What Good is a Stinkin’ iPad?


My good friend SY wrote me yesterday asking basically, “what good is a stinkin’ iPad?”

Hi Mike!

How are you??
My husband and I bought an iPad for my dad, but he decided he didn’t really have use for it (i.e. he uses his laptop and his phone and can’t get Java to work on the iPad so he can’t play ba-dook on it).

So now we are deciding whether to take it back or keep it for us–How useful is it really? You can’t edit documents or talks on it can you? Is it good for taking notes at conferences? Isn’t the wireless plan expensive on it? I pretty much bring my Mac everywhere with me, but I’m not sure it’s more than an indulgent toy for us.


I wrote back.

Hi Sung Yun. I have been asked this same question many times and can answer in the affirmative that tablets are overall great for reading and looking at stuff on. For editing and taking notes, it depends on what you are used to. And for portability, tablets>laptops. Tablets in general get a lot done, and of the tablet choices that you have, the iPad is still, for now, the best tablet a lot of money can buy.

I went all in when the first iPad came out, buying not one but two iPads. It occurred to me from the start that the pain of lugging my 15 inch Macbook Pro was soon to be relieved by the magic iPad, but I was worried that I would not be able to multitask. I normally keep several desktops and multiple windows going at the same time on my laptop, and to get a similar functionality from tablets, I feel you have to have multiple tablets. I also figured two iPads were still more portable than a single Macbook Pro (2007 issue).

The first great use of the iPad was as a reader. I own several Kindles and while I love reading books on my Kindle Paper White 3G, I equally enjoy reading them on the larger screen of my iPad. The skeuomorphic iBooks with their faux page turns are fun, but the iPad Kindle App with an Amazon Prime Account is reading heaven. Toss in FreeBooks app that feature everything out of copyright, and you have a public library in portable form. Overdrive reader app lets you access your local public library -you can look up and check out eBooks from your library! If you read magazines, most magazines feature an iPad App. Harder to find magazines can be found in newsstands like Zinio, but the killer app for magazines is Next Issue which for a monthly 8 to 15 dollars features hundreds of magazines like Esquire, Time, and People. I can’t live without my New Yorker magazine, and now rather than a mess of magazines around the house, they are all in my iPad.

The next use of the iPad is as a portable widescreen TV. While iTunes lets you purchase and then download movies and TV shows from iCloud onto your Mac, AppleTV, or iOS device (iPad, iPod Touch, iPhone), the streaming app trio of Hulu, Netflix, and Amazon Prime gives you access to thousands of current and vintage movies and television shows. Hulu Plus, a monthly subscription, gives me access to every episode of South Park, the Daily Show, Colbert Report, Community, and The New Girl. It also features the Criterion Collection of critically acclaimed but difficult to find foreign films -I am in the midst of watching Riso Amaro (Bitter Rice), an Italian post war film of lust and crime in the Italian rice paddies. Movies-Riso_AmaroNetflix has a great selection of movies and TV shows as well, and the ability to have DVD’s mailed to you. Amazon Prime’s video player also features many recently released films for streaming, and beats iTunes by letting you stream rather than download then watch rental movies. Amazon also has every Ken Burns documentary, if that is your thing.

These two features are the core of how the adults in the house use the iPad. Jen enjoys watching Downton Abbey in the bed while I read the NY Times and listen to Paloma Faith on Spotify. The NPR app, by the way, lets you listen to all the NPR that you missed during your busy day. The boys love watching their shows anywhere, anytime. The funny thing is, because we watch shows on our terms, the TV goes the whole week without being turned on except for family movie night or when dad watches sports. During baseball season, by the way, I buy an MLB season ticket to watch major league baseball games -usually as a ten minute summary of outs and hits the next morning, but often I stream the live radio broadcast just to hear John Sterling howl, “Yaaaaaaankeeeees Winnn!”

The third feature is up to you to decide if you want in the house. The iPad is a great gaming platform. While not as immersive or complicated as an XBox, Wii, or Playstation, games on the iPad are no less fun or addictive. Words with Friends pops on a larger screen. Pinball is a great stress reducer. My boys play all manner of games -most of which are free or cost 99 cents which is a lot cheaper than the average XBox game.

The utility of tablets is that eliminating the keyboard frees you to interact with the computer in a far more natural way. Drawing and music creation are two ways I put mileage on the iPad. My favorite art app, Paper, was the App Store’s App of the Year last year, and I doodle constantly. The Brushes app is used by David Hockney and other artists to create serious art. I frequently use Adobe Ideas to sketch on top of CT scans for patient consultations.

For note taking, there are innumerable apps for taking freehand notes and the better ones allow you to record the presenter’s audio synced to your notes. My favorite second brain app is Evernote which lets me data dump important files, notes, and ideas for access across all my gadgets. If you type fast, you probably aren’t going to change note taking tasks but I have to mention that it’s less intrusive to write notes on iPad than click clack away on a keyboard.

This brings me to the last part -work. I composed this blog entry on an iPad using the Logitech Slim Keyboard Case, which I recently reviewed. It turns the iPad into basically what the Microsoft Surface wants to be, a post-laptop work device. While Office for iOS isn’t out in the wild yet and probably never will be, there are many options for writing and editing. Pages is a good word processor, but Word is more universal and more importantly has collaborative editing and version control that is superior to anything on iOS. That said, Pages is unmatched in its ability to layout documents. That’s how I use it -after composing the content in a simple text processor like iA Writer, I open up and prettify it in Pages and save it as a Word file for sending out.

For presentations, Keynote is how I make all my presentations. I can make them on the fly during and after cases to present complex operations to patients and their families. You can export into Powerpoint or PDF, but equally powerful is the ability to present directly off your iPad, either via a cable or wirelessly to an AppleTV (an unpromoted feature). The usual way I create presentations is I upload all the pictures and graphics to a Dropbox folder and then compose the presentation on my iPad after taking intraop photos with my iPod Touch or iPhone. I’ve uploaded a sample presentation SFA-POP-Tibioperoneal Trunk EndoRE that I created right after a case for explaining what I did for a patient’s family.

The wireless plan is pricey if you’re not needing it, but I find it indispensable because my iPad 3 with Verizon 4G has a hotspot function which will allow me to tether other devices like a Macbook Pro or iPod Touch at high speeds. The typical use scenario is on long car trips where the iPad is the hotspot for streaming video to the boy’s tablets and I listen to This American Life episodes (every episode ever is available on their app). In a pinch, the iPad can act as a ridiculously large phone via the Line 2 app, which gives me a phone number (in Manhattan no less) for non-work use.

Now here is the last tip -I suggest you trade in your iPad for an iPad Mini with Verizon Wireless. The big screen is great, but impossible to carry around the hospital in a white coat. The 8 inch size fits perfectly. I’m holding out for the retina display iPad Mini which hopefully is next. For now, my Android Tablets fulfill this in the pocket function, and match the iPad largely feature for feature except for speed (they are older single processor devices) and ease of use. I think if you are adventuresome, the Nexus 7 is probably hits the sweetspot of price (about 200 bucks) and size (fits white coat pocket), but for cheaper, you don’t get the cellular wireless or nifty form factor, and you have to geek out on Android.

Hope that helps.


Dawn of the Dead -is all about us.

I recently watched the remake of Dawn of the Dead on Hulu while on call. In general, I find the horror genre either to be a thinly veiled subcategory of Chick Lit or generally too scary to watch. The first category, the horror Chick Lit or Chick Flick, are all the romantic vampire stories and beauty with beast fables. They are dreck even when an auteur like Joss Whedon labors to make them watchable. Something dark lies in the feminine psyche for fantasies about blood sucking, pasty faced, pretty boy immortals sells. The latter, the truly scary horror, deals in the supernatural. In the heart of all rational people, there is a primitive spot that wonders if there is good and evil and not just cause and effect. When a film taps this, and reveals the frightening voids and yawning chasms presented by contemplation and imagining of evil, even this fairly rational and educated surgeon can get a twee scared watching The Grudge in the dark (she looks like an ex-girlfriend).

But zombie movies? Not so! For some reason, I love them because I’m a doctor. The slow zombie era of Cesar Romero came to an end with the fast zombies of 28 Days Later (and its sequel, 28 Weeks Later). Zombie movies appeal to my inner infectious disease expert. In some way, I deal with the necrosis and suppuration every week, and seeing hordes of diseased people doesn’t seem too scary. It then boils down to how the undiseased people react in these circumstances which entertains me: by denying, by panicking, by getting armed, by having sex (more denial), and by getting oddly rational. When HIV began killing people in the late 80’s, the response was not unlike the plot of a zombie movie. There was fatal ignorance and denial, followed by panic, then calls for concentration camps, followed a neurotic mix of hedonism, consumerism, prudishness, and rampant heterosexualism. The collective sigh of relief was the announcement by Dr. Ho of multidrug therapy, as conceptualized by the not-gay and not down-low Magic Johnson just staying alive.

The most recent remake of Dawn of the Dead makes great fun with these concepts. The survivors of the plague hole up in a shopping mall, and all the zombies congregate there and mill about outside the locked entrances. And its the same now in the time of the economic plague that I see hordes milling about at our local mall. Despite the recession, the place is always full. I think people go there because going to the mall and shopping is a talisman of normalcy. After the horrible events of 9/11, President Bush told everyone to go shopping. Shopping! And that is what I see going on, the continued shopping for a little slice of happiness, is not unlike the zombies congregating at the mall in Dawn of the Dead. “I think its some retained memory they have that brings them here,” says one of the characters.

As a medical student, I was assigned patients and was their intern, responsible for their health. Never mind that most of them had HIV and were crack abusers, making them somewhat unstable. I learned to have a conversation with them, those who in another era would have been called possessed and unclean. I took the lessons of the plaque dedicated to the twenty medical students who died in the influenza pandemic of 1918, and understood implicitly the bargain I had to make. To be a good physician, I would have to take good care of all people. I performed central lines and spinal taps in poorly lit rooms on patients whose viral titres made them frankly toxic to be around with a needle, a scalpel, or broken glass (from lidocaine vials). I learned equanimity in the face of really horrible things like the gal who hid a roll of dollar bills in her abscess (pocket of pus) cavity on her lower abdomen. She’d pay for crack with those filthy bills and earned them by doing who knows what. If that trumps zombies, I don’t know what. I always wash my hands after touching money.

Eddie Murphy had a claymation animation sit-com in the 90’s called the PJ’s. It featured a crack addict who was spot on and completely true. Ironically, he was the straight man, and dished wisdom while eying the pigeons for a possible meal. The great tragedy in the AIDs/Crack epidemic of the 90’s was its victims who made to the hospital after living on the streets for years were incredible specimens. They had to be to survive for as long as they did. They were all tall, lean, and if you looked past the insanity, wear, tear, and grime, were usually good looking with good bone structure -think Na’Vi, twenty years after the aliens from Earth returns to Pandora, colonize them, and put them on reservations with their sensory pony tails cut and cauterized at the stump.

We forget that the heroes of the Zombie movies are in fact, the Zombies. Once infected and left to wander around for fresh brain, they are the perfect citizenry. Their behavior is predictable, and their intentions are true. They offer no political resistance by asking no questions, and their happiness lies in fresh brains. Substitute fresh brains for fresh fruit out of season, perfectly-red meat packed in styrofoam and plastic, and giant homes in the suburbs, and you have it. The real monsters in Zombie movies are the protagonists, they with their guns and fire, keeping the thronging mobs from their happiness and fulfillment.

So stop being a wet noodle! Go, run out and buy yourself some Zombie pickle and get happy! A good place to start: On January 27th, Apple will present their next great thing, by the way, you happy Zombie.

The Entertainer

img_1720This is a 17 inch Dell behemoth that weights about ten pounds and is useful for checking email. It also offers connection to Youtube, Hulu, iTunes, and Netflix, and offers more entertainment than my 42 inch DLP TV in the basement with a DirecTV HD account. On screen is the 2-3pm episode from the current season of 24. 


Broadcast television was supplanted by cable. Cable television and its prettier sister, satellite television, are headed for the attic of dead technology by video on demand over the internet. This was presaged by TIVO and the ability to time-shift programs. But Youtube and Hulu, iTunes, and Netflix, and shows available on the networks sites all presage a time when you don’t have to watch what is available, but rather you choose exactly when and where to watch what you want. 

Currently, with the offerings of Youtube, Hulu, iTunes, and Netflix, I canimg_1721 watch pretty much whatever I want whenever I want. If a program isn’t available in fact, I usually couldn’t care less. This is an important threshold -if something of critical value weren’t available -I would feel compelled to pay extra for it. This one quality that is keeping the satellite subscription alive is high definition programming. It is just valuable enough to keep it around for the sake of viewing on a large screen, but the fact of the matter is that a 50 inch widescreen TV at 10 feet is the same as watching a 10 inch screen at 2 feet (yes, I did the math -proof above). That means, streaming hi-definition images to a 10 inch netbook gives you the same images relative size as watching a 50 inch screen from a couch. 

We are about to cancel our DirecTV connection in favor of our home stable of laptops and iPod touches. The video time that we have as a family is spent in bed with a laptop watching one of 12,000 movies available over the ‘net on Netflix with a $10/month account, or downloaded to an iPod for 1.99/episode, or on DVD, again on a laptop. The large screen is okay for viewing sports, but time is short, and the networks are available over the airwaves in HD. Fact is, I prefer watching sports with other people at a sports bar. 

The purchase I am considering next is a small computer capable of streaming Netflix and running iTunes, with double duty as a email checking station. The cable company gets to stay in the house only for the internet -until fiberoptic broadband becomes available then goodbye cable. In fact, I am waiting to see what Apple does with AppleTV versus the Mac Mini.

What I discovered more recently is this: it is more fun to make TV than it is to watch it. Check out my friend Victor’s channel on Youtube (link). 

The TV is dead. It is now just a monitor.