The Apple Store: role model for clinics & FEMA

Two quick insights after picking up my iPad on Saturday:

Medical clinics could learn a lot about customer care and clinic efficiency from watching Apple Stores on normal days.

FEMA could learn a lot about efficient emergency response from watching Apple Stores on iProduct Launch days.

iClothing

I've been a fan of the Scott eVest for some time now, ever since my spouse gifted one to me. It is the perfect layered garment for a geek living in an occasionally chilly part of the country (plus, you have to love a company that puts X-Ray views of their clothing on their website). It comes with 22 pockets for electronic gear which are connected by a network of cloth conduits for cables. So far, I've only been brave enough to use 2 or 3 of these pockets. As it is, I have a hard enough time with only 4 pants pockets trying to keep MiFi routers and USB drives from an unplanned session of data laundry. However, once I finish installing our home laundry fluoroscopy unit, I'll feel brave enough to start using some of the more arcane chambers in my vest.






When the iPad was first announced, Scott was quick to point out that their eVest was probably the only stock garment on the planet that would hold a iPad without alterations. My iPad does, indeed, fit nicely in my left eVest pocket. However, I feel like I'm listing a bit to the left when I carry it there.

Where vests lead, can pants not follow? I spotted the following ad last month, and am still not sure whether it is actually a legitimate product. However, I'm glad that someone is thinking way outside the box on this issue, gag or no.

Exogenous Brainfreeze

I'm no stranger to brain freeze. Once or twice a year I'll snarf down some really cold ice cream a bit too greedily and then relive that nasty dull ache that seems to fill the center of my skull.

Yesterday was different. Cabin fever drove me out of the house for a quick bike ride during a break in the chilly rain we've been having lately. This hole closed a lot quicker than I expected, and I found myself totally soaked a mile from home.

I've been wet before and I've been cold before, but this was something new:

40 degree rain + 30 mph wind + drafty bike helmet = a whole new type of brain freeze.

It's an odd thing to have that old, familiar frigid ache now covering the entire outer part of one's skull. Exhilarating but painful at the same time. I would ride a few hundred yards until it became too intense, and then pull over under a tree to let it subside. I repeated this cycle several times until I got home to a hot shower and dry clothes.

Oops, gotta go — we're having another sunbreak. It's time for me to roll the biking weather dice again…

Waking Up is Hard to Do

If these 5 Minnesota nurse-anesthetists can pass gas as well as they can sing, I want my next surgery in their hospital.

LOGICOMIX: An Epic Search for Truth

Yesterday was to have been a day of writing and programming. Instead, I surprised myself by buzzing through a 300+ page graphic novel on the life of Bertand Russell and his quest for the foundations of mathematics.

This "comic" was an impulse buy in our local indie bookstore yesterday. It's browsing for and finding jewels like this that remind me why I still love physical bookstores so much.

The authors and illustrators tell a great story, mixing romance, two world wars, politics, philosophy, logic, math and human failings into a narrative compelling enough to distract me from A Lot of Other Stuff I Needed to Get Done.

A fine tale well told. I've passed it on to my son, to see how it fares with the tastes of a 15.9 year old.

I'm off to a play this afternoon, and then it's back to the joys of XCode and Objective C.

All Clear

Okey, doke. Lesion out and the margins are clear. The dermatopathology fellow was kind enough to give me a tour of my biopsy. It turns out that one *can* use an iPhone for photomicroscopy as long as one's expectations aren't too high.


Here is a chunk of my normal skin at medium power. I took this by just holding my iPhone 3GS up to the microscope's eyepiece. By no means diagnostic, but good enough for blogging purposes.

Once they stitch me up, I'll head over to my office and work on ARRS and AUR abstracts like a crazed ferret for the rest of the afternoon.

The Smell of Long Pig in the Morning

Turns out I'm live-blogging my outpatient surgery today via my iPhone.


I'm having a minor skin lesion removed today in our university's rather slick dermatology outpatient surgery center. The drill here is:

1. Remove the lesion
2. Take a 45 minute break while a dermatopathologist processes and analyzes the tissue.
3. Repeat until the margins of the lesion are clear.

I'm grateful for this built-in break. I came to my appointment NPO (ate nothing after midnight) and I'm hungry.

To make matters worse, the electrocautery unit they use to stop the minor bleeding creates a smell that is disturbingly similar to barbequed pork.

I used my first break to run to the espresso stand next door for a bite. There I spotted a "bacon, sausage, egg and cheese, French toast bagel sandwich" for sale. No shit. However, like a car wreck you can't turn away from, I just couldn't stop looking at it. OK, OK, I bought the damned thing.

However, the unwillingly tasty scent of sizzling long pig was still fresh in my nostrils. Fresh enough, that when the espresso lady asked: "Can I heat that up for you?", I had to say,

"Uhhhh… No!"

A Pilingual Month for Me

Blogging has taken a backseat this month to computer programming. Most of the words I've written over the past month have been in Ruby, PHP or SQL, with English way back in 4th place. I've therefore appropriated Douglas Hofstadter's neologism "pilingual" to title this post.

Besides my usual penchant for screwing around with cool technology, my latest programming has been aimed at several potential papers for the 2010 ARRS and AUR meetings, whose abstract deadlines loom next week.

Blogging here will thus continue to be lean until all abstracts have been safely excreted.

Rap ID Advice for H1N1

If you get H1N1 influenza or any other infectious disease (ID) this year, chances are really, really good that it won't be from a radiologist. If you are auscultated, touched or sneezed upon by a physician, we're not the 'droids you're looking for.

However, there are a lot of other major disease vectors out there to contend with, i.e., your friends and family and co-workers. To protect yourself from them, here are a few helpful hints from Dr. John D. Clarke, medical director of Long Island Railroad:





HT to Medgadget

Maybe There is Hope for Humans, After All

I recently posted about a very cool high speed robotic hand that could beat most humans in a finger race.

However, I was somewhat comforted today when I ran across this video of the real thing, playing guitar at speeds I would not have believed possible.

Rest easy, John Henry -- we're still ahead of the steam drills at a few things.


World Record Guitar Speed 2008 Tiago Della Vega

The Chronophage: a Clock That Eats Time

What a wonderful device...

(thanks to Suture for a Living)

Violin-Playing Robot

Okay, dammit. It's not just the banjo players that will be losing gigs. Looks like fiddlers had also better keep an eye on their rear-view mirrors.

I'm almost afraid to look at YouTube these days, lest I see an X-ray-reading robot looking back at me...

Lightning Fast Robot Hand

A friend's reaction to the following video:

I bet this thing could do wicked good banjo triplets.

No kidding. This thing could play a banjo faster than Bela Fleck, which is really saying something.

With a bit more development, it's not just musicians that this thing might put out of work -- surgeons could lose a few gigs too.

As Dr. Wes has pointed out, this thing could also have amazing benefits for the differently abled.

This robot hand would be an especially good match with the brain-computer interface described on the 8/9/09 episode of 60 minutes (the good stuff starts at the 15:00 mark).

This is great technology -- especially from the point of view of a precocious geezer who may need some of it one of these days.

Hat tip to Anita Anderson

The Samurai Journal of Radiology

Sipping from a firehose -- that's what it feels like to keep up with the medical literature these days.

Even an info nerd like myself can't keep up with all of it. However, I do have a few online tools that make my own personal information overload a lot easier to deal with.

NetNewsWire

I've used this awesome newsreader program for years. It currently grabs over 100 newsfeeds and converts them into what I like to call The Samurai Journal of Radiology™. This journal caters to my own peculiar tastes, and includes not just radiology articles, but also a fair amount of infogeek stuff and a comics section.

NetNewsWire is a Mac only program, but shares a lot of features and synchronizes with Google Reader, a non-denominational newsreader that I also use, especially on my iPhone.

These two programs do the following really, really well:

1. they insure that I will at least scan the titles of all the latest radiology articles in my field
   
2. they make it easy to read my literature at any level of granularity I desire: title only, title and abstract only, or full article
   
3. they keep track of what I've read and what I've not read
   

The main downside of NetNewsWire or Google Reader is that they make it way too easy for Type A people like me to become a newsfeed slut. Even though I've trimmed my feed list way back, I still have over 100 feeds that I somehow can't bear to delete. Sigh....

HubMed

Just about all of the radiology journals now provide RSS feeds on their websites. Radiology and the American Journal of Roentgenology also provide subspecialty feeds (such as just neuro or just musculoskeletal), keeping my reading list blissfully free of all barium articles.

However, there are some parts of my specialty that are more fascinating than others, and HubMed helps me keep up with them. Let's say that I have a special interest in one particular dysplasia: the bird-headed dwarf syndrome of Seckel. Not surprisingly, Radiology and AJR tend to have pretty spotty coverage of this rare syndrome.

However, if I type in the term "bird-headed dwarf" into HubMed's search window, it generates a special newsfeed for me on that very topic:

http://www.hubmed.org/feeds/atom.cgi?q=bird-headed%20dwarf

When I point my newsreader at this feed, it will always show me the latest 20 articles on this topic from PubMed, from all of the zillion medical journals in its database.

Very cool.

Fever

For the past week, I've been using a very cool new newsreader called Fever.

Fever, unlike conventional newsreaders, actually works better when you fill it up with a zillion newsfeeds. When you import your list of feeds into Fever, you first sort them into two piles:

1. stuff that you like to read every day
   
2. stuff that you read once in a while

Fever calls these 2 categories respectively "Kindling" and "Sparks". It then distills from them topics that are hot enough to be worth reading using the following principles:

1. if only one person writes about a topic, it's cold
   
2. if two people write about it, it's warm
   
3. if three or people more write about it, it's hot

The greater the number of posts on a topic, the hotter it is.

The downside: You'll need access to a server running Unix Apache, PHP and MySQL in order to install Fever. You don't have to be an alpha geek to get it up and running, but it doesn't hurt.

The upside: Fever has so far done a pretty good job of spotting gems that I would have otherwise missed. Well worth the $30 it cost and the few hours of time I spent configuring myserver and installing it. This alpha geek gives it two thumbs up.

How Science Publishing Works

I've become a big fan of the online comic Saturday Morning Breakfast Cereal by Zach Weiner.

I especially enjoyed his treatment today of the Least Publishable Unit.

MR Fail

We who work around MR scanners well know that odd sensation when something you forgot to take out of your pocket starts tugging you firmly toward the giant magnet.

Most of us have also idly speculated about the following question...

So, what if you actually did push a really big ferromagnetic object (like a whole ICU bed) into the scan room?

This picture from Fail Blog pretty well answers that question.


Hat tip to Better Health.

Dead-On Anatomic Art

This smoking shelter is located on the campus of a local community college. I love the artwork...

Sunscreen Advice from a Radiologist

My views on sun protection are a bit more conservative than most -- after all, what do you expect from someone whose favorite sunscreen is a lead-lined room?

However, after reading A Guide to Summer Sun Protection in the latest issue of the New Yorker, I just may switch to some of that SPF 233...

Oregon

A bit of history of the Upper North Left from XKCD.

This would explain that odd (really odd) surge in population we saw in Washington and California back in 1852...

Write When Inspired

Interesting piece by Jeffrey Zeldman on writing quality. His main point:

Write when inspired; rest when tired.

Fine words in the abstract, but not always practical in a deadline-driven world, such as medical care. I'd love to only work when I'm well rested, but some things just have to be done now, regardless of how I feel. I would counter with another aphorism:

In theory, theory and practice are the same. In practice, they're not.

Some of my orthopedic colleagues would put it more bluntly:

Sometimes best is the enemy of good enough.

The reader commentary ( and Mr. Zeldman's reply) make for a great point-counterpoint on this theme. I especially enjoyed Glenn Fleishman's comments.

Inspiration is uneven; work must be even.

(hat tip to Daring Fireball)