Playing Through

SNC10962, originally uploaded by docpark.

Hilton Head has some amazing golf courses, but even more striking are the number and size of the alligators. I grew up in Florida, and it was a rare sight to see a gator on the course that wasn’t wearing blue and orange, but in HH, the alligator density is remarkable. Every course I went to had a resident monster or two. This one decided to interrupt our round, and we let it play through.

A Par 5

IMG_0407, originally uploaded by docpark.

If life is metaphor for golf, then surgery is the closest metaphor. Some operations are short par threes on flat farmland municipals, others are 600 yard par fives alongside seaside cliffs. Some operations are best done with good company -OR times are halved and the hours spent on your feet feel like a nice walk on the course. Two or three heads and four or six hands are much better than being alone. It’s a good thing that I’m a scratch surgeon, but I still dream about scratch golf.

Arizona Immigration Law FALLOUT: New Law Sparks Fiery Debate

I was asked to go on a golf outing to Scottsdale. I will not go. I have black hair and brown skin, and driving a rental car, it would make me highly suspicious appearing under this statute. I would not be able to contain my anger and it would likely result in a resisting-arrest arrest or worse. Arizona is off my travel plans for a long time.

I am a real American. I love this country. I would die for this country and its principles. Arizona should be ashamed of this law and any positive feelings I had for Senator John McCain stemming from his 2000 run are over. I am switching parties for good. Better to be a moderate Democrat than an unwelcome token presence in a party that panders to the worst humanity’s worst instinct -the desire to subjugate, subordinate, and ultimately annihilate the other.
Read the Article at HuffingtonPost

Refried Bean Swastikas Smeared On Arizona Capitol

As an Asian-American and an immigrant, there would be ample reason to pull me over and check my papers based on how the AZ law reads. I may go all Henry Louis Gates on said law enforcement and end up in jail for my troubles -no thanks. I was actually thinking a golf outing to the Phoenician would have been fun. That said, I feel great sympathy for the rancher who got shot and killed. It speaks to a need to militarize the border, not the country, and establish a guest worker program with a path to citizenship because immigration is the fuel of America’s greatness. What this law accomplishes is that it makes it easier to exploit undocumented laborers and creates a class of serfs.
Read the Article at HuffingtonPost

Republican Governors Anti-Obama Ad Borrows Political Terrorism Theme

While everyone is entitled to their opinion, here is mine. This type of fearmongering takes its beats from Mein Kampf and the concept of the big lie. It’s cynical and appeals to the worst instincts of the electorate. Rome transitioned from Republic to Empire and dictatorship with the agitations of cynical politicians and the degeneration of the Roman public. America is being challenged on multiple fronts and change is being targeted as the number one challenge. This should be a struggle resolved in the voting booth and in the forum of ideas, not suicide bombs and sniper attacks. Maybe in the end, we will balkanize and break off a theocratic red zone where it will be a perpetual tailgate party inside a NASCAR ring, where ostensibly family friendly teen pop stars are encouraged to unironically pole dance and splay their thighs for popular consumption, where home schooling will substitute religion for science, where the jumbo supersized sweet tea will soothe the hypoglycemia of the morbidly obese, where home prices rise forever, and the new, brown slaves stripped of rights can do all the heavy lifting.

I will take my fight to the voting booth this fall. God bless America.
Read the Article at HuffingtonPost

iPad versus netbook -FIGHT!

iPad versus netbook, fight!

I am a mobile professional, I suppose. I walk a lot. As a vascular surgeon, there is a lot of downtime waiting for things to happen. Operations get booked, but the rooms have to be turned over. In these spaces of time, I endeavor to be productive. Time was, in the nineties, I had a marvelous pocketable computer called the Psion Series 5 (link) which allowed for mobility with a complete office suite. The internet was not yet ubiquitous and for what I wanted it to do, document creation, it was perfect. It allowed me to type out patient consultation notes from a corner of an emergency room and wirelessly print them out (via infrared port) to the ubiquitous HP computers around the hospital -I really think that I was the only one that used them. What it attained for me after three years of use (and three Psion’s used up), I had a bank of notes on patients which constituted a pocket EMR, indexed via the database. It let me print out very detailed notes often in 5 point font -I also had a terrible dislike of multiple pages which could easily be lost, much to the chagrin of older attending who became hopping mad at the small type sizes.

Since that time, I have tried to replace the venerable Psion Series 5 with something more modern, but nothing would replace it. It had the ability to turn instantly on and instantly off. Battery life was basically infinite as long as I had a ready supply of double A batteries. Litihium cells would routinely last over 40 hours or about a month. I tried using various Palm and Windows mobile PDA’s with keyboards, but was terribly disappointed. The Palm Treo came close with a workable thumb board, but by this time, I had joined a practice that had a fully evolved EMR which required a full PC.

The attempts at mobility then moved to laptops and sub notebooks, and more recently netbooks. It’s ironic that Psion marketed a small sub notebook called the netbook, possibly the best portable computer of its day, but soon quit the consumer electronic category. The problem with all laptops was that there was no instant on. The wait for bootup was inordinately long, and it precluded the jotting ideas down as they came up. The other thing with regular notebooks was the battery life. Even with 3 to 4 hours, it wasn’t possible to go a whole day without recharging or shutting down and replacing with a spare battery -more stuff to carry.

The netbook brought a lot to like to the table initially. As a minimized laptop running on a low energy chip (Atom), it offered better battery life with lower costs. The 8 inch screens soon grew to 10 inches and now 12 inch netbooks are available. The downside was you got what you paid for. The keyboards were often cramped and the screens were too small to see your work. What was worse, the manufacturers could not effectively shrink the trackpad down to anything workable and various awful to terrible trackpads were released. The video which offered the promise of turning the devices into cheap portable iTunes viewing station, would slow down and skip frequently, and HD video is not possible. The final straw is that they ran Windows XP, which was fine for 2005, but now serves as a constant reminder that you are running something pretty shabby.

As a workstation, I tried using a netbook and found it to be just a smaller, less capable sub notebook, poorly suited for any hard work. Running our EMR off Citrix was a chore for the tiny Atom processor and I pretty much gave up using it to blog because of how small everything was. Funny thing was even with the pocketable Psion, touch typing was a breeze, and not being able to turn the machine on with a touch of a button was a really problem.

Even loading the Mac OS X onto the netbook -called hackintoshing, resulted in an inferior experience. The OS is designed to work in a 15 inch screen -it’s barely usable on a 13 inch screen, and forget it on a 10 inch screen with a balky touchpad. The netbook pictured is a Dell Mini 10v which was discontinued recently and was touted as the most easily hackintoshable netbook.

With arrival of iPad, everything has changed. Now we have a very portable computer with a 10 inch screen with the capability of instant on. Email is not only a breeze, but a joy to look at. My calendar which is coordinated by my scheduler over Microsoft exchange is also a wonder to behold. The device is fast, and the Citrix client for it works well enough (needs some improvements) for what I do.

In particular, when I am out and about between operations, I have to find an open computer and get onto my EMR. Now, I can access it right where I stand. When I’m at home fielding a phone call from another physician or a patient, I no longer wait for boot up times, but go straight to the Citrix app.

The keyboard on the tablet is fine for quick emails and texts, but not suitable for longer missives. This blog entry was composed on the Pages app using the keyboard dock, but I also have a wireless bluetooth keyboard that I can use for it when I’m not at home. The netbook and its spare battery lays under my bed, waiting for a reason to be turned on -mostly it’s to go to Flash heavy websites which the iPad won’t run.

The other killer app is Papers -this allows me to organize my journal articles by Pubmed entry metatags with direct access to the PDF’s. All the papers I need to read are handy, and again, its a pleasure to read PDF’s on the iPad. My main Mac (a 2007 MacBook Pro) runs Papers and will wirelessly sync all the journals so my iPads will stay current. Yes, I bought two iPads because I liked the first one so much. Having two is the only way to multitask currently.

Why would you want two -well if you’re doing work with one, you can have the other one stream a live Yankees game over the MLB app, or a Netflix DVD, or a movie you bought or rented on iTunes. You might want to listen to all the NPR pieces you missed that day over the NPR app. Or have access to every episode of LOST via the ABC app.

The final killer app for the iPad is the Kindle app, which will kill the Kindle slowly. Amazon is wise in taking a wide broadcast approach to distribution. The Kindle, which is wonderfully light and has an always on 3G connection (which you can use to do light browsing), is available as an app on iPad and all your Kindle books show up wonderfully. The book light is no longer necessary. The only place the Kindle has an advantage is in direct sunlight -the iPad would not display well pool side.

I’m eagerly awaiting the camera dongle to transfer pictures from my cameras. All the photo processing software on my iphone works great on iPad, and new iPad versions roll out daily. That is the other part -the App store updates nearly hourly with some new technological wonder. The games are immersive and just funner than playing on iPhone or the Nintendo DS. Gratification is instantaneous.

The iPad is not the first tablet, just as the iPhone was not the first smartphone. But like iPhone, it redefines the category and raises the bar to a very high level. Love Apple or hate it, this kind of innovation spurred the creation of Android and even Microsoft is abandoning Windows Mobile, that instrument of suffering. Using the iPad is transformative. It makes the internet more accessible. It makes work joyful. It allows me to express myself even more fully, and that is what technology is meant to do.

The Honorable

My Golf Processor and Workstation

I played a wonderful round of golf with my early morning golf friends, BF, BR, and DH. My score of 44/50 from the blue tees at Wakonda was not so great, but in that round were some shots that were of such perfect shape and trajectory that my interest in this game was reinvigorated. Good company, I realize, is as much a part of the game as the game itself. The rules of golf dictate how we play golf, but it also imposes standards of behavior that harken to a different time where honor meant something.
Which brings me to this afternoon’s playoff results from Harbour Town’s PGA tournament.┬áJim Furyk, a perrenial winner on tour, ended up tied with Brian Davis, an Englishman who currently is 162 in the world rankings. If he could pull out a win, it would change his career in a dramatic way. His approach ended up on the beach, literally. His ball was surrounded by litter, and as he took his backswing, his clubhead touched a reed ever so slightly. If no one noticed, and usually the people in the TV booth would call it if they saw it, Brian could have kept mum and had a chance at par and staying alive in the playoff.
Much to his credit and to the credit of golf, he called the penalty on himself. He even argued with a rules official and asked to have it reviewed on video. With the two stroke penalty, he was done. Having lost the tournament though, he won the admiration of many fans, including myself, at his adherence to the rules of golf, placing honor above reward. This is the true spirit of golfism.