Kobe, on Desire

“Sometimes you want something so much that it slips away from you because you’re holding on too tight. You have to be patient. Even though you want it, you have to understand the best way of going about getting there. You have to stay focused on that. You can’t allow frustration or urgency to kind of choke the process.” – Kobe Bryant

The Illusion of Mental Illness and Creativity

From “There Was No Couch: On Mental Illness and Creativity” by Jalees Rehman.

Before I started my psychiatry rotation in San Diego, I had been convinced that mental illness fostered creativity. I had never really studied the question in much detail, but there were constant references in popular culture, movies, books and TV shows to the creative minds of patients with mental illness. The supposed link between mental illness and creativity was so engrained in my mind that the word “psychotic” automatically evoked images of van Gogh’s paintings and other geniuses whose creative minds were fueled by the bizarreness of their thoughts. Once I began seeing psychiatric patients who truly suffered from severe disabling mental illnesses, it became very difficult for me to maintain this romanticized view of mental illness. People who truly suffered from severe depression had difficulties even getting out of bed, getting dressed and meeting their basic needs. It was difficult to envision someone suffering from such a disabling condition to be able to write large volumes of poetry or to analyze the data from ground-breaking experiments. The brilliant book “Creativity and Madness: New Findings and Old Stereotypes” by Albert Rothenberg helped me understand that the supposed link between creativity and mental illness was primarily based on myths, anecdotes and a selection bias in which the creative accomplishments of patients with mental illness were glorified and attributed to the illness itself. Geniuses who suffered from schizophrenia or depression were not creative because of their mental illness but in spite of their mental illness.

 

The whole essay is fascinating and well written, covering hypermedicalization, media bias, sham science, and more.

End of Life Care

The Compassionate Physician

By Ambrose Bierce

A KIND-HEARTED Physician sitting at the bedside of a patient afflicted with an incurable and painful disease, heard a noise behind him, and turning saw a cat laughing at the feeble efforts of a wounded mouse to drag itself out of the room.”You cruel beast!” cried he. “Why don’t you kill it at once, like a lady?”

Rising, he kicked the cat out of the door, and picking up the mouse compassionately put it out of its misery by pulling off its head. Recalled to the bedside by the moans of his patient, the Kind- hearted Physician administered a stimulant, a tonic, and a nutrient, and went away.

Celebrating World Markets

…may be shortsighted. Homi K. Bhaba poignantly explains further:

“There is a kind of global cosmopolitanism, widely influential now, that configures the planet as a concentric world of national societies extending to global villages. It is a cosmopolitanism of relative prosperity and privilege founded on ideas of progress that are complicit with neo-liberal forms of governance, and free-market forces of competition. Such a concept of global development has faith in the virtually boundless powers of technological innovation and global communications. It has certainly made useful interventions into stagnant, state-controlled economies and polities and has kick-started many societies which were mired in bureaucratic corruption, inefficiency and nepotism. Global cosmopolitans of this ilk frequently inhabit ‘imagined communities’ that consist of silicon valleys and software campuses; although, increasingly, they have to face up to the carceral world of call-centres, and the sweat-shops of outsourcing. A global cosmopolitanism of this sort readily celebrates a world of plural cultures and peoples located at the periphery, so long as they produce healthy profit margins within metropolitan societies. States that participate in such multicultural multinationalism affirm their commitment to ‘diversity’, at home and abroad, so long as the demography of diversity consists largely of educated economic migrants – computer engineers, medical technicians, and entrepreneurs, rather than refugees, political exiles, or the poor. In celebrating a ‘world culture’ or ‘world markets’ this mode of cosmopolitanism moves swiftly and selectively from one island of prosperity to yet another terrain of technological productivity, paying conspicuously less attention to the persistent inequality and immiseration produced by such unequal and uneven development.”

(from Preface to the Routledge Classics Edition of ‘Location of Culture’)

I was most recently reminded of the one-sidedness of such glorification of ‘world markets’ in reading this article about Bangalore. Think about the last article you read about India. I bet it was either about a lot of people who died in some natural disaster, or about  the market potential of the region (or the failure of that potential to actualize).

“Zakaria for Sale”

Here is a trenchant look at one of today’s renowned pundits. Does his intricate web of speaking engagements, honoraria, and written endorsements make him an unfit journalist? Or are our “thought leaders” exempt from scrutiny?

“Intellectual,” however, does not seem the most apt term to apply to Zakaria. His authority seems to be grounded not so much in the power of his intellect (though he is very smart) as in the power of his influence—the simple fact that so many people, especially important people, talk and listen to him. He is what contemporary parlance calls a “thought leader.” And as a thought leader with multiple platforms and rich compensation for airing his perspective, he is also a “brand.” When people pay Zakaria for comment, they are not so much paying him for the intellectual process he has taken to form it, but for the comment itself and the sanction it grants. Zakaria’s opinion is a seal of approval that confirms smart and eminent people—people like Zakaria, who strategize at the Aspen Institute, attend the G8 Summit, or talk shop with CEOs and consultants at conferences on energy security—think one way, and therefore you should too.

(hattip to 3QD)

Time to turn the page

Time to get back in the game.

Tomorrow morning will be my first day working at the Lance Armstrong Foundation, Livestrong. I’m excited for the structure, the mission and the opportunity of a full time job again. While I’ve been rearing to go for a few weeks now, the excitement of getting health insurance and a salary won’t quite compare to 11 months of adventuring:

• I quit my full-time job and moved out of Washington, D.C.
• I traveled the world for three months.
• I started freelancing in health IT market research.
• I traveled some more.
• I quit a startup I’d been involved with for two years.
• I drove 2100 miles through DC, Atlanta, and New Orleans to Austin.

But trying to compare the two is like comparing apples and fruit snacks. I’m happy to begin the next chapter tomorrow while I wrap up old projects and get a new one off the ground. You know Livestrong as the origin of those ubiquitous yellow bracelets. Well I quickly learned they’re about a whole lot more than that.  I’ll be overseeing a couple of projects the foundation has been embarking upon that bring health IT to some of the areas where it’s missing in cancer care, from patient tools and resources to the “big data” research agenda. I’ll be wading in policy issues and building a knowledge base in oncology and cancer care, essentially from scratch. I’m going to be working with a team of dedicated and inspiring colleagues, many of whom are cancer survivors themselves. Some of our board members are MD’s, but all are BFD’s. Also, I’m going to be working in a really sweet office.

So as one adventure comes to a close, another one begins tomorrow morning. Banzai!

“I was put on this earth to accomplish a certain number of things. Right now I’m so far behind I will never die.” – Bill Watterson

The Highlight of my Week

The man with the plan: Texas State Senator Kirk Watson, with Erin and I.

…was meeting State Senator Kirk Watson. He swung by our inaugural health2.0 kickoff event last night to show his support for our idea – to build a kickass health IT community in Austin.

Senator Watson has spearheaded the health reform movement here in Austin through taking on a list of initiatives. The movement and organization is called HealthyATX, and the goals include setting up a healthcare incubator in Austin, developing more innovative ways for health care delivery, and bringing a medical school to Austin. He’s already made some progress on the last one.

If I haven’t said it yet, this city is awesome.

Fun meets Work in Austin

"Action expresses priorities." - Mahatma Gandhi

One of the rules I read about blogging in some article a long time ago was this: Don’t ever apologize to the audience for not posting in a long time. Well, I’m sorry for breaking that rule, and I’m sorry for not posting in a long time. The way I see it, maintaining a blog is equal parts fun and work. So, I suppose I’ve been bad about updating for the past two months because I’ve been busy, with work and with fun.
The Fun

I haven’t even written a post about my new hometown, Austin. I moved here because after growing up in the Boston suburbs, then spending eight long years in the Baltimore/Washington area I was ready for a different everything: Different weather, different people, different kinds of trees, different kinds of birds, different pace of life. Austin is definitely different. In the three months I’ve been here, I’ve fallen in love with everything this city has to offer. There’s a strange allure to this city – it succeeded in pulling me in, and every passing week I seem to meet another transplant who moved here and hasn’t looked back. It’s the perfect blend of progressive thinking, laid back vibe and opportunity.

Since moving here on February first, I’ve had four friends visit me (they were probably just coming to check out the city). I survived my first South-By-Southwest, a whirlwind of big events, happy hours and tons of people. I’ve been exploring the city by day and night, from hunting for the best slice of pizza in town (pizza sucks in Texas) to exploring the underrated old-school cocktail scene at bars across the city. I’ve eaten at food trucks, driven down to old San Antone, and most importantly, earned a foursquare mayorship at my local coffeeshop. The music is unbelievable – the radio stations here actually play good music. The weather is…hot. Like, 90’s. In April. And from what I hear, we’re just starting to heat up for the summer.

The Work

Since I quit my job last June, I’ve in many ways been ‘living the dream.’ I can travel when and where I feel like traveling. I can pursue topics that interest me. I can make enough money to pay the bills and fund my adventuring.  I’ve learned invaluable lessons about work from the past several months of freelancing: The importance of setting your own hours and holding yourself accountable for your work. The little habits that help foster the discipline it takes to be your own boss. I’ve had ‘offices’ at Vegas casinos, bars overhanging the Colorado river, a Panama hostel, cafes in northern Virginia and DC and my old bedroom in Massachusetts. While part of me wants to pack up and leave for somewhere exotic every day, by and large I’m happy with the way things have worked out.

I’ve learned a lot about how to conduct market research as well. It’s an interesting place to be: part journalist, part analyst, part wonk. I am very, very excited about being in a dynamic industry that is changing every day. Healthcare IT is about the co-evolution of technology with our day-to-day lives, as workers, doctors, patients, families, as people. To be sure, I’ve been doing a lot of drinking-from-the-firehose learning, about software standards for health information and message formats for sending data around and the like.  I now know what I don’t know (which is a whole lot), but I’m able to appreciate how far I’ve come from working with health insurance data and policy issues just a year ago.

I’ve been able to meet with a bunch of really cool people in the Austin healthcare scene. I’ve co-founded the local chapter of health2.0 to bring together the companies and people who will turn Austin into the next big health care IT hub. I’m confident that over the next few years I’ll be able to make an impact on this city by bringing people together. How often do you get an opportunity like that??

What was that about ‘the next few years’ you ask? Well like I said, I  love it here in Austin. So much so that I’ve decided to relinquish my freedom and settle down here for a while. I’ve decided to take a new job right here in town that will help me advance professionally and give me a chance to do some really good and important work. So while my days of living the dream are now numbered, my adventure in Austin is just getting underway.

More on the new job soon – Thanks for reading!

Biz Stone at HIMSS 2012

Biz Stone just gave a keynote at the HIMSS 2012 conference. Here are the high level takeaways from his speech.

Lessons from Biz’s life

• We’re not built for understanding a world of limited information. Einstein said “Info is not knowledge.”  More info is not more knowledge…we need understanding to go with it.
• It’s not a triumph of technology, it’s a triumph of humanity.
• Opportunity can be manufactured.
• Creativity is a renewable resource.
• To succeed spectacularly, be ready to fail spectacularly.
• There is compound interest in altruism. Start now and align yourself with a cause. Over time you will have an impact.

Seven Assumptions

• We can change the world, build a business, and have fun. (You need all three)
• We don’t always know what’s going to happen
• There is a creative solution to any problem
• There are more smart people outside our company
• We will win if we always do the right thing for our users
• The only deal worth doing is a win-win deal
• Your co-workers are smart and they have good intentions

Panama

A few days ago, I returned from my latest adventure, a 10 day jaunt through Panama with my brother. It was an amazing trip – I’d never been south past San Antonio before, so this was my first exposure to the non-north Americas and a Latin country. We arrived at Panama City and spent three days exploring the neighborhoods and downtown. Then we flew up to Bocas del Toro, a tropical island on the Caribbean side, where we spent three rain and rum-soaked days exploring tropical jungles, caves and beaches by foot, bicycle and ATV. After returning to Panama City, we took a daytrip out to En Valle, a former volcanic crater that’s now home to a lush rainforest. The last few days were spent seeing the canal and the surrounding canal zone’s flora and fauna, shopping, eating and enjoying the city’s nightlife.

It’s a really interesting country, supposedly not as touristy or developed as Costa Rica (yet), but hardly a place where you have to rough it. Panama stands at a crossroads at a nation. It’s blessed with location – the Canal pulled in $2B in revenue last year, and this is supposed to increase by a quarter next year. Low tariff rates and other provisions make it business-friendly; its economy has expanded eight percent a year since 2005. Despite this good mojo, Panama’s likely to face significant challenges in becoming the “Singapore of Central America” such as government corruption and structural inefficiency. Poverty, inequity and poor education will continue to exacerbate the availability of skilled workers going into the next few decades. While this isn’t unique in the region, given Panama’s strong economic potential, it may matter more here.

The view from Ancon, a historic hill north of the city

Ambling about the city, you can easily tell where efforts have been made to modernize, clean up or otherwise upgrade the city. For every manicured Oceanside boulevard or sanitized public space that reminded me of Singapore, there is a stretch of derelict buildings or seedy neighborhoods that reminded me of India. Though unevenly distributed, the wealth is evident in nice cars, fancy restaurants and hotels, and plenty of shopping.

We randomly stumbled upon a Gandhi statue while exploring the marketplace. I found this really interesting – apparently in 1971 Panama also issued a limited edition set of Gandhi stamps that are supposed to be very rare. A cab driver asked us where we were from, and after our response of “We’re American” garnered a long, skeptical glare, we answered “Indian” instead and he immediately launched into a broken English tribute to the Mahatma and how he was a beautiful man. As I stared at the multiple Jesus trinkets on his rearview mirror and dashboard, he switched gears and offered to take us to a strip club for some “fucky-fucky.” My Spanish is pretty bad, but I had an idea of what he meant so we politely declined.

High fashion in Panama

The highlight of the trip came on day 6, when we rented two old bicycles in Bocas Del Toro, adorned cheap plastic ponchos, and set off to bike around the island. About 8km in we found a sign for ‘La Gruta.’ We locked up our bikes to the signpost, paid a gentleman nearby $1 for headlamps, and started down the trail, at the end of which we saw the entrance to the cave adorned with several statues of the Virgin Mary. We changed into our trunks and bundled up before venturing into the water.

Holy Bats, Batman!

The first wildlife we saw was a miniature frog outside of the entrance, smaller than a penny. Upon entering the cave, while there was still some daylight, we saw ginormous crickets that were easily bigger than a quarter – looking up and around, we quickly realized that they were everywhere; over our heads, on the walls, and on the ground. We quickly opted for the aquatic path and hurriedly waded through the deepening water for about 25 meters before it was pitch black. At this point we were chest deep in water and almost completely terrified. Then we heard the squeaking. Wading around a bend in the cave, we saw a distant exit to the cave, about 100 meters away. As our eyes adjusted back to natural light, we saw a few bats flitting in and out of the cave. It was only after we paused to take a few pictures of them that we realized how many bats were inside with us. Lots. Hundreds. We crossed through and biked home, surviving a broken bike chain and hitching a ride with some locals on a minibus.

Other highlights of the trip included renting an ATV to ride through the rain to Bocas Del Drago on the northern part of the island, renting tickets for a party bus that drove around the city (not my video, though we weren’t lucky enough to hear any Rocky soundtrack on our ride), and ziplining 120m across a waterfall in the middle of the rainforest.

We spent a lot of time in Panama City. While people knock on it as a place where there’s nothing to do, I’ve always preferred big foreign cities as a place to unwind, soak in the culture and simply get to know the city. We visited innumerable cafes and bars (this one is just awesome), explored the historic quarters of the city by foot, snuck into two rooftop hotel pools and saw the same skyline from over half a dozen different vantage points.

Infinity Pool at the Trump Towers

It was an amazing trip, and a great conclusion to a year where I’ve been lucky enough to visit five foreign countries on three continents. Hopefully next year will bring even more adventures. Thanks for reading!