In-Flight WiFi -- At Last!!

Boy, do I love red-eye flights. Not. We just took one from LA to New York on an American Airlines 767. Great plane, great weather, great flight, and great service, but still -- a red-eye.

The intrinsic horror of this kind of trip was mitigated somewhat by learning that the plane had WiFi available for $5.95 per flight. I've somehow always missed flights that featured this, but finally hit the jackpot last night. I did sleep for a few hours along the way, but spent at lot of time at both ends of the flight consuming internettage via my iPhone 3GS.

The bandwidth was not too shabby. Here's a speedtest.net screenshot from not too long after takeoff:

My brother's family awoke to a pile of short messages and screenshots sent during the flight, such as the following:

Somewhere over Pennsylvania, I checked the bandwidth again. Much zippier downloads this time, probably because all of the other bandwidth hogs were now lying obtunded elsewhere in the plane.

Of course, your mileage may vary -- things might be a lot different during a blue-eye flight, when a whole planeload hits YouTube at the same time.

Hopefully, WiFi up high will soon spread to most major flights. I would love to used to this service, and think $6/flight is a good value. I just hope I never get as jaded as the dudes nailed by Louis CK below...

Windows: Yesterday's Technology -- Tomorrow!

It takes a lot of computing power to sustain the rockstar lifestyle of an academic radiologist. Whether I'm reading my usual 4 GB of images per day or crunching numbers and statistics for research projects, I'd be dead in the water without my computers.

Therefore, I've spent quite a bit of my academic career dealing with medical center and radiology IT people. We generally get along just fine, but occasionally butt heads.

The main point of contention is that I am a Mac dude. IT has been on my butt for over 20 years to convert my office computer to a PC. However, despite their dire predictions and occasional threats of non-support, I have continued to thwart them. I grudgingly use our PC-based workstations to do my image interpretations, but use a Mac for everything else. It's not just my contrary nature -- the mix of Mac and open source programs I use in my research and teaching either isn't available on the PC (e.g. OsiriX) or isn't as easy to use.

It was therefore interesting to read that other medical centers and the new Obama administration have been having the same difficulties.

One member of the White House new-media team came to work on Tuesday, right after the swearing-in ceremony, only to discover that it was impossible to know which programs could be updated, or even which computers could be used for which purposes. The team members, accustomed to working on Macintoshes, found computers outfitted with six-year-old versions of Microsoft software. Laptops were scarce, assigned to only a few people in the West Wing. The team was left struggling to put closed captions on online videos.
Senior advisers chafed at the new arrangements, which severely limit mobility -- partly by tradition but also for security reasons and to ensure that all official work is preserved under the Presidential Records Act.

"It is kind of like going from an Xbox to an Atari," Obama spokesman Bill Burton said of his new digs.

(via Orac)

E-mailing Your Doctor

Doctor, should I have the surgery?

Even mere radiologists get asked this question -- usually while they are performing face-to-face procedures on their patients (or face-to-butt, in the case of a barium enema). I usually give the stock reply that I'm a diagnostician, and treatment concerns are way out of my area of expertise.

When patients started e-mailing questions like this to me in the '90's, they were enough of a novelty that I answered them all. Currently, when each day brings me 50 - 100 nonspam e-mails, that's out of the question, and I cope by ignoring most of them. My reasons include:

1. not enough time
   
2. out of my area of expertise
   
3. I've never met the patient
   
4. rarely any way to verify they are who they say they are or have what they say they have
   
5. potential legal exposure
   
6. yadda yadda...

I do make a few exceptions. I answer e-mail from the rare patients who are actually in my care. I'm happy to help guide friends and family through the medical wilderness. In special cases, I also respond to others. With the resources of a humongous university medical center, I can sometimes answer a question they still have after months of digging on their own.

Since Real Doctors™ spend more face time with patients, they probably also get a boatload more patient e-mail than I do. I suspect that they handle these messages similar to the way I do it, and that any residual guilt I feel over unanswered messages is that much worse for them.

Real Doctors™ may find some solace in a recent Freakonomics post by Stephen Dubner: "So That’s Why Doctors Don’t Use E-Mail":

But surely it’s in everyone’s best interest for patients to stay informed, right? For patients to do their own research, to ask lots of questions — especially of their own doctors — and so forth, right? Right?

He answers his own rhetorical questions with this quote from a new working paper from the National Bureau of Economic Research, titled: Demanding Customers: Consumerist Patients and Quality of Care. From the abstract:

Consumerism arises when patients acquire and use medical information from sources apart from their physicians, such as the Internet and direct-to-patient advertising.

Consumerism has been hailed as a means of improving quality. This need not be the result. Consumerist patients place additional demands on their doctors’ time, thus imposing a negative externality on other patients. … Data from a large national survey of physicians shows that high levels of consumerism are associated with lower perceived quality.

In other words, if the squeaky wheel gets the grease, the other wheels resent it.

And we can't have that.

Duty Calls

In this latest comic, XKCD hits it out of the park yet again.

If I weren't already an XKCD fanboy, I'd be in great danger of becoming one.