Medicine Grand Rounds at Stanford

Yesterday I gave a Grand Rounds presentation at Stanford Med School. My title was

Craft, Standardization and Automation: Powerful yet Perilous Paradigms for Control when Lives are at Stake

Most of my talk was about the adoption of procedures (checklists) by US military aviation, during and after WW II. It has close analogies to the situation of health-care today.  Here is my short presentation.  A much longer presentation, with more examples but without discussion of medicine, is here.

Initially, I was concerned that my topic might seem too esoteric for Stanford’s medical faculty. However, their Medical Grand Rounds program covers a lot of ground. My topic was only 1.5 standard deviations away from the mean.

For more of my research on flying paradigms and how technologies evolve from crafts to sciences, please see this page.

 

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Police  body cams will cost $1000s per cop per year!

Police body cams sound great, but it will take years to work out all the ramifications, rules for using them, etc. One concern is cost. It’s likely that the initial cost of the cameras is a small fraction of the total cost.

One issue is the cost of storing the video recorded by cams. According to my rough calculations, this could be thousands of dollars per user per year. That will put a hole in any department’s budget.

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Each new generation needs to learn the lesson of Theranos: appearance ≠ reality

Every 10 years or so, a conspicuous bubble bursts, and in doing so it resets the expectations of the next generation of young adults.

  • Enron
  • 2008 financial collapse
  • Now Theranos

Reading this article, I’m astonished at how little substance the adulation of Elizabeth Holmes was based on. And how much secrecy her investors allowed her. Given that she was claiming that her system would be ~100x better than established technologies, why didn’t they demand evidence? Why was it left to a reporter to figure out that the emperor had no clothes? And, was she nothing more than a successful con-artist with no genuine scientific expertise?

“In a searing investigation into the once lauded biotech start-up Theranos, Nick Bilton discovers that its precocious founder defied medical experts—even her own chief scientist—about the veracity of its now discredited blood-testing technology.”

Source: Exclusive: How Elizabeth Holmes’s House of Cards Came Tumbling Down | Vanity Fair

Safety Issues for Li-ion Batteries – Reminder

I have been contributing to the comments section of this article on battery safety. Battery fires from cheap lithium-ion batteries are a genuine hazard, as I know from flying RC aircraft.

Learn what causes Li-ion to fail and what to do in case of fire. Battery makers are obligated to meet safety requirements, but less reputable firms may cheat.

Source: Safety Concerns with Li-ion Batteries – Battery University

Batteries in brand-name electronics (such as phones and laptop computers) with built-in charging systems are well made and are very safe unless physically damaged e.g.  in a car crash. But cheap batteries, which some people are starting to use in flashlights and vaping devices, are much riskier. Among other cautions, do not charge freestanding lithium-ion batteries unattended. The house you save may be your own.

Here is the site’s home page, which covers far more than safety. http://batteryuniversity.com/learn/

Art to Science: in making whiskey barrels

Whiskey is aged in oak barrels, and oak wood is highly variable. But barrel-making can still become much more scientific.

“Twenty-five years ago, it was more art than science. Now we have a healthy dose of science in with the art.” Larry Combs, the general manager for Jack Daniel’s

Recently, the two companies completed the decade-long Single Oak Project, in which they made 192 barrels, each using the wood from a single log, to find what constituted the “perfect” bourbon. (Among other things, they found that wood from the bottom of a tree made for the best aging.). Computers track each stave as it moves through assembly, while sensors analyze staves for density and moisture content. Instead of guessing how much to toast a barrel, operators use lasers and infrared cameras to monitor the temperature of the wood and the precise chemical signature that the heat coaxes to the surface — all subject to the customer’s desired flavor profile.“They’ve developed technologies so that if we say we want coconut flavors, they can apply this or that process” — like applying precise amounts of heat to different parts of the wood to tease out certain flavors — “and we’ll have it,” said Charles de Pottere, the director of production and planning at Jackson Family Wines…

… Black Swan makes barrels with a honeycomb design etched on the inside, which increases surface area and reduces a whiskey’s aging time.

Their approach: learn by experimentation, and use the new knowledge for tight process control. Same approach as machining, aviation, …. And this is a 400+ year old industry. Now I just need a word that’s better than “science” to describe this approach. (See my previous post.)

Last comment: according to the article, one of the main forces driving willingness to learn was competition from superior French barrels.

Source: Packing Technology Into the Timeless Barrel – The New York Times

Help! What’s a better way to say “art versus science?”

I’ve been working with a  colleague, Don Norman, on analyzing how the field of design has changed and will evolve in an era of smart machines. Don is back at UCSD, although since he retired from here about 20 years ago, he is limited to a fractional salary We overlapped at UCSD briefly, but I never appreciated what a usefully disruptive influence he can be. Or how many books he has written over the years.

I generally refer to “art and science” as opposite ends of a spectrum of how people work and how technologies evolve. See “Art to science” as a category in this blog. “Art to science” is widely used: “Job X is a mixture of art and science.” But neither word is correct.

Instead of “art,” I now use the correct term, which is “craft.”

But Don keeps pointing out that  “science” is not correct, either. Science is very important to technology, but it is a philosophy/methods for doing research, not for normal operation. What is a better  term? I keep thinking there should be a good Greek term, and I just located  this discussion of the Greek words Techne, Praxis, and Phronesis. But none of them is correct. Of course, the Greeks were pre-industrial by 2000 years, so it’s not surprising if they had no concept for “systematic and well understood work.”

Perhaps the Romans had  a word for  describing “the military science of systematically butchering barbarians?”   Any suggestions?

#firstsevenjobs

#firstsevenjobs is an interesting example of crowdsourcing research

  • Dishwasher (^3) (Exeter, Harvard, and a summer job)
  • Lifeguard (Local swimming hole)
  • Library assistant (^2) (Harvard. One was work and one was a sinecure. I’m still really fast at putting things in alphabetical order.)
  • Sci. programmer (Smithsonian Astrophysical Observatory)
  • IT salesman (IT startup company)
  • Business programmer (Xerox. My first taste of a really big company, and I hated it.)
  • Energy consultant (DC consulting firm)

from Twitter https://twitter.com/RogerBohn

August 10, 2016 at 10:11PM

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