that business model may work out of the gate. But eventually, when enough people start turning towards something stimulating and innovative--you will be stuck with the same way of doing business--with the same results.
@graphemeconsult
LinkedIN
They boldly offer items in front of a paywall but discreetly nudge you into paid content. Why is this problematic? I get it. We all need to make a living. The disconnect for me is advice and expertise rendered from someone safely cashing a biweekly paycheck as an employee of a marketing or communications juggernaut.
I don't know about you, but that isn't my world. You can't build a brand on beige content that everyone can digest. If you lack a unique perspective and are part of the "me too" economy that business model may work out of the gate. But eventually, when enough people start turning towards something stimulating and innovative--you will be stuck with the same way of doing business--with the same results.
@graphemeconsult
My research through early letters describing Alzheimer's Disease introduced me to the phrase "dementia praecox." This was the precursor to the mental illness we now diagnose as schizophrenia.
I discovered the story of James Edward Deeds Jr. A resident of the State Hospital No. 3 for the majority of his adult life he drew engaging pictures using a mixed media of pen, pencil, and crayons on hospital ledgers. The Electric Pencil provides a brief introduction to his early life and the discovery of his art. The State Hospital For Insane, No. 3 was actually the largest building west of the Mississippi in 1887 when it opened. The main state hospital building was torn down in 1999 but a few repurposed ancillary buildings remain. The timeline of advancement in therapies is depicted in his art work. The parallels of the collection of his art thrown on a trash heap not intended to survive earned the title of the book's introduction, The Imagined Nostalgia of James Edward Deeds Jr. |
Created a map for the discussion about opioids and best strategies to manage their use in patients that benefit from prescribed opiates. Interesting trends in prescribed vs. non-medical use...
This writing life
If you start your day confronting a challenge and winning--I am guessing it is easier to sustain. Only 45% of Americans age 45 to 64 exercise at least 3 times a week.
How many of them work in your chosen field? Do you see where I am going here? You can work harder, run further, and out pace your competition. I am a self-described insight architect. I travel to meetings and conferences because that is part of the value paradigm integrated into my work life. To avoid bias, you need to eliminate the middle man in communication and information exchange. And you will be surprised by who you meet! What are you willing to do that most don't bother? Let that be your value. |
I am not exaggerating. Last night I binge-watched episodes of the This American Life television show that appeared on Showtime for 2 seasons. After winning a host of accolades, This American Life asked for Showtime to pull the show. Doing both the television show and the radio broadcast was comprimising the quality of both (says Ira). I personally think 2 half-baked enterprises by this talented team are far better than anything else on the airwaves.
In case you have seen me laughing hysterically as I run trails with my hound Fred, I am probably listening to This American Life podcast. The poultry slam episode almost killed me. Literally. Try guffawing in the cold while out of breath from a long run...
I wanted to make sure you didn't miss the video below from the New Yorker. This week’s cover, “Mirror,” is a collaboration between The New Yorker and “This American Life”. Sometimes my blogging platform hates when I embed things so here is the link just in case. If you want to tell stories with your writing--be like Ira--generous with your time and massively talented.
In case you have seen me laughing hysterically as I run trails with my hound Fred, I am probably listening to This American Life podcast. The poultry slam episode almost killed me. Literally. Try guffawing in the cold while out of breath from a long run...
I wanted to make sure you didn't miss the video below from the New Yorker. This week’s cover, “Mirror,” is a collaboration between The New Yorker and “This American Life”. Sometimes my blogging platform hates when I embed things so here is the link just in case. If you want to tell stories with your writing--be like Ira--generous with your time and massively talented.
The two biscuit run... |
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I will call today's run, The Two Biscuit Run. I had no intention of running today. I have been under a bit of stress, tight deadlines, holiday approaching--I think you are having similar distractions. I woke up, had a hardball egg and a few scoops of avocado and carried my second coffee of the morning into my office. Somewhere between reading about Hommel-adjusted P values and deleting a spammy looking blog comment--I heard "biscuits are ready", from the kitchen.
Well I am human people so I scarfed down two. More likely because it isn't often that something comes out fo the kitchen that I haven't made but they were delicious and greatly appreciated. After a few minutes, I realized that I needed to go for a quick atonement run and so we have the Two Biscuit Run. Or if I am to be candid, the Two Biscuit Run with Butter and Apricot Jam.
I hit play on the iTunes podcast list and re-discovered Simon Sinek. I am a writer that needs creativity to blast at me from multiple speakers. I listen to London School of Economics on one end of the spectrum and along the continuum enjoy a variety of podcasts about design, culture, art, and longform journalism. I hope you will give this one a listen. At one point I had to stop and walk. You will know why if you listen. When emotion resonates with such grace that you are compelled to stop and notice--you know it was worth every bite...
Well I am human people so I scarfed down two. More likely because it isn't often that something comes out fo the kitchen that I haven't made but they were delicious and greatly appreciated. After a few minutes, I realized that I needed to go for a quick atonement run and so we have the Two Biscuit Run. Or if I am to be candid, the Two Biscuit Run with Butter and Apricot Jam.
I hit play on the iTunes podcast list and re-discovered Simon Sinek. I am a writer that needs creativity to blast at me from multiple speakers. I listen to London School of Economics on one end of the spectrum and along the continuum enjoy a variety of podcasts about design, culture, art, and longform journalism. I hope you will give this one a listen. At one point I had to stop and walk. You will know why if you listen. When emotion resonates with such grace that you are compelled to stop and notice--you know it was worth every bite...
Emergent medical differences in sex and gender...
Women's health became synonymous with reproduction: breasts, ovaries, uterus, pregnancy. It's this term we now refer to as "bikini medicine." And this stayed this way until about the 1980s, when this concept was challenged by the medical communityand by the public health policymakers when they realized that by excluding women from all medical research studies we actually did them a disservice, in that apart from reproductive issues, virtually nothing was known about the unique needs of the female patient.--Alyson McGregor Why Medicine Often Has Dangerous Side Effects for Women
We live in a short-cut infused digital universe. You want to write a blog? Here is a template already pre-designed with title mock-ups to improve your SEO, integration for your podcast (because you will need one to sell the book you will naturally write…), and look how easy it all is. Except it isn’t. At least not if you want it to be meaningful or provide value. There aren’t any shortcuts my friend.
So the new book is underway. I am writing about numeracy in medicine. What it is, how to improve it, and what we learn when we have improved insights. Here is a spectacular book that I am reading on the side--David Foster Wallace wrote a great book called, Everything and More: A Compact History of Infinity.
"Part history, part philosophy, part love letter to the study of mathematics, Everything and More is an illuminating tour of infinity."
His talent for writing was so unique. I stumbled upon the book in a used book store and was humbled by the fact that I didn't even know it existed. I serendipitously found it the morning I decided to write a book about numeracy in medicine. A cardiology resident sought me out and shared that he felt there was an opportunity and an obligation to improve numeracy in medicine. We talk about health literacy but ignore numeracy and its impact on deciphering clinical data and arriving at high-value determinations at the point of care. An inability to create a strong narrative around statistics is a significant driver of over medicalization and rising healthcare costs.
"Part history, part philosophy, part love letter to the study of mathematics, Everything and More is an illuminating tour of infinity."
His talent for writing was so unique. I stumbled upon the book in a used book store and was humbled by the fact that I didn't even know it existed. I serendipitously found it the morning I decided to write a book about numeracy in medicine. A cardiology resident sought me out and shared that he felt there was an opportunity and an obligation to improve numeracy in medicine. We talk about health literacy but ignore numeracy and its impact on deciphering clinical data and arriving at high-value determinations at the point of care. An inability to create a strong narrative around statistics is a significant driver of over medicalization and rising healthcare costs.
David Foster Wallace Found Dead...
David Foster Wallace, author of the critically acclaimed 1996 novel Infinite Jest, was found dead in his Claremont, Calif., home on Friday.
Wallace's wife told police that he'd hanged himself. He was 46.
Wallace developed a cult following in the 1980s with his early works, but it was Infinite Jest that gained him widespread attention. The novel was set in the future, in an era of hyper-commercialism. It revolved around a fictional film that was so entertaining, anyone who watched it could die — because they wouldn't want to do anything but watch it.
Infinite Jest featured a massive cast of characters, sprawled across more than 1,000 pages. And there were hundreds of footnotes.
In 2005, Time magazine named Infinite Jest one of the 100 best English-language novels since 1923. But Wallace told PBS's Charlie Rose that he found the attention a little strange.
"I didn't read a lot of the reviews, but a lot of positive ones seemed to misunderstand the book. I wanted it to be extraordinarily sad and not postmodern or fractured, and most of the reviewers that really liked it seemed to like it because it was funny, or it was erudite, or it was interestingly fractured," Wallace said.
A year after Infinite Jest was published, the MacArthur Foundation awarded Wallace a "genius grant."
Wallace's later work included nonfiction, short-story collections and essays on filmmaker David Lynch, tennis star Roger Federer and Sen. John McCain.--Wallace Invented and Reinvented Story.
Be an industry expert...
I couldn't think of the right place for this short but timely blog post. I feel like I spend a huge portion of my work week answering client emails (How much do you charge?) or colleague emails (How much should I charge for...). Well my friends, I finally feel like I have a handle on the eternal question--good, fast, or cheap. Think about the times you field calls where the potential client states they are just looking, they don't really have active projects at the moment. We are all guilty of this from time to time. The sales clerk greets you with a big smile and asks if you need any help. "Oh no, I am just looking" we respond. Yeah right. I left my house, kenneled my 3 dogs, drove 5 miles across town just to see if they still make sneakers? Of course I need help. What I don't want is a big song and dance.
Here is how you can make the process tolerable. Not the sneakers. You are on your own there but let's see if we can remove a few pain points of creating your fees. I recently had a new client that wanted a series of white papers. Before providing any details, I am asked about cost. Feeling no shame I redirect the conversation. Are you trying to accomodate a limited budget or are you interested in an asset that will continue to provide a high yield on your initial investment? I can create a white paper for you that will be evergreen, work across social media platforms, and elevate your status as an emerging expert in this industry. Boom.
Why aren't your clients being educated on the value of what you provide? If you are "famous" for a specific type of writing that has clients reaching out to you directly--create a strong value statement. Maybe you are too expensive. Or maybe this client is the wrong customer. It is more likely that you did a bad job of describing your value. I am not shy about telling potential clients that I am not the cheapest writer they can find. But if you are known for high quality, high value writing they will know where to go when they want what you and you alone can create. The pile of benefits has to be larger than the pile of money you are demanding for your services. Don't become cheaper...increase the value of what you provide.
Here is how you can make the process tolerable. Not the sneakers. You are on your own there but let's see if we can remove a few pain points of creating your fees. I recently had a new client that wanted a series of white papers. Before providing any details, I am asked about cost. Feeling no shame I redirect the conversation. Are you trying to accomodate a limited budget or are you interested in an asset that will continue to provide a high yield on your initial investment? I can create a white paper for you that will be evergreen, work across social media platforms, and elevate your status as an emerging expert in this industry. Boom.
Why aren't your clients being educated on the value of what you provide? If you are "famous" for a specific type of writing that has clients reaching out to you directly--create a strong value statement. Maybe you are too expensive. Or maybe this client is the wrong customer. It is more likely that you did a bad job of describing your value. I am not shy about telling potential clients that I am not the cheapest writer they can find. But if you are known for high quality, high value writing they will know where to go when they want what you and you alone can create. The pile of benefits has to be larger than the pile of money you are demanding for your services. Don't become cheaper...increase the value of what you provide.
Looking for more useful insights? Take a look inside Medical Writing for Smart People Because Dummies Shouldn't Write About Medicine.
I have included helpful tricks and resources to super charge your medical writing... Thoughtful discussions about content development and outcomes analytics that apply the principles and frameworks of health policy and economics to persistent and perplexing health and health care problems |
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Negotiating the cost of healthcare...
President Obama has asked congress to actually be able to negotiate drug prices with industry. Nothing absurd here as every country with the exception of the US negotiates prices. In the absence of a centralized entity that can measure opportunity costs and negotiate prices based on value and outcome there won't be an effective way to transform healthcare.
A recent article in the NY times summarizes the dialogue about Runaway Drug Prices. Industry backlash insists that costs are hard to quantify and data compilation would be prohibitive and labor intensive. |
The industry helped defeat such a bill in Oregon and is fighting to head off a bill in California that would impose new reporting requirements on makers of any prescription drug whose wholesale costs are $10,000 or more annually or per course of treatment. They would have to disclose the research, development, marketing and manufacturing costs, as well as the profits, attributable to the drug. The companies complain that some of these costs are hard to quantify and that compiling the data would be burdensome. But surely the public would benefit from increased transparency that might deter the worst abuses.
You can see the direct implications of non-negotiation when you look at the red number 2 on the graphic. The price that way pay for FDA approved drugs in the US clearly doesn't go as far in other countries with far better outcomes.
The drug and biotech companies continue to argue that high prices are justified to offset the cost of R&D--but metrics to support this point towards a free market economy that will allow industry to cost these at whatever the market will bear. And to add insult to industry many of these costs are buried and undecipherable on your medical bill. If you have school age children you either are or will become familiar with Khan Academy. Here is a tutorial on how to read your medical bill--best of luck. |
Donuts (quick nibbles)--Jacques Derrida
French philosopher on the verge of something interesting...
A recent article in the Paris Review described the early academic failures of Jacques Derrida a French philosopher known for his critical theory "Deconstruction". The specific attributes of his original way of thought are beyond the scope of this brief "donut" but what has always drawn me to philosophy is the interesting backstory of many of its most significant contributors.
As an adult, Derrida transformed English and humanities departments around the world; as a student, he had struggles of his own. When he was twenty, he submitted a paper on Shakespeare that earned him a failing grade, along with such (arguably prophetic) remarks as “quite unintelligible” and “totally incomprehensible”: “In this essay,” the instructor wrote, “you seem to be constantly on the verge of something interesting but, somewhat, you always fail to explain it clearly.”
As it turns out, Derrida was not particularly interested in the rules, but in inventing a new method. Even if his “apostasy” caused him great mental anguish—“nausea, insomnia, exhaustion, and despair” (all normal features of any higher educational experience)—it’s probably fair to say he could not do otherwise. Although his intellectual biography, like the history of any revered figure, is unlikely to offer a blueprint for success, there is perhaps at least one lesson we may draw: Whatever the difficulties, you’re probably better off just being yourself.
The take home message for me is that disruption is never easy. There will be many that ignore your content or ask you to conform to what is known and acceptable. I would suggest the opposite. What if you aren't supposed to be everyone's cup of tea? That's okay-- quite often what is needed is a strong, unapologetic espresso.